VaccinePub Date : 2025-06-23DOI: 10.1016/j.vaccine.2025.127412
Carlos F Cáceres
{"title":"Letter to the editor RE: \"Testing an experimental vaccine during a public health emergency: Lessons from a Peruvian case\".","authors":"Carlos F Cáceres","doi":"10.1016/j.vaccine.2025.127412","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.127412","url":null,"abstract":"","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"127412"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-05-12DOI: 10.1016/j.vaccine.2025.127234
Raphael O Anyango, Bryan O Nyawanda, Brian O Onyando, Fadima C Haidara, Collins Okello, Ian K Orege, Sidney Ogolla, Billy Ogwel, Alex O Awuor, Samuel Kadivane, Philip Ngere, Carolyne Nasimiyu, Eric Osoro, M Kariuki Njenga, Victor Akelo, Amos Otedo, Shirley Lidechi, John B Ochieng, Nancy A Otieno, Erick M O Muok, Kibet Sergon, Archibald Kwame Worwui, Goitom G Weldegebriel, Isabel Bergeri, Cohuet Sandra, Celine Gurry, J Pekka Nuorti, Patrick Amoth, Rose Jalang'o, Jason M Mwenda, Samba O Sow, Richard Omore
{"title":"Factors associated with laboratory-confirmed SARS-Cov-2 infection among patients with severe respiratory illness (SRI): Findings from the COVID-19 vaccine effectiveness evaluation in Kenya and Mali, 2022-2023.","authors":"Raphael O Anyango, Bryan O Nyawanda, Brian O Onyando, Fadima C Haidara, Collins Okello, Ian K Orege, Sidney Ogolla, Billy Ogwel, Alex O Awuor, Samuel Kadivane, Philip Ngere, Carolyne Nasimiyu, Eric Osoro, M Kariuki Njenga, Victor Akelo, Amos Otedo, Shirley Lidechi, John B Ochieng, Nancy A Otieno, Erick M O Muok, Kibet Sergon, Archibald Kwame Worwui, Goitom G Weldegebriel, Isabel Bergeri, Cohuet Sandra, Celine Gurry, J Pekka Nuorti, Patrick Amoth, Rose Jalang'o, Jason M Mwenda, Samba O Sow, Richard Omore","doi":"10.1016/j.vaccine.2025.127234","DOIUrl":"10.1016/j.vaccine.2025.127234","url":null,"abstract":"<p><strong>Background: </strong>Understanding the epidemiology of SARS-CoV-2 infection in settings with limited data, especially given the dynamic nature of the virus and the reported epidemiological heterogeneity across countries, is important. We used data from the COVID-19 Vaccine effectiveness evaluation to determine factors associated with SARS-COV-2 infection among patients (≥ 12 years) with severe respiratory illness (SRI) in Kenya and Mali.</p><p><strong>Methods: </strong>SRI was defined as acute onset (≤ 14 days) of at least two of the following: cough, fever, chills, rigors, myalgia, headache, sore throat, fatigue, congestion or runny nose, loss of taste or smell, or pneumonia diagnosis. We collected demographic and clinical characteristics of the patients, and nasopharyngeal and oropharyngeal specimens for SARS-CoV-2 testing using RT-PCR. We used a mixed effect logistic regression to determine factors associated with SARS-CoV-2 infection adjusting for age and sex while controlling for clustering by site and month of illness onset.</p><p><strong>Results: </strong>Between July 2022 and October 2023, a total of 9941 patients with SRI were enrolled, of whom, 588 (5.9 %) tested positive for SARS-CoV-2. Compared to patients aged 12-24 years, those who were aged >64 years were more likely to have SARS-CoV-2 infection (adjusted Odds Ratio [aOR] = 1.60; 95 % Confidence Interval [95 % CI] 1.07-2.40). Additionally, SRI patients presenting with cough (aOR = 1.37; 95 % Confidence Interval [95 % CI] 1.05-1.80), sore throat (aOR = 1.56; 95 % CI 1.23-1.99), runny nose (aOR = 1.51; 95 % CI 1.18-1.94), and ear pain discharge (aOR = 2.58; 95 % CI 1.43-4.66) were more likely to have SARS-CoV-2 infection compared to those who did not. SRI patients who had HIV were also more likely to have SAR-CoV-2 infection compared to those who did not (aOR =1.32; 95 % CI 1.04-1.67).</p><p><strong>Conclusion: </strong>Older adults and HIV patients were at increased-risk of SARS-CoV-2 infection consistent with WHO guidelines highlighting the need for targeted prevention and management strategies focused on them.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"127234"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors influencing COVID-19 vaccine uptake among pregnant women in Greater Accra Region, Ghana.","authors":"Caroline Dinam Badzi, Emefa Modey, Amos Apreku, Chris Guure, Kwasi Torpey, Berhaun Fesshaye, Jessica Schue, Rupali Limaye","doi":"10.1016/j.vaccine.2025.127073","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.127073","url":null,"abstract":"<p><strong>Background: </strong>A number of vaccines were recommended by many countries for pregnant persons to reduce the risk associated with COVID 19 infection in pregnancy. Despite this potential of the vaccine, uptake remains challenging among pregnant women especially in low-income countries. Hence, this study assessed the influence of some factors on the uptake of COVID- 19 vaccine among pregnant women.</p><p><strong>Method: </strong>A structured tool which elicited information on participants' background, knowledge, attitude and the outcome of interest 'ever vaccinated for COVID-19' at any point in time were used to interview the pregnant women from three facilities in the Greater Accra Region, Ghana.</p><p><strong>Findings: </strong>A total of 401 pregnant women were recruited consecutively from all three facilities. Most of the women were between 25 and 34 years old (55.8 %), married (75.6 %), in their third trimester of pregnancy (41.4 %) and had attained junior or senior high school education (61.1 %). The frequency of COVID-19 vaccine uptake among participants was 41.9 %. Vaccination was higher among women with a college or university education (AOR = 3.35, 95 % CI = 1.48-7.54), older women aged 35-49 years (AOR = 1.82, 95 % CI = 0.90-3.66), and women who believed the COVID-19 vaccine in pregnancy will reduce their baby's risk (AOR = 3.02, 95 % CI = 1.37-6.63).</p><p><strong>Discussion: </strong>The study recommends the need for vaccination education campaign among pregnant women with more efforts targeted at those with low level of education and younger (below 35 years old).</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"127073"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-04-06DOI: 10.1016/j.vaccine.2025.127083
Colleen A Macke, Samantha A Carreon, Kishan R Desai, Charles G Minard, Sarah K Lyons, Siripoom McKay, Sridevi Devaraj, Randi Streisand, Tricia Tang, Barbara J Anderson, Marisa E Hilliard
{"title":"COVID-19 vaccine uptake and attitudes in emerging adults with type 1 diabetes.","authors":"Colleen A Macke, Samantha A Carreon, Kishan R Desai, Charles G Minard, Sarah K Lyons, Siripoom McKay, Sridevi Devaraj, Randi Streisand, Tricia Tang, Barbara J Anderson, Marisa E Hilliard","doi":"10.1016/j.vaccine.2025.127083","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.127083","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescents and young adults have lower uptake of vaccines for preventable diseases than children and older adults. Young adults with type 1 diabetes (T1D) are at risk of complications from many vaccine-preventable illnesses. Given the elevated health risks of SARS-COV-2 infection for people with T1D, it is important to understand COVID-19 vaccination rates and attitudes. We explored vaccine uptake and characterized self-reported reasons for declining vaccination in a cohort of young adults with T1D as they were leaving pediatric care during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Participants enrolled in a randomized controlled trial of a transition intervention for young adults with T1D reported COVID-19 vaccination at baseline (2/2021-6/2023). We report rates of COVID-19 vaccination in addition to demographic and medical characteristics. Participants who did not receive vaccination were asked to note the reason(s). From these qualitative responses we identified themes.</p><p><strong>Results: </strong>Of the n = 97 participants reporting vaccination status, 70.1 % reported receiving at least one COVID-19 vaccine. No demographic or medical characteristics were significantly associated with vaccination status (p ≥ 0.05). Themes of reasons for not receiving the COVID-19 vaccination included Doubt, Fear, External Factors, and Indifference.</p><p><strong>Discussion: </strong>In young adults with T1D, COVID-19 vaccine uptake is below public health targets. Addressing fears about vaccine-related effects on T1D, doubts surrounding vaccine development and efficacy, and other external factors influencing vaccination decisions may be helpful in initiating a dialogue between clinicians and young adults considering vaccination. Further investigation into attitudes about other preventative care measures in this vulnerable population is needed. Clinical trial registry site and number: ClinicalTrials.gov ID Number - NCT04247620.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"127083"},"PeriodicalIF":3.5,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-04-02DOI: 10.1016/j.vaccine.2025.127068
Siobhan L Johnstone, Daniel Shapiro, Nicola Chiwandire, Lundi Matoti, Carmen Whyte, Jolene Bultinck-Human, Selaelo Mametja, Craig Getz, Boldwin Moyo, Mabatlo Semenya, Sibongile Walaza, Cheryl Cohen, Michelle J Groome
{"title":"Effectiveness of BNT162b2 and Ad26.COV2.S vaccines against COVID-19-related hospitalisation amongst adult members of a private health insurance plan in South Africa during the Delta and Omicron periods: A test-negative case-control study.","authors":"Siobhan L Johnstone, Daniel Shapiro, Nicola Chiwandire, Lundi Matoti, Carmen Whyte, Jolene Bultinck-Human, Selaelo Mametja, Craig Getz, Boldwin Moyo, Mabatlo Semenya, Sibongile Walaza, Cheryl Cohen, Michelle J Groome","doi":"10.1016/j.vaccine.2025.127068","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.127068","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 vaccine effectiveness estimates from Africa are limited. These data can guide decisions on selecting priority groups in vaccine programs. This study estimated VE for BNT162b2 and Ad26.COV2.S against COVID-19-related hospitalisation, stratified by age group, time since vaccination, and HIV-infection status for three SARS-CoV-2 surges in South Africa.</p><p><strong>Methods: </strong>We applied a test-negative case-control design to hospitalisations for acute respiratory infections amongst members of a medical insurance plan during the delta (9 May 2021-18 September 2021), omicron BA.1 (28 November 2021-5 February 2022), and BA.4/5 (17 April 2022-28 May 2022) variant periods. All data, including vaccination history, were extracted from insurance plan claims. Logistic regression models adjusted for age, comorbidities, time since vaccination, income level and documentation of previous SARS-CoV-2 infection, were used to calculate VE.</p><p><strong>Results: </strong>BNT162b2 was protective against COVID-19-related hospitalisation for all variant periods (VE 89.3 % (95 % CI, 85.9-91.9) for delta, reduced to 31.4 % (95 % CI, 19.1-41.9) and 22.7 % (95 % CI, 2.2-38.9) for omicron BA.1, and BA.4/5 respectively). VE estimates for Ad26.COV2·S, although lower than BNT162b2, were protective for all periods (48.8 % (95 % CI, 39.6-56.5), 19.8 % (95 % CI, 5.8-31.6), and 45.0 % (95 % CI, 29.8-57.0) for delta, omicron BA.1, and BA.4/5 respectively). Protection against severe infection was shown in those ≥60 years and younger age groups, as well as in people living with HIV (PLWH) and HIV-uninfected individuals.</p><p><strong>Conclusion: </strong>Vaccination offered significant protection against COVID-19-related hospitalisation in PLWH and the elderly, and is therefore an effective means of reducing severe outcomes in these high-risk populations in South Africa. VE against BA.4/5 waned with time since vaccination suggesting boosters may be necessary.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"127068"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-03-20DOI: 10.1016/j.vaccine.2025.126823
Adam W Crawley, Katherine Murphy, Ian D Plumb, Grace Adjoa Ocansey, Isaac Baffoe-Nyarko, Norman Nyazema, Sibongile Walaza, Eva Leidman
{"title":"Challenges and enablers to establishing COVID-19 vaccine effectiveness studies in the World Health Organization Africa region: A mixed-methods evaluation of the African region monitoring vaccine effectiveness (AFRO-MoVE) network.","authors":"Adam W Crawley, Katherine Murphy, Ian D Plumb, Grace Adjoa Ocansey, Isaac Baffoe-Nyarko, Norman Nyazema, Sibongile Walaza, Eva Leidman","doi":"10.1016/j.vaccine.2025.126823","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.126823","url":null,"abstract":"<p><strong>Background: </strong>The African Region Monitoring Vaccine Effectiveness network (AFRO-MoVE) was established by the World Health Organization Regional Office for Africa in March 2021 to support implementation of COVID-19 vaccine effectiveness studies in the region.</p><p><strong>Objectives: </strong>Primary goals of the evaluation were to assess how AFRO-MoVE addressed its objectives supporting regional vaccine effectiveness (VE) studies, to describe challenges and opportunities, and make recommendations to strengthen future efforts related to regional VE research.</p><p><strong>Methods: </strong>From September 2023 through June 2024, a mixed-methods approach was employed to synthesize information from: (1) documentation provided by AFRO-MoVE; (2) a standardized study review tool; (3) an electronic stakeholder survey; and (4) a series of key informant interviews. Data were collected and exported via REDCap and summarized using Microsoft Excel. Thematic analysis was used to analyse the qualitative data. Perceived challenges were summarized together with perceived support by the network in addressing each challenge.</p><p><strong>Results: </strong>AFRO-MoVE provided support to ten VE studies, including support for protocol development, study implementation, data management, and analysis, while also facilitating knowledge exchange and experience sharing among study implementers. While respondents reported strengthened capacity for VE studies at the national and regional levels in these areas, enrollment of SARS-CoV-2 positive cases was challenging, due to a decline in reported cases in network countries in mid-2022, when many studies were launched. These challenges contributed to a lack of published VE estimates from network study sites in time to inform vaccine policy.</p><p><strong>Conclusion: </strong>AFRO-MoVE technical assistance and financial support was viewed positively by network members and contributed to increased capacity for conducting VE studies in the region. Publication of study results would further bolster the impact of the network. These finding underscore opportunities to enhance capacity for rapid VE generation and support preparedness for future pandemics.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"126823"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-03-11DOI: 10.1016/j.vaccine.2025.126977
Kaveto Sikuvi, Natasha Nghitukwa, Ndiitodino Kakehongo, Ismael Katjitae, Carolina Matos, Philip Oedi, Sibongile Manga Netha, Emmanuel Nepolo, Christian Winter
{"title":"Effectiveness of COVID-19 vaccines against laboratory-confirmed SARS-CoV-2 infection amongst health workers, Windhoek, Namibia.","authors":"Kaveto Sikuvi, Natasha Nghitukwa, Ndiitodino Kakehongo, Ismael Katjitae, Carolina Matos, Philip Oedi, Sibongile Manga Netha, Emmanuel Nepolo, Christian Winter","doi":"10.1016/j.vaccine.2025.126977","DOIUrl":"https://doi.org/10.1016/j.vaccine.2025.126977","url":null,"abstract":"<p><strong>Introduction: </strong>As of 24 October 2021, 128,868 laboratory-confirmed COVID-19 cases and 3550 deaths were reported from Namibia. The national COVID-19 vaccination campaign that started in March 2021 included health workers (HWs) as a priority group. The vaccines most administered were Sinopharm, AstraZeneca, Pfizer-BioNtech, and Janssen. We aimed to measure the effectiveness of COVID-19 vaccines (VE) amongst HWs against laboratory-confirmed SARS-CoV-2 infection in Namibia.</p><p><strong>Methods: </strong>We conducted a test negative design (TND) amongst HWs from the two main hospitals treating COVID-19 patients. HWs were defined as all hospital staff over 18 years in direct or indirect contact with patients, eligible for COVID-19 vaccination. We interviewed actively recruited HWs with standardized questionnaires in-person from 25/10/2021 to 25/4/2022. The participants had to state their vaccination status, which was verified through vaccination card, vaccine registry and/or District Health Information System 2. RT-PCR testing of respiratory specimens and serological testing (Wantai and Platelia-ELISA) were conducted. We measured VE by comparing the vaccination status between RT-PCR positive and negative HWs using a multivariable logistic regression model, which was adjusted for confounders. We calculated VE = (1-odds ratio of vaccination)*100 %.</p><p><strong>Results: </strong>We included 1201 HWs of which 322 (26.8 %) participants were fully vaccinated with a primary series against COVID-19, 62 (5.2 %) were partially vaccinated and 735 (61.2 %) were not vaccinated. In total, 1119 (93 %) participants had antibodies against SARS-CoV-2 including 637 (90 %) of the unvaccinated participants. Fifty-eight (4.8 %) participants tested RT-PCR positive for SARS-CoV-2. The Omicron variant was detected in all 13 sequenced genomes (11 BA.1.18, 2 BA.1). The estimated overall VE for full vaccination was 61.8 % (95 %-confidence interval, 9.3-83.9 %).</p><p><strong>Conclusions: </strong>The VE results suggest that COVID-19 vaccines used in Namibia provided good protection from infections with the Omicron variant even if many participants had a SARS-CoV-2 infection before the study. Therefore, COVID-19 vaccines should be administered to risk groups such as HWs independent from previous infections.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"126977"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-03-06DOI: 10.1016/j.vaccine.2025.126976
Andrew M Abaasa, Sylvia Kusemererwa, Violet Ankunda, Terry A Ongaria, Bernadette Nayiga, Ayoub Kakande, Deogratius Ssemwanga, Geofrey Kimbugwe, Henry K Bosa, Yonas T Woldemariam, Annet Kisakye, James Humphreys, Archibald K Worwui, Sandra Cohuet, Jason M Mwenda, Alison M Elliott, Pontiano Kaleebu, Eugene Ruzagira
{"title":"Effectiveness of COVID-19 vaccine against SARS-CoV-2 infection among symptomatic COVID-19 patients in Uganda.","authors":"Andrew M Abaasa, Sylvia Kusemererwa, Violet Ankunda, Terry A Ongaria, Bernadette Nayiga, Ayoub Kakande, Deogratius Ssemwanga, Geofrey Kimbugwe, Henry K Bosa, Yonas T Woldemariam, Annet Kisakye, James Humphreys, Archibald K Worwui, Sandra Cohuet, Jason M Mwenda, Alison M Elliott, Pontiano Kaleebu, Eugene Ruzagira","doi":"10.1016/j.vaccine.2025.126976","DOIUrl":"10.1016/j.vaccine.2025.126976","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 vaccines significantly reduce severe disease outcomes, but uncertainty remains about long-term protection. We investigated vaccine effectiveness (VE) against SARS-CoV-2 infection over extended periods in the World Health Organisation AFRO-MoVE network studies in Africa.</p><p><strong>Methods: </strong>Participants with COVID-19-like symptoms were recruited between 2023 and 2024 for a test-negative case-control study conducted across 19-healthcare centres in Uganda. Cases were symptomatic patients with any three of cough, sore-throat, coryza, among others, and PCR-confirmed SARS-CoV-2, while controls were SARS-CoV-2 PCR-negative. Vaccination was verified from vaccination cards, hospital-records, vaccination registry and self-reporting. VE was assessed through three measures: (a) Annual - patients vaccinated in the past 12-months regardless of dose vs those vaccinated >12-months before symptom onset plus unvaccinated; (b) Absolute - patients vaccinated in the past 12-months vs unvaccinated; and (c) Relative - patients vaccinated in the past 12-months vs those vaccinated >12-months before symptom onset. VE was calculated as 1- adjusted odds ratio for three patient groups based on days since the last dose; (1) <365, (2) 7-269 and (3) 270-364 while adjusting for age, sex, calendar-time and chronic conditions. The sensitivity analysis excluded patients that were previously infected with SARS-CoV-2.</p><p><strong>Findings: </strong>In total, 1371 patients, 56 % female were recruited. Of these, 173 were classified as cases, with 97 (56 %) fully vaccinated compared to 701 (59 %) controls, p = 0.830. The overall adjusted VE was moderate, 45 % to 59 %, and remained consistent across the annual, absolute and relative measures. Sensitivity analysis showed consistently lower VE (32 % to 38 %) across all measures.</p><p><strong>Interpretation: </strong>The results suggest that COVID-19 vaccination provides moderate protection against symptomatic SARS-CoV-2 infection up to 12-months after the last dose and highlight the importance of up-to-date vaccinations for high-risk individuals. The lack of clear COVID-19 seasonality in this and other African settings creates a challenge to selecting the optimal timing for annual vaccination.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"126976"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VaccinePub Date : 2025-03-06DOI: 10.1016/j.vaccine.2025.126984
Sylvia Kusemererwa, Violet Ankunda, Terry A Ongaria, Andrew Abaasa, Ayoub Kakande, Deogratius Ssemwanga, Geofrey Kimbugwe, Bernadette Nayiga, Henry K Bosa, Alfred Driwale, Yonas T Woldemariam, Annet Kisakye, James Humphreys, Archibald K Worwui, Sandra Cohuet, Jason M Mwenda, Alison M Elliott, Pontiano Kaleebu, Eugene Ruzagira
{"title":"COVID-19 vaccination status and associated factors among patients presenting with COVID-19-like symptoms in Uganda.","authors":"Sylvia Kusemererwa, Violet Ankunda, Terry A Ongaria, Andrew Abaasa, Ayoub Kakande, Deogratius Ssemwanga, Geofrey Kimbugwe, Bernadette Nayiga, Henry K Bosa, Alfred Driwale, Yonas T Woldemariam, Annet Kisakye, James Humphreys, Archibald K Worwui, Sandra Cohuet, Jason M Mwenda, Alison M Elliott, Pontiano Kaleebu, Eugene Ruzagira","doi":"10.1016/j.vaccine.2025.126984","DOIUrl":"10.1016/j.vaccine.2025.126984","url":null,"abstract":"<p><strong>Introduction: </strong>The emergence of new SARS-CoV-2 variants threatens the effectiveness of global vaccination campaigns. This study examines the vaccination status and associated factors among patients presenting with COVID-19-like symptoms at 19 healthcare facilities in Uganda.</p><p><strong>Materials and methods: </strong>A cross-sectional analysis was conducted using data collected at health facilities to evaluate the effectiveness of COVID-19 vaccines in Uganda from March 2023 to March 2024. Participants were individuals aged 12 years and older with COVID-19-like symptoms who underwent a SARS-CoV-2 qPCR test within 10 days of symptom onset. The study involved obtaining informed consent, collecting medical and vaccination histories (confirmed using vaccination cards and Ministry of Health COVID-19 database), performing physical examinations, administering a questionnaire, and taking oral/nasopharyngeal swabs for SARS-CoV-2 qPCR testing. Vaccination coverage was defined as receiving at least one vaccine dose. Logistic regression was used to identify factors associated with vaccination status.</p><p><strong>Results: </strong>Among 1398 participants enrolled (55.4 % female), the median age was 30.0 years (IQR: 24.0-41.0). Vaccination coverage, was 66.6 %. Residing in Wakiso district compared to the Capital, Kampala was associated with a higher likelihood of vaccination (adjusted odds ratio [aOR] = 1.4, 95 % CI: 1.0-1.8, p = 0.021). Frontline and healthcare workers were more likely to be vaccinated (aOR = 5.0, 95 % CI: 3.6-7.3, p < 0.001), as were individuals with a previous COVID-19 diagnosis (aOR = 2.4, 95 % CI: 1.6-3.9, p < 0.001).</p><p><strong>Conclusions: </strong>Our results underscore the need for targeted public health messaging and support to promote vaccination, especially among non-healthcare workers. Addressing these gaps is crucial for maintaining high vaccination coverage and mitigating the impact of new SARS-CoV-2 variants on the population.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"126984"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}