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. 2022 Mar 26;399(10331):1254-1264.
doi: 10.1016/S0140-6736(22)00011-3. Epub 2022 Mar 15.

Effectiveness of rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines for risk of infection with SARS-CoV-2 and death due to COVID-19 in people older than 60 years in Argentina: a test-negative, case-control, and retrospective longitudinal study

Analía Rearte  1 , Juan Manuel Castelli  2 , Ramiro Rearte  3 , Nora Fuentes  4 , Velen Pennini  2 , Martina Pesce  2 , Pilar Barcena Barbeira  2 , Luciana Eva Iummato  2 , Melisa Laurora  2 , María Lucía Bartolomeu  2 , Guido Galligani  2 , María Del Valle Juarez  2 , Carlos María Giovacchini  2 , Adrián Santoro  2 , Mariano Esperatti  4 , Sonia Tarragona  2 , Carla Vizzotti  2
Affiliations

Effectiveness of rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines for risk of infection with SARS-CoV-2 and death due to COVID-19 in people older than 60 years in Argentina: a test-negative, case-control, and retrospective longitudinal study

Analía Rearte et al. Lancet. .

Erratum in

  • Department of Error.
    [No authors listed] [No authors listed] Lancet. 2022 Jun 11;399(10342):2190. doi: 10.1016/S0140-6736(22)00784-X. Lancet. 2022. PMID: 35691321 Free PMC article. No abstract available.

Abstract

Background: In January, 2021, a vaccination campaign against COVID-19 was initiated with the rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines in Argentina. The objective of this study was to estimate vaccine effectiveness at reducing risk of SARS-CoV-2 infection and COVID-19 deaths in people older than 60 years.

Methods: In this test-negative, case-control, and retrospective longitudinal study done in Argentina, we evaluated the effectiveness of three vaccines (rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV) on SARS-CoV-2 infection and risk of death in people with RT-PCR confirmed COVID-19, using data from the National Surveillance System (SNVS 2.0). All individuals aged 60 years or older reported to SNVS 2.0 as being suspected to have COVID-19 who had disease status confirmed with RT-PCR were included in the study. Unvaccinated individuals could participate in any of the analyses. People with suspected COVID-19 who developed symptoms before the start of the implementation of the vaccination programme for their age group or district were excluded from the study. The odds ratio of SARS-CoV-2 infection was evaluated by logistic regression and the risk of death in individuals with RT-PCR confirmed COVID-19 was evaluated by proportional hazard regression models, adjusted for possible confounders: age at the time of the symptom onset date, sex, district of residence, epidemiological week corresponding to the symptom onset date, and history of COVID-19. The estimation of vaccine effectiveness to prevent death due to COVID-19 was done indirectly by combining infection and death estimates. In addition, we evaluated the effect of the first dose of viral vector vaccines across time.

Findings: From Jan 31, to Sept 14, 2021, 1 282 928 individuals were included, of whom 687 167 (53·6%) were in the rAd26-rAd5 analysis, 358 431 (27·6%) in the ChAdOx1 nCoV-19 analysis, and 237 330 (18·5%) in the BBIBP-CorV analysis. Vaccine effectiveness after two doses was high for all three vaccines, adjusted odds ratio 0·36 (95% CI 0·35-0·37) for rAd26-rAd5, 0·32 (0·31-0·33) for ChAdOx1 nCoV-19, and 0·56 (0·55-0·58) for BBIBP-CorV. After two doses, the effect on deaths was higher than that on risk of infection: adjusted hazard ratio 0·19 (95% CI 0·18-0·21) for rAd26-rAd5, 0·20 (0·18-0·22) for ChAdOx1 nCoV-19, and 0·27 (0·25-0·29) for BBIBP-CorV. The indirectly estimated effectiveness on deaths was 93·1% (95% CI 92·6-93·5) for rAd26-rAd5, 93·7% (93·2-94·3) for ChAdOx1 nCoV-19, and 85·0% (84·0-86·0) for BBIBP-CorV following two doses. First dose effect of viral vector vaccines remained stable over time.

Interpretation: The vaccines used in Argentina showed effectiveness in reducing infection and death by SARS-CoV-2 and COVID-19.

Funding: None.

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Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

Figure 1
Figure 1
Characteristics of the COVID-19 pandemic and vaccine response in Argentina (A) Incident cases and number of deaths from COVID-19. (B) Circulating SARS-CoV-2 variants. (C) Vaccination coverage by age group.
Figure 2
Figure 2
Study profile (A) Individuals included in the analysis of rAd26-rAd5. (B) Individuals included in the analysis of ChAdOx1 nCoV-19. (C) Individuals included in the analysis of BBIBP-CorV.
Figure 3
Figure 3
Effect of the rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines on the risk of SARS-CoV-2 infection and on the risk of death (A) Effect of the vaccines on risk of infection. (B) Effect of the vaccines on risk of death in cases. Overall ORs were adjusted for epidemiological week, sex, history of COVID-19, and district. Overall HRs were adjusted for epidemiological week, sex, history of COVID-19 and district. Error bars are 95% CIs. HR=hazard ratio. OR=odds ratio. *Adjusted for vaccination status, age group interaction, epidemiological week, sex, history of COVID-19, and district. † Adjusted for vaccination status, age group interaction, epidemiological week, sex, history of COVID-19, and district.
Figure 4
Figure 4
Effectiveness of the rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines to prevent death due to COVID-19 Error bars are 95% CIs. *Adjusted for the vaccination status, age group interaction, epidemiological week, sex, history of COVID-19, and district.
Figure 5
Figure 5
Risk of SARS-CoV-2 infection, deaths due to COVID-19, and vaccine effectiveness over time for the rAd26-rAd5 and ChAdOx1 nCoV-19 vaccines (A) Risk of SARS-CoV-2 infection between the first dose and the symptom onset date. (B) Risk of death due to COVID-19 in cases as a function of the time elapsed between the first dose and the symptom onset date. (C) Effectiveness in preventing death by COVID-19 as a function of the time elapsed between the first dose and the symptom onset date. Error bars are 95% CIs.
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Comment in

  • Evaluating COVID-19 vaccines in the real world.
    Mills EJ, Reis G. Mills EJ, et al. Lancet. 2022 Mar 26;399(10331):1205-1206. doi: 10.1016/S0140-6736(22)00194-5. Epub 2022 Mar 15. Lancet. 2022. PMID: 35303472 Free PMC article. No abstract available.

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