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PLoS One . Primary series COVID-19 vaccine effectiveness among health care workers in the country of Georgia, March-December 2021

tetano

Editor, Senior Moderator
PLoS One


. 2024 Sep 6;19(9):e0307805.
doi: 10.1371/journal.pone.0307805. eCollection 2024. Primary series COVID-19 vaccine effectiveness among health care workers in the country of Georgia, March-December 2021

Mark A Katz[SUP] 1 [/SUP], Madelyn Yiseth Rojas Castro[SUP] 2 [/SUP], Giorgi Chakhunashvili[SUP] 3 [/SUP], Nazibrola Chitadze[SUP] 3 [/SUP], Caleb L Ward[SUP] 4 [/SUP], C Jason McKnight[SUP] 5 [/SUP], Héloïse Lucaccioni[SUP] 6 [/SUP], Iris Finci[SUP] 1 [/SUP], Tamila Zardiashvili[SUP] 7 [/SUP], Richard Pebody[SUP] 1 [/SUP], Esther Kissling[SUP] 2 [/SUP], Lia Sanodze[SUP] 3 [/SUP]



Affiliations
Abstract

Background: Healthcare workers (HCWs) have suffered considerable morbidity and mortality during the COVID-19 pandemic. Few data on COVID-19 vaccine effectiveness (VE) are available from middle-income countries in the WHO European Region. We evaluated primary series COVID-19 VE against laboratory-confirmed COVID-19 among HCWs in Georgia.
Methods: HCWs in six hospitals in Georgia were invited to enroll in a prospective cohort study conducted during March 19-December 5, 2021. Participants completed weekly symptom questionnaires. Symptomatic HCWs were tested by RT-PCR and/or rapid antigen test (RAT), and participants were routinely tested for SARS-CoV-2 by RT-PCR or RAT, regardless of symptoms. Serology was collected at enrolment, and quarterly thereafter, and tested by electrochemiluminescence immunoassay for SARS-CoV-2 antibodies. We defined primary series vaccination as two doses of COVID-19 vaccine received ≥14 days before symptom onset. We estimated VE as (1-hazard ratio)*100 using a Cox proportional hazards model with vaccination status as a time-varying covariate. Estimates were adjusted by potential confounders that changed the VE estimate by more than 5%, according to the change-in-estimate approach.
Results: Overall, 1561/3849 (41%) eligible HCWs enrolled and were included in the analysis. The median age was 40 (IQR: 30-53), 1318 (84%) were female, and 1003 (64%) had laboratory evidence of prior SARS-Cov-2 infection. At enrolment, 1300 (83%) were unvaccinated; By study end, 1082 (62%) had completed a primary vaccine series (69% BNT162b2 (Pfizer-BioNTech); 22% BBIBP-CorV (Sinopharm); 9% other). During the study period, 191(12%) participants had a new PCR- or RAT-confirmed symptomatic SARS-CoV-2 infection. VE against PCR- or RAT- confirmed symptomatic SARS-CoV-2 infection was 58% (95%CI: 41; 70) for all primary series vaccinations, 68% (95%CI: 51; 79) for BNT162b2, and 40% (95%CI: 1; 64) for BBIBP-CorV vaccines. Among previously infected HCWs, VE was 58% (95%CI: 11; 80). VE against medically attended COVID-19 was 52% (95%CI: 28; 68), and VE against hospitalization was 69% (95% CI: 36; 85). During the period of predominant Delta variant circulation (July-December 2021), VE against symptomatic COVID-19 was 52% (95%CI: 30; 66).
Conclusions: Primary series vaccination with BNT162b2 and BBIBP-CorV was effective at preventing COVID-19 among HCWs, most of whom had previous infection, during a period of mainly Delta circulation. Our results support the utility of COVID-19 primary vaccine series, and the importance of increasing coverage, even among previously infected individuals.


 
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