COVID-19 cases, hospitalizations and deaths after vaccination: a cohort event monitoring study, Islamic Republic of Iran.
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Hosseinzadeh Ali, Sahab-Negah Sajad, Nili Sairan, Aliyari Roqayeh, Goli Shahrbanoo, Fereidouni Mohammad, Alami Ali, Shati Mohsen, Ahmadnezhad Elham, Mehravaran Shiva, Fateh Mansooreh, Khajeha Hamidreza, Emamian Zahra, Behmanesh Elahe, Mahdavi Sepideh, Enayatrad Mostafa, Mangolian Shahrbabaki Parvin, Ansari-Moghaddam Alireza, Heidarzadeh Abtin, Shahraki-Sanavi Fariba, Hashemi Shahri Seyed Mohammad, Dehghan Mahlagha, Amini Moridani Mohammadreza, Sheibani Hossein, Abbaszadeh Maryam, Jafari Reza, Valikhani Maryam, Binesh Ehsan, Vahedi Hamid, Chaman Reza, Khodashahi Rozita, Amini Mahnaz, Jabbari Azad Farahzad, Rezaeitalab Fariborz, Amel Jamehdar Saeid, Eshraghi Ali, Sharifi Hamid, Hashemi Bajgani Seyed Mehdi, Mahdavi Amin, Jafarzadeh Abdollah, Farokhnia Mehrdad, Ebrahimi Saeedeh, Pardakhti Abbas, Ghaderi Ebrahim, Soltani Hasan, Jadidoleslami Sedigh, Arianejad Anoush, Gavili Hamed, Moradveisi Borhan, Motamedi Dina, Zare Hamed, Kazemi Toba, Emamian Mohammad Hassan
Аннотация
METHODS: We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death.
FINDINGS: Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0-542.7) for contracting COVID-19; 55.8 (95% CI: 51.4-60.5) for hospitalization; and 4.1 (95% CI: 3.0-5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61-0.80) with AZD1222; 0.73 (95% CI: 0.62-0.86) with Sputnik V; and 0.73 (95% CI: 0.63-0.86) with CovIran®. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69-0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination.
CONCLUSION: The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.