Estimation of vaccine effectiveness against SARS-CoV-2-associated hospitalization using sentinel surveillance in South Africa.

IF 6.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International journal of epidemiology Pub Date : 2024-08-14 DOI:10.1093/ije/dyae116

Nicola Chiwandire, Sibongile Walaza, Anne von Gottberg, Nicole Wolter, Mignon Du Plessis, Fahima Moosa, Michelle J Groome, Jeremy Nel, Ebrahim Variava, Halima Dawood, Mvuyo Makhasi, Leora R Feldstein, Perrine Marcenac, Kathryn E Lafond, Aaron M Samuels, Cheryl Cohen

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引用次数: 0

Abstract

Background: COVID-19 vaccine effectiveness (VE) studies leveraging systematic surveillance in sub-Saharan Africa are limited. We assessed the effectiveness of two vaccines (Pfizer BNT162b2 and Johnson & Johnson Ad26.COV2.S) against SARS-CoV-2-associated hospitalization in South African adults aged ≥18 years.

Methods: We conducted a test-negative case-control study using pneumonia surveillance data in South Africa. Inpatients with physician-diagnosed lower respiratory tract infection or suspected COVID-19, testing SARS-CoV-2 positive or negative from June 2021-March 2022, were cases or controls, respectively. Fully vaccinated individuals received one Ad26.COV2.S dose or two BNT162b2 doses ≥14-days before enrollment. VE was estimated using multivariable logistic regression for Delta- and Omicron BA.1/BA.2-predominant periods, stratified by age and HIV status.

Results: The study included 925 cases and 1890 controls; 38 (4%) cases and 186 (10%) controls were fully vaccinated with BNT162b2, and 30 (3%) cases and 94 (5%) controls with Ad26.COV2.S. The vaccine effectiveness of BNT162b2 against SARS-CoV-2-associated hospitalization over Delta and Omicron BA.1/BA.2 periods was 91% (95% CI: 52%, 98%) and 33% (-16%, 86%), respectively. The vaccine effectiveness of Ad26.COV2.S against hospitalization over Delta and Omicron BA.1/BA.2 periods was 72% (-36% ,94%), and -19% (-130%, 39%), respectively. The vaccine effectiveness of BNT162b2 against hospitalization over the Delta period was 94% (50%, 99%) and 89% (27%, 98%) among adults aged ≥60 years and HIV-uninfected, respectively.

Conclusions: The BNT162b2 vaccine was effective against SARS-CoV-2-associated hospitalization during the Delta period for adults aged ≥18 years, ≥60 years and those HIV-uninfected. VE for Ad26.COV2.S was inconclusive, potentially due to limited sample size or residual confounding. These findings highlight the utility of sentinel surveillance for estimating VE.

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利用南非哨点监测估算疫苗对 SARS-CoV-2 相关住院治疗的有效性。

背景：撒哈拉以南非洲地区利用系统监测技术进行的 COVID-19 疫苗有效性 (VE) 研究非常有限。我们评估了两种疫苗（辉瑞 BNT162b2 和强生 Ad26.COV2.S）对南非年龄≥18 岁成人 SARS-CoV-2 相关住院治疗的有效性：我们利用南非的肺炎监测数据进行了一项试验阴性病例对照研究。2021年6月至2022年3月期间，经医生诊断为下呼吸道感染或疑似COVID-19的住院患者，经SARS-CoV-2检测呈阳性或阴性者，分别为病例或对照。完全接种者在入组前≥14天接种一剂Ad26.COV2.S或两剂BNT162b2。采用多变量逻辑回归法估算了以德尔塔期和奥米克隆期 BA.1/BA.2 为主导的 VE，并按年龄和 HIV 感染状况进行了分层：在Delta和Omicron BA.1/BA.2时期，BNT162b2疫苗对SARS-CoV-2相关住院治疗的有效率分别为91%（95% CI：52%，98%）和33%（-16%，86%）。Ad26.COV2.S疫苗对德尔塔期和Omicron BA.1/BA.2期住院治疗的有效率分别为72%（-36% ,94%）和-19%（-130%, 39%）。在 Delta 期，BNT162b2 疫苗对年龄≥60 岁的成年人和未感染艾滋病毒者的住院治疗效果分别为 94% (50%, 99%) 和 89% (27%, 98%)：结论：BNT162b2 疫苗对年龄≥18 岁、≥60 岁和未感染 HIV 的成年人在 Delta 期间预防与 SARS-CoV-2 相关的住院治疗有效。Ad26.COV2.S的VE不确定，这可能是由于样本量有限或残留混杂所致。这些发现凸显了哨点监测对估计 VE 的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

13.60

自引率

2.60%

发文量

226

审稿时长

3 months

期刊介绍： The International Journal of Epidemiology is a vital resource for individuals seeking to stay updated on the latest advancements and emerging trends in the field of epidemiology worldwide. The journal fosters communication among researchers, educators, and practitioners involved in the study, teaching, and application of epidemiology pertaining to both communicable and non-communicable diseases. It also includes research on health services and medical care. Furthermore, the journal presents new methodologies in epidemiology and statistics, catering to professionals working in social and preventive medicine. Published six times a year, the International Journal of Epidemiology provides a comprehensive platform for the analysis of data. Overall, this journal is an indispensable tool for staying informed and connected within the dynamic realm of epidemiology.