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. 2021 Nov 24;9(12):1381.
doi: 10.3390/vaccines9121381.

PICK-ing Malaysia's Epidemic Apart: Effectiveness of a Diverse COVID-19 Vaccine Portfolio

Jing Lian Suah  1 , Peter Seah Keng Tok  2 , Su Miin Ong  2 , Masliyana Husin  2 , Boon Hwa Tng  1 , Sheamini Sivasampu  2 , Thevesh Thevananthan  1 , Maheshwara Rao Appannan  3 , Faizah Muhamad Zin  4 , Shahanizan Mohd Zin  4 , Hazlina Yahaya  3 , Norhayati Rusli  3 , Mohd Fikri Ujang  4 , Hishamshah Mohd Ibrahim  5 , Noor Hisham Abdullah  5 , Kalaiarasu M Peariasamy  2
Affiliations

PICK-ing Malaysia's Epidemic Apart: Effectiveness of a Diverse COVID-19 Vaccine Portfolio

Jing Lian Suah et al. Vaccines (Basel). .

Abstract

Malaysia rolled out a diverse portfolio of predominantly three COVID-19 vaccines (AZD1222, BNT162b2, and CoronaVac) beginning 24 February 2021. We evaluated vaccine effectiveness with two methods, covering 1 April to 15 September 2021: (1) the screening method for COVID-19 (SARS-CoV-2) infection and symptomatic COVID-19; and (2) a retrospective cohort of confirmed COVID-19 cases for COVID-19 related ICU admission and death using logistic regression. The screening method estimated partial vaccination to be 48.8% effective (95% CI: 46.8, 50.7) against COVID-19 infection and 33.5% effective (95% CI: 31.6, 35.5) against symptomatic COVID-19. Full vaccination is estimated at 87.8% effective (95% CI: 85.8, 89.7) against COVID-19 infection and 85.4% effective (95% CI: 83.4, 87.3) against symptomatic COVID-19. Among the cohort of confirmed COVID-19 cases, partial vaccination with any of the three vaccines is estimated at 31.3% effective (95% CI: 28.5, 34.1) in preventing ICU admission, and 45.1% effective (95% CI: 42.6, 47.5) in preventing death. Full vaccination with any of the three vaccines is estimated at 79.1% effective (95% CI: 77.7, 80.4) in preventing ICU admission and 86.7% effective (95% CI: 85.7, 87.6) in preventing deaths. Our findings suggest that full vaccination with any of the three predominant vaccines (AZD1222, BNT162b2, and CoronaVac) in Malaysia has been highly effective in preventing COVID-19 infection, symptomatic COVID-19, COVID-19-related ICU admission, and death.

Keywords: COVID-19; COVID-19 vaccines; Malaysia; SARS-CoV-2; cohort study; vaccine effectiveness.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure A1
Figure A1
COVID-19 vaccine coverage, daily new confirmed COVID-19 cases, and the OxCGRT Stringency Index in Malaysia from 1 April 2021 to 15 September 2021. (a) Partially vaccinated; (b) fully vaccinated.
Figure A2
Figure A2
Robustness check for the overall effectiveness of partial and full vaccination by vaccine type over the study period, with line plots representing the effectiveness for COVID-19-related ICU admission estimated with data from 1 April 2021 up to the corresponding day on the horizontal axis; dotted lines show the 95% confidence interval. (a) Effectiveness of partial vaccination against ICU admission for AZD1222; (b) Effectiveness of full vaccination against ICU admission for AZD1222; (c) Effectiveness of partial vaccination against ICU admission for BNT162b2; (d) Effectiveness of full vaccination against ICU admission for BNT162b2; (e) Effectiveness of partial vaccination against ICU admission for CoronaVac; (f) Effectiveness of full vaccination against ICU admission for CoronaVac.
Figure A3
Figure A3
Robustness check for the overall effectiveness of partial and full vaccination by vaccine type over the study period, with line plots representing the effectiveness for COVID-19-related death estimated with data from 1 April 2021 up to the corresponding day on the horizontal axis; dotted lines show the 95% confidence interval. (a) Effectiveness of partial vaccination against death for AZD1222; (b) Effectiveness of full vaccination against death for AZD1222; (c) Effectiveness of partial vaccination against death for BNT162b2; (d) Effectiveness of full vaccination against death for BNT162b2; (e) Effectiveness of partial vaccination against death for CoronaVac; (f) Effectiveness of full vaccination against death for CoronaVac.
Figure 1
Figure 1
Study participants and cohort eligibility. Cohort participants were all confirmed SARS-CoV-2 cases in Malaysia from 1 April 2021 to 15 September 2021, aged 18 years or older. All participants either had not received any (unvaccinated) or at least one dose of the AZD1222, BNT162b2, or CoronaVac vaccines. Individuals who received any vaccines other than the ones specified above were excluded from the cohort.
Figure 2
Figure 2
Robustness check for overall effectiveness of partial and full vaccination over the study period, with line plots representing the effectiveness for COVID-19-related ICU admission and death estimated with data from 1 April 2021 up to the corresponding day on the horizontal axis; dotted lines show the 95% confidence interval. (a) Effectiveness of partial vaccination against ICU admission; (b) Effectiveness of full vaccination against ICU admission; (c) Effectiveness of partial vaccination against death; (d) Effectiveness of full vaccination against death.
Figure 2
Figure 2
Robustness check for overall effectiveness of partial and full vaccination over the study period, with line plots representing the effectiveness for COVID-19-related ICU admission and death estimated with data from 1 April 2021 up to the corresponding day on the horizontal axis; dotted lines show the 95% confidence interval. (a) Effectiveness of partial vaccination against ICU admission; (b) Effectiveness of full vaccination against ICU admission; (c) Effectiveness of partial vaccination against death; (d) Effectiveness of full vaccination against death.
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