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Fabiani M, Mateo-Urdiales A, Sacco C, Fotakis EA, Battilomo S, Petrone D, Del Manso M, Bella A, Riccardo F, Stefanelli P, Palamara AT, Pezzotti P. Effectiveness against severe COVID-19 of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines in persons aged ≥60 years: Estimates over calendar time and by time since administration during prevalent circulation of different Omicron subvariants, Italy, 2022-2023. Vaccine 2024:S0264-410X(24)00653-4. [PMID: 38834428 DOI: 10.1016/j.vaccine.2024.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/21/2024] [Accepted: 05/31/2024] [Indexed: 06/06/2024]
Abstract
Evaluating how a COVID-19 seasonal vaccination program performed might help to plan future campaigns. This study aims to estimate the relative effectiveness (rVE) against severe COVID-19 of a seasonal booster dose over calendar time and by time since administration. We conducted a retrospective cohort analysis among 13,083,855 persons aged ≥60 years who were eligible to receive a seasonal booster at the start of the 2022-2023 vaccination campaign in Italy. We estimated rVE against severe COVID-19 (hospitalization or death) of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines by two-month calendar interval and at different times post-administration. We used multivariable Cox regression models, including vaccination as time-dependent exposure, to estimate adjusted hazard ratios (HR) and rVEs as [(1-HR)X100]. The rVE of a seasonal booster decreased from 64.9% (95% CI: 59.8-69.4) in October-November 2022 to 22.0% (95% CI: 15.4-28.0) in April-May 2023, when the majority of vaccinated persons (67%) had received the booster at least 4-6 months earlier. During the epidemic phase with prevalent circulation of the Omicron BA.5 subvariant, rVE of a seasonal booster received ≤90 days earlier was 83.0% (95% CI: 79.1-86.1), compared to 37.4% (95% CI: 25.5-47.5) during prevalent circulation of the Omicron XBB subvariant. During the XBB epidemic phase, rVE was estimated at 15.8% (95% CI: 9.1-20.1) 181-369 days post-administration of the booster dose. In all the analyses we observed similar trends of rVE between persons aged 60-79 and those ≥80 years, although estimates were somewhat lower for the oldest group. A seasonal booster dose received during the vaccination campaign provided additional protection against severe COVID-19 up to April-May 2023, after which the incidence of severe COVID-19 was much reduced. The results also suggest that the Omicron XBB subvariant might have partly escaped the immunity provided by the seasonal booster targeting the original and Omicron BA.4-5 strains of SARS-CoV-2.
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Affiliation(s)
- Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Alberto Mateo-Urdiales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy; European Programme on Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Emmanouil Alexandros Fotakis
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy; European Programme on Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Serena Battilomo
- General Directorate of Health Information System and Statistics, Italian Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Anna Teresa Palamara
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Viale Regina Elena 299, 00161 Rome, Italy
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Brault A, Hart A, Uribe P, Prado J, San Martín J, Maass A, Canals M. Direct impact of COVID-19 vaccination in Chile: averted cases, hospitalizations, ICU admissions, and deaths. BMC Infect Dis 2024; 24:467. [PMID: 38698324 PMCID: PMC11067253 DOI: 10.1186/s12879-024-09304-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Chile rapidly implemented an extensive COVID-19 vaccination campaign, deploying a diversity of vaccines with a strategy that prioritized the elderly and individuals with comorbidities. This study aims to assess the direct impact of vaccination on the number of COVID-19 related cases, hospital admissions, ICU admissions and deaths averted during the first year and a half of the campaign. METHODS Via Chile's transparency law, we obtained access to weekly event counts categorized by vaccination status and age. Integrating this data with publicly available census and vaccination coverage information, we conducted a comparative analysis of weekly incidence rates between vaccinated and unvaccinated groups from December 20, 2020 to July 2, 2022 to estimate the direct impact of vaccination in terms of the number of cases, hospitalizations, ICU admissions and deaths averted, using an approach that avoids the need to explicitly specify the effectiveness of each vaccine deployed. RESULTS We estimated that, from December 20, 2020 to July 2, 2022 the vaccination campaign directly prevented 1,030,648 (95% Confidence Interval: 1,016,975-1,044,321) cases, 268,784 (95% CI: 264,524-273,045) hospitalizations, 85,830 (95% CI: 83,466-88,194) ICU admissions and 75,968 (95% CI: 73,909-78,028) deaths related to COVID-19 among individuals aged 16 years and older. This corresponds to a reduction of 26% of cases, 66% of hospital admissions, 70% of ICU admissions and 67% of deaths compared to a scenario without vaccination. Individuals 55 years old or older represented 67% of hospitalizations, 73% of ICU admissions and 89% of deaths related to COVID-19 prevented. CONCLUSIONS This study highlights the role of Chile's vaccination campaign in reducing COVID-19 disease burden, with the most substantial reductions observed in severe outcomes.
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Affiliation(s)
- Antoine Brault
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile.
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, F-75015, France.
| | - Andrew Hart
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile.
| | - Paula Uribe
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile
| | - Jorge Prado
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile
| | - Jaime San Martín
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile
- Departamento de Ingeniería Matemática, Facultad de Cs. Físicas y Matemáticas, Universidad de Chile, Santiago, Chile
| | - Alejandro Maass
- Centro de Modelamiento Matemático, Universidad de Chile and CNRS IRL2807, Santiago, Chile
- Departamento de Ingeniería Matemática, Facultad de Cs. Físicas y Matemáticas, Universidad de Chile, Santiago, Chile
- Millennium Institute Center for Genome Regulation, Santiago, Chile
| | - Mauricio Canals
- Departamento de Medicina (O) y Programa de Salud Ambiental, Facultad de Medicina, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
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Corrao G, Porcu G, Tratsevich A, Cereda D, Pavesi G, Bertolaso G, Franchi M. Estimating All-Cause Deaths Averted in the First Two Years of the COVID-19 Vaccination Campaign in Italy. Vaccines (Basel) 2024; 12:413. [PMID: 38675795 PMCID: PMC11055119 DOI: 10.3390/vaccines12040413] [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: 02/29/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Comparing deaths averted by vaccination campaigns is a crucial public health endeavour. Excess all-cause deaths better reflect the impact of the pandemic than COVID-19 deaths. We used a seasonal autoregressive integrated moving average with exogenous factors model to regress daily all-cause deaths on annual trend, seasonality, and environmental temperature in three Italian regions (Lombardy, Marche and Sicily) from 2015 to 2019. The model was used to forecast excess deaths during the vaccinal period (December 2020-October 2022). We used the prevented fraction to estimate excess deaths observed during the vaccinal campaigns, those which would have occurred without vaccination, and those averted by the campaigns. At the end of the vaccinal period, the Lombardy region proceeded with a more intensive COVID-19 vaccination campaign than other regions (on average, 1.82 doses per resident, versus 1.67 and 1.56 in Marche and Sicily, respectively). A higher prevented fraction of all-cause deaths was consistently found in Lombardy (65% avoided deaths, as opposed to 60% and 58% in Marche and Sicily). Nevertheless, because of a lower excess mortality rate found in Lombardy compared to Marche and Sicily (12, 24 and 23 per 10,000 person-years, respectively), a lower rate of averted deaths was observed (22 avoided deaths per 10,000 person-years, versus 36 and 32 in Marche and Sicily). In Lombardy, early and full implementation of adult COVID-19 vaccination was associated with the largest reduction in all-cause deaths compared to Marche and Sicily.
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Affiliation(s)
- Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy; (G.C.); (A.T.); (M.F.)
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Gloria Porcu
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy; (G.C.); (A.T.); (M.F.)
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- Specialization School of Health Statistics and Biometrics, University of Padua, 35131 Padua, Italy
| | - Alina Tratsevich
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy; (G.C.); (A.T.); (M.F.)
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Danilo Cereda
- Preventive Unit of Welfare Department, Lombardy Region, 20124 Milan, Italy;
| | - Giovanni Pavesi
- General Directorate of Welfare Department, Lombardy Region, 20124 Milan, Italy;
| | | | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy; (G.C.); (A.T.); (M.F.)
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
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de Waure C, Gärtner BC, Lopalco PL, Puig-Barbera J, Nguyen-Van-Tam JS. Real world evidence for public health decision-making on vaccination policies: perspectives from an expert roundtable. Expert Rev Vaccines 2024; 23:27-38. [PMID: 38084895 DOI: 10.1080/14760584.2023.2290194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries' targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence. AREAS COVERED During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations. EXPERT OPINION Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.
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Affiliation(s)
- Chiara de Waure
- Public Health, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Barbara C Gärtner
- Department and Institute of Microbiology, Saarland University Hospital, Homburg, Germany
| | | | - Joan Puig-Barbera
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Region, Valencia, Spain
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Tan-Lhernould L, Tamandjou C, Deschamps G, Platon J, Sommen C, Chereau F, Parent du Châtelet I, Cauchemez S, Vaux S, Paireau J. Impact of vaccination against severe COVID-19 in the French population aged 50 years and above: a retrospective population-based study. BMC Med 2023; 21:426. [PMID: 37940955 PMCID: PMC10633992 DOI: 10.1186/s12916-023-03119-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Given the widespread implementation of COVID-19 vaccination to mitigate the pandemic from the end of 2020, it is important to retrospectively evaluate its impact, in particular by quantifying the number of severe outcomes prevented through vaccination. METHODS We estimated the number of hospitalizations, intensive care unit (ICU) admissions and deaths directly averted by vaccination in France, in people aged ≥ 50 years, from December 2020 to March 2022, based on (1) the number of observed events, (2) vaccination coverage, and (3) vaccine effectiveness. We accounted for the effect of primary vaccination and the first booster dose, the circulating variants, the age groups, and the waning of vaccine-induced protection over time. RESULTS An estimated 480,150 (95% CI: 260,072-582,516) hospitalizations, 132,156 (50,409-157,767) ICU admissions and 125,376 (53,792-152,037) deaths were directly averted by vaccination in people aged ≥ 50 years, which corresponds to a reduction of 63.2% (48.2-67.6), 68.7% (45.6-72.4) and 62.7% (41.9-67.1) respectively, compared to what would have been expected without vaccination over the study period. An estimated 5852 (2285-6853) deaths were directly averted among the 50-59 years old, 16,837 (6568-19,473) among the 60-69 years old, 32,136 (13,651-36,758) among the 70-79 years old and 70,551 (31,288-88,953) among the ≥ 80 years old. CONCLUSIONS The vaccination campaign in France considerably reduced COVID-19 morbidity and mortality, as well as stress on the healthcare system.
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Affiliation(s)
- Laetitia Tan-Lhernould
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Cynthia Tamandjou
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Guilhem Deschamps
- Direction Appui, Traitements et Analyses de données, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Johnny Platon
- Direction Appui, Traitements et Analyses de données, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Cécile Sommen
- Direction Appui, Traitements et Analyses de données, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Fanny Chereau
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Isabelle Parent du Châtelet
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, F-75015, France
| | - Sophie Vaux
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France
| | - Juliette Paireau
- Direction des Maladies Infectieuses, Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94415, France.
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, F-75015, France.
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Zhang Z, Shi L, Liu N, Jia B, Mei K, Zhang L, Zhang X, Lu Y, Lu J, Yao Y. Coverage and impact of influenza vaccination among children in Minhang District, China, 2013-2020. Front Public Health 2023; 11:1193839. [PMID: 37711236 PMCID: PMC10499390 DOI: 10.3389/fpubh.2023.1193839] [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: 05/10/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
Background Young children have a great disease burden and are particularly vulnerable to influenza. This study aimed to assess the direct effect of influenza vaccination among children and to evaluate the indirect benefit of immunizing children. Methods The influenza vaccination records for all children born during 2013-2019 in Minhang District and surveillance data for reported influenza cases were obtained from the Minhang CDC. 17,905 children were recorded in the vaccination system and included in this study. Descriptive epidemiology methods were used for data analysis, including an ecological approach to estimate the number of influenza cases averted by vaccination and linear regression to estimate the reduction in influenza cases in the general population per thousand additional childhood vaccination doses. Results During the study period, the annual vaccination coverage rate ranged from 10.40% in 2013-2014 to 27.62% in 2015-2016. The estimated number of influenza cases averted by vaccination ranged from a low of 0.28 (range: 0.23-0.34) during 2013-2014 (PF: 6.15%, range: 5.11-7.38%) to a high of 15.34 (range: 12.38-18.51) during 2017-2018 (PF: 16.54%, range: 13.79-19.30%). When increasing vaccination coverage rate by 10% in each town/street, a ratio of 7.27-10.69% cases could be further averted on the basis of observed cases. In four selected periods, the number of influenza cases in the general population was most significantly correlated with the cumulative childhood vaccination doses in the prior 2-5 months, and the reduction in influenza cases ranged from 0.73 to 3.18 cases per thousand additional childhood vaccination doses. Conclusion Influenza vaccination among children is estimated to have direct effects in terms of averted cases and might provide an underlying indirect benefit to the general population. Vaccination coverage in high-coverage areas should be further expanded to avert more influenza cases.
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Affiliation(s)
- Zhaowen Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Liming Shi
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Nian Liu
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Biyun Jia
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Kewen Mei
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Liping Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - XuanZhao Zhang
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Yihan Lu
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jia Lu
- Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Ye Yao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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Mazagatos C, Delgado-Sanz C, Milagro A, Liébana-Rodríguez M, Larrauri A. Impact of Influenza Vaccination on the Burden of Severe Influenza in the Elderly: Spain, 2017-2020. Vaccines (Basel) 2023; 11:1110. [PMID: 37376499 DOI: 10.3390/vaccines11061110] [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: 05/17/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Annual influenza vaccination is the main strategy to reduce the burden of seasonal influenza epidemics and is recommended for the elderly in most countries with influenza vaccination strategies, with the main objective of preventing hospitalizations and mortality associated with seasonal influenza in this age group. Studies from different countries have estimated the benefits of seasonal influenza vaccination programs in the elderly, preventing a considerable number of cases, hospitalizations and deaths every year. A study measured the number of medically attended confirmed influenza cases in primary care that are prevented annually by vaccination in the population aged 65 and older in Spain, the Netherlands and Portugal, but estimates of the impact of the national influenza vaccination program in the prevention of severe disease in Spain are lacking. The two objectives of this study were to estimate the burden of severe influenza disease in the Spanish population and to measure the impact of influenza vaccination in the prevention of these outcomes in the population aged 65 years and older. Using influenza surveillance systems put in place before the COVID-19 pandemic, we conducted a retrospective observational study to estimate the burden of hospitalizations and ICU admissions in Spain between 2017-18 and 2019-20, by season and age group. Burden estimates for the 65+ group, combined with vaccine effectiveness (VE) and vaccination coverage (VC) data, were used as input data in an ecological, observational study to estimate the impact of the influenza vaccination program on the elderly. We found a higher burden of severe influenza disease in seasons 2017-18 and 2018-19, with A(H3N2) circulation, and in the youngest and oldest age groups. In those aged 65 and older, we estimated an average of 9900 influenza hospitalizations and 1541 ICU admissions averted by vaccination each year. Seasonal influenza vaccination was able to prevent between 11 and 26% influenza hospitalizations and around 40% ICU admissions in the elderly in the three pre-pandemic seasons. In conclusion, our study complements previous analyses in the primary care setting in Spain and demonstrates the benefits of the annual influenza vaccination program in the prevention of severe influenza disease in the elderly, even in seasons with moderate VE.
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Affiliation(s)
- Clara Mazagatos
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Ana Milagro
- Miguel Servet University Hospital, Microbiology, 50009 Zaragoza, Spain
- Health Research Institute Aragón, 50009 Zaragoza, Spain
| | - María Liébana-Rodríguez
- Servicio Medicina Preventiva, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Reina C, Roa P, Garcés A, Valencia A, Torres M, Concha-Eastman A. COVID-19 mortality in two waves of the pandemic in Cali, Colombia, before and during vaccination roll-out. Rev Panam Salud Publica 2023; 47:e76. [PMID: 37223328 PMCID: PMC10202339 DOI: 10.26633/rpsp.2023.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/20/2023] [Indexed: 05/25/2023] Open
Abstract
Objective To describe the variation in COVID-19 mortality among residents of Cali, Colombia, in the second wave of the pandemic, before vaccines, and in the fourth wave, with vaccination roll-out in process, taking into account variables of sex, age group, comorbidities, and interval between onset of symptoms and death, and to estimate the number of deaths averted by vaccination. Methods A cross-sectional study of second wave and fourth wave deaths and vaccination coverage. The frequencies of attributes of deceased population in the two waves were compared, including comorbidities. Machado's method was used to calculate an estimate of the number of deaths averted in the fourth wave. Results There were 1 133 deaths in the second wave and 754 deaths in the fourth wave. It was calculated that approximately 3 763 deaths were averted in the fourth wave in Cali in the context of vaccination roll-out. Conclusions The decline in COVID-19-associated mortality observed supports the continuation of the vaccination program. Given the lack of data to explain other possible reasons for this decline, such as on the severity of novel viral variants, the limitations of the study are discussed.
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Affiliation(s)
- Carlos Reina
- Secretaría de Salud PúblicaCaliColombiaSecretaría de Salud Pública, Cali, Colombia
| | - Pablo Roa
- Secretaría de Salud PúblicaCaliColombiaSecretaría de Salud Pública, Cali, Colombia
| | - Anthony Garcés
- Secretaría de Salud PúblicaCaliColombiaSecretaría de Salud Pública, Cali, Colombia
| | - Andrés Valencia
- Secretaría de Salud PúblicaCaliColombiaSecretaría de Salud Pública, Cali, Colombia
| | - Miyerlandi Torres
- Secretaría de Salud PúblicaCaliColombiaSecretaría de Salud Pública, Cali, Colombia
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Hastenreiter Filho HN, Peres IT, Maddalena LG, Baião FA, Ranzani OT, Hamacher S, Maçaira PM, Bozza FA. What we talk about when we talk about COVID-19 vaccination campaign impact: a narrative review. Front Public Health 2023; 11:1126461. [PMID: 37250083 PMCID: PMC10211334 DOI: 10.3389/fpubh.2023.1126461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/06/2023] [Indexed: 05/31/2023] Open
Abstract
Background The lack of precise definitions and terminological consensus about the impact studies of COVID-19 vaccination leads to confusing statements from the scientific community about what a vaccination impact study is. Objective The present work presents a narrative review, describing and discussing COVID-19 vaccination impact studies, mapping their relevant characteristics, such as study design, approaches and outcome variables, while analyzing their similarities, distinctions, and main insights. Methods The articles screening, regarding title, abstract, and full-text reading, included papers addressing perspectives about the impact of vaccines on population outcomes. The screening process included articles published before June 10, 2022, based on the initial papers' relevance to this study's research topics. The main inclusion criteria were data analyses and study designs based on statistical modelling or comparison of pre- and post-vaccination population. Results The review included 18 studies evaluating the vaccine impact in a total of 48 countries, including 32 high-income countries (United States, Israel, and 30 Western European countries) and 16 low- and middle-income countries (Brazil, Colombia, and 14 Eastern European countries). We summarize the main characteristics of the vaccination impact studies analyzed in this narrative review. Conclusion Although all studies claim to address the impact of a vaccination program, they differ significantly in their objectives since they adopt different definitions of impact, methodologies, and outcome variables. These and other differences are related to distinct data sources, designs, analysis methods, models, and approaches.
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Affiliation(s)
- Horácio N. Hastenreiter Filho
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
- School of Management, Federal University of Bahia, Salvador, Brazil
| | - Igor T. Peres
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucas G. Maddalena
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda A. Baião
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Otavio T. Ranzani
- Barcelona Institute for Global Health, Barcelona, Spain
- Pulmonary Division, Heart Institute, Faculty of Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Silvio Hamacher
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula M. Maçaira
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando A. Bozza
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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10
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van Iersel SCJL, McDonald SA, de Gier B, Knol MJ, de Melker HE, Henri van Werkhoven CH, Hahné SJM. Number of COVID-19 hospitalisations averted by vaccination: Estimates for the Netherlands, January 6, 2021 through August 30, 2022. Vaccine 2023:S0264-410X(23)00545-5. [PMID: 37202273 DOI: 10.1016/j.vaccine.2023.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Vaccines against COVID-19 have proven effective in preventing COVID-19 hospitalisation. In this study, we aimed to quantify part of the public health impact of COVID-19 vaccination by estimating the number of averted hospitalisations. We present results from the beginning of the vaccination campaign ('entire period', January 6, 2021) and a subperiod starting at August 2, 2021 ('subperiod') when all adults had the opportunity to complete their primary series, both until August 30, 2022. METHODS Using calendar-time specific vaccine effectiveness (VE) estimates and vaccine coverage (VC) by round (primary series, first booster and second booster) and the observed number of COVID-19 associated hospitalisations, we estimated the number of averted hospitalisations per age group for the two study periods. From January 25, 2022, when registration of the indication of hospitalisation started, hospitalisations not causally related to COVID-19 were excluded. RESULTS In the entire period, an estimated 98,170 (95 % confidence interval (CI) 96,123-99,928) hospitalisations were averted, of which 90,753 (95 % CI 88,790-92,531) were in the subperiod, representing 57.0 % and 67.9 % of all estimated hospital admissions. Estimated averted hospitalisations were lowest for 12-49-year-olds and highest for 70-79-year-olds. More admissions were averted in the Delta period (72.3 %) than in the Omicron period (63.4 %). CONCLUSION COVID-19 vaccination prevented a large number of hospitalisations. Although the counterfactual of having had no vaccinations while maintaining the same public health measures is unrealistic, these findings underline the public health importance of the vaccination campaign to policy makers and the public.
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Affiliation(s)
- Senna C J L van Iersel
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Scott A McDonald
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C H Henri van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Susan J M Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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11
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Sacco C, Mateo-Urdiales A, Petrone D, Spuri M, Fabiani M, Vescio MF, Bressi M, Riccardo F, Del Manso M, Bella A, Pezzotti P. Estimating averted COVID-19 cases, hospitalisations, intensive care unit admissions and deaths by COVID-19 vaccination, Italy, January-September 2021. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2021; 26. [PMID: 34823637 PMCID: PMC8619872 DOI: 10.2807/1560-7917.es.2021.26.47.2101001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We assessed the impact of COVID-19 vaccination in Italy, by estimating numbers of averted COVID-19 cases, hospitalisations, ICU admissions and deaths between January and September 2021, by age group and geographical macro areas. Timing and speed of vaccination programme implementation varied slightly between geographical areas, particularly for older adults. We estimated that 445,193 (17% of expected; range: 331,059−616,054) cases, 79,152 (32%; range: 53,209−148,756) hospitalisations, 9,839 ICU admissions (29%; range: 6,434−16,276) and 22,067 (38%; range: 13,571−48,026) deaths were prevented by vaccination.
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Affiliation(s)
- Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Matteo Spuri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marco Bressi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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- The members of the Italian Integrated Surveillance of COVID-19 study group are acknowledged at the end of the article
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12
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Meslé MM, Brown J, Mook P, Hagan J, Pastore R, Bundle N, Spiteri G, Ravasi G, Nicolay N, Andrews N, Dykhanovska T, Mossong J, Sadkowska-Todys M, Nikiforova R, Riccardo F, Meijerink H, Mazagatos C, Kyncl J, McMenamin J, Melillo T, Kaoustou S, Lévy-Bruhl D, Haarhuis F, Rich R, Kall M, Nitzan D, Smallwood C, Pebody RG. Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021. Euro Surveill 2021; 26:2101021. [PMID: 34823641 PMCID: PMC8619871 DOI: 10.2807/1560-7917.es.2021.26.47.2101021] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/25/2021] [Indexed: 01/31/2023] Open
Abstract
Since December 2019, over 1.5 million SARS-CoV-2-related fatalities have been recorded in the World Health Organization European Region - 90.2% in people ≥ 60 years. We calculated lives saved in this age group by COVID-19 vaccination in 33 countries from December 2020 to November 2021, using weekly reported deaths and vaccination coverage. We estimated that vaccination averted 469,186 deaths (51% of 911,302 expected deaths; sensitivity range: 129,851-733,744; 23-62%). Impact by country ranged 6-93%, largest when implementation was early.
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Affiliation(s)
- Margaux Mi Meslé
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Jeremy Brown
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Piers Mook
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - José Hagan
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Roberta Pastore
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Giovanni Ravasi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Nick Andrews
- UK Health Security Agency, London, United Kingdom
| | | | | | | | - Raina Nikiforova
- Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | | | | | | | - Jan Kyncl
- National Institute of Public Health, Prague, Czechia
| | | | | | | | | | | | - Rivka Rich
- Israel Ministry of Health, Jerusalem, Israel
| | - Meaghan Kall
- UK Health Security Agency, London, United Kingdom
| | - Dorit Nitzan
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Catherine Smallwood
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
| | - Richard G Pebody
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
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13
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Understanding the Influence of Individual and Systemic Factors on Vaccination Take-Up in European Citizens Aged 55 or Older. Vaccines (Basel) 2021; 9:vaccines9020169. [PMID: 33671437 PMCID: PMC7922776 DOI: 10.3390/vaccines9020169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: High vaccination coverage provides extensive public health benefits. Hence, increasing vaccination rates is an important policy goal within the EU and worldwide. We aim to evaluate individual and systemic parameters associated with vaccination in European Union citizens aged 55 or older, using data from the Special Eurobarometer 488. Methods: Linear probability and probit models are estimated to analyze the determinants of vaccination take-up. Further, descriptive analyses are used to explore how the reasons for not having a vaccination differ by welfare regime. Results: High knowledge about the effectiveness and safety of vaccination increases the probability of receiving a vaccination during the past five years by 26 percentage points (pp), medium knowledge increases it by 15 pp. Focusing on the specific case of the flu, official recommendations increase this probability by, on average, 6 pp; while having to pay out-of-pocket for a recommended vaccination decreases it by, on average, 10 pp. Furthermore, the differences for no vaccination differ widely across welfare systems and television is the primary source for information about vaccination. Conclusions: Reported vaccination rates in Europe fall far below targets set by official recommendations. Increasing vaccination knowledge and offering vaccinations free of charge can help to increase vaccination rates. A specific focus should be put on reaching individuals with potential difficulties of access such as those living alone and unemployed.
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