1. Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand 2. Data Management Unit, Centre of Learning and Research in Celebration of HRH Princess Chulabhorn's 60th Birthday Anniversary, Chulabhorn Royal Academy, Bangkok 10210, Thailand 3. Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand
Protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of inactivated vaccines is not well characterized in people with comorbidities, who are at high risk of severe infection. We compared the risk of SARS-CoV-2 infection after complete vaccination with Sinopharm/BBIBP in people with comorbidities (e.g., autoimmune diseases, cardiovascular disease, chronic lung disease, and diabetes) with healthy individuals using a Cox-proportional hazard model. In July–September 2021, a total of 10 548 people (comorbidities, 2143; healthy, 8405) receiving the complete primary series of vaccination with Sinopharm/BBIBP in Bangkok, Thailand were prospectively followed for SARS-CoV-2 infection through text messaging and telephone interviewing for 6 months. A total of 295 infections from 284 participants were found. HRs (95% CI) of individuals with any comorbidities did not increase (unadjusted, 1.02 (0.77–1.36), P = 0.89; adjusted, 1.04 (0.78–1.38), P = 0.81). HRs significantly increased in the subgroup of autoimmune diseases (unadjusted, 2.64 (1.09–6.38), P = 0.032; adjusted, 4.45 (1.83–10.83), P = 0.001) but not in cardiovascular disease, chronic lung disease, or diabetes. The protection against SARS-CoV-2 infection of the Sinopharm vaccine was similar in participants with any comorbidities vs. healthy individuals. However, the protection appeared lower in the subgroup of autoimmune diseases, which may reflect suboptimal immune responses among these people.
Incidence rate (95% CI), No. of event per 1 000 000 person-days
P
Unadjusted HR(95% CI) a, b
P
Adjusted HR(95% CI) a, b, c
P
Comorbid
No comorbid
Comorbid
No comorbid
Comorbid
No comorbid
Any Comorbidities
1260
3780
38
95
160.5 (116.8–220.6)
134.3 (109.9–164.3)
0.35
1.21 (0.83–1.77)
0.31
1.17 (0.80–1.71)
0.40
Autoimmune disease
64
192
4
5
328.9 (123.4–876.2)
139.1 (57.9–334.2)
0.22
2.32 (0.62–8.69)
0.21
5.90 (1.08–32.33)
0.041
Cardiovascular disease
73
219
3
6
218.9 (70.6–678.7)
146.1 (65.6–325.2)
0.56
1.60 (0.40–6.43)
0.50
2.02 (0.48–8.45)
0.33
Chronic lung disease
148
444
3
11
108.3 (34.9–335.9)
132.7 (73.5–239.6)
0.79
0.80 (0.22–2.85)
0.72
0.82 (0.23–2.95)
0.76
Diabetes mellitus
293
879
7
23
127.2 (60.6–266.9)
139.4 (92.7–209.8)
0.86
0.92 (0.39–2.14)
0.84
0.99 (0.42–2.31)
0.97
Tab.3
Fig.4
Participant cohort
No. of participants with events/Total participants (%)
Unadjusted HR a
P
Adjusted HR a, b
P
Comorbidities
No comorbidities
Any comorbidities
87/2143 (4.06%)
314/8405 (3.74%)
1.06 (0.84–1.35)
0.60
1.10 (0.87–1.39)
0.41
Autoimmune disease
6/68 (8.82%)
395/10480 (3.77%)
1.84 (0.76–4.46)
0.17
2.78 (1.15–6.73)
0.024
Cardiovascular disease
7/164 (4.27%)
394/10384 (3.79%)
1.40 (0.72–2.71)
0.31
1.63 (0.84–3.16)
0.14
Chronic lung disease
6/188 (3.19%)
395/10360 (3.81%)
0.81 (0.36–1.81)
0.60
0.82 (0.37–1.85)
0.63
Diabetes mellitus
17/645 (2.64%)
384/9903 (3.88%)
0.73 (0.46–1.16)
0.18
0.80 (0.51–1.27)
0.34
Tab.4
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