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Effectiveness of two coronavirus disease 2019 (COVID-19) vaccines (viral vector and inactivated viral vaccine) against severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in a cohort of healthcare workers

Published online by Cambridge University Press:  30 March 2022

Alexandre R. Marra*
Affiliation:
Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
João Luiz Miraglia
Affiliation:
Saúde Populacional, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Daniel Tavares Malheiros
Affiliation:
Health Economics Department, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Yang Guozhang
Affiliation:
Health Economics Department, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Vanessa Damazio Teich
Affiliation:
Health Economics Department, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Elivane da Silva Victor
Affiliation:
Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
João Renato Rebello Pinho
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Adriana Cypriano
Affiliation:
Health Economics Department, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Laura Wanderly Vieira
Affiliation:
Saúde do Trabalho, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Miria Polonio
Affiliation:
Saúde do Trabalho, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Rafael Herrera Ornelas
Affiliation:
Saúde Populacional, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Solange Miranda de Oliveira
Affiliation:
Saúde do Trabalho, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Flavio Araujo Borges Junior
Affiliation:
Saúde Populacional, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
Audrey Rie Ogawa Shibata
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Guilherme de Paula Pinto Schettino
Affiliation:
Instituto Israelita de Responsabilidade Social Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
Ketti Gleyzer de Oliveira
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Rúbia Anita Ferraz Santana
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Fernanda de Mello Malta
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Deyvid Amgarten
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Ana Laura Boechat
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Noelly Maria Zimpel Trecenti
Affiliation:
Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
Takaaki Kobayashi
Affiliation:
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
Jorge L. Salinas
Affiliation:
Stanford University, Stanford, California, United States
Michael B. Edmond
Affiliation:
West Virginia University School of Medicine, Morgantown, West Virginia, United States
Luiz Vicente Rizzo
Affiliation:
Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
*
Author for correspondence: Alexandre R. Marra, MD, E-mail: alexandre.marra@einstein.br or alexandre-rodriguesmarra@uiowa.edu

Abstract

Objective:

We investigated real-world vaccine effectiveness for Oxford-AstraZeneca (ChAdOx1) and CoronaVac against laboratory-confirmed severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers (HCWs).

Methods:

We conducted a retrospective cohort study among HCWs (aged ≥18 years) working in a private healthcare system in Brazil between January 1, 2021 and August 3, 2021, to assess vaccine effectiveness. We calculated vaccine effectiveness as 1 − rate ratio (RR), with RR determined by adjusting Poisson models with the occurrence of SARS-CoV-2 infection as the outcome and the vaccination status as the main variable. We used the logarithmic link function and simple models adjusting for sex, age, and job types.

Results:

In total, 13,813 HCWs met the inclusion criteria for this analysis. Among them, 6,385 (46.2%) received the CoronaVac vaccine, 5,916 (42.8%) received the ChAdOx1 vaccine, and 1,512 (11.0%) were not vaccinated. Overall, COVID-19 occurred in 6% of unvaccinated HCWs, 3% of HCWs who received 2 doses of CoronaVac vaccine, and 0.7% of HCWs who received 2 doses of ChAdOx1 vaccine (P < .001). In the adjusted analyses, the estimated vaccine effectiveness rates were 51.3% for CoronaVac, and 88.1% for ChAdOx1 vaccine. Both vaccines reduced the number of hospitalizations, the length of hospital stay, and the need for mechanical ventilation. In addition, 19 SARS-CoV-2 samples from 19 HCWs were screened for mutations of interest. Of 19 samples, 18 were the γ (gamma) variant.

Conclusions:

Although both COVID-19 vaccines (viral vector and inactivated virus) can significantly prevent COVID-19 among HCWs, CoronaVac was much less effective. The COVID-19 vaccines were also effective against the dominant γ variant.

Type
Original Article
Creative Commons
Creative Common License - CCCreative Common License - BY
To the extent this is a work of the US Government, it is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© Hospital Israelita Albert Einstein, University of Iowa, Stanford University, and West Virginia University, 2022

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