Vaccine effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca to prevent severe COVID-19 in Costa Rica: A nationwide, observational study of hospitalizations prevalence (Preprint)

2021 ◽  
Author(s):  
Luis Rosero-Bixby
Keyword(s):  
Single Dose ◽  
Costa Rica ◽  
Observational Study ◽  
Real World ◽  
Vaccine Coverage ◽  
Secondary Analysis ◽  
Vaccine Effectiveness ◽  
Costa Rican ◽  
Vaccination Program ◽  
Severe Illness

BACKGROUND The Costa Rican vaccination program uses Pfizer-BioNTech and Oxford-AstraZeneca vaccines. Real-world estimates of these vaccines effectiveness to prevent hospitalizations range from 90% to 98% for two doses and from 70% to 91% for a single dose. Almost all of these estimates predate the Delta variant. OBJECTIVE To estimate the dose-dependent effectiveness of coronavirus disease (COVID-19) vaccines to prevent severe illness in real-world conditions of Costa Rica, after the Delta variant became dominant. METHODS This observational study is a secondary analysis of hospitalizations prevalence. The participants are all 3.67 million adults residents in Costa Rica by mid-2021. The study is based on public aggregated data of 5978 COVID-19-related hospital records from 14th September to 20th October, 2021 and 6.1 million vaccination doses administered to determine hospitalization prevalence by dose-specific vaccination status. The intervention retrospectively evaluated is vaccination with Pfizer-BioNTech (78%) and Oxford-AstraZeneca (22%). The main outcome studied is being hospitalized. RESULTS Vaccine effectiveness to prevent hospitalization (VEH) was estimated as 93.4% (95% confidence interval [CI]: 93.0 to 93.9) for complete vaccination and 76.7% (CI: 75.0 to 78.3) for single-dose vaccination among adults of all ages. VEH was lower and more uncertain among older adults aged 58 years and above: 92% (CI: 91% to 93%) for those who had received full vaccination and 64% (CI: 58% to 69%) for those who had received partial vaccination. Single-dose VEH declined over time during the study period, especially in the older age group. Estimates were sensitive to possible errors in the population count used to determine the residual number of unvaccinated people when vaccine coverage is high. CONCLUSIONS The Costa Rican vaccination program that administered Pfizer and Oxford vaccines are highly effective to prevent COVID-19-related hospitalizations after the Delta variant had become dominant. Moreover, a single dose is reasonably effective, justifying the continuation of the national policy of postponing the application for the second dose of the Pfizer vaccine to accelerate the vaccination and increase the number of people being vaccinated. Timely monitoring of vaccine effectiveness is important to detect eventual failures and motivate the public based on information that the vaccinations are effective.

scholarly journals Vaccine effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca to prevent severe COVID-19 in Costa Rica by September and October 2021: A nationwide, observational study of hospitalisations prevalence.

2021 ◽  
Author(s):  
Luis Rosero-Bixby
Keyword(s):  
Single Dose ◽  
Costa Rica ◽  
Observational Study ◽  
Vaccine Coverage ◽  
Adult Population ◽  
Secondary Analysis ◽  
National Policy ◽  
Vaccine Effectiveness ◽  
Severe Illness ◽  
Population Count

Objective To estimate the dose-dependent effectiveness of coronavirus disease (COVID-19) vaccines to prevent severe illness in real-world conditions of Costa Rica, after the Delta variant became dominant. Design Observational study; secondary analysis of hospitalisation prevalence. Setting Nationwide adult population, Costa Rica. Participants All 3.67 million adults residents in Costa Rica by mid-2021. Public aggregated data of 5978 hospital records from 14th September to 20th October, 2021 and 6.1 million vaccination doses administered. Interventions Vaccination with Pfizer-BioNTech (78%) and Oxford-AstraZeneca (22%). Main outcome measures Prevalence of COVID-19-related hospitalisations Results Vaccine effectiveness to prevent hospitalisation (VEH) was estimated as 93.4% (95% confidence interval [CI]: 93.0 to 93.9) for complete vaccination and 76.7% (CI: 75.0 to 78.3) for single-dose vaccination among adults of all ages. VEH was lower and more uncertain among older adults aged 58 years and above: 92% (CI: 91% to 93%) for those who had received full vaccination and 64% (CI: 58% to 69%) for those who had received partial vaccination. Single-dose VEH declined over time during the study period, especially in the older age group. Estimates were sensitive to possible errors in the population count used to determine the residual number of unvaccinated people in groups with high vaccine coverage. Conclusion The Costa Rican vaccination programme that administered Pfizer and Oxford vaccines are highly effective to prevent COVID-19-related hospitalisations after the Delta variant had become dominant. Moreover, a single dose is reasonably effective, justifying the continuation of the national policy of postponing the application for the second dose of the Pfizer vaccine to accelerate the vaccination and increase the number of people being vaccinated. Timely monitoring of vaccine effectiveness is important to detect eventual failures and motivate the public based on information that the vaccinations are effective.

scholarly journals COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies

2021 ◽  
Author(s):  
Manuela Di Fusco ◽  
Jay Lin ◽  
Shailja Vaghela ◽  
Melissa Lingohr-Smith ◽  
Jennifer L Nguyen ◽  
...  
Keyword(s):  
Literature Review ◽  
Expert Opinion ◽  
Real World ◽  
Preliminary Evidence ◽  
Vaccine Effectiveness ◽  
Severe Illness ◽  
Protective Measures ◽  
Vaccine Protection ◽  
General Populations ◽  
Over Time

AbstractIntroductionFrom July through October of 2021, several countries issued recommendations for increased COVID-19 vaccine protection for individuals with one or more immunocompromised (IC) conditions. It is critically important to understand the vaccine effectiveness (VE) of COVID-19 vaccines among IC populations as recommendations are updated over time in response to the evolving COVID-19 pandemic.Areas coveredA targeted literature review was conducted to identify real-world studies that assessed COVID-19 VE in IC populations between December 2020 and September 2021. A total of 10 studies from four countries were identified and summarized in this review.Expert opinion/commentaryVE of the widely available COVID-19 vaccines, including BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), Ad26.COV2.S (Janssen), and ChAdOx1 nCoV-19 (Oxford/AstraZeneca), ranged from 64%-90% against SARS-CoV-2 infection, 73%-84% against symptomatic illness, 70%-100% against severe illness, and 63%-100% against COVID-19-related hospitalization among the fully vaccinated IC populations included in the studies. COVID-19 VE for most outcomes in the IC populations included in these studies was lower than in the general populations. These findings provide preliminary evidence that the IC population requires greater protective measures to prevent COVID-19 infection and associated illness, hence should be prioritized while implementing recommendations of additional COVID-19 vaccine doses.

scholarly journals Outbreak of SARS-CoV-2 in a prison: Low effectiveness of a single dose of the adenovirus vector ChAdOx1 vaccine in recently vaccinated inmates

2021 ◽  
Author(s):  
A Marco ◽  
N Teixidó ◽  
RA Guerrero ◽  
L Puig ◽  
X Rué ◽  
...  
Keyword(s):  
Single Dose ◽  
Observational Study ◽  
Preventive Measures ◽  
Adenovirus Vector ◽  
Vaccine Effectiveness ◽  
Infection Rates ◽  
Rt Pcr ◽  
Post Vaccination

AbstractIntroductionTo analyse the effectiveness of a dose of adenovirus vector ChAdOx1 vaccine (AVChOx1) in an outbreak of SARS-CoV-2 detected in a prison.MethodsObservational study carried out at Brians-1 Prison, Barcelona. After detecting a case of infection, rt-PCR was administered to all prisoners (some of whom had been vaccinated 21-23 days previously with a dose of AVChOx1) and to staff. Infection rates in vaccinated and unvaccinated populations were calculated, as was vaccine effectiveness.ResultsOne hundred and eighty-four asymptomatic prisoners (50.3% vaccinated) and 33 staff were screened. Forty-eight (25.9%) infections by the SCV-B.1.17 variant were recorded in prisoners and none in staff. Infection rates were higher in younger prisoners, immigrants, and those admitted ≥7 days previously. In all, 22.6% of vaccinated subjects were infected vs. 29.3% of unvaccinated. Vaccine effectiveness was 23%. Only 6.2 cases would have been prevented by vaccinating the unvaccinated individuals. At seven days, the rt-PCR was negative in 46.2% of vaccinated subjects vs. 13.6% of unvaccinated (p = 0.02).DiscussionIn a prison outbreak, a dose of AVChAdOx1 administered 21-23 days earlier did not significantly prevent the occurrence of infections, but did reduce the duration of rt-PCR positivity. Maintaining post-vaccination preventive measures is essential.

Parity without Equality

2018 ◽  
Author(s):  
Jennifer M. Piscopo
Keyword(s):  
Costa Rica ◽  
Party System ◽  
Political Representation ◽  
Costa Rican ◽  
Women In Politics ◽  
Negative Consequences ◽  
Economic Problems ◽  
Crisis Of Representation ◽  
Female Legislators ◽  
Female President

Jennifer M. Piscopo examines how the crisis of representation in Costa Rica has placed a ceiling on gender equality in representation. The restructuring of the Costa Rican party system and party fragmentation has made electing multiple candidates from any one ballot more difficult. Top spots have become even more prestigious and more likely to be allocated to men, which reduces women’s electoral chances. Corruption scandals, party breakdown, citizen frustration, and economic problems tainted the administration of the nation’s first female president, Laura Chinchilla. Female legislators have often worked to promote women’s issues and feminist policies, but Chinchilla eschewed feminism, even though several of her policies did benefit women. Overall, her failed presidency may create difficulties for other women seeking top political offices and could have negative consequences for views of women in politics. These challenges notwithstanding, Piscopo concludes that Costa Rica remains at the vanguard of women’s political representation in Latin America.

scholarly journals Trends of pulmonary fungal infections from 2013 to 2019: an AI-based real-world observational study in Guangzhou, China

2021 ◽  
Vol 10 (1) ◽  
pp. 450-460
Author(s):  
Zhengtu Li ◽  
Yongming Li ◽  
Yijun Chen ◽  
Jing Li ◽  
Shaoqiang Li ◽  
...  
Keyword(s):  
Observational Study ◽  
Real World ◽  
Fungal Infections ◽  
Pulmonary Fungal Infections

Factor product utilization and health outcomes in patients with haemophilia A and B on extended half‐life concentrates: A Canadian observational study of real‐world outcomes

Haemophilia ◽  
2021 ◽  
Author(s):  
Haowei (Linda) Sun ◽  
Ming Yang ◽  
Man‐Chiu Poon ◽  
Adrienne Lee ◽  
K. Sue Robinson ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Outcomes ◽  
Real World ◽  
Half Life ◽  
Haemophilia A

Stability and performance of the EnSite Precision cardiac mapping system for electrophysiology mapping and ablation procedures: results from the EnSite Precision observational study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lin ◽  
B Glover ◽  
J Colley ◽  
B Thibault ◽  
C.M Steinberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Real World ◽  
Cardiac Electrophysiology ◽  
Median Number ◽  
System Stability ◽  
Cardiac Mapping ◽  
Average Force ◽  
Mapping System ◽  
Respiratory Change ◽  
Electrophysiology Mapping

Abstract Background The EnSite Precision™ Cardiac Mapping System is a catheter navigation and mapping system capable of displaying the three-dimensional (3D) position of conventional and sensor enabled electrophysiology catheters, as well as displaying cardiac electrical activity as waveform traces and dynamic 3-D maps of cardiac chambers. Objective The EnSite Precision™ Observational Study was designed to quantify and characterize the use of the EnSite Precision™ Cardiac Mapping System for mapping and ablation of cardiac arrhythmias in a real-world environment and to evaluate procedural and subsequent clinical outcomes. Methods 1065 patients were enrolled at 38 centers in the U.S. and Canada between 2017–2018. Eligible subjects were adults undergoing a cardiac electrophysiology mapping and radiofrequency ablation procedures using the EnSite Precision™ System. Results Of 989 patients who completed the protocol, a geometry was created in 936 (94.7%). Most initial maps were created using Automap (n=545, 67.0%) or a combination of Automap and manually mapping (n=151, 18.6%). Median time to create an initial map was 9.0 min (IQR 5.0–15.0), with a median number of used mapping points per minute of 92.7 (IQR 30.0–192.0). During ablation, AutoMark was used in 817 (82.6%) of procedures. The most frequent metrics for lesion color were Impedance Drop or Impedance Drop Percent (45.5% combined), time (23.9%) and average force (14.2%). At Canadian sites where LSI was an option, it was used as the color metric in 87 (45.8%) of cases (10.6% overall). The EnSite System was stable throughout 79.7% (n=788 of 989) of procedures. Factors affecting stability were respiratory change (n=88 of 989, 8.9%), patient movement (n=73, 7.4%), CS Positional Reference dislodgement (n=32, 3.2%), and cardioversion (n=19, 1.9%). Conscious sedation was used in 189 (19.1%) of patients. Acute success was reached based on the pre-defined endpoints for the procedure in 97.4% (n=963) of cases. Conclusion In a real-world study analysis, the EnSite Precision™ mapping system was associated with a high prevalence of acute procedural success, low mapping times, and high system stability. Funding Acknowledgement Type of funding source: None

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