Effectiveness and Respiratory Adverse Events Following Inactivated and mRNA COVID-19 Vaccines in Patients with COPD and Asthma: A Chinese Population-Based Study

Simon Xiwen Qin, Franco Wing Tak Cheng, Wang Chun Kwok, Lydia W. Y. Fung, Tian Tian Ma, Hei Hang Edmund Yiu, Chloe Bloom, Christine F. McDonald, Ching-Lung Cheung, Francisco Tsz Tsun Lai, Celine Sze Ling Chui, Xue Li, Carlos King Ho Wong, Eric Yuk Fai Wan, Ian Chi Kei Wong () and Esther Wai Yin Chan ()
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Simon Xiwen Qin: The University of Hong Kong
Franco Wing Tak Cheng: The University of Hong Kong
Wang Chun Kwok: The University of Hong Kong
Lydia W. Y. Fung: The University of Hong Kong
Tian Tian Ma: The University of Hong Kong
Hei Hang Edmund Yiu: The University of Hong Kong
Chloe Bloom: Imperial College London
Christine F. McDonald: University of Melbourne
Ching-Lung Cheung: The University of Hong Kong
Francisco Tsz Tsun Lai: The University of Hong Kong
Celine Sze Ling Chui: Hong Kong Science and Technology Park
Xue Li: The University of Hong Kong
Carlos King Ho Wong: The University of Hong Kong
Eric Yuk Fai Wan: The University of Hong Kong
Ian Chi Kei Wong: The University of Hong Kong
Esther Wai Yin Chan: The University of Hong Kong

Drug Safety, 2024, vol. 47, issue 2, No 4, 135-146

Abstract: Abstract Introduction Effectiveness and respiratory adverse events following coronavirus disease-2019 (COVID-19) vaccines have not been well investigated in Chinese patients with chronic obstructive pulmonary disease (COPD) and asthma. Methods Using electronic health care records in Hong Kong, we included adults with COPD or asthma or both and hospitalised for severe respiratory exacerbation in a self-controlled case series (SCCS) study between 23/02/2021 and 30/11/2022. Conditional Poisson regression models were used to estimate the incidence of outcomes within exposure periods (28 days after each dose) compared with baseline periods. Cox proportional hazard models evaluated vaccine effectiveness (VE) against COVID-related mortality, hospitalisation, and severe complications, including admission to intensive care units or ventilatory support. The VE assessment was based on vaccine types and the number of doses. Results In the SCCS, 343 CoronaVac recipients and 212 BNT162b2 recipients were included. No increased risk of outcomes was observed within the exposure periods. In the cohort study, 108,423 and 83,323 patients received ≥ 2 doses of CoronaVac and BNT162b2, respectively. The VE (95% CI) against COVID-related mortality, hospitalisation, and severe complications after two-dose CoronaVac was 77% (74–80%), 18% (6–23%), and 29% (12–43%), respectively, while for the two-dose regimen of BNT162b2, it was 92% (91–94%), 33% (30–37%), and 57% (45–66%), respectively. Higher VE against COVID-related mortality, hospitalisation, and severe complications was found for the three-dose regimen of CoronaVac (94%, 40%, and 71%) and BNT162b2 (98%, 65%, and 83%). Administering a fourth dose of either vaccine showed additional reductions in COVID-related outcomes. Conclusions Among people with COPD and asthma, the COVID-19 vaccines CoronaVac and BNT162b2 did not increase severe exacerbations and achieved moderate-to-high effectiveness against COVID-related outcomes. COVID-19 vaccination remains essential and should be encouraged to protect this vulnerable population in future epidemic waves.

Date: 2024
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DOI: 10.1007/s40264-023-01364-7

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