Waning effectiveness against COVID-19-related hospitalization, severe complications, and mortality with two to three doses of CoronaVac and BNT162b2: a case–control study

Autor: Vincent Ka Chun Yan, Eric Yuk Fai Wan, Xuxiao Ye, Anna Hoi Ying Mok, Francisco Tsz Tsun Lai, Celine Sze Ling Chui, Xue Li, Carlos King Ho Wong, Philip Hei Li, Tiantian Ma, Simon Qin, Chak Sing Lau, Ian Chi Kei Wong, Esther Wai Yin Chan
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Emerging Microbes and Infections, Vol 12, Iss 1 (2023)
Druh dokumentu: article
ISSN: 22221751
2222-1751
DOI: 10.1080/22221751.2023.2209201
Popis: ABSTRACTBackground: This study aims to evaluate waning effectiveness against severe and fatal COVID-19 with two to three doses of CoronaVac/BNT162b2, where data are limited. Methods: A case–control study included individuals aged ≥18 years, unvaccinated or received two to three doses of CoronaVac/BNT162b2, using electronic healthcare databases in Hong Kong. Those with first COVID-19-related hospitalization, severe complications, or mortality between 1 January and 15 August 2022 were defined as cases and matched with up-to-10 controls by age, sex, index date, and Charlson Comorbidity Index. Vaccine effectiveness (VE) against COVID-19-related outcomes was estimated at different time intervals from second and third-dose vaccination (0–13 up-to 210–240 days) using conditional logistic regression adjusted for comorbidities and medications. Results: By 211–240 days after second dose, VE against COVID-19-related hospitalization reduced to 46.6% (40.7–51.8%) for BNT162b2 and 36.2% (28.0–43.4%) for CoronaVac, and VE against COVID-19-related mortality were 73.8% (55.9–84.4%) and 76.6% (60.8–86.0%). After third dose, VE against COVID-19-related hospitalization decreased from 91.2% (89.5–92.6%) for BNT162b2 and 76.7% (73.7–79.4%) for CoronaVac at 0–13 days, to 67.1% (60.4–72.6%) and 51.3% (44.2–57.5%) at 91–120 days. VE against COVID-19-related mortality for BNT162b2 remained high from 0–13 days [98.2% (95.0–99.3%)] to 91–120 days [94.6% (77.7–98.7%)], and for CoronaVac reduced from 0–13 days [96.7% (93.2–98.4%)] to 91–120 days [86.4% (73.3–93.1%)]. Conclusions: Significant risk reduction against COVID-19-related hospitalization and mortality after CoronaVac or BNT162b2 vaccination was observed for >240 and >120 days after second and third doses compared to unvaccinated, despite significant waning over time. Timely administration of booster doses could provide higher levels of protection.
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