Effectiveness of a nation-wide COVID-19 vaccination program in Mexico

  1. Omar Yaxmehen Bello-Chavolla
  2. Neftali Eduardo Antonio-Villa
  3. Sergio Ivån Valdés-Ferrer
  4. Carlos A. FermĂ­n-MartĂ­nez
  5. Luisa FernĂĄndez-Chirino
  6. Daniel RamĂ­rez-GarcĂ­a
  7. Javier Mancilla-Galindo
  8. Ashuin Kammar-GarcĂ­a
  9. José Alberto Ávila-Funes
  10. Clemente Humberto ZĂșñiga-Gil
  11. Miguel GarcĂ­a-Grimshaw
  12. Santa Elizabeth Ceballos-Liceaga
  13. Guillermo Carbajal-Sandoval
  14. José Antonio Montes-Gonzålez
  15. Christian Arturo Zaragoza-Jiménez
  16. Gabriel GarcĂ­a-RodrĂ­guez
  17. Ricardo Cortés-Alcalå
  18. Gustavo Reyes-TerĂĄn
  19. Hugo LĂłpez-Gatell
  20. Luis Miguel Gutiérrez-Robledo
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Abstract

BACKGROUND

Vaccination has been effective in ameliorating the impact of COVID-19. However, estimation of vaccine effectiveness (VE) is still unavailable for some widely used vaccines and underrepresented groups. Here, we report on the effectiveness of a nation-wide COVID-19 vaccination program in Mexico.

METHODS

We used a test-negative design within a national COVID-19 surveillance system to assess VE of the BNT162b2, mRNA-12732, Gam-COVID-Vac, Ad5-nCoV, Ad26.COV2.S, ChAdOx1 and CoronaVac vaccines, against SARS-CoV-2 infection, COVID-19 related hospitalization and death for adults ≥18 years in Mexico. VE was estimated using Cox proportional hazard models considering time-varying vaccination status in partial and fully vaccinated individuals compared to unvaccinated adults, adjusted by age, sex, comorbidities and municipality. We also estimated VE for adults ≥60 years, for cases with diabetes and comparing periods with predominance of variants B.1.1.519 and B.1.617.2.

RESULTS

We assessed 793,487 vaccinated compared to 4,792,338 unvaccinated adults between December 24 th , 2020, and September 27 th , 2021. VE against SARS-CoV-2 infection was highest for fully vaccinated individuals with mRNA-12732 (91.5%, 95%CI 90.3-92.4) and Ad26.COV2.S (82.2%, 95%CI 81.4-82.9), whereas for COVID-19 related hospitalization were BNT162b2 (84.3%, 95%CI 83.6-84.9) and Gam-COVID-Vac (81.4% 95%CI 79.5-83.1) and for mortality BNT162b2 (89.8%, 95%CI 89.2-90.2) and mRNA-12732 (93.5%, 95%CI 86.0-97.0). VE for all evaluated vaccines was reduced for adults ≥60 years, people with diabetes, and in periods of Delta variant predominance.

CONCLUSIONS

All evaluated vaccines were effective against SARS-CoV-2 infection and COVID-19 related hospitalization and death. Mass vaccination campaigns with multiple vaccine products are feasible and effective to maximize vaccination coverage.

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