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Vaccine Effectiveness of BNT162b2 and CoronaVac against SARS-CoV-2 Omicron BA.2 in CKD
Franco Wing Tak Cheng1, Vincent Ka Chun Yan1, Eric Yuk Fai Wan1,2,3
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Insights
COVID-19 vaccines, including BNT162b2 and CoronaVac, significantly reduced infection, hospitalization, and mortality risks in patients with chronic kidney disease (CKD). Three doses showed strong effectiveness, with even one dose preventing all-cause mortality in this high-risk group.
Area of Science:
- Epidemiology
- Vaccinology
- Nephrology
Background:
- The COVID-19 pandemic disproportionately affects individuals with chronic kidney disease (CKD), increasing their risk of severe outcomes.
- Existing data on COVID-19 vaccine effectiveness in CKD patients are limited, particularly for non-dialysis populations.
Purpose of the Study:
- To evaluate the effectiveness of BNT162b2 and CoronaVac vaccines in preventing COVID-19 infection, hospitalization, and mortality among adults with CKD.
- To assess the impact of vaccine dosage on effectiveness within the CKD population.
Main Methods:
- A case-control study utilized electronic health records from Hong Kong, matching COVID-19 PCR-confirmed cases with unvaccinated controls.
- Conditional logistic regression analysis adjusted for comorbidities and medication history.
- Vaccine effectiveness was estimated for BNT162b2 and CoronaVac against infection, hospitalization, and all-cause mortality.
Main Results:
- Three doses of BNT162b2 and CoronaVac significantly reduced infection risk (64% and 42%, respectively), hospitalization (82% and 80%), and mortality (94% and 93%).
- Vaccine effectiveness against infection and hospitalization was lower in CKD subgroups with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m².
- However, even a single vaccine dose was effective in preventing all-cause mortality across all CKD severity levels.
Conclusions:
- A dose-response relationship exists for BNT162b2 and CoronaVac effectiveness against COVID-19 infection and related comorbidities in CKD patients.
- COVID-19 vaccination is crucial for reducing severe outcomes in individuals with chronic kidney disease.
Background:
The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed increased risks of hospitalization and mortality in patients with underlying CKD. Current data on vaccine effectiveness of COVID-19 vaccines are limited to patients with CKD on dialysis and seroconversion in the non-dialysis population.
Methods:
A case-control study was conducted of adults with CKD using data extracted from the electronic health record database in Hong Kong. Adults with CKD and COVID-19 confirmed by PCR were included in the study. Each case was matched with up to ten controls attending Hospital Authority services without a diagnosis of COVID-19 on the basis of age, sex, and index date (within three calendar days). The vaccine effectiveness of BNT162b2 and CoronaVac in preventing COVID-19 infection, hospitalizations, and all-cause mortality was estimated using conditional logistic regression adjusted by patients' comorbidities and medication history during the outbreak from January to March 2022.
Results:
A total of 20,570 COVID-19 cases, 6604 COVID-19-related hospitalizations, and 2267 all-cause mortality were matched to 81,092, 62,803, and 21,348 controls, respectively. Compared with the unvaccinated group, three doses of BNT162b2 or CoronaVac were associated with a reduced risk of infection (BNT162b2: 64% [95% confidence interval (CI), 60 to 67], CoronaVac: 42% [95% CI, 38 to 47]), hospitalization (BNT162b2: 82% [95% CI, 77 to 85], CoronaVac: 80% [95% CI, 76 to 84]), and mortality (BNT162b2: 94% [95% CI, 88 to 97], CoronaVac: 93% [95% CI, 88 to 96]). Vaccines were less effective in preventing infection and hospitalization in the eGFR <15 and 15-29 ml/min per 1.73 m 2 subgroups as compared with higher GFR subgroups. However, receipt of vaccine, even for one dose, was effective in preventing all-cause mortality, with estimates similar to the higher eGFR subgroups, as compared with unvaccinated.
Conclusions:
A dose-response relationship was observed between the number of BNT162b2 or CoronaVac doses and the effectiveness against COVID-19 infection and related comorbidity in the CKD population.
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