Effectiveness of CoronaVac, ChAdOx1, BNT162b2 and Ad26.COV2.S among individuals with prior SARS-CoV-2 infection in Brazil

Cerqueira‐Silva, Thiago; Andrews, Jason R.; Boaventura, Viviane; Ranzani, Otávio T.; Oliveira, Vinícius de Araújo; Paixão, Enny S.; Bertoldo, Juracy; Machado, Tales Mota; Hitchings, Matt D T; Dorion, Murilo; Lind, Margaret L; Penna, Gerson Oliveira; Cummings, Derek A. T.; Dean, Natalie E.; Werneck, Guilherme Loureiro; Pearce, Neil; Barreto, Maurício Lima; Ko, Albert Icksang; Croda, Júlio; Barral‐Netto, Manoel

doi:10.1101/2021.12.21.21268058

Cited by 5 publications

(10 citation statements)

References 28 publications

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“…Twenty seven (6.7%) were protocols, seven (1.7%) were vaccine safety studies, and 370 (91.6%) only examined immunogenicity and reactogenicity in people who were vaccinated. Of the remaining 76 studies, we were able to extract data from 53,2223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374 which gave us a sample size of 100 190 476 participants from 15 countries. Supplementary table 2 presents a summary of the study characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies included high risk populations (defined as having more than one chronic condition),27404143474869 of which two studies included patients who were immunocompromised in a subset of the high risk populations 4869. Of the 53 included studies, 19 investigated the protectiveness of vaccines against covid-19 variants of concern or variants of interest, including alpha (B.1.1.7), beta (B.1.351), gamma (P.1), delta (B.1.617.2), and omicron (B.1.1.529) 22263032343738394142444748495761636870…”

Section: Resultsmentioning

confidence: 99%

“…We evaluated the risk of bias by following instructions in ROB-2 for randomised controlled trials and ROBINS-I for non-randomised studies 1819. Of the 37 non-randomised studies, 16 were rated to have a moderate risk of bias, mainly because they did not control for confounders such as comorbidities and other baseline characteristics 22323334353738444650566061656874. Nine studies from the same pool were also prone to high selection bias for having an imbalanced proportion of participants of different ages and sexes 223233343537505661.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

Cheung

2022

BMJ

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Objective To evaluate the effectiveness of heterologous and homologous covid-19 vaccine regimens with and without boosting in preventing covid-19 related infection, hospital admission, and death. Design Living systematic review and network meta-analysis. Data sources World Health Organization covid-19 databases, including 38 sources of published studies and preprints. Study selection Randomised controlled trials, cohort studies, and case-control studies. Methods 38 WHO covid-19 databases were searched on a weekly basis from 8 March 2022. Studies that assessed the effectiveness of heterologous and homologous covid-19 vaccine regimens with or without a booster were identified. Studies were eligible when they reported the number of documented, symptomatic, severe covid-19 infections, covid-19 related hospital admissions, or covid-19 related deaths among populations that were vaccinated and unvaccinated. The primary measure was vaccine effectiveness calculated as 1−odds ratio. Secondary measures were surface under the cumulative ranking curve (SUCRA) scores and the relative effects for pairwise comparisons. The risk of bias was evaluated by using the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for all cohort and case-control studies. The Cochrane risk of bias tool (version 2; ROB-2) was used to assess randomised controlled trials. Results The first round of the analysis comprised 53 studies. 24 combinations of covid-19 vaccine regimens were identified, of which a three dose mRNA regimen was found to be the most effective against asymptomatic and symptomatic covid-19 infections (vaccine effectiveness 96%, 95% credible interval 72% to 99%). Heterologous boosting using two dose adenovirus vector vaccines with one mRNA vaccine has a satisfactory vaccine effectiveness of 88% (59% to 97%). A homologous two dose mRNA regimen has a vaccine effectiveness of 99% (79% to 100%) in the prevention of severe covid-19 infections. Three dose mRNA is the most effective in reducing covid-19 related hospital admission (95%, 90% to 97%). The vaccine effectiveness against death in people who received three doses of mRNA vaccine remains uncertain owing to confounders. In the subgroup analyses, a three dose regimen is similarly effective in all age groups, even in the older population (≥65 years). A three dose mRNA regimen works comparably well in patients who are immunocompromised and those who are non-immunocompromised. Homologous and heterologous three dose regimens are effective in preventing infection by covid-19 variants (alpha, delta, and omicron). Conclusion An mRNA booster is recommended to supplement any primary vaccine course. Heterologous and homologous three dose regimens work comparably well in preventing covid-19 infections, even against different variants. The effectiveness of three dose vaccine regimens against covid-19 related death remains uncertain. Systematic review registration This review was not registered. The protocol is included in the supplementary document. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

Cheung

2022

BMJ

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“…These values were lower after only a single dose: 70-90% for death, 55-95% for severe infection, 35-93% for symptomatic disease, and 30-80% for any infection. Some studies found lower effectiveness in special populations, including residents of long-term care facilities 84,149,150 , priority groups 122 , the elderly 147 , and those previously infected 113,179 . Heterogeneities between studies made direct comparisons of efficacy/effectiveness for variants difficult.…”

Section: Results Of Covid-19 Vaccine Studiesmentioning

confidence: 99%

A systematic review of COVID-19 vaccine efficacy and effectiveness against SARS-CoV-2 infection and disease

Higdon

Wahl

Jones

et al. 2021

Preprint

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Billions of doses of COVID-19 vaccines have been administered around the world, dramatically reducing SARS-CoV-2 incidence in some settings. Many studies suggest vaccines provide a high degree of protection against infection and disease, but precise estimates vary and studies differ in design, outcomes measured, dosing regime, location, and circulating virus strains. Here we conduct a systematic review of COVID-19 vaccines as of August 2021. We included efficacy data from Phase 3 clinical trials for 13 vaccines within the WHO Emergency Use Listing evaluation process and real-world effectiveness for 5 vaccines with observational studies meeting inclusion criteria. Vaccine metrics collected include effects against asymptomatic infection, any infection, symptomatic COVID-19, and severe outcomes including hospitalization and death, for both partial and complete vaccination, and against SARS-CoV-2 variants of concern. In addition, we review the epidemiological principles behind the design and interpretation of vaccine effects, and explain important sources of heterogeneity between studies.

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“…Previous studies, conducted prior to the Omicron epidemic wave, found that primary vaccination (two doses) afforded protection against reinfection beyond that provided by a prior infection(6–9) and that a booster dose significantly increase such protection. (10) In contrast, Shrestha et al found that primary vaccination did not provide additional protection (Hazard Ratio, 0.77; 95% CI, 0.53-1.12) against SARS-CoV-2 re-infection among previously infected people during the first month of the Omicron wave. (11) Furthermore, evidence is lacking for the additional benefit of booster vaccination against Omicron infection in individuals with a prior infection, which is needed to inform vaccination policies for this sub-population.…”

Section: Introductionmentioning

confidence: 98%

Effectiveness of Primary and Booster COVID-19 mRNA Vaccination against Omicron Variant SARS-CoV-2 Infection in People with a Prior SARS-CoV-2 Infection

Lind

Robertson

Silva

et al. 2022

Preprint

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ImportanceThe benefit of primary and booster vaccination in people who experienced prior SARS-CoV-2 infection remains unclear.ObjectiveTo estimate the effectiveness of a primary (two-dose) and booster (third dose) vaccination against Omicron infection among previously infection people.DesignTest-negative case-control study.SettingYale New Haven Health System facilities serving southern Connecticut communities.ParticipantsVaccine eligible people who received SARS-CoV-2 RT-PCR testing between November 1, 2021, and January 31, 2022.ExposureCOVID-19 mRNA primary and booster vaccination.Main Outcomes and MeasuresWe conducted two analyses, each with an outcome of Omicron BA.1 variant infection (S-gene target failure defined) and each stratified by prior SARS-CoV-2 infection status. We estimated the effectiveness of primary vaccination during the period before and during booster eligibility (14-149 and ≥150 days, respectively, after 2nd dose) and of booster vaccination (≥14 days after booster dose). To test whether booster vaccination reduced the risk of infection beyond that of the primary series, we compared the odds among boosted and booster eligible people.ResultsOverall, 10,676 cases and 119,397 controls were included (median age: cases: 35 years, controls: 39 years). Among cases and controls, 6.1% and 7.8% had a prior infection. The effectiveness of primary vaccination 14-149 days after 2nd dose was 36.1% (95% CI, 7.1-56.1%) and 28.5% (95% CI, 20.0-36.2%) for people with and without prior infection, respectively. The effectiveness of booster vaccination was 45.8% (95% CI, 20.0-63.2%) and 56.9% (95% CI, 52.1-61.2%) in people with and without prior infection, respectively. The odds ratio comparing boosted and booster eligible people with prior infection was 0.83 (95% CI, 0.56-1.23), whereas the odds ratio comparing boosted and booster eligible people without prior infection was 0.51 (95% CI, 0.46-0.56).Conclusions and RelevancePrimary vaccination provided significant but limited protection against Omicron BA.1 infection among people with and without prior infection. While booster vaccination was associated with additional protection in people without prior infection, it was not associated with additional protection among people with prior infection. These findings support primary vaccination in people regardless of prior infection status but suggest that infection history should be considered when evaluating the need for booster vaccination.

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Effectiveness of CoronaVac, ChAdOx1, BNT162b2 and Ad26.COV2.S among individuals with prior SARS-CoV-2 infection in Brazil

Cited by 5 publications

References 28 publications

Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

Effectiveness of heterologous and homologous covid-19 vaccine regimens: living systematic review with network meta-analysis

A systematic review of COVID-19 vaccine efficacy and effectiveness against SARS-CoV-2 infection and disease

Effectiveness of Primary and Booster COVID-19 mRNA Vaccination against Omicron Variant SARS-CoV-2 Infection in People with a Prior SARS-CoV-2 Infection

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