Real-world Evidence of COVID-19 Vaccines Effectiveness in Solid-organ Transplant Recipient Population in Colombia: A Study Nested in the Esperanza Cohort

Abstract

Background. Solid-organ transplant recipients (SOTRs) have a higher risk of coronavirus disease 2019 (COVID-19) complications and death and a less powerful and lasting response to vaccines and to natural infection. In Colombia, this population was prioritized in the National Vaccination Plan against COVID-19 and received vaccines from different platforms. The aim of this study was to estimate the effectiveness of the complete vaccination schedule and of the vaccine booster for COVID-19 administered to SOTRs in Colombia. Methods. A nested-cohort was assembled within the population-based ESPERANZA cohort and included the subset of 16 y and older SOTRs (n = 6963); the follow-up period spanned March 11, 2021, to May 11, 2022. The vaccine effectiveness was estimated with Cox proportional-hazards models so that the overall effectiveness of the complete vaccination schedule, the vaccine booster, each used vaccine, and the homologous and heterologous schedules were estimated, adjusting by the main confounders. Results. The overall effectiveness of being fully vaccinated was 73.7% (95% confidence interval [CI], 68.9%-77.0%) to prevent COVID-19 infection, 83.7% (95% CI, 78.7%-87.5%) to prevent hospitalization, and 92.1% (95% CI, 88.8%-94.4%) to prevent death due to COVID-19. Similarly, the effectiveness of the vaccine booster was 76.7% (95% CI, 70.6%-81.5%), 86.9% (95% CI, 79.4%-91.6%), and 94.5% (95% CI, 89.8%-97.1%) to prevent confirmed COVID-19 infection, hospitalization, and death due to COVID-19, respectively. In both cases, there were no statistically significant differences across age groups. Conclusions. Findings from this work show a high protection of vaccination against infection, hospitalization, and death due to COVID-19 in SOTRs, which increases with the vaccine booster.

Vaccine Effectiveness Against the SARS-CoV-2 B.1.1.529 Omicron Variant in Solid Organ and Islet Transplant Recipients in England: A National Retrospective Cohort Study

“…These studies have been reviewed by Napuri et al 25 Our study one of the first to report outcomes during the Omicron era in SOT patients on a national scale. 27 Pinto-Alvarez et al 27 recently reported VE in a Colombian cohort of almost 7000 solid organ transplant recipients, showing that 3 vaccine doses appeared to provide almost 95% protection against death due to COVID-19 between March 2021 and May 2022. We were able to examine outcomes in a larger population, enabling us to specifically study VE during the Omicron-dominant period between December 2021 and March 2022.…”

Outcomes of COVID-19 in kidney transplant recipients in the vaccination Era: A national multicenter cohort from Thailand

“…Initially, the mortality rate of COVID-19 in KTR was as high as 30 %, but it has decreased to less than 10 % in subsequent periods [ 2 , 14 , 29 , 30 ]. Several factors have contributed to this improvement, including better knowledge of patient care, the use of corticosteroids, appropriate utilization of antiviral medications and monoclonal antibodies, and non-pharmacologic interventions [ [31] , [32] , [33] , [34] , [35] ].…”

“…Previous studies have shown that KTR have an inferior immune response to SARS-CoV-2 vaccination compared to the general population, and booster doses are necessary to enhance immune response for protection against SARS-CoV-2 infection and its severe complications [ 4 , 11 ]. However, the real-world efficacy of booster vaccinations in KTR, especially in Eastern countries with differing vaccine distribution and socioeconomic factors from Western countries, still require more data [ 9 , [11] , [12] , [13] , [14] , 36 ].…”

“…At present, most of the information about COVID-19 outcomes in KTR comes from Western countries [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. This leaves a notable gap in knowledge about Asian KTR, where a wider variety of vaccine types, including inactivated, viral vector, and mRNA vaccines, have been used.…”