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Open Forum Infect Dis . Population-Level Effectiveness of an Inactivated Whole-Virion COVID-19 Vaccine: A Test Negative Case-Control Study in the Do

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2023 Feb 14;10(3):ofad075.
doi: 10.1093/ofid/ofad075. eCollection 2023 Mar.
Population-Level Effectiveness of an Inactivated Whole-Virion COVID-19 Vaccine: A Test Negative Case-Control Study in the Dominican Republic


Eddy Pérez-Then[SUP] 1 [/SUP], Marija Miric[SUP] 2 [/SUP], Han-Zhu Qian[SUP] 3 [/SUP], Ying Qing Chen[SUP] 4 [/SUP], Yixin Wang[SUP] 4 [/SUP], Virginia Vallejo[SUP] 2 [/SUP], Wanda Quezada[SUP] 2 [/SUP], Melissa Flaquer[SUP] 2 [/SUP], Juan Olivo[SUP] 2 [/SUP], Jean Castillo[SUP] 2 [/SUP], Natalia García[SUP] 5 [/SUP], Katherine Calderón[SUP] 5 [/SUP], Scarlet Cueto[SUP] 6 [/SUP], Bienvenido Veras[SUP] 7 [/SUP], Miguel Russo[SUP] 8 [/SUP], Indira Jiménez[SUP] 9 [/SUP], Sorileydi Guzmán[SUP] 9 [/SUP], Luz Garabito[SUP] 10 [/SUP], Evelyn Cueto[SUP] 11 [/SUP], Fátima Colombo[SUP] 12 [/SUP], Dominga Taveras[SUP] 6 [/SUP], Dania Torres[SUP] 13 [/SUP], Jeannette Baez[SUP] 14 [/SUP], Jose Yunen[SUP] 15 [/SUP], Ellen Koenig[SUP] 16 [/SUP], Eladio Pérez[SUP] 1 [/SUP], Oscar López[SUP] 17 [/SUP], Fior Estephanie Severino Medina[SUP] 18 [/SUP], Xuanyi Wang[SUP] 19 [/SUP], Yiming Shao[SUP] 20 [/SUP], Sten H Vermund[SUP] 3 [/SUP]; DR Vaccine Study Team



Collaborators, Affiliations

Abstract

Background: A continuing nationwide vaccination campaign began in the Dominican Republic on February 16, 2021 to prevent severe consequences of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Estimates of vaccine effectiveness under real-world conditions are needed to support policy decision making and inform further vaccine selection.
Methods: We conducted a test-negative case-control study to assess the real-world effectiveness of nationwide coronavirus disease 2019 (COVID-19) vaccination program using an inactivated vaccine (CoronaVac) on preventing symptomatic SARS-CoV-2 infections and hospitalizations from August to November 2021 in the Dominican Republic. Participants were recruited from 10 hospitals in 5 provinces to estimate the effectiveness of full immunization (≥14 days after receipt of the second dose) and partial immunization (otherwise with at least 1 dose ≥14 days after receipt of the first dose).
Results: Of 1078 adult participants seeking medical care for COVID-19-related symptoms, 395 (36.6%) had positive polymerase chain reaction (PCR) tests for SARS-CoV-2; 142 (13.2%) were hospitalized during 15 days of follow up, including 91 (23%) among 395 PCR-positive and 51 (7.5%) among 683 PCR-negative participants. Full vaccination was associated with 31% lower odds of symptomatic infection (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.52-0.93) and partial vaccination was associated with 49% lower odds (OR, 0.51; CI, 0.30-0.86). Among 395 PCR-positive participants, full vaccination reduced the odds of COVID-19-related hospitalization by 85% (OR, 0.15; 95% CI, 0.08-0.25) and partial vaccination reduced it by 75% (OR, 0.25; 95% CI, 0.08-0.80); full vaccination was associated with reduced use of assisted ventilation by 73% (OR, 0.27; 95% CI, 0.15-0.49).
Conclusions: Given the ancestral and delta viral variants circulating during this study period, our results suggest that the inactivated COVID-19 vaccine offered moderate protection against symptomatic SARS-CoV-2 infections and high protection against COVID-19-related hospitalizations and assisted ventilation. This is reassuring given that, as of August 2022, an estimated 2.6 billion inactivated CoronaVac vaccine doses had been administered worldwide. This vaccine will become a basis for developing multivalent vaccine against the currently circulating omicron variant.

Keywords: COVID-19; Dominican Republic; SARS-CoV-2; test-negative case-control study; vaccine effectiveness.
 
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