1
|
Gaviria A, Tamayo-Trujillo R, Paz-Cruz E, Cadena-Ullauri S, Guevara-Ramírez P, Ruiz-Pozo VA, Cevallos F, Aguirre-Tello V, Risueño K, Yánez MP, Cabrera-Andrade A, Zambrano AK. Assessment of the COVID-19 pandemic progression in Ecuador through seroprevalence analysis of anti-SARS-CoV-2 IgG/IgM antibodies in blood donors. Front Cell Infect Microbiol 2024; 14:1373450. [PMID: 38975325 PMCID: PMC11224293 DOI: 10.3389/fcimb.2024.1373450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness caused by the RNA virus SARS-CoV-2. Globally, there have been over 759.4 million cases and 6.74 million deaths, while Ecuador has reported more than 1.06 million cases and 35.9 thousand deaths. To describe the COVID-19 pandemic impact and the vaccinations effectiveness in a low-income country like Ecuador, we aim to assess the seroprevalence of IgG and IgM antibodies against SARS-CoV-2 in a sample from healthy blood donors at the Cruz Roja Ecuatoriana. Methods The present seroprevalence study used a lateral flow immunoassay (LFIA) to detect anti-SARS-CoV-2 IgG and IgM antibodies in months with the highest confirmed case rates (May 2020; January, April 2021; January, February, June, July 2022) and months with the highest vaccination rates (May, June, July, August, December 2021) in Quito, Ecuador. The IgG and IgM seroprevalence were also assessed based on sex, age range, blood type and RhD antigen type. The sample size was 8,159, and sampling was performed based on the availability of each blood type. Results The results showed an overall IgG and IgM seroprevalence of 47.76% and 3.44%, respectively. There were no differences in IgG and IgM seroprevalences between blood groups and sex, whereas statistical differences were found based on months, age range groups, and RhD antigen type. For instance, the highest IgG seroprevalence was observed in February 2022 and within the 17-26 years age range group, while the highest IgM seroprevalence was in April 2021 and within the 47-56 years age range group. Lastly, only IgG seroprevalence was higher in RhD+ individuals while IgM seroprevalence was similar across RhD types. Discussion This project contributes to limited data on IgG and IgM antibodies against SARS-CoV-2 in Ecuador. It suggests that herd immunity may have been achieved in the last evaluated months, and highlights a potential link between the RhD antigen type and COVID-19 susceptibility. These findings have implications for public health strategies and vaccine distribution not only in Ecuador but also in regions with similar characteristics.
Collapse
Affiliation(s)
- Aníbal Gaviria
- Laboratorio de Genética, Centros Médicos Especializados Cruz Roja Ecuatoriana, Quito, Ecuador
- Hemocentro Nacional, Cruz Roja Ecuatoriana, Quito, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Elius Paz-Cruz
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Santiago Cadena-Ullauri
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Viviana A. Ruiz-Pozo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Francisco Cevallos
- Laboratorio de Genética, Centros Médicos Especializados Cruz Roja Ecuatoriana, Quito, Ecuador
- Hemocentro Nacional, Cruz Roja Ecuatoriana, Quito, Ecuador
| | | | - Karla Risueño
- Laboratorio de Genética, Centros Médicos Especializados Cruz Roja Ecuatoriana, Quito, Ecuador
| | - Martha Paulina Yánez
- Laboratorio de Genética, Centros Médicos Especializados Cruz Roja Ecuatoriana, Quito, Ecuador
| | - Alejandro Cabrera-Andrade
- Grupo de Bio-Quimioinformática, Universidad de Las Américas, Quito, Ecuador
- Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| |
Collapse
|
2
|
Leon-Rojas JE, Veloz T, Teran J, Perez M, Arias-Erazo F, Villacis L, Velez J, Recalde R, Jiménez P, Martin M, Chis Ster I, Cooper P, Romero N. The dynamics and determinants of specific systemic and mucosal antibody responses to SARS-CoV-2 in three adult cohorts in the Ecuadorian Andes: a study protocol. F1000Res 2024; 11:1392. [PMID: 38434000 PMCID: PMC10905138 DOI: 10.12688/f1000research.126577.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction There are limited longitudinal data on the systemic and mucosal antibody responses to SARS-CoV-2 from Latin America, a region severely affected by COVID-19, and where vaccine strategies have been implemented during the evolving pandemic. Objective To evaluate determinants of seroprevalence and changes in levels of anti-SARS-CoV-2 antibodies longitudinally in adults with different levels of exposure to SARS-CoV-2 (defined a priori as low, medium, and high based on presumed occupational risk), in two Andean cities in Ecuador. Methods Longitudinal cohort study of 1,000 adults aged 18 years and older with questionnaire data and sample collection done at 0, 3, 6, and 12 months during the period 2020-2023. Observations collected included WHO-ISARIC questionnaire and peripheral blood and saliva samples for measurement of IgG and IgA antibodies, respectively. Planned analyses are tailored to the longitudinal nature of the outcomes defined by participants' antibody levels and aim at estimating their average trends with time since infection in each of the occupational groups, adjusted for demographics and calendar-time levels of SARS-CoV-2 infection in the general population. The latter reflect the impact of the national control measures such as vaccinations and movement restrictions. Importance Understanding the duration and the dynamics of waning immunity to SARS-CoV-2, in the context of exposures to emerging virus variants and immunization, will inform the implementation of targeted public health strategies in the Latin American region. Ethics and Dissemination This study will observe the bioethical principles of the Declaration of Helsinki. Informed written consent will be obtained. Samples from participants will be stored for up to three years after which they will be destroyed. The study protocol was approved by the Ecuadorian Ministry of Public Health Ethics Committee for COVID-19 Research. Antibody results will be provided to participants and participating institutions and to the national health authorities.
Collapse
Affiliation(s)
- Jose E. Leon-Rojas
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
| | - Tatiana Veloz
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Jair Teran
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Monica Perez
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Fernanda Arias-Erazo
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
- Departamento de Ciencias de la Vida y de la Agricultura, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Ecuador
| | - Lizet Villacis
- Medical School, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Jorge Velez
- Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
| | - Ricardo Recalde
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Patricia Jiménez
- Departamento de Ciencias de la Vida y de la Agricultura, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Ecuador
- Grupo de Investigación en Sanidad Animal y Humana (GISAH), Quito, Ecuador
| | - Miguel Martin
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | | | - Philip Cooper
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
- St George's University of London, London, UK
| | - Natalia Romero
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| |
Collapse
|
3
|
Nogueira de Brito R, Passarella Teixeira AI, Carvalho Gontijo C, Da Silva Faria R, Massa Ramalho W, Sierra Romero GA, Castro M, Pessoa V, Araújo Torres L, Pereira Leite L, Ferreira Noronha E, Haddad R, Navegantes de Araújo W. Seroprevalence of SARS-CoV-2 and Vaccination Coverage among Residents of a Lower-Middle-Class Population in the Federal District, Brazil. Vaccines (Basel) 2023; 11:vaccines11050916. [PMID: 37243020 DOI: 10.3390/vaccines11050916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/01/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
Estimating seroprevalence and vaccination coverage against COVID-19 is crucial to the development of well-targeted public health policies at the local level. Here, we estimated seroprevalence and vaccination coverage in a lower-middle-class population in Brazil. We conducted an observational, cross-sectional, population-based survey from 24 September to 19 December 2021. CMIA tests were used to detect anti-SARS-CoV-2 IgG against the N-protein. The overall seroprevalence was 24.15% (177/733), and vaccination coverage was 91.40% (670/733); 72.09% (483/670) were fully vaccinated. Among vaccinated participants, seroprevalence was 24.77% (95% CI 21.50-28.04; 166/670), with a prevalence ratio (PR) of 1.03 (95% CI 0.98-1.08; p-value 0.131). Among participants who received an mRNA vaccine with S-based epitope (485), seroprevalence was 16.29% (95% CI 13.04-19.85; 79/485). Among unvaccinated participants, seroprevalence was 17.46% (95% CI 10.04-28.62; 11/63). Finally, in spite of the political climate and other possible causes for vaccine hesitancy, the positive Brazilian culture towards vaccination might have curbed hesitancy.
Collapse
Affiliation(s)
| | | | | | - Rafael Da Silva Faria
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Walter Massa Ramalho
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | | | - Manoel Castro
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Vitoria Pessoa
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Larissa Araújo Torres
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Larissa Pereira Leite
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Elza Ferreira Noronha
- Department of Tropical Medicine, University of Brasilia, Brasilia 70910-900, DF, Brazil
| | - Rodrigo Haddad
- Laboratório de Diagnóstico Molecular, Hospital Universitário de Brasília, Brasilia 70910-900, DF, Brazil
| | | |
Collapse
|
4
|
da Silva Torres MK, Lopes FT, de Lima ACR, Cordeiro Lima CN, dos Santos Brito WR, Gonçalves JSS, dos Santos Oliveira O, de Oliveira Freitas V, dos Santos BC, Santos de Sousa R, Carvalho Gomes JL, Sarmento Botelho BJ, Alves Correa AC, Machado LFA, Martins Feitosa RN, Lima SS, Cayres Vallinoto IMV, Vallinoto ACR. Changes in the seroprevalence and risk factors between the first and second waves of COVID-19 in a metropolis in the Brazilian Amazon. Front Cell Infect Microbiol 2022; 12:932563. [PMID: 36189360 PMCID: PMC9524613 DOI: 10.3389/fcimb.2022.932563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
In Brazil, the coronavirus disease 2019 (COVID-19) epidemic spread rapidly in a heterogeneous way, mainly due to the different socioeconomic and behavioral characteristics of different regional populations and different evaluation periods. We performed a cross-sectional study including 1,337 individuals (first wave = 736/second wave = 601) after the first two waves of COVID-19 in the city of Belém, the capital of the state of Pará. The detection of IgG anti-SARS-CoV-2 antibodies was performed using an enzyme-linked immunosorbent assay test followed by statistical analysis using the RStudio program. Our results showed an increase in the seroprevalence (first wave= 39.1%/second wave= 50.1%) of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies in the population of Belém from the first to the second pandemic wave. Advanced age, primary or secondary education level, lack of social isolation, and a low frequency of protective mask use were considered risk factors for SARS-CoV-2 infection during the first wave compared to the second wave. This study is one of the firsts to provide important information about the dynamics of virus circulation and the groups vulnerable to exposure in the two major periods. Our data emphasize the socioeconomic characteristics of the affected population and that nonpharmacological prevention measures are crucial for combating the pandemic.
Collapse
Affiliation(s)
- Maria Karoliny da Silva Torres
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Felipe Teixeira Lopes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Carlos Neandro Cordeiro Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Wandrey Roberto dos Santos Brito
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Janete Silvana S. Gonçalves
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Onayane dos Santos Oliveira
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | | | | | - Renata Santos de Sousa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | | | | | | | - Luiz Fernando A. Machado
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Rosimar Neris Martins Feitosa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Izaura Maria Vieira Cayres Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
| | - Antonio Carlos R. Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Graduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém, Brazil
- *Correspondence: Antonio Carlos R. Vallinoto,
| |
Collapse
|
5
|
Fofana MO, Nery N, Aguilar Ticona JP, de Andrade Belitardo EMM, Victoriano R, Anjos RO, Portilho MM, de Santana MC, dos Santos LL, de Oliveira D, Cruz JS, Muenker MC, Khouri R, Wunder EA, Hitchings MDT, Johnson O, Reis MG, Ribeiro GS, Cummings DAT, Costa F, Ko AI. Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey. PLoS Med 2022; 19:e1004093. [PMID: 36074784 PMCID: PMC9499230 DOI: 10.1371/journal.pmed.1004093] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 09/22/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The structural environment of urban slums, including physical, demographic, and socioeconomic attributes, renders inhabitants more vulnerable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Yet, little is known about the specific determinants that contribute to high transmission within these communities. We therefore aimed to investigate SARS-CoV-2 seroprevalence in an urban slum in Brazil. METHODS AND FINDINGS We performed a cross-sectional serosurvey of an established cohort of 2,041 urban slum residents from the city of Salvador, Brazil between November 2020 and February 2021, following the first Coronavirus Disease 2019 (COVID-19) pandemic wave in the country and during the onset of the second wave. The median age in this population was 29 years (interquartile range [IQR] 16 to 44); most participants reported their ethnicity as Black (51.5%) or Brown (41.7%), and 58.5% were female. The median size of participating households was 3 (IQR 2 to 4), with a median daily per capita income of 2.32 (IQR 0.33-5.15) US Dollars. The main outcome measure was presence of IgG against the SARS-CoV-2 spike protein. We implemented multilevel models with random intercepts for each household to estimate seroprevalence and associated risk factors, adjusting for the sensitivity and specificity of the assay, and the age and gender distribution of our study population. We identified high seroprevalence (47.9%, 95% confidence interval [CI] 44.2% to 52.1%), particularly among female residents (50.3% [95% CI 46.3% to 54.8%] versus 44.6% [95% CI 40.1% to 49.4%] among male residents, p < 0.01) and among children (54.4% [95% CI 49.6% to 59.3%] versus 45.4% [95% CI 41.5% to 49.7%] among adults, p < 0.01). Adults residing in households with children were more likely to be seropositive (48.6% [95% CI 44.8% to 52.3%] versus 40.7% [95% CI 37.2% to 44.3%], p < 0.01). Women who were unemployed and living below the poverty threshold (daily per capita household income <$1.25) were more likely to be seropositive compared to men with the same employment and income status (53.9% [95% CI 47.0% to 60.6%] versus 32.9% [95% CI 23.2% to 44.3%], p < 0.01). Participation in the study was voluntary, which may limit the generalizability of our findings. CONCLUSIONS Prior to the peak of the second wave of the COVID-19 pandemic, cumulative incidence as assessed by serology approached 50% in a Brazilian urban slum population. In contrast to observations from industrialized countries, SARS-CoV-2 incidence was highest among children, as well as women living in extreme poverty. These findings emphasize the need for targeted interventions that provide safe environments for children and mitigate the structural risks posed by crowding and poverty for the most vulnerable residents of urban slum communities.
Collapse
Affiliation(s)
- Mariam O. Fofana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- * E-mail: (MOF); (AIK)
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Juan P. Aguilar Ticona
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | | | - Renato Victoriano
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | | | - Moyra M. Portilho
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | | | | | | | - Jaqueline S. Cruz
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | | | - Ricardo Khouri
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Elsio A. Wunder
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Matt D. T. Hitchings
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America
| | - Olatunji Johnson
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Mitermayer G. Reis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Derek A. T. Cummings
- Department of Biology, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Federico Costa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
- * E-mail: (MOF); (AIK)
| |
Collapse
|
6
|
Hitchings MDT, Ranzani OT, Lind ML, Dorion M, D'Agostini TL, de Paula RC, de Paula OFP, de Moura Villela EF, Scaramuzzini Torres MS, de Oliveira SB, Schulz W, Almiron M, Said R, de Oliveira RD, Vieira da Silva P, de Araújo WN, Gorinchteyn JC, Dean NE, Andrews JR, Cummings DAT, Ko AI, Croda J. Change in covid-19 risk over time following vaccination with CoronaVac: test negative case-control study. BMJ 2022; 377:e070102. [PMID: 35697361 PMCID: PMC9189440 DOI: 10.1136/bmj-2022-070102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To estimate the change in odds of covid-19 over time following primary series completion of the inactivated whole virus vaccine CoronaVac (Sinovac Biotech) in São Paulo State, Brazil. DESIGN Test negative case-control study. SETTING Community testing for covid-19 in São Paulo State, Brazil. PARTICIPANTS Adults aged ≥18 years who were residents of São Paulo state, had received two doses of CoronaVac, did not have a laboratory confirmed SARS-CoV-2 infection before vaccination, and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 14 December 2021. Cases were matched to test negative controls by age (in 5 year bands), municipality of residence, healthcare worker status, and epidemiological week of RT-PCR test. MAIN OUTCOME MEASURES RT-PCR confirmed symptomatic covid-19 and associated hospital admissions and deaths. Conditional logistic regression was adjusted for sex, number of covid-19 associated comorbidities, race, and previous acute respiratory illness. RESULTS From 202 741 eligible people, 52 170 cases with symptomatic covid-19 and 69 115 test negative controls with covid-19 symptoms were formed into 43 257 matched sets. Adjusted odds ratios of symptomatic covid-19 increased with time since completion of the vaccination series. The increase in odds was greater in younger people and among healthcare workers, although sensitivity analyses suggested that this was in part due to bias. In addition, the adjusted odds ratios of covid-19 related hospital admission or death significantly increased with time compared with the odds 14-41 days after series completion: from 1.25 (95% confidence interval 1.04 to 1.51) at 70-97 days up to 1.94 (1.41 to 2.67) from 182 days onwards. CONCLUSIONS Significant increases in the risk of moderate and severe covid-19 outcomes occurred three months after primary vaccination with CoronaVac among people aged 65 and older. These findings provide supportive evidence for the implementation of vaccine boosters in these populations who received this inactivated vaccine. Studies of waning should include analyses designed to uncover common biases.
Collapse
Affiliation(s)
- Matt D T Hitchings
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Otavio T Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Margaret L Lind
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Murilo Dorion
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | | | | | | | | | | | | | - Wade Schulz
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Maria Almiron
- Pan American Health Organization, Brasília, DF, Brazil
| | - Rodrigo Said
- Pan American Health Organization, Brasília, DF, Brazil
| | | | | | - Wildo Navegantes de Araújo
- Pan American Health Organization, Brasília, DF, Brazil
- Universidade de Brasília, Brasília, DF, Brazil
- National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, RS, Brazil
| | | | - Natalie E Dean
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
- Contributed equally
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Contributed equally
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil
- Contributed equally
| | - Julio Croda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Universidade Federal de Mato Grosso do Sul - UFMS, Campo Grande, MS, Brazil
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz, Campo Grande, MS, Brazil
- Contributed equally
| |
Collapse
|