BMJ

, volume 374 , pages n2015

Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study

Otavio T. Ranzani ^{1, 2}

Matt D. T. Hitchings ³

Murilo Dorion ⁴

Tatiana Lang Dagostini ⁵

Regiane Cardoso De Paula ⁵

Olivia Ferreira Pereira De Paula ⁵

Edlaine Faria De Moura Villela ⁶

Mario Sergio Scaramuzzini Torres ⁶

Silvano Barbosa De Oliveira ^{7, 8}

Wade Schulz ⁹

Maria Almiron ⁷

Rodrigo Said ⁷

Roberto Dias De Oliveira ¹⁰

Patricia Vieira Da Silva ¹¹

Wildo Navegantes De Araújo ^{7, 8, 12}

Jean Carlo Gorinchteyn ¹³

Jason R. Andrews ¹⁴

Derek A. T. Cummings ^{15, 16}

Albert I. Ko ^{4, 17}

Julio Croda ^{4, 11, 18}

Hide authors affiliations Show authors affiliations: 18 affiliations

Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain |

Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil |

Department of Biostatistics, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA |

⁴

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA |

⁵

Disease Control Coordination of the São Paulo State Department of Health, São Paulo, Brazil |

⁶

Municipal Health Secretary of Manaus, Brazil, AM, Brazil |

⁷

Pan American Health Organization, Brasília, DF, Brazil |

⁸

Universidade de Brasília, Brasília, DF, Brazil |

⁹

Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA |

¹⁰

State University of Mato Grosso do Sul - UEMS, Dourados, MS, Brazil |

¹¹

Universidade Federal de Mato Grosso do Sul - UFMS, Campo Grande, MS, Brazil |

¹²

National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, RS, Brazil |

¹³

Health Secretariat of the State of São Paulo, São Paulo, Brazil |

¹⁴

Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA |

¹⁵

Department of Biology, University of Florida, Gainesville, FL, USA |

¹⁶

Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA |

¹⁷

Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil |

¹⁸

Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz, Campo Grande, MS, Brazil |

Publication type: Journal Article

Publication date: 2021-08-20

BMJ

scimago Q1

wos Q1

SJR: 2.976

CiteScore: 20.4

Impact factor: 42.7

ISSN: 09598146, 17561833, 09598138, 14685833, 00071447

DOI: 10.1136/bmj.n2015

Copy DOI

PubMed ID: 34417194

General Engineering

Abstract

Objective

To estimate the effectiveness of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech), against symptomatic covid-19 in the elderly population of São Paulo state, Brazil during widespread circulation of the gamma variant.

Design

Test negative case-control study.

Setting

Community testing for covid-19 in São Paulo state, Brazil.

Participants

43 774 adults aged ≥70 years who were residents of São Paulo state and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 29 April 2021. 26 433 cases with symptomatic covid-19 and 17 622 test negative controls with covid-19 symptoms were formed into 13 283 matched sets, one case with to up to five controls, according to age, sex, self-reported race, municipality of residence, previous covid-19 status, and date of RT-PCR test (±3 days).

Intervention

Vaccination with a two dose regimen of CoronaVac.

Main outcome measures

RT-PCR confirmed symptomatic covid-19 and associated hospital admissions and deaths.

Results

Adjusted vaccine effectiveness against symptomatic covid-19 was 24.7% (95% confidence interval 14.7% to 33.4%) at 0-13 days and 46.8% (38.7% to 53.8%) at ≥14 days after the second dose. Adjusted vaccine effectiveness against hospital admissions was 55.5% (46.5% to 62.9%) and against deaths was 61.2% (48.9% to 70.5%) at ≥14 days after the second dose. Vaccine effectiveness ≥14 days after the second dose was highest for the youngest age group (70-74 years)—59.0% (43.7% to 70.2%) against symptomatic disease, 77.6% (62.5% to 86.7%) against hospital admissions, and 83.9% (59.2% to 93.7%) against deaths—and declined with increasing age.

Conclusions

Vaccination with CoronaVac was associated with a reduction in symptomatic covid-19, hospital admissions, and deaths in adults aged ≥70 years in a setting with extensive transmission of the gamma variant. Vaccine protection was, however, low until completion of the two dose regimen, and vaccine effectiveness was observe to decline with increasing age among this elderly population.

Found

1 citation

Alexandrino Eduardo

59 publications, 1 519 citations

h-index: 15

Federal University of São Paulo

Research interests

Antimicrobial resistance

COVID-19

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GOST |

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GOST Copy

Ranzani O. T. et al. Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study // BMJ. 2021. Vol. 374. p. n2015.

GOST all authors (up to 50) Copy

Ranzani O. T., Hitchings M. D. T., Dorion M., Dagostini T. L., De Paula R. C., De Paula O. F. P., Villela E. F. D. M., Torres M. S. S., De Oliveira S. B., Schulz W., Almiron M., Said R., De Oliveira R. D., Vieira Da Silva P., De Araújo W. N., Gorinchteyn J. C., Andrews J. R., Cummings D. A. T., Ko A. I., Croda J. Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study // BMJ. 2021. Vol. 374. p. n2015.

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Cite this

RIS Copy

TY - JOUR

DO - 10.1136/bmj.n2015

UR - https://doi.org/10.1136/bmj.n2015

TI - Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study

T2 - BMJ

AU - Ranzani, Otavio T.

AU - Hitchings, Matt D. T.

AU - Dorion, Murilo

AU - Dagostini, Tatiana Lang

AU - De Paula, Regiane Cardoso

AU - De Paula, Olivia Ferreira Pereira

AU - Villela, Edlaine Faria De Moura

AU - Torres, Mario Sergio Scaramuzzini

AU - De Oliveira, Silvano Barbosa

AU - Schulz, Wade

AU - Almiron, Maria

AU - Said, Rodrigo

AU - De Oliveira, Roberto Dias

AU - Vieira Da Silva, Patricia

AU - De Araújo, Wildo Navegantes

AU - Gorinchteyn, Jean Carlo

AU - Andrews, Jason R.

AU - Cummings, Derek A. T.

AU - Ko, Albert I.

AU - Croda, Julio

PY - 2021

DA - 2021/08/20

PB - BMJ

SP - n2015

VL - 374

PMID - 34417194

SN - 0959-8146

SN - 1756-1833

SN - 0959-8138

SN - 1468-5833

SN - 0007-1447

ER -

BibTex

Cite this

BibTex (up to 50 authors) Copy

@article{2021_Ranzani,

author = {Otavio T. Ranzani and Matt D. T. Hitchings and Murilo Dorion and Tatiana Lang Dagostini and Regiane Cardoso De Paula and Olivia Ferreira Pereira De Paula and Edlaine Faria De Moura Villela and Mario Sergio Scaramuzzini Torres and Silvano Barbosa De Oliveira and Wade Schulz and Maria Almiron and Rodrigo Said and Roberto Dias De Oliveira and Patricia Vieira Da Silva and Wildo Navegantes De Araújo and Jean Carlo Gorinchteyn and Jason R. Andrews and Derek A. T. Cummings and Albert I. Ko and Julio Croda},

title = {Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study},

journal = {BMJ},

year = {2021},

volume = {374},

publisher = {BMJ},

month = {aug},

url = {https://doi.org/10.1136/bmj.n2015},

pages = {n2015},

doi = {10.1136/bmj.n2015}

}

Publisher

BMJ

Journal

BMJ

scimago Q1

wos Q1

SJR

2.976

CiteScore

20.4

Impact factor

42.7

ISSN

09598146 (Print)

17561833 (Electronic)

09598138 (Print)

14685833 (Electronic)

00071447 (Print)