TY - JOUR
T1 - The added effect of non-pharmaceutical interventions and lifestyle behaviors on vaccine effectiveness against severe COVID-19 in Chile
T2 - A matched case-double control study
AU - Urquidi, Cinthya
AU - Santelices, Emilio
AU - Lagomarcino, Anne J.
AU - Teresa Valenzuela, María
AU - Larrañaga, Nicolás
AU - Gonzalez, Emilio
AU - Pavez, Axel
AU - Wosiack, Amanda
AU - Maturana, Marcela
AU - Moller, Paulina
AU - Pablo Torres, Juan
AU - Muñoz, Sergio
AU - O'Ryan G, Miguel
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023
Y1 - 2023
N2 - Background: World Health Organization approved vaccines have demonstrated relatively high protection against moderate to severe COVID-19. Prospective vaccine effectiveness (VE) designs with first-hand data and population-based controls are nevertheless rare. Neighborhood compared to hospitalized controls, may differ in compliance to non-pharmacuetical interventions (NPI) compliance, which may influence VE results in real-world settings. We aimed to determine VE against COVID-19 intensive-care-unit (ICU) admission using hospital and community-matched controls in a prospective design. Methods: We conducted a multicenter, observational study of matched cases and controls (1:3) in adults ≧18 years of age from May to July 2021. For each case, a hospital control and two community controls were matched by age, gender, and hospital admission date or neighborhood of residence. Conditional logistic regression models were built, including interaction terms between NPIs, lifestyle behaviors, and vaccination status; the model's β coefficients represent the added effect these terms had on COVID-19 VE. Results: Cases and controls differed in several factors including education level, obesity prevalence, and behaviors such as compliance with routine vaccinations, use of facemasks, and routine handwashing. VE was 98·2% for full primary vaccination and 85·6% for partial vaccination when compared to community controls, and somewhat lower, albeit not significantly, compared to hospital controls. A significant added effect to vaccination in reducing COVID-19 ICU admission was regular facemask use and VE was higher among individuals non-compliant with the national vaccine program, and/or tonroutine medical visits during the prior year. Conclusion: VE against COVID-19 ICU admission in this stringent prospective case-double control study reached 98% two weeks after full primary vaccination, confirming the high effectiveness provided by earlier studies. Face mask use and hand washing were independent protective factors, the former adding additional benefit to VE. VE was significantly higher in subjects with increased risk behaviors.
AB - Background: World Health Organization approved vaccines have demonstrated relatively high protection against moderate to severe COVID-19. Prospective vaccine effectiveness (VE) designs with first-hand data and population-based controls are nevertheless rare. Neighborhood compared to hospitalized controls, may differ in compliance to non-pharmacuetical interventions (NPI) compliance, which may influence VE results in real-world settings. We aimed to determine VE against COVID-19 intensive-care-unit (ICU) admission using hospital and community-matched controls in a prospective design. Methods: We conducted a multicenter, observational study of matched cases and controls (1:3) in adults ≧18 years of age from May to July 2021. For each case, a hospital control and two community controls were matched by age, gender, and hospital admission date or neighborhood of residence. Conditional logistic regression models were built, including interaction terms between NPIs, lifestyle behaviors, and vaccination status; the model's β coefficients represent the added effect these terms had on COVID-19 VE. Results: Cases and controls differed in several factors including education level, obesity prevalence, and behaviors such as compliance with routine vaccinations, use of facemasks, and routine handwashing. VE was 98·2% for full primary vaccination and 85·6% for partial vaccination when compared to community controls, and somewhat lower, albeit not significantly, compared to hospital controls. A significant added effect to vaccination in reducing COVID-19 ICU admission was regular facemask use and VE was higher among individuals non-compliant with the national vaccine program, and/or tonroutine medical visits during the prior year. Conclusion: VE against COVID-19 ICU admission in this stringent prospective case-double control study reached 98% two weeks after full primary vaccination, confirming the high effectiveness provided by earlier studies. Face mask use and hand washing were independent protective factors, the former adding additional benefit to VE. VE was significantly higher in subjects with increased risk behaviors.
KW - COVID-19
KW - Non-pharmacological intervention
KW - Risk factors
KW - SARS-Cov-2
KW - Vaccine effectiveness
UR - http://www.scopus.com/inward/record.url?scp=85151754841&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/d84c4fd2-aa7e-3886-8e01-ea900f58d8d8/
U2 - 10.1016/j.vaccine.2023.03.060
DO - 10.1016/j.vaccine.2023.03.060
M3 - Article
AN - SCOPUS:85151754841
SN - 0264-410X
VL - 41
SP - 2947
EP - 2955
JO - Vaccine
JF - Vaccine
IS - 18
ER -