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Effectiveness of ChAdOx1 vaccine in older adults during SARS-CoV-2 Gamma variant circulation in São Paulo

Author

Listed:
  • Matt D. T. Hitchings

    (University of Florida)

  • Otavio T. Ranzani

    (Barcelona Institute for Global Health, ISGlobal
    Universidade de São Paulo)

  • Murilo Dorion

    (Yale School of Public Health)

  • Tatiana Lang D’Agostini

    (Disease Control Coordination of the São Paulo State Department of Health)

  • Regiane Cardoso de Paula

    (Disease Control Coordination of the São Paulo State Department of Health)

  • Olivia Ferreira Pereira de Paula

    (Disease Control Coordination of the São Paulo State Department of Health)

  • Edlaine Faria de Moura Villela

    (Disease Control Coordination of the São Paulo State Department of Health)

  • Mario Sergio Scaramuzzini Torres

    (Municipal Health Secretary of Manaus)

  • Silvano Barbosa de Oliveira

    (Pan American Health Organization
    Universidade de Brasília)

  • Wade Schulz

    (Yale University School of Medicine)

  • Maria Almiron

    (Pan American Health Organization)

  • Rodrigo Said

    (Pan American Health Organization)

  • Roberto Dias de Oliveira

    (State University of Mato Grosso do Sul - UEMS)

  • Patricia Vieira Silva

    (Universidade Federal de Mato Grosso do Sul - UFMS)

  • Wildo Navegantes de Araújo

    (Pan American Health Organization
    Universidade de Brasília
    National Institute for Science and Technology for Health Technology Assessment)

  • Jean Carlo Gorinchteyn

    (Health Secretariat of the State of São Paulo)

  • Jason R. Andrews

    (Stanford University)

  • Derek A. T. Cummings

    (University of Florida
    University of Florida)

  • Albert I. Ko

    (Yale School of Public Health
    Instituto Gonçalo Moniz, Fundação Oswaldo Cruz)

  • Julio Croda

    (Yale School of Public Health
    Universidade Federal de Mato Grosso do Sul - UFMS
    Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz)

Abstract

A two-dose regimen of the Oxford-AstraZeneca (ChAdOx1) Covid-19 vaccine with an inter-dose interval of three months has been implemented in many countries with restricted vaccine supply. However, there is limited evidence for the effectiveness of ChAdOx1 by dose in elderly populations in countries with high prevalence of the Gamma variant of SARS-CoV-2. Here, we estimate ChAdOx1 effectiveness by dose against the primary endpoint of RT-PCR-confirmed Covid-19, and secondary endpoints of Covid-19 hospitalization and Covid-19-related death, in adults aged ≥60 years during an epidemic with high Gamma variant prevalence in São Paulo state, Brazil using a matched, test-negative case-control study. Starting 28 days after the first dose, effectiveness of a single dose of ChAdOx1 is 33.4% (95% CI, 26.4–39.7) against Covid-19, 55.1% (95% CI, 46.6–62.2) against hospitalization, and 61.8% (95% CI, 48.9–71.4) against death. Starting 14 days after the second dose, effectiveness of the two-dose schedule is 77.9% (95% CI, 69.2–84.2) against Covid-19, 87.6% (95% CI, 78.2–92.9) against hospitalization, and 93.6% (95% CI, 81.9–97.7) against death. Completion of the ChAdOx1 vaccine schedule affords significantly increased protection over a single dose against mild and severe Covid-19 outcomes in elderly individuals during widespread Gamma variant circulation.

Suggested Citation

  • Matt D. T. Hitchings & Otavio T. Ranzani & Murilo Dorion & Tatiana Lang D’Agostini & Regiane Cardoso de Paula & Olivia Ferreira Pereira de Paula & Edlaine Faria de Moura Villela & Mario Sergio Scaramu, 2021. "Effectiveness of ChAdOx1 vaccine in older adults during SARS-CoV-2 Gamma variant circulation in São Paulo," Nature Communications, Nature, vol. 12(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-26459-6
    DOI: 10.1038/s41467-021-26459-6
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    References listed on IDEAS

    as
    1. Laura Matrajt & Julia Eaton & Tiffany Leung & Dobromir Dimitrov & Joshua T. Schiffer & David A. Swan & Holly Janes, 2021. "Optimizing vaccine allocation for COVID-19 vaccines shows the potential role of single-dose vaccination," Nature Communications, Nature, vol. 12(1), pages 1-18, December.
    2. Dami A. Collier & Isabella A. T. M. Ferreira & Prasanti Kotagiri & Rawlings P. Datir & Eleanor Y. Lim & Emma Touizer & Bo Meng & Adam Abdullahi & Anne Elmer & Nathalie Kingston & Barbara Graves & Emma, 2021. "Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2," Nature, Nature, vol. 596(7872), pages 417-422, August.
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