Second booster doses of adenoviral- and mRNA-based COVID-19 vaccines increase protection against COVID-19 hospitalization: Final analysis from the REFORCO-Brazil real-world effectiveness study during Omicron

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Autor(es): dc.contributorBioPharmaceuticals Medical-
Autor(es): dc.contributorBioPharmaceuticals R&D-
Autor(es): dc.contributorTechtrials Healthcare Data Science-
Autor(es): dc.contributorFederal University of Paraná-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorAstraZeneca-
Autor(es): dc.creatorMeeraus, Wilhelmine-
Autor(es): dc.creatorPostema, Abigail-
Autor(es): dc.creatorGray, Christen M.-
Autor(es): dc.creatorLee, Andrew-
Autor(es): dc.creatorMaria, Andre Santa-
Autor(es): dc.creatorFurtado, Bárbara Emoingt-
Autor(es): dc.creatorConde-Sousa, Eduardo-
Autor(es): dc.creatorOuwens, Mario-
Autor(es): dc.creatorValverde, Douglas Andreas-
Autor(es): dc.creatorda Cunha, Clóvis Arns-
Autor(es): dc.creatorBarbosa, Alexandre Naime-
Autor(es): dc.creatorCorte, Claudia-
Autor(es): dc.creatorTaylor, Sylvia-
Data de aceite: dc.date.accessioned2025-08-21T17:14:07Z-
Data de disponibilização: dc.date.available2025-08-21T17:14:07Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2025-04-19-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1016/j.vaccine.2025.126955-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/297483-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/297483-
Descrição: dc.descriptionBackground: Booster doses of COVID-19 vaccines are required to maintain protection against SARS-CoV-2. However, real-world evidence from South America, needed to inform optimal vaccination strategies, is lacking. Herein, we present the final analysis of REFORCO-Brazil, a large-scale assessment of relative vaccine effectiveness (rVE) of second boosters (vs first boosters) against hospitalization with COVID-19. Methods: REFORCO-Brazil is a test-negative case-control study (NCT05697705) that utilized Brazilian national data on severe acute respiratory syndrome (SARS) surveillance and COVID-19 vaccination. Individuals hospitalized with SARS from January 1 to December 31, 2022, were classified as test-positive cases (via SARS-CoV-2 antigen/reverse transcription polymerase chain reaction [RT-PCR]) or test-negative case-controls (via RT-PCR) and matched by admission date, region, sex, preceding COVID-19 vaccinations, and age. We used conditional logistic regression combined with multiple covariate adjustments to estimate rVE for second boosters (versus first boosters received ≥4 months prior) overall, by type (AZD1222, Ad26.COV2·S, BNT162b2, and CoronaVac) and in vulnerable subgroups (elderly and immunocompromised/high-risk individuals). Results: Median (range) time between second booster and SARS hospitalization was 87.0 (8.0–307.0) and 79.0 (8.0–303.0) days among 5426 test-positive cases and 6131 test-negative controls, respectively. Overall rVE of any second booster against hospitalization was 18.7 % (95 % confidence interval [CI]: 10.5–26.1). The rVE of adenoviral- and mRNA-based vaccines was similar; 18.2 % (4.8–29.8) for AZD1222, 20.7 % (10.2–30.0) for Ad26.COV2·S, and 23.2 % (9.7–34.7) for BNT162b2. Similar levels of added protective benefit, or ‘boosting’, was observed in very elderly and immunocompromised/high-risk individuals. Additional protection was highest within 2 months post-dosing, decreasing thereafter. Exploratory analyses revealed increased protection against severe in-hospital outcomes, including mortality. Conclusions: Our results support the use of monovalent adenoviral/mRNA-based vaccine maintain protection against COVID-19 hospitalization from Omicron subvariants. However, optimal timing of booster vaccinations will need to be carefully considered for future booster strategies, especially among vulnerable subgroups.-
Descrição: dc.descriptionMedical Evidence Vaccines & Immune Therapies BioPharmaceuticals Medical, AstraZeneca-
Descrição: dc.descriptionFormerly Medical Evidence Vaccines & Immune Therapies BioPharmaceuticals Medical, AstraZeneca-
Descrição: dc.descriptionReal World Data Science BioPharmaceuticals Medical, AstraZeneca-
Descrição: dc.descriptionMedical and Payor Statistics BioPharmaceuticals Medical, AstraZeneca-
Descrição: dc.descriptionEarly Phase Clinical Development Respiratory & Immunology BioPharmaceuticals R&D, AstraZeneca-
Descrição: dc.descriptionVaccines & Immune Therapies BioPharmaceuticals Medical, AstraZeneca-
Descrição: dc.descriptionTechtrials Healthcare Data Science-
Descrição: dc.descriptionFederal University of Paraná, Curitiba-
Descrição: dc.descriptionDepartment of Infectious Diseases Botucatu School of Medicine São Paulo State University-
Descrição: dc.descriptionFormerly Evidence Generation AstraZeneca-
Descrição: dc.descriptionDepartment of Infectious Diseases Botucatu School of Medicine São Paulo State University-
Idioma: dc.languageen-
Relação: dc.relationVaccine-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectCOVID-19-
Palavras-chave: dc.subjectEffectiveness-
Palavras-chave: dc.subjectFourth dose-
Palavras-chave: dc.subjectHospitalization-
Palavras-chave: dc.subjectOmicron-
Palavras-chave: dc.subjectVaccine-
Título: dc.titleSecond booster doses of adenoviral- and mRNA-based COVID-19 vaccines increase protection against COVID-19 hospitalization: Final analysis from the REFORCO-Brazil real-world effectiveness study during Omicron-
Tipo de arquivo: dc.typelivro digital-
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