The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context
Summary: Background: Brazil started the COVID-19 mass vaccination in January 2021 with CoronaVac and ChAdOx1, followed by BNT162b2 and Ad26.COV2.S vaccines. By the end of 2021, more than 317 million vaccine doses were administered in the adult population. This study aimed at estimating the effectiv...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X2300039X |
| _version_ | 1797870523764441088 |
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| author | Cleber Vinicius Brito dos Santos Naiara Cristina Morais Valiati Tatiana Guimarães de Noronha Victor Bertollo Gomes Porto Antônio Guilherme Pacheco Laís Picinini Freitas Flávio Codeço Coelho Marcelo Ferreira da Costa Gomes Leonardo Soares Bastos Oswaldo Gonçalves Cruz Raquel Martins Lana Paula Mendes Luz Luiz Max Fagundes de Carvalho Guilherme Loureiro Werneck Claudio José Struchiner Daniel Antunes Maciel Villela |
| author_facet | Cleber Vinicius Brito dos Santos Naiara Cristina Morais Valiati Tatiana Guimarães de Noronha Victor Bertollo Gomes Porto Antônio Guilherme Pacheco Laís Picinini Freitas Flávio Codeço Coelho Marcelo Ferreira da Costa Gomes Leonardo Soares Bastos Oswaldo Gonçalves Cruz Raquel Martins Lana Paula Mendes Luz Luiz Max Fagundes de Carvalho Guilherme Loureiro Werneck Claudio José Struchiner Daniel Antunes Maciel Villela |
| author_sort | Cleber Vinicius Brito dos Santos |
| collection | DOAJ |
| description | Summary: Background: Brazil started the COVID-19 mass vaccination in January 2021 with CoronaVac and ChAdOx1, followed by BNT162b2 and Ad26.COV2.S vaccines. By the end of 2021, more than 317 million vaccine doses were administered in the adult population. This study aimed at estimating the effectiveness of the primary series of COVID-19 vaccination and booster shots in protecting against severe cases and deaths in Brazil during the first year of vaccination. Methods: A cohort dataset of over 158 million vaccination and severe cases records linked from official national registries was analyzed via a mixed-effects Poisson model, adjusted for age, state of residence, time after immunization, and calendar time to estimate the absolute vaccine effectiveness of the primary series of vaccination and the relative effectiveness of the booster. The method permitted analysis of effectiveness against hospitalizations and deaths, including in the periods of variant dominance. Findings: Vaccine effectiveness against severe cases and deaths remained over 25% and 50%, respectively, after 19 weeks from primary vaccination of BNT162b2, ChAdOx1, or CoronaVac vaccines. The boosters conferred greater protection than the primary series of vaccination, with heterologous boosters providing marginally greater protection than homologous. The effectiveness against hospitalization during the Omicron dominance in the 60+ years old population started at 61.7% (95% CI, 26.1–86.2) for ChAdOx1, 95.6% (95% CI, 82.4–99.9) for CoronaVac, and 72.3% (95% CI, 51.4–87.4) for the BNT162b2 vaccine. Interpretation: This study provides real-world evidence of the effectiveness of COVID-19 vaccination in Brazil, including during the Omicron wave, demonstrating protection even after waning effectiveness. Comparisons of the effectiveness among different vaccines require caution due to potential bias effects related to age groups, periods in the pandemic, and eventual behavioural changes. Funding: Fundação Oswaldo Cruz (FIOCRUZ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Pan American Health Organization (PAHO), Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde do Ministério da Saúde do Brasil (DECIT/SCTIE/MS). |
| first_indexed | 2024-04-10T00:29:49Z |
| format | Article |
| id | doaj.art-6a5143894662469d9a91488253def07d |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-10T00:29:49Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-6a5143894662469d9a91488253def07d2023-03-15T04:29:17ZengElsevierThe Lancet Regional Health. Americas2667-193X2023-04-0120100465The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in contextCleber Vinicius Brito dos Santos0Naiara Cristina Morais Valiati1Tatiana Guimarães de Noronha2Victor Bertollo Gomes Porto3Antônio Guilherme Pacheco4Laís Picinini Freitas5Flávio Codeço Coelho6Marcelo Ferreira da Costa Gomes7Leonardo Soares Bastos8Oswaldo Gonçalves Cruz9Raquel Martins Lana10Paula Mendes Luz11Luiz Max Fagundes de Carvalho12Guilherme Loureiro Werneck13Claudio José Struchiner14Daniel Antunes Maciel Villela15Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilInstituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil; Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal Fluminense (UFF), Rio de Janeiro, BrazilPrograma Nacional de Imunização, Ministério da Saúde, Brasília, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilEscola de Matemática Aplicada, Fundação Getúlio Vargas (FGV), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil; Barcelona Supercomputing Center (BSC), Barcelona, SpainInstituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilEscola de Matemática Aplicada, Fundação Getúlio Vargas (FGV), Rio de Janeiro, BrazilDepartamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, BrazilDepartamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Escola de Matemática Aplicada, Fundação Getúlio Vargas (FGV), Rio de Janeiro, BrazilPrograma de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil; Corresponding author.Summary: Background: Brazil started the COVID-19 mass vaccination in January 2021 with CoronaVac and ChAdOx1, followed by BNT162b2 and Ad26.COV2.S vaccines. By the end of 2021, more than 317 million vaccine doses were administered in the adult population. This study aimed at estimating the effectiveness of the primary series of COVID-19 vaccination and booster shots in protecting against severe cases and deaths in Brazil during the first year of vaccination. Methods: A cohort dataset of over 158 million vaccination and severe cases records linked from official national registries was analyzed via a mixed-effects Poisson model, adjusted for age, state of residence, time after immunization, and calendar time to estimate the absolute vaccine effectiveness of the primary series of vaccination and the relative effectiveness of the booster. The method permitted analysis of effectiveness against hospitalizations and deaths, including in the periods of variant dominance. Findings: Vaccine effectiveness against severe cases and deaths remained over 25% and 50%, respectively, after 19 weeks from primary vaccination of BNT162b2, ChAdOx1, or CoronaVac vaccines. The boosters conferred greater protection than the primary series of vaccination, with heterologous boosters providing marginally greater protection than homologous. The effectiveness against hospitalization during the Omicron dominance in the 60+ years old population started at 61.7% (95% CI, 26.1–86.2) for ChAdOx1, 95.6% (95% CI, 82.4–99.9) for CoronaVac, and 72.3% (95% CI, 51.4–87.4) for the BNT162b2 vaccine. Interpretation: This study provides real-world evidence of the effectiveness of COVID-19 vaccination in Brazil, including during the Omicron wave, demonstrating protection even after waning effectiveness. Comparisons of the effectiveness among different vaccines require caution due to potential bias effects related to age groups, periods in the pandemic, and eventual behavioural changes. Funding: Fundação Oswaldo Cruz (FIOCRUZ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Pan American Health Organization (PAHO), Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde do Ministério da Saúde do Brasil (DECIT/SCTIE/MS).http://www.sciencedirect.com/science/article/pii/S2667193X2300039XCOVID-19COVID-19 vaccinesEffectivenessRegistry-based studyBrazilLatin America |
| spellingShingle | Cleber Vinicius Brito dos Santos Naiara Cristina Morais Valiati Tatiana Guimarães de Noronha Victor Bertollo Gomes Porto Antônio Guilherme Pacheco Laís Picinini Freitas Flávio Codeço Coelho Marcelo Ferreira da Costa Gomes Leonardo Soares Bastos Oswaldo Gonçalves Cruz Raquel Martins Lana Paula Mendes Luz Luiz Max Fagundes de Carvalho Guilherme Loureiro Werneck Claudio José Struchiner Daniel Antunes Maciel Villela The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context The Lancet Regional Health. Americas COVID-19 COVID-19 vaccines Effectiveness Registry-based study Brazil Latin America |
| title | The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context |
| title_full | The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context |
| title_fullStr | The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context |
| title_full_unstemmed | The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context |
| title_short | The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based studyResearch in context |
| title_sort | effectiveness of covid 19 vaccines against severe cases and deaths in brazil from 2021 to 2022 a registry based studyresearch in context |
| topic | COVID-19 COVID-19 vaccines Effectiveness Registry-based study Brazil Latin America |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X2300039X |
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