Breakthrough infections, hospital admissions, and mortality after major COVID-19 vaccination profiles: a prospective cohort study

• Published in: The Lancet regional health. Southeast Asia Vol. 8; p. 100106
• Main Authors: Wichaidit, Mingkwan, Nopsopon, Tanawin, Sunan, Krittiyaporn, Phutrakool, Phanupong, Ruchikachorn, Puripant, Wanvarie, Dittaya, Pratanwanich, Ploy Naruemon, Cheewaruangroj, Nontawit, Punyabukkana, Proadpran, Pongpirul, Krit
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2023
• Subjects: VV; PDPA; MN; SV; MR; IN; IgG; Co-Lab; PZ; CO-Ward; PEC; CVC; RT-PCR; AZ; SP; VSDMC; PDPA, Personal Data Protection Act; AZ, ChAdOx1 nCoV-19, Vaxzevria, Cambridge, AstraZeneca, UK; PZ, BNT162b2, Comirnaty, BioNTech, Mainz, Germany; CVC, central vaccination center; Co-Lab, Thai COVID-19 infection dataset; VV, viral vector vaccine; IgG, immunoglobulin G; SP, Sinopharm, Beijing Institute of Biological Products, China; IN, inactivated vaccine; CO-Ward, Thai COVID-19 hospitalization dataset; MN, mRNA-1273, Moderna, NIAID, USA; PEC, primary eligibiligy criteria; SV, CoronaVac, Sinovac Biotech, Beijing, China; MR, mRNA vaccine; RT-PCR, reverse transcription-polymerase chain reaction; VSDMC, Vaccine Safety and Data Monitoring Committee
• ISSN: 2772-3682; 2772-3682
• DOI: 10.1016/j.lansea.2022.100106

Several COVID-19 vaccination rollout strategies are implemented. Real-world data from the large-scale, government-mandated Central Vaccination Center (CVC), Thailand, could be used for comparing the breakthrough infection, across all available COVID-19 vaccination profiles. This prospective cohort study combined the vaccine profiles from the CVC registry with three nationally validated outcome datasets to assess the breakthrough COVID-19 infection, hospitalization, and death among Thais individuals who received at least one dose of the COVID-19 vaccine. The outcomes were analyzed by comparing vaccine profiles to investigate the shot effect and homologous effect. Of 2,407,315 Thais who had at least one dose of COVID-19 vaccine, 63,469 (2.75%) had breakthrough infection, 42,001 (1.79%) had been hospitalized, and 431 (0.02%) died. Per one vaccination shot added, there was an 18% risk reduction of breakthrough infection (adjusted hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.80–0.82), a 25% risk reduction of hospitalization (HR 0.75, 95% CI 0.73–0.76), and a 96% risk reduction of mortality (HR 0.04, 95% CI 0.03–0.06). The heterologous two-shot vaccine profiles had a higher protective effect against infection, hospitalization, and mortality compared to the homologous counterparts. COVID-19 breakthrough infection, hospitalization, and death differ across vaccination profiles that had a different number of shots and types of vaccines. This study did not involve any funding.