Evaluation of a COVID-19 Vaccine Campaign and SARS-CoV-2 Infection and Mortality Among Adults Aged 60 Years And Older in a Middle-Income Country.
Evaluation of a COVID-19 Vaccine Campaign and SARS-CoV-2 Infection and Mortality Among Adults Aged 60 Years And Older in a Middle-Income Country.
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DOI：
10.1001/jamanetworkopen.2021.30800
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发表时间：
2021-10-01
影响因子：
13.8
通讯作者：
de Quirós FGB
中科院分区：
文献类型：
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作者：
Macchia A;Ferrante D;Angeleri P;Biscayart C;Mariani J;Esteban S;Tablado MR;de Quirós FGB
务实、大规模使用 rAd26-rAd5、ChAdOx1 和 BBIBP-CorV COVID-19 疫苗是否可以降低 60 岁以上人群的发病率、全因死亡率和 COVID-19 相关死亡率？在这项对 663-602 名参与者进行的队列研究中，使用 1 剂疫苗可显着减少全因死亡、与新冠病毒相关的死亡和记录的感染，使用 2 剂疫苗可显着减少新冠病毒 (COVID-19) 疫苗的使用。这些发现表明，务实使用现有的 COVID-19 疫苗可能会显着降低发病率和死亡率。本队列研究调查了阿根廷布宜诺斯艾利斯市 60 岁及以上成年人的 COVID-19 疫苗接种活动与 SARS-CoV-2 感染和死亡率之间的关系。尽管有关于在现实世界人群中实施 COVID-19 疫苗的报告，但这些报告来自高收入国家或来自信使 RNA 技术疫苗的经验。缺乏有关低收入或中等收入国家疫苗部署结果的数据。旨在评估阿根廷现有的 3 种 COVID-19 疫苗（其中 2 种疫苗迄今为止尚未有在现实环境中进行评估的报告）的实际应用是否与 COVID-19 发病率、全因死亡率和死亡率的降低有关。该队列研究使用个体和生态数据来探索接种 rAd26-rAd5、ChAdOx1 和 BBIBP-CorV 疫苗后的结果。为了纠正暴露时间的差异，结果使用从疫苗接种运动开始（2020年12月29日）到事件发生或随访结束（2021年5月15日）每100 000人日的发病密度来显示。参与者包括居住在阿根廷布宜诺斯艾利斯市的 663 602 名 60 岁以上人士。统计分析于2021年6月1日至6月15日进行。通过逆转录聚合酶链反应确认的COVID-19诊断、全因死亡以及诊断COVID-19后30天内死亡。拟合泊松回归模型来估计与所有 3 个结果的关联。在该研究中，布宜诺斯艾利斯市 663 602 名居民中，540 792 人 (81.4%) 接种了至少 1 剂疫苗，其中 457 066 人接种了 1 剂（平均 [SD] 年龄为 74.5 (8.9) 岁；61.5% 为女性 [n = 281 284]； 68.0% [n = 310 987] 接受了 rAd26-rAd5 疫苗；29.5% [n = 135 036] 接受了 ChAdOx1；2.4% [n = 11 043] 接受了 BBIBP-CorV），83 726 人接受了 2 剂疫苗[SD] 年龄，73.4 [6.8] 岁；63.5% 为女性 [n = 53 204]）。未接种疫苗的人群中，确诊的 COVID-19 发病密度为 36.25 例/100 000 人日（95% CI，35.80-36.70 例/100 000 人日），未接种疫苗的人群为 19.13 例/100 000 人日（95% CI，18.63-19.62）接受 1 剂的患者中为 4.33 例/100 000 人日），接受 2 剂的患者中为 4.33 例/100 000 人日（95% CI，3.85-4.81 例/100 000 人日）。全因死亡率为11.74例/100 000人日（95% CI，11.51-11.96例/100 000人日）、4.01例/100 000人日（95% CI，3.78-4.24例/100 000人日）， 0.40 例/100 000 人·日（95% CI，0.26-0.55 例/100 000 人·日）。 COVID-19相关死亡率为2.31例/100 000人日（95% CI，2.19-2.42例/100 000人日）、0.59例/100 000人日（95% CI，0.50-0.67例/100 000人日），同一组中为0.04例/100 000人日（95% CI，0.0-0.09例/100 000人日）。 2 剂疫苗接种计划与记录的感染减少 88.1%（95% CI，86.8%-89.2%）、全因死亡减少 96.6%（95% CI，95.3%-97.5%）以及与 COVID-19 相关的死亡减少 98.3%（95% CI，95.3%-99.4%）相关。单剂量可将记录的感染减少 47.2%（95% CI，44.2%-50.1%）、全因死亡减少 65.8%（95% CI，61.7%-69.5%）以及与 COVID-19 相关的死亡减少 74.5%（95% CI，66%-80.8%）。这项研究发现，在疫苗接种活动开始后的前 5 个月内，疫苗接种与 COVID-19 感染率的显着减少以及死亡率的降低有关。
Is pragmatic, large-scale use of rAd26-rAd5, ChAdOx1, and BBIBP-CorV COVID-19 vaccines associated with reduction of morbidity, all-cause mortality, and COVID-19–related mortality in a population of individuals aged at least 60 years? In this cohort study of 663 602 participants, the use of COVID-19 vaccines was associated with a significant reduction in all-cause death, COVID-related death, and documented infection with the use of 1 dose and even more with the use of 2 doses. These findings suggest that pragmatic use of available COVID-19 vaccines may significantly reduce morbidity and mortality. This cohort study examines the association of a COVID-19 vaccine campaign and SARS-CoV-2 infection and mortality among adults aged 60 years and older in the city of Buenos Aires, Argentina. Although there are reports of COVID-19 vaccine implementation in real-world populations, these come from high-income countries or from experience with messenger RNA technology vaccines. Data on outcomes of vaccine deployment in low- or middle-income countries are lacking. To assess whether the pragmatic application of the 3 COVID-19 vaccines available in Argentina, 2 of which have no reports of evaluation in real-world settings to date, were associated with a reduction in morbidity, all-cause mortality, and mortality due to COVID-19. This cohort study used individual and ecological data to explore outcomes following vaccination with rAd26-rAd5, ChAdOx1, and BBIBP-CorV. To correct for differences in exposure times, results are shown using incidence density per 100 000 person-days from the start of the vaccination campaign (December 29, 2020) to the occurrence of an event or the end of follow-up (May 15, 2021). Participants included 663 602 people aged at least 60 years residing in the city of Buenos Aires, Argentina. Statistical analysis was performed from June 1 to June 15, 2021. Diagnosis of COVID-19 confirmed by reverse transcription–polymerase chain reaction, death from all causes, and death within 30 days of a diagnosis of COVID-19. Poisson regression models were fitted to estimate associations with all 3 outcomes. Among 663 602 residents of the city of Buenos Aires included in the study, 540 792 (81.4%) were vaccinated with at least 1 dose, with 457 066 receiving 1 dose (mean [SD] age, 74.5 (8.9) years; 61.5% were female [n = 281 284]; 68.0% [n = 310 987] received the rAd26-rAd5 vaccine; 29.5% [n = 135 036] received ChAdOx1; 2.4% [n = 11 043] received BBIBP-CorV) and 83 726 receiving 2 doses (mean [SD] age, 73.4 [6.8] years; 63.5% were female [n = 53 204]). The incidence density of confirmed COVID-19 was 36.25 cases/100 000 person-days (95% CI, 35.80-36.70 cases/100 000 person-days) among those who did not receive a vaccine, 19.13 cases/100 000 person-days (95% CI, 18.63-19.62 cases/100 000 person-days) among those who received 1 dose, and 4.33 cases/100 000 person-days (95% CI, 3.85-4.81 cases/100 000 person-days) among those who received 2 doses. All-cause mortality was 11.74 cases/100 000 person-days (95% CI, 11.51-11.96 cases/100 000 person-days), 4.01 cases/100 000 person-days (95% CI, 3.78-4.24 cases/100 000 person-days) and 0.40 cases/100 000 person-days (95% CI, 0.26-0.55 cases/100 000 person-days). COVID-19–related-death rate was 2.31 cases/100 000 person-days (95% CI, 2.19-2.42 cases/100 000 person-days), 0.59 cases/100 000 person-days (95% CI, 0.50-0.67 cases/100 000 person-days), and 0.04 cases/100 000 person-days (95% CI, 0.0-0.09 cases/100 000 person-days) among the same groups. A 2-dose vaccination schedule was associated with an 88.1% (95% CI, 86.8%-89.2%) reduction in documented infection, 96.6% (95% CI, 95.3%-97.5%) reduction in all-cause death, and 98.3% (95% CI, 95.3%-99.4%) reduction in COVID-19–related death. A single dose was associated with a 47.2% (95% CI, 44.2%-50.1%) reduction in documented infection, 65.8% (95% CI, 61.7%-69.5%) reduction in all-cause death, and 74.5% (95% CI, 66%-80.8%) reduction in COVID-19–related death. This study found that within the first 5 months after the start of the vaccination campaign, vaccination was associated with a significant reduction in COVID-19 infection as well as a reduction in mortality.
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DOI：
10.1016/s0140-6736(20)32661-1
发表时间：
2021-01-09
期刊：
Lancet (London, England)
影响因子：
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Voysey M;Clemens SAC;Madhi SA;Weckx LY;Folegatti PM;Aley PK;Angus B;Baillie VL;Barnabas SL;Bhorat QE;Bibi S;Briner C;Cicconi P;Collins AM;Colin-Jones R;Cutland CL;Darton TC;Dheda K;Duncan CJA;Emary KRW;Ewer KJ;Fairlie L;Faust SN;Feng S;Ferreira DM;Finn A;Goodman AL;Green CM;Green CA;Heath PT;Hill C;Hill H;Hirsch I;Hodgson SHC;Izu A;Jackson S;Jenkin D;Joe CCD;Kerridge S;Koen A;Kwatra G;Lazarus R;Lawrie AM;Lelliott A;Libri V;Lillie PJ;Mallory R;Mendes AVA;Milan EP;Minassian AM;McGregor A;Morrison H;Mujadidi YF;Nana A;O'Reilly PJ;Padayachee SD;Pittella A;Plested E;Pollock KM;Ramasamy MN;Rhead S;Schwarzbold AV;Singh N;Smith A;Song R;Snape MD;Sprinz E;Sutherland RK;Tarrant R;Thomson EC;Török ME;Toshner M;Turner DPJ;Vekemans J;Villafana TL;Watson MEE;Williams CJ;Douglas AD;Hill AVS;Lambe T;Gilbert SC;Pollard AJ;Oxford COVID Vaccine Trial Group
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影响因子：
7.7
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DOI：
10.1056/nejmoa2101765
发表时间：
2021-04-15
期刊：
The New England journal of medicine
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