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Covid-19 vaccination programme effectiveness against SARS-CoV-2 related infections, hospital admissions and deaths in the Apulia region of Italy: a one-year retrospective cohort study.
Homan, Tobias; Mazzilli, Sara; Chieti, Antonio; Musa, Alessandra; Roth, Adam; Fortunato, Francesca; Bisceglia, Lucia; Prato, Rosa; Lopalco, Pier Luigi; Martinelli, Domenico.
  • Homan T; Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Degli Aviatori, 2, 71122, Foggia, Italy.
  • Mazzilli S; ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
  • Chieti A; Scuola Normale Superiore - Pisa, Toscana, Italy.
  • Musa A; Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy.
  • Roth A; Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy.
  • Fortunato F; ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
  • Bisceglia L; European Centre for Disease Prevention and Control, Solna, Sweden.
  • Prato R; Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Degli Aviatori, 2, 71122, Foggia, Italy.
  • Lopalco PL; Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy.
  • Martinelli D; Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Degli Aviatori, 2, 71122, Foggia, Italy.
Sci Rep ; 12(1): 18597, 2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2106465
ABSTRACT
Studies reporting vaccine effectiveness against COVID-19 outcomes concentrate mainly on estimates of one single type of vaccine and variant, seldom considering waning effects. We aimed to estimate the effectiveness of the overall COVID-19 vaccination programme implemented in the Apulia region of Italy at preventing SARS-CoV-2 infections, COVID-19-related hospital admissions and deaths during alpha and delta variant dominant periods. We conducted a retrospective cohort study using electronic health records of persons 16 years and older resident in the Apulia region, assessing the effectiveness of the combined use of BNT162b2, mRNA-1273, ChAdOx1-S and Ad26.COV2.S vaccines against confirmed COVID-19 infections, hospitalisations and deaths, for fully and partially vaccinated persons as well as by time since vaccination and variants. Cox regression models yielding hazard ratios were used to calculate the overall vaccination programme effectiveness. From 1 January to 1 December 2021, we included 3,530,967 eligible persons in the cohort, of whom 2,770,299 were fully vaccinated and 158,313 were COVID-19 positive at the end of the study period. The effectiveness of the programme over the entire study period for fully vaccinated persons against COVID-19 infection, hospitalisation and death were 87.69% (CI95% 87.73-88.18), 94.08% (93.58-94.54) and 95.95% (CI95% 95.26-96.54), respectively. The effectiveness against COVID-19 infection of fully vaccinated subjects during the alpha and delta period was respectively 88.20% (CI95% 87.60-99.78) and 59.31% (CI95% 57.91-60.67), against hospitalisation 93.89% (CI95% 92.67-94.90) and 88.32% (CI95% 86.50-89.90) and against death 93.83% (CI95% 91.65-95.45) and 85.91 (CI95% 79.98-90.09). The waning effects of the programme regarding COVID-19 infection during the delta period were stronger than for alpha, with 75.85% (CI95% 74.38-77.24) effectiveness after 1-2 months and 8.35% (CI95% 3.45-13.01) after 5-6 months after full vaccination. The effectiveness against hospitalisation and death during the delta period waned rapidly and at 7-8-months after the full vaccination respectively decreased to 27.67% (CI95% 7.48-43.45) and 48.47 (CI95% 53.97-34.82). Our study suggests that the COVID-19 vaccination program in Apulia was strongly protective against COVID-19 infection, hospitalisation, and death due to alpha as well as delta variants, although its effectiveness is reduced over time.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Humans Language: English Journal: Sci Rep Year: 2022 Document Type: Article Affiliation country: S41598-022-23235-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines / Variants Limits: Humans Language: English Journal: Sci Rep Year: 2022 Document Type: Article Affiliation country: S41598-022-23235-4