The Effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca Vaccines to Prevent Severe COVID-19 in Costa Rica: Nationwide, Ecological Study of Hospitalization Prevalence

dc.creatorRosero Bixby, Luis
dc.date.accessioned2024-08-13T21:38:58Z
dc.date.available2024-08-13T21:38:58Z
dc.date.issued2022
dc.description.abstractBackground: The Costa Rican COVID-19 vaccination program has used Pfizer-BioNTech and Oxford-AstraZeneca vaccines. Real-world estimates of the effectiveness of these vaccines to prevent hospitalizations range from 90%-98% for two doses and from 70%-91% for a single dose. Almost all of these estimates predate the Delta variant. Objective: The aim of this study is to estimate the dose-dependent effectiveness of COVID-19 vaccines to prevent severe illness in real-world conditions in Costa Rica, after the Delta variant became dominant. Methods: This observational study is a secondary analysis of hospitalization prevalence. The sample is all 3.67 million adult residents living in Costa Rica by mid-2021. The study is based on public aggregated data of 5978 COVID-19–related hospital records from September 14, 2021, to October 20, 2021, and 6.1 million vaccination doses administered to determine hospitalization prevalence by dose-specific vaccination status. The intervention retrospectively evaluated is vaccination with Pfizer-BioNTech (78%) and Oxford-AstraZeneca (22%). The main outcome studied is being hospitalized. Results: Vaccine effectiveness against hospitalization (VEH) was estimated as 93.4% (95% CI 93.0-93.9) for complete vaccination and 76.7% (95% CI 75.0-78.3) for single-dose vaccination among adults of all ages. VEH was lower and more uncertain among older adults aged ≥58 years: 92% (95% CI 91%-93%) for those who had received full vaccination and 64% (95% CI 58%-69%) for those who had received partial vaccination. Single-dose VEH declined over time during the study period, especially in the older age group. Estimates were sensitive to possible errors in the population count used to determine the residual number of unvaccinated people when vaccine coverage is high. Conclusions: The Costa Rican COVID-19 vaccination program that administered Pfizer-BioNTech and Oxford-AstraZeneca vaccines seems to be highly effective at preventing COVID-19–related hospitalization after the Delta variant became dominant. Even a single dose seems to provide some degree of protection, which is good news for people whose second dose of the Pfizer-BioNTech vaccine was postponed several weeks to more rapidly increase the number of people vaccinated with a first dose. Timely monitoring of vaccine effectiveness is important to detect eventual failures and motivate the public to get vaccinated by providing information regarding the effectiveness of the vaccines.en_CR
dc.description.urihttps://publichealth.jmir.org/2022/5/e35054/
dc.identifier.issn2369-2960es_CR
dc.identifier.urihttps://repositorio.sibdi.ucr.ac.cr/handle/123456789/22487
dc.language.isoengen_CR
dc.publisherJMIR Public Health and Surveillance, vol.8(5)en_CR
dc.subjectCOVID-19es_CR
dc.subjectVACCINEes_CR
dc.subjectEFFECTIVENESSes_CR
dc.subjectHOSPITALIZATIONes_CR
dc.subjectEPIDEMIOLOGYes_CR
dc.subjectPREVENTIONes_CR
dc.subjectSEVERITYes_CR
dc.subjectOBSERVATIONALes_CR
dc.subjectPREVALENCEes_CR
dc.subjectREAL-WORLDes_CR
dc.subjectVIRUSes_CR
dc.subjectVARIANTes_CR
dc.titleThe Effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca Vaccines to Prevent Severe COVID-19 in Costa Rica: Nationwide, Ecological Study of Hospitalization Prevalenceen_CR
dc.typeArticle

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