Association Between the Effectiveness and Immunogenicity of Inactivated SARS-CoV2 Vaccine (CoronaVac) with the Presence of Hypertension among Health Care Workers

ABSTRACT

Objective

This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination.

Methods

We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18–59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA.

Results

Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination.

Conclusion

Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.

KEYWORDS:

• Hypertension
• Covid-19
• coronavac
• vaccination
• anti-SRBD antibody

Acknowledgments

The authors thank the Saiful Anwar General Hospital Malang, Indonesia, for the funding of this study. We thank the director of Saiful Anwar General Hospital Malang, Indonesia, Dr. dr. Kohar Hari Santoso, SpAn, KAP, KIC for supporting this study. The authors also would like to thank dr. Mochamad Bachtiar Budianto, SpB(K)Onk as the assistant director of Education and Professional Development in Saiful Anwar General Hospital, Malang, Indonesia, and dr. Syaifullah Asmiragani, SpOT(K), as the assistant director of Medical and Nursing Services of Saiful Anwar General Hospital, Malang, Indonesia. We would also like to thank the management and staff in the Education and Research Saiful Anwar General Hospital Malang Indonesia that also helped this study. The authors also thank Mokhamad Fahmi Rizki Syaban, MD, for the assistance in writing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded and supported by Saiful Anwar General Hospital, Malang, Indonesia funded and supported by Saiful Anwar General Hospital, Malang, Indonesiaf.