COVID-19 Vaccine Uptake and Effectiveness by Time since Vaccination in the Western Cape Province, South Africa: An Observational Cohort Study during 2020-2022.

Autor: Kassanjee R; Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa., Davies MA; Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Division of Public Health Medicine, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Centre for Infectious Diseases Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Health Intelligence, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Heekes A; Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Health Intelligence, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Mahomed H; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa.; Metro Health Services, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Hawkridge AJ; Rural Health Services, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Morden E; Health Intelligence, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa.; School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa., Jacobs T; Health Intelligence, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Cohen C; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa.; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa., Moultrie H; Centre for Tuberculosis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa., Lessells RJ; KwaZulu-Natal Research Innovation & Sequencing Platform, University of KwaZulu-Natal, Durban 4001, South Africa., Van Der Walt N; Emergency & Clinical Services Support, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Arendse JO; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa.; Emergency & Clinical Services Support, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Wolter N; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa.; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa., Walaza S; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa.; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa., Jassat W; Health Practice, Genesis Analytics, Johannesburg 2196, South Africa.; Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa., von Gottberg A; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa.; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa., Hannan PL; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa., Feikin DR; Department of Immunizations, Vaccines, and Biologicals, World Health Organization, CH-1211 Geneva, Switzerland., Cloete K; Western Cape Department of Health and Wellness, Cape Town 8000, South Africa., Boulle A; Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Division of Public Health Medicine, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Centre for Infectious Diseases Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.; Health Intelligence, Western Cape Department of Health and Wellness, Cape Town 8000, South Africa.
Jazyk: angličtina
Zdroj: Vaccines [Vaccines (Basel)] 2024 Jun 05; Vol. 12 (6). Date of Electronic Publication: 2024 Jun 05.
DOI: 10.3390/vaccines12060628
Abstrakt: There are few data on the real-world effectiveness of COVID-19 vaccines and boosting in Africa, which experienced widespread SARS-CoV-2 infection before vaccine availability. We assessed the association between vaccination and severe COVID-19 in the Western Cape, South Africa, in an observational cohort study of >2 million adults during 2020-2022. We described SARS-CoV-2 testing, COVID-19 outcomes, and vaccine uptake over time. We used multivariable cox models to estimate the association of BNT162b2 and Ad26.COV2.S vaccination with COVID-19-related hospitalization and death, adjusting for demographic characteristics, underlying health conditions, socioeconomic status proxies, and healthcare utilization. We found that by the end of 2022, 41% of surviving adults had completed vaccination and 8% had received a booster dose. Recent vaccination was associated with notable reductions in severe COVID-19 during periods dominated by Delta, and Omicron BA.1/2 and BA.4/5 (sub)lineages. During the latest Omicron BA.4/5 wave, within 3 months of vaccination or boosting, BNT162b2 and Ad26.COV2.S were each 84% effective against death (95% CIs: 57-94 and 49-95, respectively). However, distinct reductions of effectiveness occurred at longer times post completing or boosting vaccination. Results highlight the importance of continued emphasis on COVID-19 vaccination and boosting for those at high risk of severe COVID-19, even in settings with widespread infection-induced immunity.
Databáze: MEDLINE