Identification of priority groups for COVID-19 vaccination in Brazil

Detalhes bibliográficos
Autor(a) principal: Raquel Martins Lana
Data de Publicação: 2021
Outros Autores: Laís Picinini Freitas, Cláudia Torres Codeço, Antônio Guilherme Pacheco, Luiz Max Fagundes de Carvalho, Daniel Antunes Maciel Villela, Flávio Codeço Coelho, Oswaldo Gonçalves Cruz, Roberta Pereira Niquini, Victor Bertollo Gomes Porto, Caroline Gava, Marcelo Ferreira da Costa Gomes, Leonardo Soares Bastos
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840
Resumo: In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.
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spelling Identification of priority groups for COVID-19 vaccination in BrazilIdentificação de grupos prioritários para a vacinação contra COVID-19 no BrasilCOVID-19Severe Acute Respiratory SyndromeEpidemiological MonitoringComorbidityCOVID-19Síndrome Respiratória Aguda GraveMonitoramento EpidemiológicoComorbidadeIn a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.En un contexto de transmisión comunitaria y escasez de vacunas, la vacunación contra la COVID-19 debe enfocarse en la reducción directa de la morbilidad y de la mortalidad causadas por la enfermedad. Por lo tanto, es fundamental la definición de grupos prioritarios para la vacunación por el Programa Nacional de Inmunizaciones (PNI), basada en el riesgo de hospitalización y óbito por la enfermedad. Para tal fin, calculamos el sobrerriesgo por sexo, franja de edad y comorbilidades mediante los registros de hospitalización y óbito por síndrome respiratorio agudo grave con confirmación de COVID-19 (SRAG-COVID) en todo Brasil, durante los primeros seis meses de epidemia. Presentaron mayor sobrerriesgo personas del sexo masculino (hospitalización = 1,1 y óbito = 1,2), personas por encima de 45 años para hospitalización (SRfe variando de 1,1 a 8,5) y personas por encima de 55 años para óbitos (SRfe variando de 1,5 a 18,3). En los grupos de comorbilidades, enfermedad renal crónica, diabetes mellitus, enfermedad cardiovascular y neumopatía crónica ofrecieron sobrerriesgo, mientras que para el asma no hubo evidencia. Sufrir una enfermedad renal crónica o diabetes mellitus y tener 60 años o más mostró un factor todavía más fuerte, alcanzando sobrerriesgo de enfermedad 14 y 10 veces mayor que en la población general, respectivamente. Para todas las comorbilidades, hubo un sobrerriesgo más alto en edades mayores, con un gradiente de disminución en franjas más altas. Este patrón se invirtió cuando consideramos el sobrerriesgo en relación con la población general, tanto para hospitalización como para óbito. El presente estudio proporcionó evidencias respecto al sobrerriesgo de hospitalización y óbito por SRAG-COVID, ayudando en la definición de grupos prioritarios para la vacunación contra la COVID-19.Em um contexto de transmissão comunitária e escassez de vacinas, a vacinação contra a COVID-19 deve focar na redução direta da morbidade e da mortalidade causadas pela doença. Portanto, é fundamental a definição de grupos prioritários para a vacinação pelo Programa Nacional de Imunizações (PNI), baseada no risco de hospitalização e óbito pela doença. Para tal, calculamos o sobrerrisco por sexo, faixa etária e comorbidades por meio dos registros de hospitalização e óbito por síndrome respiratória aguda grave com confirmação de COVID-19 (SRAG-COVID) em todo o Brasil nos primeiros seis meses de epidemia. Apresentaram maior sobrerrisco pessoas do sexo masculino (hospitalização = 1,1 e óbito = 1,2), pessoas acima de 45 anos para hospitalização (SRfe variando de 1,1 a 8,5) e pessoas acima de 55 anos para óbitos (SRfe variando de 1,5 a 18,3). Nos grupos de comorbidades, doença renal crônica, diabetes mellitus, doença cardiovascular e pneumopatia crônica conferiram sobrerrisco, enquanto para asma não houve evidência. Ter doença renal crônica ou diabetes mellitus e 60 anos ou mais mostrou-se um fator ainda mais forte, alcançando sobrerrisco de óbito 14 e 10 vezes maior do que na população geral, respectivamente. Para todas as comorbidades, houve um sobrerrisco mais alto em idades maiores, com um gradiente de diminuição em faixas mais altas. Esse padrão se inverteu quando consideramos o sobrerrisco em relação à população geral, tanto para hospitalização quanto para óbito. O presente estudo forneceu evidências a respeito do sobrerrisco de hospitalização e óbito por SRAG-COVID, auxiliando na definição de grupos prioritários para a vacinação contra a COVID-19.Reports in Public HealthCadernos de Saúde Pública2021-10-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840Reports in Public Health; Vol. 37 No. 10 (2021): OctoberCadernos de Saúde Pública; v. 37 n. 10 (2021): Outubro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17538https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17539https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17540https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17541Raquel Martins LanaLaís Picinini FreitasCláudia Torres CodeçoAntônio Guilherme PachecoLuiz Max Fagundes de CarvalhoDaniel Antunes Maciel VillelaFlávio Codeço CoelhoOswaldo Gonçalves CruzRoberta Pereira NiquiniVictor Bertollo Gomes PortoCaroline GavaMarcelo Ferreira da Costa GomesLeonardo Soares Bastosinfo:eu-repo/semantics/openAccess2024-03-06T15:30:12Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7840Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:00.359312Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Identification of priority groups for COVID-19 vaccination in Brazil
Identificação de grupos prioritários para a vacinação contra COVID-19 no Brasil
title Identification of priority groups for COVID-19 vaccination in Brazil
spellingShingle Identification of priority groups for COVID-19 vaccination in Brazil
Raquel Martins Lana
COVID-19
Severe Acute Respiratory Syndrome
Epidemiological Monitoring
Comorbidity
COVID-19
Síndrome Respiratória Aguda Grave
Monitoramento Epidemiológico
Comorbidade
title_short Identification of priority groups for COVID-19 vaccination in Brazil
title_full Identification of priority groups for COVID-19 vaccination in Brazil
title_fullStr Identification of priority groups for COVID-19 vaccination in Brazil
title_full_unstemmed Identification of priority groups for COVID-19 vaccination in Brazil
title_sort Identification of priority groups for COVID-19 vaccination in Brazil
author Raquel Martins Lana
author_facet Raquel Martins Lana
Laís Picinini Freitas
Cláudia Torres Codeço
Antônio Guilherme Pacheco
Luiz Max Fagundes de Carvalho
Daniel Antunes Maciel Villela
Flávio Codeço Coelho
Oswaldo Gonçalves Cruz
Roberta Pereira Niquini
Victor Bertollo Gomes Porto
Caroline Gava
Marcelo Ferreira da Costa Gomes
Leonardo Soares Bastos
author_role author
author2 Laís Picinini Freitas
Cláudia Torres Codeço
Antônio Guilherme Pacheco
Luiz Max Fagundes de Carvalho
Daniel Antunes Maciel Villela
Flávio Codeço Coelho
Oswaldo Gonçalves Cruz
Roberta Pereira Niquini
Victor Bertollo Gomes Porto
Caroline Gava
Marcelo Ferreira da Costa Gomes
Leonardo Soares Bastos
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Raquel Martins Lana
Laís Picinini Freitas
Cláudia Torres Codeço
Antônio Guilherme Pacheco
Luiz Max Fagundes de Carvalho
Daniel Antunes Maciel Villela
Flávio Codeço Coelho
Oswaldo Gonçalves Cruz
Roberta Pereira Niquini
Victor Bertollo Gomes Porto
Caroline Gava
Marcelo Ferreira da Costa Gomes
Leonardo Soares Bastos
dc.subject.por.fl_str_mv COVID-19
Severe Acute Respiratory Syndrome
Epidemiological Monitoring
Comorbidity
COVID-19
Síndrome Respiratória Aguda Grave
Monitoramento Epidemiológico
Comorbidade
topic COVID-19
Severe Acute Respiratory Syndrome
Epidemiological Monitoring
Comorbidity
COVID-19
Síndrome Respiratória Aguda Grave
Monitoramento Epidemiológico
Comorbidade
description In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.
publishDate 2021
dc.date.none.fl_str_mv 2021-10-08
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https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17539
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7840/17540
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dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 37 No. 10 (2021): October
Cadernos de Saúde Pública; v. 37 n. 10 (2021): Outubro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
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institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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