Effectiveness of inactivated COVID-19 vaccines among older adults in Shanghai: retrospective cohort study

We conducted a matched retrospective cohort study of two cohorts to estimate inactivated vaccine effectiveness (VE) and its comparative effectiveness of booster dose among older people in Shanghai. Cohort 1 consisted of a vaccinated group (>= 1 dose) and an unvaccinated group (3,317,475 pairs), and cohort 2 consisted of a booster vaccinated group and a fully vaccinated group (2,084,721 pairs). The Kaplan-Meier method and Cox regression models were used to estimate risk and hazard ratios (HRs) study outcomes. For cohort 1, the overall estimated VEs of >= 1 dose of inactivated vaccine against SARS-CoV-2 infection, severe/critical Covid-19, and Covid-19 related death were 24.7% (95%CI 23.7%-25.7%), 86.6% (83.1%-89.4%), and 93.2% (88.0%-96.1%), respectively. Subset analysis showed that the booster vaccination provided greatest protection. For cohort 2, compared with full vaccination, relative VEs of booster dose against corresponding outcome were 16.3% (14.4%-17.9%), 60.5% (37.8%-74.9%), and 81.7% (17.5%-95.9%). Here we show, although under the scenario of persistent dynamic zero-Covid policy and non-pharmaceutical interventions, promoting high uptake of the full vaccination series and booster dose among older adults is critically important. Timely vaccination with the booster dose provided effective protection against Covid-19 outcomes. Inactivated COVID-19 vaccines have been widely used in China, but there is limited real-world evidence for their effectiveness in this setting. Here, the authors estimate effectiveness of inactivated vaccines for people aged 60 or older in Shanghai during a period when Omicron was the dominant circulating variant.

Automated summary

We performed a retrospective cohort study in Shanghai to estimate the effectiveness of inactivated vaccines and compare the effectiveness of booster doses among older individuals. The study included two cohorts: one with a vaccinated group (>= 1 dose) and an unvaccinated group, and another with a booster vaccinated group and a fully vaccinated group. The results showed that both the initial vaccination and booster dose provided substantial protection against SARS-CoV-2 infection and severe/critical Covid-19, with the booster dose offering the greatest protection. These findings highlight the importance of promoting high vaccination uptake among older adults, even in the context of ongoing non-pharmaceutical interventions.