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Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile.
N Engl J Med. 2021 09 02; 385(10):875-884.NEJM

Abstract

BACKGROUND

Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support decision making. A countrywide mass vaccination campaign with the use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021.

METHODS

We used a prospective national cohort, including participants 16 years of age or older who were affiliated with the public national health care system, to assess the effectiveness of the inactivated SARS-CoV-2 vaccine with regard to preventing Covid-19 and related hospitalization, admission to the intensive care unit (ICU), and death. We estimated hazard ratios using the extension of the Cox proportional-hazards model, accounting for time-varying vaccination status. We estimated the change in the hazard ratio associated with partial immunization (≥14 days after receipt of the first dose and before receipt of the second dose) and full immunization (≥14 days after receipt of the second dose). Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics.

RESULTS

The study was conducted from February 2 through May 1, 2021, and the cohort included approximately 10.2 million persons. Among persons who were fully immunized, the adjusted vaccine effectiveness was 65.9% (95% confidence interval [CI], 65.2 to 66.6) for the prevention of Covid-19 and 87.5% (95% CI, 86.7 to 88.2) for the prevention of hospitalization, 90.3% (95% CI, 89.1 to 91.4) for the prevention of ICU admission, and 86.3% (95% CI, 84.5 to 87.9) for the prevention of Covid-19-related death.

CONCLUSIONS

Our results suggest that the inactivated SARS-CoV-2 vaccine effectively prevented Covid-19, including severe disease and death, a finding that is consistent with results of phase 2 trials of the vaccine. (Funded by Agencia Nacional de Investigación y Desarrollo and others.).

Authors+Show Affiliations

From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).From the Ministry of Health (A.J., C.G., F.P., T.F., G.J., A.P., J.A., K.L., F.L., C.S., P.L., P.S., H.G.-E., R.A.), Facultad de Matemáticas (A.J.) and Escuela de Gobierno (E.A.U.), Pontificia Universidad Católica de Chile, Millennium Nucleus Center for the Discovery of Structures in Complex Data (A.J.), Millennium Initiative for Collaborative Research in Bacterial Resistance (E.A.U., R.A.), the Research Center for Integrated Disaster Risk Management (E.A.U.), Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (R.A.), and the Advanced Center for Chronic Diseases (R.A.) - all in Santiago, Chile; and the CIFAR Azrieli Global Scholars Program, CIFAR, Toronto (E.A.U.).

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34233097

Citation

Jara, Alejandro, et al. "Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile." The New England Journal of Medicine, vol. 385, no. 10, 2021, pp. 875-884.
Jara A, Undurraga EA, González C, et al. Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile. N Engl J Med. 2021;385(10):875-884.
Jara, A., Undurraga, E. A., González, C., Paredes, F., Fontecilla, T., Jara, G., Pizarro, A., Acevedo, J., Leo, K., Leon, F., Sans, C., Leighton, P., Suárez, P., García-Escorza, H., & Araos, R. (2021). Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile. The New England Journal of Medicine, 385(10), 875-884. https://doi.org/10.1056/NEJMoa2107715
Jara A, et al. Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile. N Engl J Med. 2021 09 2;385(10):875-884. PubMed PMID: 34233097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile. AU - Jara,Alejandro, AU - Undurraga,Eduardo A, AU - González,Cecilia, AU - Paredes,Fabio, AU - Fontecilla,Tomás, AU - Jara,Gonzalo, AU - Pizarro,Alejandra, AU - Acevedo,Johanna, AU - Leo,Katherinne, AU - Leon,Francisco, AU - Sans,Carlos, AU - Leighton,Paulina, AU - Suárez,Pamela, AU - García-Escorza,Heriberto, AU - Araos,Rafael, Y1 - 2021/07/07/ PY - 2021/7/8/pubmed PY - 2021/9/14/medline PY - 2021/7/7/entrez SP - 875 EP - 884 JF - The New England journal of medicine JO - N Engl J Med VL - 385 IS - 10 N2 - BACKGROUND: Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support decision making. A countrywide mass vaccination campaign with the use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021. METHODS: We used a prospective national cohort, including participants 16 years of age or older who were affiliated with the public national health care system, to assess the effectiveness of the inactivated SARS-CoV-2 vaccine with regard to preventing Covid-19 and related hospitalization, admission to the intensive care unit (ICU), and death. We estimated hazard ratios using the extension of the Cox proportional-hazards model, accounting for time-varying vaccination status. We estimated the change in the hazard ratio associated with partial immunization (≥14 days after receipt of the first dose and before receipt of the second dose) and full immunization (≥14 days after receipt of the second dose). Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics. RESULTS: The study was conducted from February 2 through May 1, 2021, and the cohort included approximately 10.2 million persons. Among persons who were fully immunized, the adjusted vaccine effectiveness was 65.9% (95% confidence interval [CI], 65.2 to 66.6) for the prevention of Covid-19 and 87.5% (95% CI, 86.7 to 88.2) for the prevention of hospitalization, 90.3% (95% CI, 89.1 to 91.4) for the prevention of ICU admission, and 86.3% (95% CI, 84.5 to 87.9) for the prevention of Covid-19-related death. CONCLUSIONS: Our results suggest that the inactivated SARS-CoV-2 vaccine effectively prevented Covid-19, including severe disease and death, a finding that is consistent with results of phase 2 trials of the vaccine. (Funded by Agencia Nacional de Investigación y Desarrollo and others.). SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/34233097/Effectiveness_of_an_Inactivated_SARS-CoV-2_Vaccine_in_Chile. L2 - https://www.nejm.org/doi/10.1056/NEJMoa2107715?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -