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Vaccine Effectiveness of Two and Three Doses of BNT162b2 and Coronavac Against COVID-19 in Hong Kong
28 Pages Posted: 23 Mar 2022More...
Background: Hong Kong maintained extremely low circulation of SARS-CoV-2 until a major community epidemic of Omicron BA.2 starting in January 2022. Both mRNA BNT162b2 (BioNTech/Fosun Pharma) and inactivated CoronaVac (Sinovac) vaccines are widely available, however coverage has remained low in older adults. Vaccine effectiveness in this predominantly infection-naïve population is unknown.
Methods: We used individual-level case data on mild/moderate, severe/fatal and fatal hospitalized COVID-19 from December 31, 2021 to March 8, 2022, along with census information and coverage data of BNT162b2 and CoronaVac. We used a negative binomial model, adjusting for age and calendar day to estimate vaccine effectiveness of one, two and three dose schedules of both vaccines, and relative effectiveness by number of doses and vaccine type.
Findings: A total of 12.7 million vaccine doses were administered in Hong Kong’s 7.3 million population, and we analyzed data from confirmed cases with mild/moderate (N=5,474), severe/fatal (N=5,294) and fatal (N=4,093) COVID-19. Two doses of either vaccine protected against severe disease and death, with higher effectiveness among adults ≥60 years with BNT162b2 (VE: 88.2%, 95% confidence interval, CI: 84.4%, 91.1%) compared to CoronaVac (VE: 74.1%, 95% CI: 67.8%, 79.2%). Three doses of either vaccine offered very high levels of protection against severe outcomes (VE: 98.1%, 95% CI: 97.1%, 98.8%).
Interpretation: Third doses of either BNT162b2 or CoronaVac provide substantial additional protection against severe COVID-19 and should be prioritized, particularly in older adults who received CoronaVac primary schedules. Longer follow-up is needed to assess persistence of different vaccine platforms and schedules.
Funding Information: This project was supported by the China CDC-sponsored COVID-19 Vaccines Evaluation Program (COVEP). BJC is supported by the Theme-based Research Scheme (project no. T11- 712/19-N) from the Research Grants Council from the University Grants Committee of Hong Kong, and an RGC Senior Research Fellowship (grant number: HKU SRFS2021-7S03).
Declaration of Interests: BJC reports honoraria from AstraZeneca, Fosun Pharma, GlaxoSmithKline, Moderna, Pfizer, Roche and Sanofi Pasteur. JN was previously employed by and owns shares in Sanofi. The authors report no other potential conflicts of interest.
Ethics Approval Statement: This project received approval from the Institutional Review Board of the University of Hong Kong.
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