Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: Analyses of routinely-collected data on vaccine coverage and mortality.
Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: Analyses of routinely-collected data on vaccine coverage and mortality.
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DOI：
10.1016/j.eclinm.2021.101036
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
Barros PAJD
中科院分区：
文献类型：
--
作者：
Victora PC;Castro PMC;Gurzenda S;Medeiros AC;França GVA;Barros PAJD
背景：巴西于2021年1月开始接种COVID-19疫苗，重点人群是卫生工作者和老年人。我们评估了在SARS-CoV-2 γ (P.1)变体广泛传播的背景下，接种疫苗是否对老年人死亡率有影响。方法：截至2021年5月15日，巴西死亡率信息系统共报告了238,414例COVID-19死亡病例。死亡率的分母是通过校正2020年报告的全因死亡的人口估计值来计算的。计算了70-79岁和80岁以上人群的死亡率与所有年龄段死亡率的比例，包括因COVID-19和其他原因导致的死亡，以及COVID-19死亡率与0-69岁人群死亡率的比例。疫苗覆盖率数据来自卫生部。所有结果按2021年流行病学第1-19周制成表格。研究结果：80岁以上人群的COVID-19死亡率比例在第1-6周超过25%，在第19周迅速下降至12.4%，而70-79岁人群的COVID-19死亡率比例在第15周开始下降。其他原因造成的比例死亡率的趋势保持稳定。截至第6周，80岁以上年龄组的死亡率比0-69岁年龄组的死亡率高出13倍以上，在第19周下降到5.0倍。到第9周，80岁以上的个体疫苗接种覆盖率（第一剂）达到90%，到第13周，70-79岁的个体疫苗接种覆盖率达到90%。Coronavac和AstraZeneca分别占第1-4周给药总剂量的65.4%和29.8%，而第15-19周分别占36.5%和53.3%。解释：在伽马变异体占主导地位的情况下，与年轻人相比，巴西老年人疫苗接种覆盖率的迅速扩大与相对死亡率的显著下降有关。如果到第6周，老年人的死亡率仍然与观察到的成比例，那么到第19周，预计将再增加43,802例与covid - 19相关的死亡。资金：CGV和AJDB由Todos pela Saúde（巴西圣保罗）倡议资助。
Background: Vaccination against COVID-19 in Brazil started in January 2021, with health workers and the elderly as the priority groups. We assessed whether there was an impact of vaccinations on the mortality of elderly individuals in a context of wide transmission of the SARS-CoV-2 gamma (P.1) variant. Methods: By May 15, 2021, 238,414 COVID-19 deaths had been reported to the Brazilian Mortality Information System. Denominators for mortality rates were calculated by correcting population estimates for all-cause deaths reported in 2020. Proportionate mortality at ages 70–79 and 80+ years relative to deaths at all ages were calculated for deaths due to COVID-19 and to other causes, as were COVID-19 mortality rate ratios relative to individuals aged 0–69 years. Vaccine coverage data were obtained from the Ministry of Health. All results were tabulated by epidemiological weeks 1–19, 2021. Findings: The proportion of all COVID-19 deaths at ages 80+ years was over 25% in weeks 1–6 and declined rapidly to 12.4% in week 19, whereas proportionate COVID-19 mortality for individuals aged 70–79 years started to decline by week 15. Trends in proportionate mortality due to other causes remained stable. Mortality rates were over 13 times higher in the 80+ years age group compared to that of 0–69 year olds up to week 6, and declined to 5.0 times in week 19. Vaccination coverage (first dose) of 90% was reached by week 9 for individuals aged 80+ years and by week 13 for those aged 70–79 years. Coronavac accounted for 65.4% and AstraZeneca for 29.8% of all doses administered in weeks 1–4, compared to 36.5% and 53.3% in weeks 15–19, respectively. Interpretation: Rapid scaling up of vaccination coverage among elderly Brazilians was associated with important declines in relative mortality compared to younger individuals, in a setting where the gamma variant predominates. Had mortality rates among the elderly remained proportionate to what was observed up to week 6, an estimated additional 43,802 COVID-related deaths would have been expected up to week 19. Funding: CGV and AJDB are funded by the Todos pela Saúde (São Paulo, Brazil) initiative.
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DOI：
10.1016/s0140-6736(18)31221-2
发表时间：
2018-09-01
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2016 Brazil Collaborators
通讯作者：
GBD 2016 Brazil Collaborators
DOI：
10.1016/s0140-6736(21)00677-2
发表时间：
2021-05-01
期刊：
Lancet (London, England)
影响因子：
--
作者：
Vasileiou E;Simpson CR;Shi T;Kerr S;Agrawal U;Akbari A;Bedston S;Beggs J;Bradley D;Chuter A;de Lusignan S;Docherty AB;Ford D;Hobbs FR;Joy M;Katikireddi SV;Marple J;McCowan C;McGagh D;McMenamin J;Moore E;Murray JL;Pan J;Ritchie L;Shah SA;Stock S;Torabi F;Tsang RS;Wood R;Woolhouse M;Robertson C;Sheikh A
通讯作者：
Sheikh A
影响因子：
34.3
作者：
Baqui, Pedro;Bica, Ioana;van der Schaar, Mihaela
通讯作者：
van der Schaar, Mihaela
影响因子：
56.9
作者：
Castro, Marcia C.;Kim, Sun;Singer, Burton H.
通讯作者：
Singer, Burton H.
DOI：
10.1016/s2213-2600(20)30560-9
发表时间：
2021-04
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Ranzani OT;Bastos LSL;Gelli JGM;Marchesi JF;Baião F;Hamacher S;Bozza FA
通讯作者：
Bozza FA