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":"乌干达COVID-19疫苗在有症状的COVID-19患者中预防SARS-CoV-2感染的有效性","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":null,"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":0.0000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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\":null,\"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\":0.0000,\"publicationDate\":\"2025-03-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vaccine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.vaccine.2025.126976\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vaccine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.vaccine.2025.126976","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Effectiveness of COVID-19 vaccine against SARS-CoV-2 infection among symptomatic COVID-19 patients in Uganda.
Background: 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.
Methods: 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.
Findings: 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.
Interpretation: 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.
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