Effectiveness of BBV152/Covaxin and AZD1222/Covishield Vaccines Against Severe COVID-19 and B.1.617.2/Delta Variant in India, 2021: A Multi-Centric Hospital-Based Case-Control Study

Bhatnagar, Tarun; Chaudhuri, Sirshendu; Ponnaiah, Manickam; Yadav, Pragya; Sabarinathan, R.; Sahay, Rima R.; Ahmed, Faheem; Sreedevi, Aswathy; Bhardwaj, Pankaj; Bilimale, Anil S.; Muthusamy, Santhosh Kumar; Logaraj, M; Narlawar, Uday; Chinnakali, Palanivel; Patel, Prakash; Sanjay, K; Saxena, Vartika; Singh, Arvind Kumar; Thangaraj, Jeromie Wesley Vivian; Agarwal, Ashwini; Alvi, Yasir; Amoghashree, .; Ashok, P; Babu, Dinesh; Bahurupi, Yogesh; Bhalavi, Sangita; Behera, Priyamadhaba; Biswas, Priyanka Pandit; Charan, Jaykaran; Chauhan, Nishant Kumar; Chetak, KB; Dar, Lalit; Das, Ayan Kumar; Deepashree, R; Dhar, Minakshi; Dhodapkar, Rahul; Ts, Dipu; Dudeja, Mridu; Dudhmal, Manisha; Gadepalli, Ravisekhar; Garg, Mahendra Kumar; Gayathri, A V; Goel, Akhil Dhanesh; Gowdappa, Basavana; Guleria, Randeep; Gupta, Manoj Kumar; Islam, Farzana; Jain, Mannu; Jain, Vineet; Jawahar, M; Joshi, Rajendra; Kant, Shashi; Kar, Sitanshu Sekhar; Kalita, Deepjyoti; Khapre, Meenakshi; Khichar, Satyendra; Kombade, Sarika P; Kohli, Sunil; Kumar, Abhinendra; Kumar, Anil; Kumar, Deepak; Kulirankal, Kiran G; Leela, K.V.; Majumdar, Triparna; Mishra, Baijayantimala; Misra, Puneet; Misra, Sanjeev; Mohapatra, Prasanta Raghab; Murthy, MR Narayana; Nyayanit, Dimpal A; Patel, Manish; Pathania, Monika; Patil, Savita; Patro, Binod Kumar; Jalandra, Ramniwas; Rathod, Pragati; Shah, Naimesh; Shete, Anita M.; Shukla, Deepak; Shwethashree, M; Sinha, Smita; Surana, Ashish; Trikha, Anjan; Tejashree, A; Venkateshan, Mahalingam; Vijaykrishnan, G; Wadhava, Sarita; Wig, Naveet; Gupta, Nivedita; Abraham, Priya; Murhekar, Manoj

doi:10.2139/ssrn.3955739

Cited by 8 publications

(10 citation statements)

References 13 publications

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“… 42 In a recent multicentric study by ICMR, the vaccine effectiveness of Covaxin for preventing severe COVID-19 disease was 69% (95% CI: 54%–79%). 43 The number of severe COVID-19 cases in our study was nil, and only five had moderate COVID-19 disease. Majority of our participants were from younger age-groups and had received the vaccination which may explain the findings.…”

Section: Discussioncontrasting

confidence: 47%

Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India

Behera

Singh

Subba

et al. 2022

Human Vaccines & Immunotherapeutics

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India approved COVID-19 vaccine called Covaxin, developed by the Indian Council of Medical Research and Bharat Biotech Ltd. The primary objective of the study was to estimate the effectiveness of Covaxin in preventing breakthrough SARS-CoV-2 infection in healthcare workers (HCWs). A test-negative matched case-control study was conducted among HCWs of tertiary care hospital in Eastern India. Any HCW who tested positive for COVID-19 using RT-PCR during April and May 2021 was taken as the case. The HCWs who tested negative for COVID-19 by RT-PCR were considered as controls after matching with the date of testing and profession of the cases. Vaccination data were collected from the institution’s vaccine database and recall. In case of discrepancy, it was confirmed from the CoWIN portal (cowin.gov.in). The sample size was 670 participants (335 pairs). Conditional logistic regression models were used to calculate the adjusted odds ratio for breakthrough SARS-CoV-2 infection. Vaccine effectiveness was calculated using the following formula: VE = (1-aOR) × 100%. Sensitivity analysis was done for effectiveness of Covaxin, excluding Covishield vaccination. The mean age of participants was 29.1 years (SD = 7.1), and the majority were males (55.2%). Among the study participants, 60% were completely vaccinated, 18.51% were partially vaccinated, and 21.49% were unvaccinated. After adjusting for age, gender, type of household and past history of COVID-19 disease in conditional logistic models, the vaccine effectiveness was 22% (aOR 0.78, 95% CI: 0.52–1.17; p = .233). Sensitivity analysis with Covaxin showed an effectiveness of 29% (aOR 0.71, 95% CI: 0.47–1.08; p = .114) for preventing breakthrough SARS-CoV-2 infection.

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Section: Discussioncontrasting

confidence: 47%

Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India

Behera

Singh

Subba

et al. 2022

Human Vaccines & Immunotherapeutics

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“…As infections increased, it became clear that the Delta strain dominated the vaccine breakthrough cases (1,2). While the overall efficacy of the approved Indian vaccines was low for Delta infections, their effectiveness in preventing severe infections ranged from 70% ->90% depending on the population (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Impact of Delta and Vaccination on SARS-CoV-2 transmission risk: Lessons for Emerging Breakthrough infections

Sriraman

Shaikh

Vaswani

et al. 2022

Preprint

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With the continuous emergence of SARS-CoV-2 variants of concern and implementation of mass-scale interventions like vaccination, understanding factors affecting disease transmission has critical implications for control efforts. Here we used a simple adapted N95 mask sampling method to demonstrate the impact of circulating SARS-CoV-2 variants and vaccination on 92 COVID-19 patients to expel virus into the air translating to a transmission risk. Between July and September 2021, when the Delta was the dominant circulating strain in Mumbai, we noted a two-fold increase in the proportion of people expelling virus (95%), about an eighty-fold increase in median viral load and a three-fold increase in high emitter type (41%; people expelling >1000 viral copy numbers in 30 minutes) compared to initial strains of 2020. Eight percent of these patients continued to be high emitters even after eight days of symptom onset, suggesting a probable increased transmission risk for Delta strain even at this stage. There was no significant difference in expelling pattern between partial, full and un-vaccinated individuals suggesting similar transmission risk. We noted significantly more infections among vaccinated study patients and their household members than unvaccinated, probably due to increased duration from vaccination and/or increased risk behaviour upon vaccination due to lower perceived threat. This study provides biological evidence for possible continued transmission of the Delta strain even with vaccination, emphasizing the need to continue COVID-19 appropriate behaviour. The study also indicates that the mask method may be useful for screening future vaccine candidates, therapeutics or interventions for their ability to block transmission.

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“…However, there is adequate evidence to support the usefulness of COVID-19 vaccines in preventing severe infection in India. Two hospital-based case-control studies among RT-PCR tested individuals reported around 80% effectiveness of Covishield (14,27). The effectiveness was 92-94% among a cohort of HCWs predominantly vaccinated with Covishield (13).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of ChAdOx1 nCoV-19 Corona Virus Vaccine (Covishield™) in preventing SARS-CoV2 infection, Chennai, Tamil Nadu, India, 2021

Murali

Sakthivel

Pattabi

et al. 2022

Preprint

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Background: India experienced the second wave of the COVID-19 pandemic in March 2021, driven by the delta variant. Apprehensions around the usefulness of vaccines against delta variant posed a risk to the vaccination program. Therefore, we estimated the effectiveness of two doses of the ChAdOx1 nCoV-19 (Covishield) vaccine against COVID-19 infection among individuals ≥45 years in Chennai, India. Methods: A community-based cohort study was conducted from May to September 2021 in a selected geographic area in Chennai, Tamil Nadu. The estimated sample size was 10,232. We enumerated individuals from all eligible households and periodically updated vaccination and COVID-19 infection data. We computed vaccine effectiveness with its 95% confidence interval for two doses of the Covishield vaccine against any COVID-19 infection. Results: We enrolled 69,435 individuals, of which 21,793 were above 45 years. Two dose coverage of Covishield in the 18+ and 45+ age group was 18% and 31%, respectively. The overall incidence of COVID-19 infection was 1099 per 100,000 population. The vaccine effectiveness against COVID-19 disease in the ≥45 age group was 61.3% (95% CI: 43.6 - 73.4) at least two weeks after receiving the second dose of Covishield. Genomic analysis of 74 (28 with two doses, 15 with one dose, and 31 with zero dose) out of the 90 aliquots collected from the 303 COVID-19 positive individuals in the 45+ age group showed delta variants and their sub-lineages. Conclusion: We demonstrated the effectiveness of two doses of the ChAdOx1 vaccine against the delta variant in the general population of Chennai. We recommend similar future studies considering emerging variants and newer vaccines. Two-dose vaccine coverage could be ensured to protect against COVID-19 infection.

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Effectiveness of BBV152/Covaxin and AZD1222/Covishield Vaccines Against Severe COVID-19 and B.1.617.2/Delta Variant in India, 2021: A Multi-Centric Hospital-Based Case-Control Study

Cited by 8 publications

References 13 publications

Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India

Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India

Impact of Delta and Vaccination on SARS-CoV-2 transmission risk: Lessons for Emerging Breakthrough infections

Effectiveness of ChAdOx1 nCoV-19 Corona Virus Vaccine (Covishield™) in preventing SARS-CoV2 infection, Chennai, Tamil Nadu, India, 2021

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