Comparative effectiveness and durability of COVID‐19 vaccination against death and severe disease in an ongoing nationwide mass vaccination campaign
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Abstract
As national coronavirus disease 2019 (COVID‐19) mass vaccination campaigns are rolled out, monitoring real‐world Vaccine Effectiveness (VE) and its durability is essential. We aimed to estimate COVID‐19 VE against severe disease and death in the Greek population, for all vaccines currently in use. Nationwide active surveillance and vaccination registry data during January–December 2021 were used to estimate VE via quasi‐Poisson regression, adjusted for age and calendar time. Interaction terms were included to assess VE by age group, against the “delta” severe acute respiratory syndrome coronavirus 2 variant and waning of VE over time. Two doses of BNT162b2, mRNA‐1273, or ChAdOx1 nCov‐19 vaccines offered very high (>90%) VE against both intubation and death across all age groups, similar against both “delta” and previous variants, with one‐dose Ad26.COV2.S slightly lower. VE waned over time but remained >80% at 6 months, and three doses increased VE again to near 100%. Vaccination prevented an estimated 19 691 COVID‐19 deaths (95% confidence interval: 18 890–20 788) over the study period. All approved vaccines offer strong and also durable protection against COVID‐19 severe disease and death. Every effort should be made to vaccinate the population with at least two doses, to reduce the mortality and morbidity impact of the pandemic.
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SciScore for 10.1101/2022.01.28.22270009: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Data on the latter were provided by the National SARS-CoV-2 Genomic Surveillance Network, coordinated by EODY; before ISO week 25/2021 “delta” was absent and after week 30/2021 fully dominant, while for the intermediate period (weeks 25-30/2021) the proportion of “delta” among all randomly selected and genotyped samples was used (Supplementary Table 2). Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from Limitation…SciScore for 10.1101/2022.01.28.22270009: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Data on the latter were provided by the National SARS-CoV-2 Genomic Surveillance Network, coordinated by EODY; before ISO week 25/2021 “delta” was absent and after week 30/2021 fully dominant, while for the intermediate period (weeks 25-30/2021) the proportion of “delta” among all randomly selected and genotyped samples was used (Supplementary Table 2). Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, there are certain limitations as well. We did not examine laboratory-confirmed COVID-19 cases to estimate VE against infection, as these are highly dependent on healthseeking behaviour and testing patterns, and thus susceptible to bias. We did not have information on comorbidities or socioeconomic status; these are possible confounders since they are associated with both vaccination and risk of COVID-19 [26], although comorbidities are also largely associated with age, for which adjustment was made. Finally, we did not have information on previous SARS-CoV-2 infection; since infected persons were recommended to receive a single dose of COVID-19 vaccine, which creates strong “hybrid” immunity [27], this might have led to some overestimation of 1-dose VE in particular. In conclusion, our study provides valuable documentation of the very high and durable effectiveness of COVID-19 vaccination in preventing severe disease and death in all age groups, both against the “delta” and older SARS-CoV-2 variants. The findings support the efforts to promote vaccination uptake, thereby reducing the mortality and morbidity impact of the COVID-19 pandemic. Conducting formal studies to monitor the effectiveness of COVID-19 vaccination is essential, as simple comparisons of counts or rates in surveillance data will underestimate effectiveness primarily due to confounding by age. Finally, as the “omicron” variant emerges, our study provides a blueprint for long-term monitoring of vaccin...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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