COVID-19 third wave experience in India, a survey of 5971 adults

  1. Rajeev Jayadevan
  2. Ramesh Shenoy
  3. TS Anithadevi

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Abstract

Background

The third wave of the pandemic in India lasted from January till March 2022, and breakthrough infections were common. Third dose of vaccine was rolled out to priority groups in the beginning of 2022. There is no published information available about the clinical outcomes in this context.

Aims

  • To assess the community level experience of the pandemic, with focus on the third wave and vaccination in India.

  • To describe the experience of the boosted and non-boosted population during the 3 rd wave.

  • To study the public perception about the precautionary (3 rd ) dose in India.

    • Results

    Among 5971 respondents, 98.6% were vaccinated, 40% of whom had also received the 3 rd dose. Age range: 24% were below 40, 50% were 40-59, 26% were >60 years.

    45% were women, 53% were healthcare workers.

    COVID-19 was reported by 3361 (56%) respondents. Among those who reported COVID-19, 2311 (70%) were infected during the third wave. Severe symptoms occurred in <1%, while moderate severity was reported by 42%. Repeated bouts of infection were common; 15% of those with a history of COVID-19 had been infected at least twice. 44% of the respondents (2610/5971) did not report a history of COVID-19.

    The third dose was taken by 2383 individuals, of whom 30% reported COVID-19 during the 3 rd wave. The boosted group also had higher N95 use, and a greater proportion of healthcare workers. Among those who did not take a 3 rd dose, 45% reported COVID-19 in the 3 rd wave. COVID-19 incidence was lower at 27% among those in this group who had recently received their second dose. Longer gap after the second dose correlated with higher chance of infection during 3 rd wave. Giving a 3 rd dose before a 6-month gap since the second dose did not make a difference in infection rate.

    Covaxin and Covishield recipients had the same incidence of COVID-19 during the third wave.

    While 35% of the respondents believed it was helpful, 65% of the respondents were either uncertain or disapproving of the benefit of a 3 rd dose.

    Conclusions

  • 30% of respondents who received a 3 rd dose went on to get COVID-19 during the 3 rd wave.

  • Younger adults were more likely to be affected during 3 rd wave.

  • Although severe disease was rare, 42% reported having symptoms of moderate severity that could temporarily incapacitate people, affecting their routine and productivity.

  • The proportion of different grades of severity was similar among all vaccinated people, regardless of whether they received a 3 rd dose.

  • Reinfections occurred in 15%, and were not always milder.

  • Among those who did not receive a 3 rd dose, 45% reported COVID-19 in the 3 rd wave. However, this group had lower use of N95 masks (50%) than the 3 rd dose group (68%) which may have reduced the overall protection.

  • The longer the gap after the second dose, the greater was the chance of reporting COVID-19.

  • People who received their second dose recently had the same incidence of third wave COVID-19 as following a 3 rd dose.

  • The 3 rd dose, given too close to the second dose, made no difference in the infection rate.

  • Covaxin and Covishield recipients had the same rate of COVID-19 in the third wave.

  • Although the respondents were 98.6% vaccinated at baseline, there was considerable uncertainty (65%) amongst them about the benefit of a 3 rd dose.

    • Article activity feed

    1. ScreenIT

      SciScore for 10.1101/2022.04.26.22274273: (What is this?)

      Please note, not all rigor criteria are appropriate for all manuscripts.

      Table 1: Rigor

      Ethicsnot detected.
      Sex as a biological variablenot detected.
      Randomizationnot detected.
      Blindingnot detected.
      Power Analysisnot detected.
      Cell Line AuthenticationAuthentication: Questions were formatted in a clear and binary fashion and were validated before the wide launch through email and social media platforms.

      Table 2: Resources

      Software and Algorithms
      SentencesResources
      All the data were entered in Microsoft excel and analyzed using SPSS version 20.00.
      Microsoft excel
      suggested: (Microsoft Excel, RRID:SCR_016137)
      SPSS
      suggested: (SPSS, RRID:SCR_002865)

      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:
      The limitations of our study are that because it was a survey, all the data provided could not be independently verified. All positive and negative cases were based on self-reported information. Besides, limitations in language proficiency in individual cases could have affected the quality of the response. While analysing the data, we did however talk with several respondents by phone, where contact information was provided. A significant limitation was that the number of unvaccinated individuals was small, constituting only 1.4% of the total number of respondents. Therefore, a meaningful comparison of their disease profile was not possible. A cross-sectional survey is a descriptive research tool that provides a broad snapshot of society at a given time-point, and is not to be equated with a case-control study or a randomised trial that are able to select the participants and oversee data collection. Although useful to study disease patterns across large sections of the population, a survey is therefore not a method that can be used to calculate effectiveness of interventions like booster doses.

      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.

      About SciScore

      SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

    2. Version published to 10.1101/2022.04.26.22274273v1 on medRxiv