Real-World Effectiveness of COVID-19 Vaccines Among Colombian Adults: A Retrospective, Population-Based Study of the ESPERANZA Cohort

34 Pages Posted: 22 Mar 2023

See all articles by Maylen Rojas-Botero

Maylen Rojas-Botero

Facultad Nacional de Salud Pública

Julián Alfredo Fernández Niño

Johns Hopkins Bloomberg School of Public Health

Leonardo Arregoces Castillo

Pontificia Universidad Javeriana

Andrés Felipe Palacios-Clavijo

Andres Felipe Palacios Clavijo

Mariana Pinto-Alvarez

Fundación Universitaria Sanitas; Ministry of Health and Social Protection

Fernando Ruiz-Gómez

Processum

Date Written: March 7, 2023

Abstract

Background: COVID-19 vaccines have been essential for reducing the impact of the pandemic, nevertheless, population-based data under real-life conditions are needed to compare their effectiveness in various contexts. The objective of this study was to estimate the effectiveness of vaccines in preventing hospitalization and death from COVID-19 in Colombia under real-life conditions among people aged 18 years and older, according to sex, age, confirmed history of COVID-19 and vaccination series, including the effects of boosters.

Methods: This investigation was an observational, retrospective, population-based study based on the Colombian cohort “Esperanza” (what means hop in Spanish). A total of 14,213,409 individuals aged 18 years and older were analyzed, who were matched in a 1:1 ratio of vaccinated to unvaccinated. The study groups consisted of unvaccinated individuals, those with a complete series (CS) and individuals with a CS plus booster. The vaccinated individuals received either homologous or heterologous vaccinations with Ad26.COV2-S, BNT162b2, ChAdOx1 nCoV-19, CoronaVac and mRNA-1273 vaccines. Follow-up was conducted between February 2021 and June 2022. Cox proportional hazards models were used, adjusted for potential confounders, to estimate the effectiveness of different vaccination series in preventing hospitalization and death.

Results: For adults aged 18 years and older, the overall effectiveness of the vaccines in preventing hospitalization was 82.7% (95% CI 82.1 - 83.2) for CS and 80.2% (95%CI 78.7 - 81.6) for CS + booster. The effectiveness in preventing death was 86.0% (95%CI 85.5 - 86.5) for CS and 83.1% (95%CI 81.5 - 84.5) for CS + booster. Effectiveness decreased with age. While all efficacies were high, CoronaVac offered significantly lower protection, although this improved with a booster.

Conclusions: Real-world evidence shows that the vaccines studied offer good protection for preventing hospitalization and death from COVID-19 among adults in Colombia. To control the pandemic, reduce the burden of disease and protect national health systems, mass vaccination should continue to be a strategic priority, especially in low- and middle-income countries.

Note:
Funding Information: The authors of this study were employees or contractors of the Ministry of Health and Social Protection of Colombia during the time this analysis was carried out. Therefore, the study was financed through payment for the researchers’ work time at the Ministry of Health.

Conflict of Interests: The authors of this article worked as officials or contractors at the Ministry of Health and Social Protection of Colombia during the time that this analysis was conducted. From 2020 to 2022, FR-G was the Minister of Health, LA-C and JA-FN were technical directors. These three investigators were also part of the advisory committee for the pandemic response and of the committee in charge of vaccine selection in Colombia. The other authors were part of the technical team that supported these committees. During the analysis phase, before August 2022, funding from the Ministry of Health was indirectly provided through salaries and payments made to the statistician and one epidemiologist on the project.

Ethical Approval: This investigation meets the scientific, technical, administrative and ethical considerations stipulated by existing regulations for research with human beings in Colombia. In accordance with 1993 resolution 8430, this study is classified as no risk since it exclusively uses secondary data sources. None of the study researchers accessed the databases that contained the original personal identifiers, they used only anonymized databases. All standards for handling information were followed. Given these factors, this study did not require review or approval by a research ethics committee. The Ministry of Health and Social Protection is regulated by national legislation on information management, habeas data laws, and institutional manuals on best practices. All information sources were directly managed by the Ministry of Health, and the databases were anonymized, joined and made available for use by this study by independent technicians who linked the sources using their own encrypted key code, without using the original personal citizen identification. Therefore, it was not possible for researchers or external agents to recover the original identity numbers or personal data.

Keywords: COVID-19 Vaccines, Effectiveness, cohort studies, COVID-19, SARS-CoV-2, Colombia. ated]

JEL Classification: I10

Suggested Citation

Rojas Botero, Maylen and Fernández Niño, Julián Alfredo and Arregoces Castillo, Leonardo and Palacios-Clavijo, Andrés Felipe and Pinto-Alvarez, Mariana and Ruiz-Gómez, Fernando, Real-World Effectiveness of COVID-19 Vaccines Among Colombian Adults: A Retrospective, Population-Based Study of the ESPERANZA Cohort (March 7, 2023). Available at SSRN: https://ssrn.com/abstract=4381545 or http://dx.doi.org/10.2139/ssrn.4381545

Maylen Rojas Botero

Facultad Nacional de Salud Pública ( email )

Cl. 62 #52-59
Medellín, Antioquia 50010
Colombia

HOME PAGE: http://saludpublica.udea.edu.co/

Julián Alfredo Fernández Niño (Contact Author)

Johns Hopkins Bloomberg School of Public Health ( email )

Wolfe Street
Baltimore, MD 21205
United States

Leonardo Arregoces Castillo

Pontificia Universidad Javeriana ( email )

Calle 40 # 6-23
Bogota, CO 110231
Colombia

Andrés Felipe Palacios-Clavijo

Andres Felipe Palacios Clavijo ( email )

573152783103 (Phone)

Mariana Pinto-Alvarez

Fundación Universitaria Sanitas ( email )

Calle 170 # 8-41
Bogotá DC
Colombia

Ministry of Health and Social Protection ( email )

Colombia

Fernando Ruiz-Gómez

Processum ( email )

Avenida Carrera 19, No 114-09
Bogotá, Bogotá 110110
Colombia

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