Vásquez-Velásquez Cinthya, Fano-Sizgorich Diego, Gonzales Gustavo F
Laboratorio de Endocrinología y Reproducción, Laboratorio de Investigación y Desarrollo (LID), Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru.
Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru.
High Alt Med Biol. 2025 Mar;26(1):37-44. doi: 10.1089/ham.2024.0045. Epub 2024 Jul 23.
Vásquez-Velásquez, Cinthya, Diego Fano-Sizgorich, and Gustavo F. Gonzales. Death risk response of high-altitude resident populations to COVID-19 vaccine: a retrospective cohort study. 26:37-44, 2025. Peru had one of the highest mortality rates caused by the coronavirus disease 2019 (COVID-19) pandemic worldwide. Vaccination significantly reduces mortality. However, the effectiveness of vaccination might differ at different altitudinal levels. The study aimed to evaluate the effect modification of altitude on the association between vaccination and COVID-19 mortality in Peru. A retrospective cohort, using open access databases of deaths, COVID-19 cases, hospitalizations, and vaccination was obtained from the Peruvian Ministry of Health. Deaths due to COVID-19 were evaluated in vaccinated and nonvaccinated patients. Crude (RR) and adjusted relative risks (aRR) were calculated using generalized linear models of Poisson family with robust variances. Models were adjusted for age, sex, pandemic wave, and Human Development Index. To evaluate the interaction by altitude, a stratified analysis by this variable was performed. The variable altitude was categorized as, 0-499 m (828,298 cases), 500-1,499 m (64,735 cases), 1,500-2,499 m (106,572 cases), and ≥2,500 m (179,004 cases). The final sample studied included 1,362,350 cases. The vaccine showed a considerable reduction of death risk with the second (aRR: 0.41, 95% confidence interval [CI]: 0.38-0.44) and third doses (aRR: 0.21, 95% CI: 0.20-0.23). In the adjusted and interaction model, it can be observed that medium and high altitude present a higher risk of death compared to sea level (aRR: 2.58 and 2.03, respectively). Likewise, the two doses' group presents an aRR:1.22 for medium altitude (1,500-2,499 m) and 1.6 for high altitude (≥2,500 m), compared with low-altitude population, suggesting that the action of vaccination at high altitude is altered by the effect of the altitude itself. Altitude might modify the protective effect of SARS-CoV-2 vaccine against COVID-19 death.
瓦斯克斯 - 贝拉斯克斯、辛西娅、迭戈·法诺 - 西佐里奇和古斯塔沃·F·冈萨雷斯。高海拔居民群体对新冠疫苗的死亡风险反应：一项回顾性队列研究。26:37 - 44，2025年。秘鲁是2019冠状病毒病（COVID - 19）大流行导致全球死亡率最高的国家之一。接种疫苗可显著降低死亡率。然而，在不同海拔高度，疫苗接种的效果可能有所不同。该研究旨在评估海拔高度对秘鲁疫苗接种与COVID - 19死亡率之间关联的效应修正作用。
使用秘鲁卫生部开放获取的死亡、COVID - 19病例、住院和疫苗接种数据库进行回顾性队列研究。对接种和未接种疫苗的患者中因COVID - 19导致的死亡情况进行评估。使用具有稳健方差的泊松族广义线性模型计算粗相对风险（RR）和调整后的相对风险（aRR）。模型针对年龄、性别、疫情波次和人类发展指数进行了调整。为评估海拔高度的交互作用，按该变量进行了分层分析。海拔高度变量被分类为0 - 499米（828,298例）、500 - 1,499米（64,735例）、1,500 - 2,499米（106,572例）和≥2,500米（179,004例）。最终研究样本包括1,362,350例。
疫苗在接种第二剂（aRR：0.41，95%置信区间[CI]：0.38 - 0.44）和第三剂时（aRR：0.21，95%CI：0.20 - 0.23）显示出死亡风险的显著降低。在调整后的交互模型中，可以观察到与海平面相比，中高海拔地区的死亡风险更高（分别为aRR：2.58和2.03）。同样，与低海拔人群相比，两剂疫苗组在中海拔（1,500 - 2,499米）的aRR为1.22，在高海拔（≥2,500米）为1.6，这表明高海拔地区疫苗接种的作用因海拔本身的影响而改变。海拔高度可能会改变SARS-CoV-2疫苗对COVID - 19死亡的保护作用。
