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      Effectiveness of COVID-19 Vaccination Against SARS-CoV-2 Omicron Variant Infection and Symptoms — China, December 2022–February 2023

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          Abstract

          What is already known about this topic?

          A considerable percentage of the population has received both primary and booster vaccinations, which could potentially provide protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron infections and related symptoms.

          What is added by this report?

          The self-reported infection rate, as determined from an online survey, reached its peak (15.5%) between December 19 and 21, 2022, with an estimated 82.4% of individuals in China being infected as of February 7, 2023. During the epidemic, the effectiveness of booster vaccinations against SARS-CoV-2 Omicron infection was found to be 49.0% within three months of vaccination and 37.9% between 3 and 6 months following vaccination. Furthermore, the vaccine effectiveness of the booster vaccination in relation to symptom prevention varied from 48.7% to 83.2% within three months and from 25.9% to 69.0% between 3 and 6 months post-booster vaccination.

          What are the implications for public health practice?

          The development and production of efficacious vaccines, together with prompt vaccinations or emergency vaccinations, have the potential to mitigate the epidemic’s impact and safeguard public health.

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          Most cited references8

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          The central role of the propensity score in observational studies for causal effects

          Paul R. Rosenbaum, Donald B Rubin (1983)
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            Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile

            Alejandro Jara, Eduardo Undurraga, Cecilia SENÉN GONZÁLEZ … (2021)
            Background Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support decision making. A countrywide mass vaccination campaign with the use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021. Methods We used a prospective national cohort, including participants 16 years of age or older who were affiliated with the public national health care system, to assess the effectiveness of the inactivated SARS-CoV-2 vaccine with regard to preventing Covid-19 and related hospitalization, admission to the intensive care unit (ICU), and death. We estimated hazard ratios using the extension of the Cox proportional-hazards model, accounting for time-varying vaccination status. We estimated the change in the hazard ratio associated with partial immunization (≥14 days after receipt of the first dose and before receipt of the second dose) and full immunization (≥14 days after receipt of the second dose). Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics. Results The study was conducted from February 2 through May 1, 2021, and the cohort included approximately 10.2 million persons. Among persons who were fully immunized, the adjusted vaccine effectiveness was 65.9% (95% confidence interval [CI], 65.2 to 66.6) for the prevention of Covid-19 and 87.5% (95% CI, 86.7 to 88.2) for the prevention of hospitalization, 90.3% (95% CI, 89.1 to 91.4) for the prevention of ICU admission, and 86.3% (95% CI, 84.5 to 87.9) for the prevention of Covid-19–related death. Conclusions Our results suggest that the inactivated SARS-CoV-2 vaccine effectively prevented Covid-19, including severe disease and death, a finding that is consistent with results of phase 2 trials of the vaccine. (Funded by Agencia Nacional de Investigación y Desarrollo and others.)
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              Vaccine effectiveness of heterologous CoronaVac plus BNT162b2 in Brazil

              Thiago Cerqueira‐Silva, Srinivasa Vittal Katikireddi, Vinicius de Araujo Oliveira … (2022)
              There is considerable interest in the waning of effectiveness of coronavirus disease 2019 (COVID-19) vaccines and vaccine effectiveness (VE) of booster doses. Using linked national Brazilian databases, we undertook a test-negative design study involving almost 14 million people (~16 million tests) to estimate VE of CoronaVac over time and VE of BNT162b2 booster vaccination against RT–PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death). Compared with unvaccinated individuals, CoronaVac VE at 14–30 d after the second dose was 55.0% (95% confidence interval (CI): 54.3–55.7) against confirmed infection and 82.1% (95% CI: 81.4–82.8) against severe outcomes. VE decreased to 34.7% (95% CI: 33.1–36.2) against infection and 72.5% (95% CI: 70.9–74.0) against severe outcomes over 180 d after the second dose. A BNT162b2 booster, 6 months after the second dose of CoronaVac, improved VE against infection to 92.7% (95% CI: 91.0−94.0) and VE against severe outcomes to 97.3% (95% CI: 96.1−98.1) 14–30 d after the booster. Compared with younger age groups, individuals 80 years of age or older had lower protection after the second dose but similar protection after the booster. Our findings support a BNT162b2 booster vaccine dose after two doses of CoronaVac, particularly for the elderly. A test-negative case–control analysis of data from Brazil shows that vaccine effectiveness against SARS-CoV-2 infection and severe COVID-19 outcomes declines after two doses of CoronaVac but increases after a booster dose of the BNT162b2 vaccine.
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                Author and article information

                Contributors
                Xiaofeng Liang
                Wenjun Ma
                Journal
                Journal ID (nlm-ta): China CDC Wkly
                Journal ID (publisher-id): CCDCW
                Title: China CDC Weekly
                Publisher: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention (Beijing, China )
                ISSN (Electronic): 2096-7071
                Publication date (Print): 28 April 2023
                Volume: 5
                Issue: 17
                Pages: 369-373
                Affiliations
                [1 ] Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
                [2 ] Disease Control and Prevention Institute, Jinan University, Guangzhou City, Guangdong Province, China
                [3 ] Key Laboratory of Ministry of Education for Viral Pathogenesis & Infection Prevention and Control, Jinan University, Guangzhou City, Guangdong Province, China
                [4 ] Fuyang District Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province
                [5 ] Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
                Author notes

                & Joint first authors.

                Article
                Publisher ID: ccdcw-5-17-369
                DOI: 10.46234/ccdcw2023.070
                PMC ID: 10184382
                SO-VID: 0b27683b-9145-4c29-894e-bd9c842a9d23
                Copyright © Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2023
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

                History
                Date received : 17 April 2023
                Date accepted : 24 April 2023
                Funding
                This study was supported by the National Key Research and Development Program of China (2021YFC2301604), the Young Elite Scientists Sponsorship Program by CAST (2022QNRC001), Emergency Grants for Prevention and Control of SARS-CoV-2 in Guangdong Province (2022A1111090004), and the Science and Technology Program of Guangzhou (202102021285)
                Categories
                Subject: Preplanned Studies

                Keywords: covid-19,vaccine effectiveness,case-control study
                Data availability:
                Keywords: covid-19, vaccine effectiveness, case-control study

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