Vaccine effectiveness against severe COVID-19 outcomes within the French overseas territories: A cohort study of 2-doses vaccinated individuals matched to unvaccinated ones followed up until September 2021 and based on the National Health Data System
Open accessAbstract
Importance: Although several observational studies on the effectiveness of SARS-CoV-2 vaccination have been published, vaccination coverage by August, 3 2021, remained low in the French overseas territories, despite Martinique and Guadeloupe experiencing an unprecedented number of COVID-19-related hospitalizations. We aimed to determine the association between COVID-19 vaccination and severe COVID-19 in the French overseas territories. Methods: The French National Health Data System was used to conduct a 1:1 matched-cohort study. For each individual receiving a first dose of BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, or Ad26.COV2-S vaccine between December 27, 2020, and July 31, 2021, one unvaccinated individual was randomly selected and matched for year of birth, sex, and overseas territories on the date of vaccination. We estimated vaccine effectiveness against COVID-19-related hospitalization and in-hospital death after a full vaccination schedule, defined as ≥14 days after the second dose. Analyses were stratified according to the number of comorbidities. Results: 276,778 vaccinated individuals had a double-dose vaccination during the follow-up period and were followed with their paired unvaccinated control. The average age was 50 years and 53% were women. During a median 77 days of follow-up from day 14 after the second injection, 96 COVID-19-related hospitalizations occurred among vaccinated individuals and 1,465 among their unvaccinated counterparts. Overall, vaccine effectiveness against hospitalization was 94% (95%CI [93–95]) and exceeded 90% in each overseas territory, except Mayotte. The results were similar looking specifically at hospitalizations between July 15 and September 30, 2021. Vaccine effectiveness against in-hospital death was similar (94% [95%CI 91–96]). The risk of COVID-19-related hospitalization increased with the number of comorbidities, especially among vaccinated individuals. Conclusions and relevance: In conclusion, vaccination has a major effect in reducing the risk of severe Covid-19 in the French overseas territories. The risk of COVID-19-hospitalization was very low among vaccinated individuals, especially in the absence of comorbidities. These results aim to increase confidence in vaccine effectiveness in overseas territories in hope of achieving better vaccination coverage.
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Only a few studies have reported on vaccine protection in the French population, especially among those most at risk of severe COVID-19 disease.
“To date, only a few studies [12,23,24] have reported on the protection afforded by vaccines in the French population, especially among the most at risk of severe COVID-19 disease.”
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- Authors
- Semenzato, L., Botton, J., Baricault, B., Deloumeaux, J., Joachim, C., Sylvestre, E., Dray-Spira, R., Weill, A., & Zureik, M.
- Affiliations
- Conservatoire National des Arts et Métiers (FR)
- Centre Hospitalier Universitaire de Martinique (MQ)
- Corresponding author
- Semenzato, Laura
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2022-09-09
- Volume
- 17
- Issue
- 9
- Pages
- e0274309
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC9462750
- OpenAlex
- W4295049451
- Cited by
- 13
- References
- 16
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 5 · 2022: 1
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 vaccination, severe COVID-19, hospitalization, in-hospital mortality, French overseas territories, BNT162b2, mRNA-1273, ChAdOx1 nCoV-19 vaccine, Ad26.COV2-S, comorbidities, matched cohort, vaccination coverage, Mayotte
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, Vaccine Efficacy, BNT162 Vaccine, ChAdOx1 nCoV-19, Female, Hospitalization, Humans, Male, Middle Aged, Cohort Studies, Hospital Mortality
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