Change in COVID-19 risk over time following vaccination with CoronaVac: A test-negative case-control study
Abstract Objective To estimate the change in odds of covid-19 over time following primary series completion of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech) in São Paulo state, Brazil.Design Test negative case-control study.Setting Community testing for covid-19 in São Paulo state, Brazil.Participants Adults aged 18-120 years who were residents of São Paulo state, without a previous laboratory-confirmed covid-19 infection, who received only two doses of CoronaVac, and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 30 September 2021.Main outcome measures RT-PCR-confirmed symptomatic covid-19 and associated hospital admissions and deaths. Cases were pair-matched to test-negative controls by age (in 5-year bands), municipality of residence, healthcare worker (HCW) status, and date of RT-PCR test (±3 days). Conditional logistic regression was adjusted for sex, number of covid-19-associated comorbidities, race, and previous acute respiratory infection.Results From 137,820 eligible individuals, 37,929 cases with symptomatic covid-19 and 25,756 test-negative controls with covid-19 symptoms were formed into 37,929 matched pairs. Adjusted odds ratios of symptomatic covid-19 increased with time since series completion, and this increase was greater in younger individuals, and among HCWs compared to non-HCWs. Adjusted odds ratios of covid-19 hospitalisation or death were significantly increased from 98 days since series completion, compared to individuals vaccinated 14-41 days previously: 1.40 (95% confidence interval 1.09 to 1.79) from 98-125 days, 1.55 (1.16 to 2.07) from 126-153 days, 1.56 (1.12 to 2.18) from 154-181 days, and 2.12 (1.39-3.22) from 182 days.Conclusions In the general population of São Paulo state, Brazil, an increase in odds of moderate and severe covid-19 outcomes was observed over time following primary series completion with CoronaVac.What is already known on this topic <jats:list list-type="simple"><jats:label>-</jats:label>The effectiveness of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech) against moderate and severe covid-19 has been demonstrated in clinical trials and observational studies.<jats:label>-</jats:label>Observational studies have suggested that effectiveness of other covid-19 vaccines appears to decrease over time, prompting many countries to deploy additional doses for individuals who have completed their primary series.<jats:label>-</jats:label>There is currently no evidence for change in the rate of breakthrough infection in individuals who have received a primary series of CoronaVac.What this study adds <jats:list list-type="simple"><jats:label>-</jats:label>In individuals receiving two doses of CoronaVac, the odds of symptomatic covid-19 increased over time since series completion.<jats:label>-</jats:label>Larger increases in covid-19 odds were observed in individuals aged 18-40, and in healthcare workers compared to non-healthcare workers.<jats:label>-</jats:label>Odds of covid-19 hospitalisation or death increased over time since series completion, but to a lesser extent..
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Preprint| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
bioRxiv.org - (2021) vom: 30. Dez. Zur Gesamtaufnahme - year:2021 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hitchings, Matt D.T. [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.1101/2021.12.23.21268335 |
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| PPN (Katalog-ID): |
XBI03329707X |
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| 245 | 1 | 0 | |a Change in COVID-19 risk over time following vaccination with CoronaVac: A test-negative case-control study |
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| 520 | |a Abstract Objective To estimate the change in odds of covid-19 over time following primary series completion of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech) in São Paulo state, Brazil.Design Test negative case-control study.Setting Community testing for covid-19 in São Paulo state, Brazil.Participants Adults aged 18-120 years who were residents of São Paulo state, without a previous laboratory-confirmed covid-19 infection, who received only two doses of CoronaVac, and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 30 September 2021.Main outcome measures RT-PCR-confirmed symptomatic covid-19 and associated hospital admissions and deaths. Cases were pair-matched to test-negative controls by age (in 5-year bands), municipality of residence, healthcare worker (HCW) status, and date of RT-PCR test (±3 days). Conditional logistic regression was adjusted for sex, number of covid-19-associated comorbidities, race, and previous acute respiratory infection.Results From 137,820 eligible individuals, 37,929 cases with symptomatic covid-19 and 25,756 test-negative controls with covid-19 symptoms were formed into 37,929 matched pairs. Adjusted odds ratios of symptomatic covid-19 increased with time since series completion, and this increase was greater in younger individuals, and among HCWs compared to non-HCWs. Adjusted odds ratios of covid-19 hospitalisation or death were significantly increased from 98 days since series completion, compared to individuals vaccinated 14-41 days previously: 1.40 (95% confidence interval 1.09 to 1.79) from 98-125 days, 1.55 (1.16 to 2.07) from 126-153 days, 1.56 (1.12 to 2.18) from 154-181 days, and 2.12 (1.39-3.22) from 182 days.Conclusions In the general population of São Paulo state, Brazil, an increase in odds of moderate and severe covid-19 outcomes was observed over time following primary series completion with CoronaVac.What is already known on this topic <jats:list list-type="simple"><jats:label>-</jats:label>The effectiveness of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech) against moderate and severe covid-19 has been demonstrated in clinical trials and observational studies.<jats:label>-</jats:label>Observational studies have suggested that effectiveness of other covid-19 vaccines appears to decrease over time, prompting many countries to deploy additional doses for individuals who have completed their primary series.<jats:label>-</jats:label>There is currently no evidence for change in the rate of breakthrough infection in individuals who have received a primary series of CoronaVac.What this study adds <jats:list list-type="simple"><jats:label>-</jats:label>In individuals receiving two doses of CoronaVac, the odds of symptomatic covid-19 increased over time since series completion.<jats:label>-</jats:label>Larger increases in covid-19 odds were observed in individuals aged 18-40, and in healthcare workers compared to non-healthcare workers.<jats:label>-</jats:label>Odds of covid-19 hospitalisation or death increased over time since series completion, but to a lesser extent. | ||
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