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Effectiveness of COVID-19 Vaccines in Older Adults in Colombia: First Report of the Esperanza Cohort. A Matched-Pair, National Study

18 Pages Posted: 16 Dec 2021

See all articles by Leonardo Arregoces Castillo

Leonardo Arregoces Castillo

Pontificia Universidad Javeriana, Bogotá

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics

Maylen Liseth Rojas-Botero

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data

Andrés Palacios Clavijo

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data

Maryory Galvis Pedraza

University of Groningen; Universidad Libre Cali; Secretaria de Salud Distrital Cali

Luz Emilse Rincón Medrano

Ministry of Health and Social Protection, Bogota - Administration

Mariana Pinto-Álvarez

Ministry of Health and Social Protection, Bogota - Public Health

Fernando Ruiz Gómez

Ministry of Health and Social Protection, Bogota - Public Health

Belem Trejo-Valdivia

National Institute of Public Health of Mexico (INSP) - Biosattistics

More...

Abstract

Background: Although clinical trials showed that vaccines have a high efficacy and safety, differences in study designs and populations do not allow for comparison across products and age groups. The real-world effectiveness in population with the high risk of severe disease or death of a diversified portfolio of vaccines acquired by Colombia becomes important for assessing national vaccination plans and future decision-making.

Methods: We carried out a population-based matched-pair cohort study in 2828294 people 60 years and older. The exposed cohort consisted of older adults fully vaccinated with Ad26.COV2.S, BNT162b2, ChAdOx1 nCoV-19, or CoronaVac without history of Sars-CoV-2 infection. The follow-up was made between March 11 and October 26, 2021. To estimate effectiveness, we constructed cause-specific Cox survival models in presence of competitive risks (hospitalisation vs death due to COVID-19). Finally, we estimated the effectiveness of each vaccine adjusting by main potential confounders over each age group.

Findings: The overall effectiveness of vaccines to prevent hospitalisation without subsequent death was 61·6% (95% CI 58·0 - 65·0), to prevent death after hospitalisation for COVID-19, 79·8% (95% CI 78·5 - 81·1), and to prevent death without previous COVID-19 hospitalisation, 72·8% (95% CI 70·1 - 75·3). The effectiveness of vaccines to prevent death after hospitalisation for COVID-19 was 22·6 percentage points less in adults 80 and older compared with adults between 60 and 69 years old (68·4% vs 91·0%). We found statistically significant differences in effectiveness between vaccines in preventing hospitalisations and deaths.

Interpretation: The Ad26.COV2.S, BNT162b2, ChAdOx1 nCoV-19, and CoronaVac vaccines are effective in preventing hospitalisations and deaths caused by COVID-19 in fully vaccinated adults 60 years and older. BNT162b2 showed the highest effectiveness among this population. Effectiveness decreases with increasing age, regardless of the type of vaccine used in the primary scheme. An additional dose of the vaccine seems to be the best alternative for increase protection in older adults.

Funding Information: Colombian Ministry of Health and Social Protection.

Declaration of Interests: FRG, LAC and JFN are members of the Colombian COVID-19 vaccine advisory committee. All other authors declare no competing interests.

Ethics Approval Statement: This investigation complies with the scientific, technical, and administrative regulation for human health research in Colombia, which classifies this study as research without risk since it only used secondary data sources of anonymised information. Due to its characteristics, this study does not require the review or approval of a research ethics committee.

Keywords: COVID-19, Vaccines, Survival Analysis, Pandemics, Cohort studies, Colombia

Suggested Citation

Arregoces Castillo, Leonardo and Fernández-Niño, Julián Alfredo and Rojas-Botero, Maylen Liseth and Palacios Clavijo, Andrés and Galvis Pedraza, Maryory and Rincón Medrano, Luz Emilse and Pinto-Álvarez, Mariana and Ruiz Gómez, Fernando and Trejo-Valdivia, Belem, Effectiveness of COVID-19 Vaccines in Older Adults in Colombia: First Report of the Esperanza Cohort. A Matched-Pair, National Study. Available at SSRN: https://ssrn.com/abstract=3978556 or http://dx.doi.org/10.2139/ssrn.3978556

Leonardo Arregoces Castillo (Contact Author)

Pontificia Universidad Javeriana, Bogotá ( email )

Calle 40 # 6-23
Bogota, CO 110231
Colombia

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics ( email )

Colombia

Maylen Liseth Rojas-Botero

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data ( email )

Bogotá
Colombia

Andrés Palacios Clavijo

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data ( email )

Bogotá
Colombia

Maryory Galvis Pedraza

University of Groningen ( email )

P.O. Box 800
9700 AH Groningen, Groningen 9700 AV
Netherlands
0627562924 (Phone)
8921 ED (Fax)

Universidad Libre Cali ( email )

Diagonal 37A Nro. 3 - 29
Santa Isabel PBX
Cali, 472
Colombia
0627562924 (Phone)
8921 ED (Fax)

Secretaria de Salud Distrital Cali ( email )

Cl. 4b #36-00, El Sindicato, Cali, Valle del Cauca
Cali, 760001
Colombia
0627562924 (Phone)
8921 ED (Fax)

Luz Emilse Rincón Medrano

Ministry of Health and Social Protection, Bogota - Administration ( email )

Bogotá
Colombia

Mariana Pinto-Álvarez

Ministry of Health and Social Protection, Bogota - Public Health ( email )

Bogotá
Colombia

Fernando Ruiz Gómez

Ministry of Health and Social Protection, Bogota - Public Health ( email )

Bogotá
Colombia

Belem Trejo-Valdivia

National Institute of Public Health of Mexico (INSP) - Biosattistics ( email )

Av Universidad 655, Santa María Ahuacatitlán
Cuernavaca
Mexico

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