RESUMEN
Background: A continuing nationwide vaccination campaign began in the Dominican Republic on February 16, 2021 to prevent severe consequences of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Estimates of vaccine effectiveness under real-world conditions are needed to support policy decision making and inform further vaccine selection. Methods: We conducted a test-negative case-control study to assess the real-world effectiveness of nationwide coronavirus disease 2019 (COVID-19) vaccination program using an inactivated vaccine (CoronaVac) on preventing symptomatic SARS-CoV-2 infections and hospitalizations from August to November 2021 in the Dominican Republic. Participants were recruited from 10 hospitals in 5 provinces to estimate the effectiveness of full immunization (≥14 days after receipt of the second dose) and partial immunization (otherwise with at least 1 dose ≥14 days after receipt of the first dose). Results: Of 1078 adult participants seeking medical care for COVID-19-related symptoms, 395 (36.6%) had positive polymerase chain reaction (PCR) tests for SARS-CoV-2; 142 (13.2%) were hospitalized during 15 days of follow up, including 91 (23%) among 395 PCR-positive and 51 (7.5%) among 683 PCR-negative participants. Full vaccination was associated with 31% lower odds of symptomatic infection (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.52-0.93) and partial vaccination was associated with 49% lower odds (OR, 0.51; CI, 0.30-0.86). Among 395 PCR-positive participants, full vaccination reduced the odds of COVID-19-related hospitalization by 85% (OR, 0.15; 95% CI, 0.08-0.25) and partial vaccination reduced it by 75% (OR, 0.25; 95% CI, 0.08-0.80); full vaccination was associated with reduced use of assisted ventilation by 73% (OR, 0.27; 95% CI, 0.15-0.49). Conclusions: Given the ancestral and delta viral variants circulating during this study period, our results suggest that the inactivated COVID-19 vaccine offered moderate protection against symptomatic SARS-CoV-2 infections and high protection against COVID-19-related hospitalizations and assisted ventilation. This is reassuring given that, as of August 2022, an estimated 2.6 billion inactivated CoronaVac vaccine doses had been administered worldwide. This vaccine will become a basis for developing multivalent vaccine against the currently circulating omicron variant.
RESUMEN
This study compares the trends in AIDS case reports in Southern states and in other regions and estimates the factors associated with the trends. Data from the HIV/AIDS Surveillance Reports 1999 and 2004 of the Centers for Disease Control and Prevention were used to calculate the proportion of the total cumulative cases (1981-2004) that occurred in the five most recent years (2000-2004). A linear regression model was fitted to estimate the factors associated with the highest recent growth rate for AIDS cases by state. Results revealed that Southern states (including the District of Columbia) are more likely to have a disproportionate proportion of total AIDS cases reported within the past five years (25.5% in 16 states and the District) compared to the rest of the U.S. (mean = 19.3% in 34 states and Puerto Rico and the U.S. Virgin Islands; p < 0.001). Being a southern state (4.3% higher in proportion; 95% CI, 1.3%-7.3%) and higher representation of black race (0.1%, 95% CI, 0.02%-0.2%) were factor independently associated with higher recent growth rate for a state. AIDS case rates suggest recent worrisome trends in the South. Those states and territories that are in the South and that have higher proportions of African-Americans have a higher proportion of recent AIDS case reports than elsewhere, suggesting the need for a special geographic focus to encourage prevention, HIV testing, and access to care.