Background
CC-BY-NC-ND 4.0 International license . High rates of virus transmission and the presence of variants of concern can affect vaccine effectiveness (VE). Both conditions occur in low-income countries, which primarily use viral vector or inactivated virus vaccine technologies. However, few VE analyses have been conducted in such countries, and most lack the power to evaluate effectiveness in subgroups, such as the elderly.
Methods
The present retrospective cohort study evaluated the effectiveness of Vaxzevria and CoronaVac vaccines for COVID-19-related infection in 60,577,870 Brazilian vaccinees from January 18 to June 30, 2021. Study outcomes included documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Covid-19–related hospitalization, ICU admission and death. We estimated VE for each outcome as one minus the hazard ratio using Cox regression adjusted for age, sex, Brazilian deprivation index, and month/region of dose administration.
Results
Vaccination with Vaxzevria or CoronaVac was found to be effective against SARS-CoV-2 infection and highly effective against hospitalization, ICU admission and death in individuals up to 79 years. From 80-89 years of age, 91.2 (95CI: 89.1-92.9) VE against death was seen in Vaxzevria-vaccinated individuals versus 67.3 (95CI: 63.6-70.6) for Coronvac. Above 90 years, 70.5 (95CI: 51.4-82.1) protection was conferred to Vaxzevria-vaccinated individuals versus 35.4 (95CI: 23.8-45.1) in Coronavac-vaccinated individuals
Conclusions
Both vaccines demonstrated overall effectiveness against severe COVID-19 up to 80 years of age. Our results suggest that individuals aged 90 years or older may benefit from an expedited third booster dose. Ongoing evaluations, including any additional vaccines authorized, are crucial to monitoring long-term vaccine effectiveness.
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