Kahn Rebecca, Janusz Cara B, Castro Marcia C, da Rocha Matos Aline, Domingues Carla, Ponmattam Jamie, Rey-Benito Gloria, Toscano Cristiana M, Helena de Oliveira Lucia
Harvard TH Chan School of Public Health, 677 Huntington Ave Suite 506, Boston, MA, 02115, USA.
University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Lancet Reg Health Am. 2023 Apr;20:100474. doi: 10.1016/j.lana.2023.100474. Epub 2023 Mar 29.
As of September 2022, nearly 1.3 billion doses of COVID-19 vaccine products have been administered in Latin America and the Caribbean, where 27% of global COVID-19 deaths have occurred. This study aimed to estimate the effectiveness of COVID-19 vaccines against lab-confirmed COVID-19 related hospitalizations and deaths among adults in Argentina, Brazil, Chile, and Colombia.
Using a test-negative case control design, we evaluated the effectiveness of a primary vaccination series considering six COVID-19 vaccine products (Sputnik V, mRNA-1273, CoronaVac, ChAdOx1, BNT162b2, Ad26.COV2.S) against lab-confirmed COVID-19 hospitalizations and deaths among 83,708 hospitalized adults from February-December, 2021. Data from hospitalization records, COVID surveillance, and vaccination registries were used. Vaccine effectiveness was estimated using logistic regression ((1-OR) x 100).
The average age of participants was 56.7 (SD = 17.5), and 45,894 (54.8%) were male. Adjusted VE (aVE) estimates for full vaccination against hospitalization were 82% for mRNA-1273 (95% confidence interval (CI) = -30 to 98%), 76% (71%-81%) for BNT162b2, 65% (61-68%) for ChAdOx1, 57% (10-79%) for Sputnik V, 53% (50-56%) for CoronaVac, and 46% (23-62%) for Ad26.COV2.S. Estimates, particularly for CoronaVac, varied by variant. Decreasing aVE was estimated as age increased, particularly for CoronaVac and ChAdOx1. aVE estimates against death were generally higher, with 100% (CI not estimated) for mRNA-1273, 82% (69-90%) for BNT162b2, 73% (69-77%) for ChAdOx1, 65% (60-67%) for CoronaVac, 38% (-75 to 78%) for Sputnik V, 6% (-58 to 44%) for Ad26.COV2.S.
Primary series vaccination with available COVID-19 vaccine products was effective against COVID-19 hospitalization and mortality. Effectiveness varied by product and declined with increasing age.
This study was funded by the Pan-American Health Organization (PAHO, World Health Organization (WHO)). PAHO convened and led the study implementation.
截至2022年9月，拉丁美洲和加勒比地区已接种近13亿剂新冠疫苗产品，该地区发生了全球27%的新冠死亡病例。本研究旨在评估新冠疫苗对阿根廷、巴西、智利和哥伦比亚成年人中实验室确诊的新冠相关住院和死亡病例的有效性。
采用检测阴性病例对照设计，我们评估了六种新冠疫苗产品（卫星V、mRNA-1273、科兴新冠疫苗、牛津阿斯利康疫苗、辉瑞BNT162b2、强生Ad26.COV2.S）的基础免疫接种系列对2021年2月至12月期间83708名住院成人中实验室确诊的新冠住院和死亡病例的有效性。使用了住院记录、新冠监测和疫苗接种登记的数据。疫苗有效性通过逻辑回归（(1-OR)×100）进行估计。
参与者的平均年龄为56.7岁（标准差=17.5），男性有45894人（54.8%）。针对住院的完全接种调整后疫苗有效性（aVE）估计值，mRNA-1273为82%（95%置信区间(CI)=-30至98%），辉瑞BNT162b2为76%（71%-81%），牛津阿斯利康疫苗为65%（61-68%），卫星V为57%（10-79%），科兴新冠疫苗为53%（50-56%），强生Ad26.COV2.S为46%（23-62%）。估计值，特别是科兴新冠疫苗的估计值，因变异株而异。随着年龄增长，aVE估计值下降，特别是科兴新冠疫苗和牛津阿斯利康疫苗。针对死亡的aVE估计值通常更高，mRNA-1273为100%（CI未估计），辉瑞BNT162b2为82%（69-90%），牛津阿斯利康疫苗为73%（69-77%），科兴新冠疫苗为65%（60-67%），卫星V为38%（-75至78%），强生Ad26.COV2.S为6%（-58至44%）。
使用现有的新冠疫苗产品进行基础免疫接种对新冠住院和死亡有效。有效性因产品而异，并随年龄增长而下降。
本研究由泛美卫生组织（PAHO，世界卫生组织（WHO））资助。PAHO召集并领导了研究实施。
