Indirect Impact of COVID-19 Vaccination on Weekly Trends in Morbidity and Mortality Indicators in Brazil, 2020 to 2021

Abstract Background: With the outbreak of the COVID-19 pandemic, safe and efficacious vaccines were quickly developed and made available to reduce its morbidity and mortality. This study aimed to describe the trends and evaluate the association of COVID-19 vaccination with indicators of morbidity and mortality due to the disease in Brazil.Methods: This was an ecological study whose unit of analysis was the time elapsed between February 16th, 2020, from the introduction of COVID-19 in Brazil and July 17th, 2021, six months after the start of vaccination in the country. From secondary databases, indicators of morbidity and mortality (incidence of hospitalization, proportion of severe cases, lethality and mortality) and vaccine coverage (doses 1, 2 or single dose) per epidemiological week (EW) and age groups were calculated (18 to 59 years and 60 years or older). Indicators of morbimortality were compared in the pre-vaccination (EW 8/2020 to EW 2/2021) and vaccination (EW 3/2021 to EW 28/2021) periods, analyzing the trends estimated using the JointPoint model and their associations using the Poisson model.Results: For individuals aged 60 years and over, during the period of COVID-19 vaccination there was a weekly trend towards a reduction in the incidence of hospitalizations (PMSV: -4.7%), severity (PMSV: -0.3%, lethality (PMSV: -2.0%) and mortality (PMSV: -2.8%); the increase in COVID-19 vaccination coverage was inversely associated with the incidence of hospitalizations (IRR: 0.969), lethality (IRR: 0.993), and mortality (IRR: 0.981). For individuals aged 18 to 59 years of age, during the period of COVID-19 vaccination there was a weekly trend towards a reduction in the incidence of hospitalizations (PMSV: -2.6%) and lethality (PMSV: -2.0%), while there was an increase in mortality (PMSV: 3.8%); the increase in COVID-19 vaccination coverage was inversely associated with the incidence of hospitalizations (IRR: 0.975) and lethality (IRR: 0.939). Conversely, it was directly associated with mortality (IRR: 1.054).Conclusions: it was demonstrated that COVID-19 vaccination had an indirect impact in reducing the morbidity and mortality trend from the disease in Brazil, especially in the elderly population, in which vaccination was prioritized and achieved greater coverage, when compared to individuals aged 18 to 59 years.

Download Full-text

Estimating the early impact of immunization against COVID-19 on deaths among elderly people in Brazil: analyses of secondary data on vaccine coverage and mortality

10.1101/2021.04.27.21256187 ◽

2021 ◽

Author(s):

Cesar Victora ◽

Marcia C Castro ◽

Susie Gurzenda ◽

Aluisio J D Barros

Keyword(s):

Vaccination Coverage ◽

Health Workers ◽

Vaccine Coverage ◽

Age Groups ◽

Secondary Data ◽

The Elderly ◽

Mortality Rates ◽

Age Group ◽

Rate Ratios ◽

Two Age Groups

ABSTRACTBackgroundImmunization against COVID-19 in Brazil started in January 2021, with health workers and the elderly as the priority groups. We assessed whether there was an impact of immunizations on the mortality of individuals aged 80+ years.MethodsBy April 22, 2021, 147,454 COVID-19 deaths had been reported to the Brazilian Mortality Information System. Denominators for mortality rates were calculated by correcting population estimates for all-cause deaths reported in 2020. Proportionate mortality at ages 80+ and 90+ years relative to deaths at all ages were calculated, and mortality rate ratios compared these two age groups with individuals aged 0-79 years. Vaccine coverage data were obtained from the Ministry of Health vaccination monitoring website. All results were tabulated by two-week periods from epidemiological weeks 1-14, 2021.FindingsAs the P.1 variant spread throughout Brazil, the total number of deaths increased over time starting in epidemiological week 9 of 2021. The proportion of all deaths occurring at ages 80+ years was over 25% in weeks 1-6 and declined rapidly to 13.1% in weeks 13-14. Mortality rates were over 13 times higher in the 80+ years age group compared to that of 0-79 year olds up to week 6, and declined to 6.9 times in weeks 13-14. Coronavac accounted for 77.3% and AstraZeneca for 15.9% of all doses administered. Vaccination coverage (first dose) increased rapidly among individuals aged 80+ years, reaching 49.1% in weeks 5-6 and over 90% after week 9.InterpretationRapid scaling up of vaccination coverage among elderly Brazilians was associated with an important decline in relative mortality compared to younger individuals, in a setting where the P.1 variant predominates. Had mortality rates among the elderly remained proportionate to what was observed up to week 6, an estimated additional 13,824 deaths would have been expected up to week 14.

Download Full-text

Mathematical modeling of vaccination rollout and NPIs lifting on COVID-19 transmission with VOC: a case study in Toronto, Canada

10.1101/2021.08.11.21261932 ◽

2021 ◽

Author(s):

Elena Aruffo ◽

Pei Yuan ◽

Yi Tan ◽

Evgenia Gatov ◽

Iain Moyles ◽

...

Keyword(s):

Vaccination Coverage ◽

Age Groups ◽

Vaccination Strategy ◽

The Elderly ◽

Public Health Agencies ◽

Initial Strategy ◽

Working Age ◽

Waning Immunity ◽

Nonpharmaceutical Interventions ◽

The Impact

ABSTRACT Background: Since December 2020, public health agencies have implemented a variety of vaccination strategies to curb the spread of SARS-CoV-2, along with pre-existing Nonpharmaceutical Interventions (NPIs). Initial strategy focused on vaccinating the elderly to prevent hospitalizations and deaths. With vaccines becoming available to the broader population, we aimed to determine the optimal strategy to enable the safe lifting of NPIs while avoiding virus resurgence. Methods: We developed a compartmental deterministic SEIR model to simulate the lifting of NPIs under different vaccination rollout scenarios. Using case and vaccination data from Toronto, Canada between December 28, 2020 and May 19, 2021, we estimated transmission throughout past stages of NPI escalation/relaxation to compare the impact of lifting NPIs on different dates on cases, hospitalizations, and deaths, given varying degrees of vaccine coverages by 20-year age groups, accounting for waning immunity. Results: We found that, once coverage among the elderly is high enough (80% with at least one dose), the main age groups to target are 20-39 and 40-59 years, whereby first-dose coverage of at least 70% by mid-June 2021 is needed to minimize the possibility of resurgence if NPIs are to be lifted in the summer. While a resurgence was observed for every scenario of NPI lifting, we also found that under an optimistic vaccination coverage (70% by mid-June, postponing reopening from August 2021 to September 2021can reduce case counts and severe outcomes by roughly 80% by December 31, 2021. Conclusions: Our results suggest that focusing the vaccination strategy on the working-age population can curb the spread of SARS-CoV-2. However, even with high vaccination coverage in adults, lifting NPIs to pre-pandemic levels is not advisable since a resurgence is expected to occur, especially with earlier reopening.

Download Full-text

Influenza vaccination coverage rates in the general population and risk groups: A review of the current international situation

Postępy Higieny i Medycyny Doświadczalnej ◽

10.5604/01.3001.0012.8258 ◽

2018 ◽

Vol 72 ◽

pp. 1138-1147

Author(s):

Aneta Nitsch-Osuch ◽

Anna Jagielska ◽

Lidia B. Brydak

Keyword(s):

Health Care ◽

General Population ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Risk Groups ◽

The Elderly ◽

Current Data ◽

Health Care Facilities ◽

Coverage Rates

Although several national and international recommendations have been published, influenza vaccinations are carried out too rarely and thus vaccine coverage rates, both in the general population and in risk groups, remain at an unsatisfactorily low level. The paper presents the current data describing influenza vaccine coverage rates in different countries, in the general population and risk groups (including patients with chronic diseases, pregnant women, children the elderly) and health care workers. It is emphasized that there are many limitations related to the estimation of coverage rates. Methods that are currently used for the assessment of influenza vaccination coverage rates include the following: an analysis of data from health care facilities or providers, from national health insurance records, from well-documented national or private vaccine programs targeting at specific smaller groups, evaluation of national vaccine register, and national surveys of individuals. The establishment of coverage rates among specific groups usually requires another approach with the use of individual web- or telephone- based surveys, which is why selection bias and recall bias should be taken into consideration while discussing the results. The most common drivers and barriers for influenza vaccination are also identified and presented in the review.

Download Full-text

An Analytical Study on Anemia in Rural Population

Academia Journal of Medicine ◽

10.47008/ajm.2020.3.2.7 ◽

2020 ◽

Vol 3 (2) ◽

pp. 28-33

Author(s):

Shirish Ardhapuskar ◽

Raghu Rammulu

Keyword(s):

Age Groups ◽

The Elderly ◽

Medical Problem ◽

Morbidity And Mortality ◽

Common Symptom ◽

Age Group ◽

Expert Group ◽

Adult Males ◽

Medical College ◽

The Common

Background: Anemia is one of the common Hematological disorders in India and worldwide. It affects all the age groups both in Males and Females. Moderate to Severe Anemia causes increased morbidity and mortality in elderly patients (AWHO expert group) - According to Worlds Health Organization, Anemia is a define when adults males are having Hemoglobin less than 13.5gr% when adults females non-pregnant less than 12 gr% and when pregnant females are having less than 11 ger%. The incidence of Anemia is very high in old age people who are more than 75 years of age. It ranges from 9% to 41%. In India Anemia is commonly due to nutrition, pregnancy, Hookworm infestation, DUB in the case of females, and Malignancy. The prevalence of anemia in the elderly has been found to range from 9% to 42% with the highest prevalence in 80 years and above. The common causes of anemia in India are Nutritional, Pregnancy, Hookworm infestation, and DUB in the case of Females and Malignancy. The common symptom is General weakness, Fatigue, Lack of concentration, Shortness of Breath, and Palpitations. A WHO expert group proposed that anemia should be considered when hemoglobin level below 13.5gr& in adult males; 12gr% in adults females non-pregnant; 11 gr% in adult female pregnant; 12gr% in children over 14yrs(1). The aim is to evaluate the etiology and clinical features of anemia in adults in rural medical colleges. Subjects & Methods: This study is conducted at GEMS Medical College, Srikakulam, A.P for the period of 1 year from April 2018 to March 2019. This study includes 120 patients with Anemia. The age group is between 20 years and 70 years. Males were 56 and females were 64. Results: We have conducted this study at GEMS Medical College, Srikakulam for 1 year, from April 2019 to March 2019 total no. of patients included in this study are 120 males 56 and females 64. The age group is between 20 years and 70 years. The maximum patients are in between 30 years and 70 years in both sexes. Conclusion: Anemia is a common medical problem in developing countries. In a rural part of India, the disorders will complicate the pregnancy also. So periodical examination and education of the people can decrease morbidity and mortality. In our area still, the common cause is nutritional.

Download Full-text

M1745 Morbidity and Mortality of TIPS Placement in the Elderly Is No Different Than in Younger Age Groups

Gastroenterology ◽

10.1016/s0016-5085(08)61916-2 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-410

Author(s):

Neehar Parikh ◽

Andres T. Blei ◽

Steven L. Flamm

Keyword(s):

Age Groups ◽

The Elderly ◽

Morbidity And Mortality ◽

Younger Age

Download Full-text

P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.167 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ryan Suk ◽

Heetae Suk ◽

Keith Sigel ◽

Kalyani Sonawane ◽

Ashish Deshmukh

Keyword(s):

Vaccination Coverage ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Age Groups ◽

Population Level ◽

Vaccine Uptake ◽

Population Estimate ◽

Age Group ◽

Old Patients

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

Download Full-text

Assessing real-world vaccine effectiveness against severe forms of SARS-CoV-2 infection from routine surveillance data in Switzerland

10.31219/osf.io/rxk9b ◽

2021 ◽

Author(s):

Nanina Anderegg ◽

Christian L Althaus ◽

Samuel Colin ◽

Anthony Hauser ◽

Anne Laube ◽

...

Keyword(s):

Relative Risk ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Age Groups ◽

Vaccine Effectiveness ◽

Surveillance Data ◽

Age Group ◽

Routine Surveillance ◽

Vaccination Campaigns ◽

Over Time

Background. In Switzerland, SARS-CoV-2 vaccination campaigns started early 2021. Vaccine coverage reached 65% of the population in December 2021, mostly using mRNA vaccines from Moderna and Pfizer-BioNtech. Simultaneously, the proportion of vaccinated among COVID-19-related hospitalizations and deaths rose, creating some confusion in the general population. We aim to assess vaccine effectiveness against severe forms of SARS-CoV-2 infection using routine surveillance data on the vaccination status of COVID-19-related hospitalizations and deaths and data on vaccination coverage in Switzerland.Methods. We consider all routine surveillance data on COVID-19-related hospitalizations and deaths received at the Swiss Federal Office of Public Health from 1 July 2021 to 1 December 2021. We estimate the relative risk of COVID-19 related hospitalization or death for non-fully vaccinated compared to fully vaccinated individuals, adjusted for the dynamics of vaccination coverage over time, by age and location. We stratify the analysis by age group and by calendar month. We assess variations in the relative risk of hospitalization associated with the time since vaccination.Results. We include a total of 5,948 COVID-19-related hospitalizations of which 1,245 (21%) were fully vaccinated, and a total of 739 deaths of which 259 (35%) were fully vaccinated. We find that the relative risk of COVID-19 related hospitalization is 12.5 (95%CI: 11.7 to 13.4) times higher for non-fully vaccinated than for fully vaccinated individuals. This translates into a vaccine effectiveness against hospitalization of 92.0% (95%CI: 91.4 to 92.5%). Vaccine effectiveness against death is estimated to 90.3% (95%CI: 88.6 to 91.8%). Effectiveness appears comparatively lower in age groups over 70 and during the months of October and November 2021. We also find evidence of a decrease in vaccine effectiveness against hospitalization for individuals vaccinated for 25 weeks or more, but this decrease only appears in age groups below 70.Conclusions. The observed proportions of vaccinated among COVD-19-related hospitalizations and deaths in Switzerland are compatible with a high effectiveness of mRNA vaccines from Moderna and Pfizer-BioNtech against hospitalization and death in all age groups. Effectiveness appears comparatively lower in older age groups, suggesting the importance of booster vaccinations. We find inconclusive evidence that vaccine effectiveness is waning over time. Repeated analyses will be able to better assess waning and the effect of boosters.

Download Full-text

Estimation and Comparison of Immunization Coverage under Different Sampling Methods for Health Surveys

International Journal of Population Research ◽

10.1155/2014/850479 ◽

2014 ◽

Vol 2014 ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

D. C. Nath ◽

B. Patowari

Keyword(s):

Hepatitis B ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Age Groups ◽

Immunization Coverage ◽

Public Health Problem ◽

Hepatitis B Vaccine ◽

Systematic Sampling ◽

Cluster Sampling ◽

Major Public Health Problem

Immunization currently averts an estimated 2-3 million deaths every year in all age groups. Hepatitis B is a major public health problem worldwide. In this study, the estimates of hepatitis B vaccine coverage are compared among three sampling plans namely, 30×30 sampling and 30×7 sampling method under cluster sampling and systematic random sampling schemes. The data has been taken from the survey “Comparison of Two Survey Methodologies to Estimate Total Vaccination Coverage” sponsored by Indian Council of Medical Research, New Delhi. It is observed that the estimations of proportions of this vaccination coverage are significantly not different at 5% level of probability. Both 30×30 sampling and 30×7 sampling will be preferred to systematic sampling in estimation of hepatitis B vaccine coverage for this study population because of quick estimation and lesser cost. The 30×7 cluster sampling is the most recommended method for such immunization coverage especially in a developing country.

Download Full-text

Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130164 ◽

2013 ◽

Vol 71 (11) ◽

pp. 841-845 ◽

Cited By ~ 2

Author(s):

Gabriel Alcala-Cerra ◽

Adam M.H. Young ◽

Angel Paternina-Caicedo ◽

Eduardo Santamaria Carvalhal Ribas

Keyword(s):

Subarachnoid Hemorrhage ◽

Age Groups ◽

Poisson Model ◽

The Elderly ◽

Population Based ◽

Epidemiologic Transition ◽

Mortality Trend ◽

Population Based Study ◽

Younger Age ◽

Traumatic Subarachnoid Hemorrhage

Objective To assess trends in mortality from 1999 to 2008 resulting from non-traumatic subarachnoid hemorrhage (SAH) in the Colombian population. Method This population-based study analyzed all deaths by assuming a Poisson model. Results Subarachnoid hemorrhage-related deaths showed a statistically significant increase of 1.6% per year (p<0.001). The age-standardized analysis demonstrated an increased mortality trend of 3.3% per year (p<0.001) in people older than 70 years, but a decreased mortality trend in people younger than 50. It remained stable in patients 50-69 years old. Conclusion The overall SAH-related mortality rate in Colombia has increased because increased mortality among the elderly has been counterbalanced by reduced mortality rates in younger age groups. These disparities may reflect epidemiologic transition, treatment inequities, or a less favorable comorbid profile.

Download Full-text

Febre amarela: cobertura vacinal na região metropolitana de Belo Horizonte

Revista Remecs - Revista Multidisciplinar de Estudos Científicos em Saúde ◽

10.24281/rremecs2526-2874.2019.4.6.26-34 ◽

2019 ◽

Vol 4 (6) ◽

pp. 26

Author(s):

Juliana Araújo do Espírito Santo ◽

Keli Bahia Felicíssimo Zocratto

Keyword(s):

Yellow Fever ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Secondary Data ◽

The Elderly ◽

Descriptive Study ◽

Yellow Fever Vaccine ◽

National Immunization ◽

Belo Horizonte ◽

Yellow Fever Vaccination

Descrever a cobertura vacinal de febre amarela nos últimos cinco anos (2013 a 2017) nos municípios de Belo Horizonte, Nova Lima e Ribeirão das Neves. Estudo descritivo onde foram utilizados dados secundários coletados em sites oficiais relativos ao período de 2013 a 2017 para os municípios de Belo Horizonte, Nova Lima e Ribeirão das Neves. No período analisado, foram aplicadas 1.687.937 doses da vacina contra febre amarela, sendo que a cobertura vacinal em Belo Horizonte caiu de 80% para 0,09% no ano de 2014. Observou-se maior concentração de doses aplicadas na faixa etária de 15 a 59 anos. Em idosos as doses aplicadas aumentaram de 1.888 para 68.570 no ano de 2017. Ressalta-se que a vacinação aumentou consideravelmente após o início da epidemia em 2016. Considerando os anos analisados, os três municípios mantiveram a cobertura vacinal próxima da meta determinada pelo Programa Nacional de Imunização.Descritores: Febre Amarela, Vacinação, Epidemia.Yellow fever: vaccine coverage in the metropolitan area of Belo HorizonteAbstract: To describe the vaccination coverage of yellow fever in the last five years (2013 to 2017) in the municipalities of Belo Horizonte, Nova Lima and Ribeirão das Neves. A descriptive study using secondary data collected from official sites for the period from 2013 to 2017 for the municipalities of Belo Horizonte, Nova Lima and Ribeirão das Neves. In the analyzed period, 1,687,937 doses of the yellow fever vaccine were applied, and vaccination coverage in Belo Horizonte fell from 80% to 0.09% in 2014. There was a higher concentration of doses applied in the range from 15 to 59 years. In the elderly, the doses increased from 1,888 to 68,570 in the year 2017. It should be emphasized that vaccination increased considerably after the onset of the epidemic in 2016. Considering the years analyzed, the three municipalities-maintained vaccination coverage close to the goal determined by the National Immunization Program.Descriptors: Yellow Fever, Vaccination, Epidemic.Fiebre Amarilla: cobertura vacunal en la región metropolitana de Belo HorizonteResumen: Describir la cobertura vacunal de fiebre amarilla en los últimos cinco años (2013 a 2017) en los municipios de Belo Horizonte, Nova Lima y Ribeirão das Neves. Estudio descriptivo donde se utilizaron datos secundarios recogidos en sitios oficiales relativos al período de 2013 a 2017 para los municipios de Belo Horizonte, Nova Lima y Ribeirão das Neves. En el período analizado, se aplicaron 1.687.937 dosis de la vacuna contra la fiebre amarilla, siendo que la cobertura vacunal en Belo Horizonte bajó del 80% al 0,09% en el año 2014. Se observó una mayor concentración de dosis aplicadas en el rango de 15 a 59 años. En los ancianos las dosis aplicadas aumentaron de 1.888 a 68.570 en el año 2017. Se resalta que la vacunación aumentó considerablemente después del inicio de la epidemia en 2016. Considerando los años analizados, los tres municipios mantuvieron la cobertura vacunal próxima a la meta determinada por el Programa Nacional de Inmunización.Descriptores: Fiebre Amarilla, Vacunación, Epidemia.

Download Full-text