Effectiveness of COVID-19 vaccines on hospitalization and death in Guilan, Iran: a test-negative case-control study

Abtin Heidarzadeh; Mohammadreza Amini Moridani; Saman Khoshmanesh; Samira Kazemi; Marziyeh Hajiaghabozorgi; Manoochehr Karami

doi:10.1016/j.ijid.2022.12.024

Effectiveness of COVID-19 vaccines on hospitalization and death in Guilan, Iran: a test-negative case-control study

Int J Infect Dis. 2023 Mar:128:212-222. doi: 10.1016/j.ijid.2022.12.024. Epub 2022 Dec 24.

Authors

Abtin Heidarzadeh¹, Mohammadreza Amini Moridani², Saman Khoshmanesh³, Samira Kazemi⁴, Marziyeh Hajiaghabozorgi⁵, Manoochehr Karami⁶

Affiliations

¹ Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: abtinh@gmail.com.
² Deputy of Health, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: Mohammad.amini@gums.ac.ir.
³ Deputy of Health, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: khoshmaneshsaman@gmail.com.
⁴ Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. Electronic address: kazemisamira75@gmail.com.
⁵ Deputy of Health, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: Bozorgi_arezoo@yahoo.com.
⁶ School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: Man.karami@yahoo.com.

Abstract

Objectives: The present study was conducted to estimate the effectiveness of (BBIBP)-CorV (Sinopharm), ChAdOx1-S/nCoV-19 (AZD1222, Oxford-AstraZeneca), rAd26-rAd5 (Gam-COVID-Vac, Sputnik V), and BIV1-CovIran (COVIran Barekat) and BBV152 COVAXIN (Bharat Biotech) vaccines against hospitalization and death of COVID-19 in Guilan Province of Iran from May 22 to December 21, 2021.

Methods: This test-negative case-control study was conducted on the population aged 5 years and above by extracting information from local databases (The Medical Care Monitoring Center and The Integrated Health System). A logistic regression analysis was performed to estimate the effectiveness of the vaccines against COVID-19 hospitalization and death.

Results: The total study population was 42,084, including 19,500 cases (with a positive Reverse Transcriptase-Polymerase Chain Reaction test admitted to hospitals in Guilan Province) and 22,586 controls (with a negative Reverse Transcriptase-Polymerase Chain Reaction test). Among the admitted patients, 1887 deaths occurred. The maximum effectiveness of BBIBP-CorV (Sinopharm) in preventing temporary hospitalization and regular hospitalization was observed 151 days after receiving the second dose, 95% (95% CI: 67-99.4%) and 85% (95% CI: 77-91%) respectively. The maximum effectiveness of the BBIBP-CorV (Sinopharm) vaccine 91-120 days after receiving the second dose against death was showed 56% (95% CI: 33-71%). The maximum effectiveness of ChAdOx1-S/nCoV-19 (AZD1222, Oxford-AstraZeneca) and BIV1-CovIran (COVIran Barekat) in preventing regular hospitalization and death was observed 121-150 and 61-90 days (respectively) after receiving the second dose, reaching 98% (95% CI: 94-99%) and 92% (95% CI: 48-99%), respectively for ChAdOx1-S/nCoV-19 and 95% (95% CI: 91-97%) and 89% (95% CI: 55-98%) respectively, for BIV1-CovIran.

Conclusion: For almost all vaccines, the study observed an increase in effectiveness against hospitalization and death over time.

Keywords: COVID-19; Effectiveness; Pandemic; Vaccine.

MeSH terms

COVID-19 Vaccines* / therapeutic use
COVID-19* / mortality
COVID-19* / prevention & control
Case-Control Studies
ChAdOx1 nCoV-19
Hospitalization* / statistics & numerical data
Humans
Iran / epidemiology
RNA-Directed DNA Polymerase
SARS-CoV-2

Substances

BBV152 COVID-19 vaccine
BIBP COVID-19 vaccine
ChAdOx1 nCoV-19
COVID-19 Vaccines
RNA-Directed DNA Polymerase