Autor(es):
Lanièce Delaunay, Charlotte ; Martínez-Baz, Iván ; Sève, Noémie ; Domegan, Lisa ; Mazagatos, Clara ; Buda, Silke ; Meijer, Adam ; Kislaya, Irina ; Pascu, Catalina ; Carnahan, AnnaSara ; Oroszi, Beatrix ; Ilić, Maja ; Maurel, Marine ; Melo, Aryse ; Sandonis Martín, Virginia ; Trobajo-Sanmartín, Camino ; Enouf, Vincent ; McKenna, Adele ; Pérez-Gimeno, Gloria ; Goerlitz, Luise ; de Lange, Marit ; Rodrigues, Ana Paula ; Lazar, Mihaela ; Latorre-Margalef, Neus ; Túri, Gergő ; Castilla, Jesús ; Falchi, Alessandra ; Bennett, Charlene ; Gallardo, Virtudes ; Dürrwald, Ralf ; Eggink, Dirk ; Guiomar, Raquel ; Popescu, Rodica ; Riess, Maximilian ; Horváth, Judit Krisztina ; Casado, Itziar ; García, M. del Carmen ; Hooiveld, Mariëtte ; Machado, Ausenda ; Bacci, Sabrina ; Kaczmarek, Marlena ; Kissling, Esther
Data: 2024
Identificador Persistente: http://hdl.handle.net/10400.18/10321
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Vacina COVID-19; VEBIS-LOT5; SARS-CoV-2 BA.1/BA.2; Efetividade; Cuidados de Saúde; COVID-19; SARS-CoV-2; Test-negative Design; Vaccine Effectiveness; Symptomatic Infection
Descrição
Background: Scarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants. Aim: We aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases. Methods: This European test-negative multicentre study tested primary care patients with acute respiratory symptoms for SARS-CoV-2 in the BA.1/BA.2-dominant period. We estimated PS and booster VE among adults and adolescents (PS only) for all products combined and for Comirnaty alone, by time since vaccination, age and chronic condition. We investigated potential bias due to correlation between COVID-19 and influenza vaccination and explored effect modification and confounding by prior SARS-CoV-2 infection. Results: Among adults, PS VE was 37% (95% CI: 24–47%) overall and 60% (95% CI: 44–72%), 43% (95% CI: 26–55%) and 29% (95% CI: 13–43%) < 90, 90–179 and ≥ 180 days post vaccination, respectively. Booster VE was 42% (95% CI: 32–51%) overall and 56% (95% CI: 47–64%), 22% (95% CI: 2–38%) and 3% (95% CI: −78% to 48%), respectively. Primary series VE was similar among adolescents. Restricting analyses to Comirnaty had little impact. Vaccine effectiveness was higher among older adults. There was no signal of bias due to correlation between COVID-19 and influenza vaccination. Confounding by previous infection was low, but sample size precluded definite assessment of effect modification. Conclusion: Primary series and booster VE against symptomatic infection with BA.1/BA.2 ranged from 37% to 42%, with similar waning post vaccination. Comprehensive data on previous SARS-CoV-2 infection would help disentangle vaccine- and infection-induced immunity.
Key public health message: - What did you want to address in this study and why? COVID-19 vaccine effectiveness can vary across populations and periods depending on multiple factors including the SARS-CoV-2 variants circulating, the time since last vaccination and the proportion of people who have been recently infected. We estimated the effectiveness of primary series and first booster vaccination against symptomatic infection with Omicron lineages BA.1 and BA.2 in a European study in 10 countries, up to June 2022. - What have we learnt from this study? The overall effectiveness of primary series vaccination and booster vaccination was around 40%, meaning that the risk of symptomatic COVID-19 was 40% lower among vaccinated people than among unvaccinated people. Vaccines provided lower protection against symptomatic infection with BA.1 and BA.2 than with previously circulating variants (e.g. Delta), and this protection decreased with time. - What are the implications of your findings for public health? Our results suggest that the timing of COVID-19 vaccination is key: vaccines should be administered in the weeks preceding periods of high SARS-CoV-2 circulation, and adapted vaccines could be considered. Primary series and booster vaccination had similar effectiveness, therefore if may be sufficient to estimate VE by time since last dose among those who received at least primary series vaccination, rather than by number of doses.
