First and second doses of Covishield vaccine provided high level of protection against SARS-CoV-2 infection in highly transmissible settings: results from a prospective cohort of participants residing in congregate facilities in India

Covishield 백신의 1차 및 2차 접종은 전염성이 높은 환경에서 SARS-CoV-2 감염에 대한 높은 수준의 보호를 제공했습니다: 인도의 집단 시설에 거주하는 예상 참가자 집단의 결과

Published on
Journal: BMJ Global Health
[저자] Tenzin Tsundue, Tenzin Namdon, Tenzin Tsewang, Sonam Topgyal, Tashi Dolma, Dekyi Lhadon, Tsering Choetso, Tenzin Woesal, Tenzin Yangkyi, Amita Gupta, David Peters, Zorba Paster, Dawa Phunkyi, Tsetan Dorji Sadutshang, Richard E Chaisson, Kunchok Dorjee
[Category] COVID19(2023년), SARS, 변종,
PMC URL    [DOI] 10.1136/bmjgh-2021-008271    
[Article Type] Article
[Source] PMC

Abstract
Objectives: This study aimed to determine the effectiveness of Covishield vaccine among residents of congregate residential facilities.
Design: A prospective cohort study in congregate residential facilities.
Setting: Dharamshala, Himachal Pradesh, India, from December 2020 to July 2021.
Participants: Residents of all ages in seven facilities-three monasteries, two old age homes and two learning centres-were enrolled.
Exposures: First and second doses of Covishield vaccine against SARS-CoV-2 infection.
Main outcomes measures: Primary outcome was development of COVID-19. Secondary outcome was unfavourable outcomes, defined as a composite of shortness of breath, hospitalisation or death. Vaccine effectiveness (%) was calculated as (1-HR)×100.
Results: There were 1114 residents (median age 31 years) participating in the study, 82% males. Twenty-eight per cent (n=308/1114) were unvaccinated, 50% (n=554/1114) had received one dose and 23% (n=252/1114) had received two doses of Covishield. The point prevalence of COVID-19 for the facilities ranged from 11% to 57%. Incidence rates (95% CI) of COVID-19 were 76 (63 to 90)/1000 person-months in the unvaccinated, 25 (18 to 35)/1000 person-months in recipients of one dose and 9 (4 to 19)/1000 person-months in recipients of two doses. The effectiveness of first and second doses of Covishield were 71% (adjusted HR (aHR) 0.29; 95% CI 0.18 to 0.46; p<0.001) and 80% (aHR 0.20; 95% CI 0.09 to 0.44; p<0.001), respectively, against SARS-CoV-2 infection and 86% (aHR 0.24; 95% CI 0.07 to 0.82; p=0.023) and 99% (aHR 0.01; 95% CI 0.002 to 0.10; p<0.001), respectively, against unfavourable outcome. The effectiveness was higher after 14 days of receiving the first and second doses, 93% and 98%, respectively. Risk of infection was higher in persons with chronic hepatitis B (aHR 1.78; p=0.034) and previous history of tuberculosis (aHR 1.62; p=0.047).
Conclusion: Covishield was effective in preventing SARS-CoV-2 infection and reducing disease severity in highly transmissible settings during the second wave of the pandemic driven by the Delta variant.
Keywords: COVID-19; Epidemiology; Public Health.

All Keywords
【저자키워드】 COVID-19, public health, Epidemiology, 【초록키워드】 public health, Vaccine, pandemic, Tuberculosis, SARS-COV-2 infection, disease severity, India, Infection, outcome, prospective cohort study, delta variant, resident, outcomes, Effectiveness, death, second wave, age, hospitalisation, dose, Chronic Hepatitis B, Composite, chronic hepatitis, point prevalence, old age, Shortness of breath, incidence rates, Primary outcome, 95% CI, recipients, second dose, median age, secondary outcome, doses, recipient, Public, effective, secondary, males, Seven, Dharamshala, enrolled, defined, receiving, calculated, adjusted, determine, reducing, driven by, ranged, prevalence of COVID-19, 【제목키워드】 Vaccine, prospective cohort, second dose, participant, provided,
{{{ 추상적인 }}} {{ 목적: }} 이 연구는 집단 주거 시설의 거주자를 대상으로 Covishield 백신의 효과를 확인하는 것을 목표로 했습니다. {{ 디자인: }} 집단 주거 시설에 대한 전향적 코호트 연구. {{ 설정: }} 인도 히마찰프라데시주 다람샬라, 2020년 12월부터 2021년 7월까지 {{ 참가자: }} 7개 시설(3개의 수도원, 2개의 노인 주택, 2개의 학습 센터)에 모든 연령대의 거주자가 등록되었습니다. {{ 노출: }} SARS-CoV-2 감염에 대한 Covishield 백신의 1차 및 2차 접종. {{ 주요 결과 측정: }} 주요 결과는 COVID-19의 발전이었습니다. 2차 결과는 호흡 곤란, 입원 또는 사망의 복합으로 정의된 불리한 결과였습니다. 백신 유효성(%)은 (1-HR) x 100으로 계산하였다. {{ 결과: }} 1114명의 레지던트(중앙 연령 31세)가 연구에 참여했으며 82%가 남성이었습니다. 28%(n=308/1114)는 예방접종을 받지 않았고, 50%(n=554/1114)는 1회 접종, 23%(n=252/1114)는 2회 접종을 받았습니다. 시설에 대한 코로나19의 포인트 유병률은 11%에서 57% 사이였습니다. COVID-19의 발병률(95% CI)은 백신 접종을 하지 않은 사람에서 76(63~90)/1000인월, 1회 접종을 받은 사람에서 25(18~35)/1000인개월, 9(4~19) 접종을 받았습니다. /1000인-월 2회 접종 수혜자. Covishield의 첫 번째 및 두 번째 용량의 효과는 71%(조정된 HR(aHR) 0.29; 95% CI 0.18~0.46; p<0.001) 및 80%(aHR 0.20; 95% CI 0.09~0.44; p<0.00)였습니다. SARS-CoV-2 감염에 대해 각각 86%(aHR 0.24; 95% CI 0.07~0.82; p=0.023) 및 99%(aHR 0.01; 95% CI 0.002~0.10; p<0.001)에 대해 결과. 효과는 1차 및 2차 접종 14일 후에 각각 93% 및 98% 더 높아졌습니다. 감염 위험은 만성 B형 간염(aHR 1.78; p=0.034) 및 이전 결핵 병력(aHR 1.62; p=0.047)이 있는 사람에서 더 높았습니다. {{ 결론: }} Covishield는 Delta 변종에 의해 주도된 전염병의 두 번째 물결 동안 SARS-CoV-2 감염을 예방하고 전염성이 높은 환경에서 질병 중증도를 줄이는 데 효과적이었습니다. {{ 키워드: }} 코로나19; 역학; 공중 위생.