Impact of vaccination on COVID-19 severity during the second wave in Brunei Darussalam, 2021

Authors

  • Chee Fui Chong National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Muhammad Syafiq Abdullah National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Pui Lin Chong National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Rosmonaliza Asli National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Babu Ivan Mani National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Natalie Raimiza Momin National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Justin Wong National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Noor Afizan Rahman National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Jackson Tan National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
  • Vui Heng Chong National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam

DOI:

https://doi.org/10.5365/wpsar.2024.15.1.992

Keywords:

COVID-19, SARS-CoV-2, effectiveness, vaccination, disease severity, Brunei

Abstract

Objective: Coronavirus disease (COVID-19) vaccinations have been shown to prevent infection with efficacies ranging from 50% to 95%. This study assesses the impact of vaccination on the clinical severity of COVID-19 during the second wave in Brunei Darussalam in 2021, which was due to the Delta variant.

Methods: Patients included in this study were randomly selected from those who were admitted with COVID-19 to the National Isolation Centre between 7 August and 6 October 2021. Cases were categorized as asymptomatic, mild (symptomatic without pneumonia), moderate (pneumonia), severe (needing supplemental oxygen therapy) or critical (needing mechanical ventilation) but for statistical analysis purposes were dichotomized into asymptomatic/mild or moderate/severe/critical cases. Univariate and multivariable analyses were conducted to identify risk factors associated with moderate/severe/critical disease. Propensity score-matched analysis was also performed to evaluate the impact of vaccination on disease severity.

Results: The study cohort of 788 cases (mean age: 42.1 + 14.6 years; 400 males) comprised 471 (59.8%) asymptomatic/mild and 317 (40.2%) moderate/severe/critical cases. Multivariable logistic regression analysis showed older age group (>45 years), diabetes mellitus, overweight/obesity and vaccination status to be associated with increased severity of disease. In propensity score-matched analysis, the relative risk of developing moderate/severe/critical COVID-19 for fully vaccinated (two doses) and partially vaccinated (one dose) cases was 0.33 (95% confidence interval [CI]: 0.16–0.69) and 0.62 (95% CI: 0.46–0.82), respectively, compared with a control group of non-vaccinated cases. The corresponding relative risk reduction (RRR) values were 66.5% and 38.4%, respectively. Vaccination was also protective against moderate/severe/critical disease in a subgroup of overweight/obese patients (RRR: 37.2%, P = 0.007).

Discussion: Among those who contracted COVID-19, older age, having diabetes, being overweight/obese and being unvaccinated were significant risk factors for moderate/severe/critical disease. Vaccination, even partial, was protective against moderate/severe/critical disease.

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Published

25-03-2024

How to Cite

1.
Chong CF, Abdullah MS, Chong PL, Asli R, Mani BI, Momin NR, Wong J, Rahman NA, Tan J, Chong VH. Impact of vaccination on COVID-19 severity during the second wave in Brunei Darussalam, 2021. Western Pac Surveill Response J [Internet]. 2024 Mar. 25 [cited 2024 Apr. 20];15(1):11. Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/992

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Original Research

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