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Estimation of vaccine effectiveness against SARS-CoV-2-associated hospitalisation using sentinel surveillance in South Africa, a test-negative case-control study

Article scientifique 2023 Anglais

Résumé

Abstract Background COVID-19 vaccine effectiveness (VE) studies leveraging systematic surveillance in sub-Saharan Africa are limited. We aimed to assess BNT162b2 and Ad26.COV2.S VE against SARS-CoV-2-associated hospitalisation in South African individuals aged ≥ 18 years. Methods We conducted a test-negative case-control study to estimate VE against hospitalisation in individuals enrolled in pneumonia surveillance in South Africa. Inpatients with physician-diagnosed lower respiratory tract infection or suspected COVID-19, testing SARS-CoV-2 positive or negative from May 2021‒March 2022 were cases or controls, respectively. Receiving one Ad26.COV2.S dose or two BNT162b2 doses ≥ 14 days before enrolment was considered fully vaccinated. VE was estimated using multivariable logistic regression for the Delta- and Omicron BA.1/BA.2-predominant periods; stratified by age and HIV-status. Results A total of 985 cases and 1,963 controls were included. Thirty-eight (3.9%) cases and 186 (9.5%) controls were fully vaccinated with BNT162b2; 30 (3.0%) cases and 94 (4.8%) controls were fully vaccinated with Ad26.COV2.S. BNT162b2 VE against SARS-CoV-2-associated hospitalisation over Delta and Omicron BA.1/BA.2 periods was 77% (95% CI: 26%;93%) and 38% (-9%;64%), respectively. Ad26.COV2.S VE against hospitalisation over Delta and Omicron BA.1/BA.2 periods was 47% (-57%;82%), and − 19% (-128%;37%), respectively. BNT162b2 VE against hospitalisation over Delta period was 84% (37%;96%) and 76% (21%;93%) among adults aged ≥ 60 years and HIV-uninfected, respectively. Conclusions BNT162b2 vaccine was effective against SARS-CoV-2-associated hospitalisation during the Delta period for adults aged ≥ 18 years, those aged ≥ 60 years, and HIV-uninfected adults. VE for Ad26.COV2.S was non-significant potentially due to limited sample size or residual confounding. These findings highlight the utility of sentinel surveillance for estimating VE.

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Chiwandire, N., Walaza, S., Gottberg, A., Wolter, N., Plessis, M., Moosa, F., Groome, M., Nel, J., Variava, E., Dawood, H., Makhasi, M., Feldstein, L., Marcenac, P., Lafond, K., Samuels, A., Cohen, C. (2023). Estimation of vaccine effectiveness against SARS-CoV-2-associated hospitalisation using sentinel surveillance in South Africa, a test-negative case-control study. https://doi.org/10.21203/rs.3.rs-3423529/v1

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Auteur(s)

Nicola Chiwandire Sibongile Walaza Anne von Gottberg Nicole Wolter Mignon du Plessis Fahima Moosa Michelle J. Groome Jeremy Nel Ebrahim Variava Halima Dawood Mvuyo Makhasi Leora R. Feldstein Perrine Marcenac Kathryn E. Lafond Aaron M. Samuels Cheryl Cohen

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