Vaccine coverage and effectiveness against laboratory-confirmed symptomatic and severe Covid-19 in indigenous people in Brazil: a cohort study

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  • dc.contributor.author Pescarini, Julia M.
  • dc.contributor.author Cardoso, Andrey M.
  • dc.contributor.author Ventura Santos, Ricardo
  • dc.contributor.author Scaff, Priscila F.
  • dc.contributor.author Paixao, Enny S.
  • dc.contributor.author Ranzani, Otavio
  • dc.contributor.author Cerqueira Silva, Thiago
  • dc.contributor.author Boaventura, Viviane S.
  • dc.contributor.author Bertoldo Junior, Juracy
  • dc.contributor.author Oliveira, Vinicius A. de
  • dc.contributor.author Werneck, Guilherme L.
  • dc.contributor.author Barreto, Mauricio L.
  • dc.contributor.author Barral Netto, Manoel
  • dc.date.accessioned 2023-11-07T07:28:05Z
  • dc.date.available 2023-11-07T07:28:05Z
  • dc.date.issued 2023
  • dc.description.abstract Background: Indigenous people have historically suffered devastating impacts from epidemics and continue to have lower access to healthcare and be especially vulnerable to respiratory infections. We estimated the coverage and effectiveness of Covid-19 vaccines against laboratory-confirmed Covid-19 cases among indigenous people in Brazil. Methods: We linked nationwide Covid-19 vaccination data with flu-like surveillance records and studied a cohort of vaccinated indigenous people aged ≥ 5 years between 18th January 2021 and 1st March 2022. We considered individuals unexposed from the date they received the first dose of vaccine until the 13th day of vaccination, partially vaccinated from the 14th day after the first dose until the 13th day after receiving the second dose, and fully vaccinated onwards. We estimated the Covid-19 vaccination coverage and used Poisson regression to calculate the relative risks (RR) and vaccine effectiveness (VE) of CoronaVac, ChAdOx1, and BNT162b2 against Covid-19 laboratory-confirmed cases incidence, mortality, hospitalisation, and hospital-progression to Intensive Care Unit (ICU) or death. VE was estimated as (1-RR)*100, comparing unexposed to partially or fully vaccinated. Results: By 1st March 2022, 48.7% (35.0-62.3) of eligible indigenous people vs. 74.8% (57.9-91.8) overall Brazilians had been fully vaccinated for Covid-19. Among fully vaccinated indigenous people, we found a lower risk of symptomatic cases (RR: 0.47, 95%CI: 0.40-0.56) and mortality (RR: 0.47, 95%CI: 0.14-1.56) after the 14th day of the second dose. VE for the three Covid-19 vaccines combined was 53% (95%CI:44-60%) for symptomatic cases, 53% (95%CI:-56-86%) for mortality and 41% (95%CI:-35-75%) for hospitalisation. In our sample, we found that vaccination did not reduce Covid-19 related hospitalisation. However, among hospitalised patients, we found a lower risk of progression to ICU (RR: 0.14, 95%CI: 0.02-0.81; VE: 87%, 95%CI:27-98%) and Covid-19 death (RR: 0.04, 95%CI:0.01-0.10; VE: 96%, 95%CI: 90-99%) after the 14th day of the second dose. Conclusions: Lower coverage but similar Covid-19 VE among indigenous people than overall Brazilians suggest the need to expand access, timely vaccination, and urgently offer booster doses to achieve a great level of protection among this group.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Pescarini JM, Cardoso AM, Santos RV, Scaff PF, Paixao ES, Ranzani OT, Cerqueira-Silva T, Boaventura VS, Bertoldo-Junior J, de Oliveira VA, Werneck GL, Barreto ML, Barral-Netto M. Vaccine coverage and effectiveness against laboratory-confirmed symptomatic and severe Covid-19 in indigenous people in Brazil: a cohort study. BMC Public Health. 2023 Jun 29;23(1):1267. DOI: 10.1186/s12889-023-16196-4
  • dc.identifier.doi http://dx.doi.org/10.1186/s12889-023-16196-4
  • dc.identifier.issn 1471-2458
  • dc.identifier.uri http://hdl.handle.net/10230/58217
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.relation.ispartof BMC Public Health. 2023 Jun 29;23(1):1267
  • dc.rights © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Brazil
  • dc.subject.keyword COVID-19
  • dc.subject.keyword Cohort study
  • dc.subject.keyword Indigenous peoples
  • dc.subject.keyword Vaccine coverage
  • dc.subject.keyword Vaccine effectiveness
  • dc.title Vaccine coverage and effectiveness against laboratory-confirmed symptomatic and severe Covid-19 in indigenous people in Brazil: a cohort study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion