Effectiveness of inactivated COVID-19 vaccines among older adults in Shanghai: retrospective cohort study

Zhuoying Huang, Shuangfei Xu, Jiechen Liu, Linlin Wu, Jing Qiu, Nan Wang, Jia Ren, Zhi Li, Xiang Guo, Fangfang Tao, Jian Chen, Donglei Lu, Yuheng Wang, Juan Li, Xiaodong Sun () and Weibing Wang ()
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Zhuoying Huang: Shanghai Municipal Center of Disease Control and Prevention
Shuangfei Xu: Fudan University
Jiechen Liu: Shanghai Municipal Center of Disease Control and Prevention
Linlin Wu: Shanghai Municipal Center of Disease Control and Prevention
Jing Qiu: Shanghai Municipal Center of Disease Control and Prevention
Nan Wang: Shanghai Municipal Center of Disease Control and Prevention
Jia Ren: Shanghai Municipal Center of Disease Control and Prevention
Zhi Li: Shanghai Municipal Center of Disease Control and Prevention
Xiang Guo: Shanghai Municipal Center of Disease Control and Prevention
Fangfang Tao: Shanghai Municipal Center of Disease Control and Prevention
Jian Chen: Shanghai Municipal Center of Disease Control and Prevention
Donglei Lu: Shanghai Municipal Center of Disease Control and Prevention
Yuheng Wang: Shanghai Municipal Center of Disease Control and Prevention
Juan Li: Shanghai Municipal Center of Disease Control and Prevention
Xiaodong Sun: Shanghai Municipal Center of Disease Control and Prevention
Weibing Wang: Fudan University

Nature Communications, 2023, vol. 14, issue 1, 1-12

Abstract: Abstract We conducted a matched retrospective cohort study of two cohorts to estimate inactivated vaccine effectiveness (VE) and its comparative effectiveness of booster dose among older people in Shanghai. Cohort 1 consisted of a vaccinated group (≥1 dose) and an unvaccinated group (3,317,475 pairs), and cohort 2 consisted of a booster vaccinated group and a fully vaccinated group (2,084,721 pairs). The Kaplan–Meier method and Cox regression models were used to estimate risk and hazard ratios (HRs) study outcomes. For cohort 1, the overall estimated VEs of ≥1 dose of inactivated vaccine against SARS-CoV-2 infection, severe/critical Covid-19, and Covid-19 related death were 24.7% (95%CI 23.7%−25.7%), 86.6% (83.1%−89.4%), and 93.2% (88.0%−96.1%), respectively. Subset analysis showed that the booster vaccination provided greatest protection. For cohort 2, compared with full vaccination, relative VEs of booster dose against corresponding outcome were 16.3% (14.4%−17.9%), 60.5% (37.8%−74.9%), and 81.7% (17.5%−95.9%). Here we show, although under the scenario of persistent dynamic zero-Covid policy and non-pharmaceutical interventions, promoting high uptake of the full vaccination series and booster dose among older adults is critically important. Timely vaccination with the booster dose provided effective protection against Covid-19 outcomes.

Date: 2023
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DOI: 10.1038/s41467-023-37673-9

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