Effectiveness of Coronavirus Disease 2019 Vaccines in Preventing Infection, Hospital Admission, and Death: A Historical Cohort Study Using Iranian Registration Data During Vaccination Program

The mass vaccination program in Iran has been associated with a dramatic reduction in COVID-19 detected infections, as well as in hospital admissions and deaths related to the COVID-19 diagnosis. Background There are some concerns about the effectiveness of the inactivated and vector-based vaccines against severe acute respiratory syndrome coronavirus 2 in real-world settings with the emergence of new mutations, especially variants of concern. Data derived from administrative repositories during mass vaccination campaigns or programs are of interest to study vaccine effectiveness. Methods Using 4-repository administrative data linkage, we conducted a historical cohort study on a target population of 1 882 148 inhabitants aged at least 18 years residing in southern Iran. Results We estimated a 71.9% [95% confidence interval [CI], 70.7%-73.1%], 81.5% [95% CI, 79.5%-83.4%], 67.5% [95% CI, 59.5%-75.6%], and 86.4% [95% CI, 84.1%-88.8%] hospital admission reduction for those who received the full vaccination schedule of BBIBP-CorV (Sinopharm), ChAdOx1-S/nCoV-19 vaccine (AZD1222, Oxford-AstraZeneca), rAd26-rAd5 (Gam-COVID-Vac, Sputnik V), and BIV1-CovIran (COVIran Barekat) vaccines, respectively. A high reduction in mortality (at least 85%) was observed in all age subgroups of the fully immunized population. Conclusions The pragmatic implementation of a vaccination plan including all available vaccine options in the Iranian population was associated with a significant reduction in coronavirus disease 2019 (COVID-19) detected infections as well as hospital admissions and deaths associated with COVID-19.

Automated summary

The mass vaccination program in Iran has led to a significant reduction in COVID-19 infections, hospital admissions, and deaths associated with COVID-19.