| Author | Aguilar, Soraida | |
| Author | Bastos, Leonardo S. L. | |
| Author | Maçaira, Paula | |
| Author | Baião, Fernanda | |
| Author | Simões, Paulo | |
| Author | Cerbino-Neto, José | |
| Author | Ranzani, Otavio | |
| Author | Hamacher, Silvio | |
| Author | Bozza, Fernando A. | |
| Access date | 2024-08-20T19:39:26Z | |
| Available date | 2024-08-20T19:39:26Z | |
| Document date | 2024 | |
| Citation | AGUILAR, Soraida et al. Impact of the first year of COVID-19 vaccination strategy in Brazil: an ecological study. BMJ Open, v. 14, n. 7, p. 1-9, Jul. 2024. | en_US |
| ISSN | 2044-6055 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/65453 | |
| Sponsorship | This work is part of the Grand Challenges ICODA pilot initiative, delivered by Health Data Research UK and funded by the Bill & Melinda Gates Foundation and the Minderoo Foundation. This study was also supported by the National Council for Scientific and Technological Development (CNPq), the Coordination for the Improvement of Higher Education Personnel (CAPES) - Finance Code 001, Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ), the Pontifical Catholic University of Rio de Janeiro. OR is funded by a Sara Borrell grant from the Instituto de Salud Carlos III (CD19/00110). PM acknowledges suppor from the CNPq (Grant 311519/2022-9). OR acknowledges support from the Spanish Ministry of Science and Innovation and State Research Agency through the ‘Centro de Excelencia Severo Ochoa 2019-2023’ programme (CEX2018-000806-S) and support from the Generalitat de Catalunya through the CERCA programme. All authors carried out the research independently of the funding bodies. The findings and conclusions in this manuscript reflect the opinions of the authors alone. | en_US |
| Language | eng | en_US |
| Publisher | BMJ Publishing Group | en_US |
| Rights | open access | en_US |
| Title | Impact of the first year of COVID-19 vaccination strategy in Brazil: an ecological study | en_US |
| Type | Article | en_US |
| DOI | 10.1136/bmjopen-2023-072314 | |
| Abstract | Objectives: No consensus exists about the best COVID-19 vaccination strategy to be adopted by low-income and middle-income countries. Brazil adopted an age-based calendar strategy to reduce mortality and the burden on the healthcare system. This study evaluates the impact of the vaccination campaign in Brazil on the progression of the reported COVID-19 deaths. Methods: This ecological study analyses the dynamic of vaccination coverage and COVID-19 deaths in hospitalised adults (≥20 years) during the first year of the COVID-19 vaccination roll-out (January to December 2021) using nationwide data (DATASUS). We stratified the adult population into 20-49, 50-59, 60-69 and 70+ years. The dynamic effect of the vaccination campaign on mortality rates was estimated by applying a negative binomial regression. The prevented and possible preventable deaths (observed deaths higher than expected) and potential years of life lost (PYLL) for each age group were obtained in a counterfactual analysis. Results: During the first year of COVID-19 vaccination, 266 153 517 doses were administered, achieving 91% first-dose coverage. A total of 380 594 deaths were reported, 154 091 (40%) in 70+ years and 136 804 (36%) from 50-59 or 20-49 years. The mortality rates of 70+ decreased by 52% (rate ratio [95% CI]: 0.48 [0.43-0.53]) in 6 months, whereas rates for 20-49 were still increasing due to low coverage (52%). The vaccination roll-out strategy prevented 59 618 deaths, 53 088 (89%) from those aged 70+ years. However, the strategy did not prevent 54 797 deaths, 85% from those under 60 years, being 26 344 (45%) only in 20-9, corresponding to 1 589 271 PYLL, being 1 080 104 PYLL (68%) from those aged 20-49 years. Conclusion: The adopted aged-based calendar vaccination strategy initially reduced mortality in the oldest but did not prevent the deaths of the youngest as effectively as compared with the older age group. Countries with a high burden, limited vaccine supply and young populations should consider other factors beyond the age to prioritise who should be vaccinated first. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Barcelona Institute for Global Health. ISGlobal. Hospital Clínic-Universitat de Barcelona. Barcelona, Spain / University of São Paulo. Faculty of Medicine. Clinical Hospital. Heart Institute. Pulmonary Division. São Paulo, SP, Brazil. | en_US |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil / Pontifical Catholic University of Rio de Janeiro. Tecgraf Institute. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Intensive Medicine. Rio de Janeiro, RJ, Brazil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Universidade NOVA de Lisboa. NOVA Medical School. Comprehensive Health Research Centre. Lisbon, Portugal. | en_US |
| Subject | COVID-19 | en_US |
| Subject | Epidemiology | en_US |
| Subject | Public health | en_US |
| e-ISSN | 2044-6055 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
