Efficacy of mRNA and Inactivated Whole Virus Vaccines Against COVID-19 in Patients with Chronic Respiratory Diseases

Figures & data

Table 1 Baseline Demographic and Clinical Characteristics of Included Patients

	COVID-19 Group	Control Group	p-value
No. of patients	109	218
Age (years), mean ± SD	70 ± 14.7	69.5 ± 14.5	1.0
Gender			1.0
Male	70 (64.2%)	140 (64.2%)
Female	39 (35.8%)	78 (35.8%)
Ever smoker	73 (67.0%)	146 (67.0%)	1.0
Underlying respiratory disease			1.0
Asthma	17 (15.6%)	34 (15.6%)
Bronchiectasis	41 (37.6%)	82 (37.6%)
COPD	51 (46.8%)	102 (46.8%)
Co-morbidities
Hypertension	48 (44.0%)	71 (32.6%)	0.051
Diabetes Mellitus	22 (20.2%)	35 (16.1%)	0.359
Ischemic heart disease	14 (12.8%)	29 (13.3%)	0.529
Type of vaccine			0.163
CoronaVac	38 (34.9%)	65 (29.8%)
mRNA vaccine	24 (22.0%)	70 (32.1%)
COVID-19 vaccine			<0.001
Unvaccinated	47 (43.1%)	83 (38.1%)
Partially vaccinated (1 dose or within 13 days after 2nd dose)	17 (15.6%)	11 (5.0%)
Fully vaccinated for at least 14 days	36 (33.0%)	64 (29.4%)
Booster for at least 14 days	9 (8.2%)	60 (27.5%)
Time since second dose
Median	163 days	241 days	<0.001
0–13 days	3 (6.67%)	0 (0%)
14–90 days	11 (24.4%)	22 (10.1%)
91–210 days	17 (37.8%)	19 (8.7%)
>210 days	14 (31.1%)	82 (37.6%)
Baseline lung function
FEV1 (% predicted), mean ± SD	72 ± 26	74 ± 26	0.723
FVC (% predicted), mean ± SD	86 ± 30	87 ± 32	0.772
FEV1 impairment, % predicted			0.689
Mild, ≥80%	38 (34.9%)	86 (39.4%)
Moderate, 50% to <80%	48 (44.0%)	92 (42.2%)
Severe, <50%	23 (21.1%)	40 (18.3%)

Abbreviations: SD, standard deviation; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity.

Table 2 Time from Vaccination to COVID-19 Infection

	Median Time from Vaccination to COVID-19 Infection (Days)	Interquartile Range (25th and 75th Percentile)	p-value
First dose			0.357
CoronaVac	99	50–224
mRNA vaccine	158	157.5–228
Second dose			0.512
CoronaVac	179	68–229
mRNA vaccine	150	59.5–210
Third dose			0.089
CoronaVac	48	46–90
mRNA vaccine	22	21–22

Figure 1 Flow diagram for case selection.

Table 3 Comparing Unvaccinated Patients with Those Who Received at Least 2 Doses of Inactivated Whole Virus COVID-19 Vaccine and Those Who Received at Least 2 Doses of mRNA Vaccine

	% (No. of Cases/No. in Group)			Vaccine Effectiveness (Method 1)		Vaccine Effectiveness (Method 2)
	BNT162b2^a (A) (n = 85)	CoronaVac^a (B) (n =83)	Unvaccinated (C) (n = 130)	BNT162b2 (A vs C)	CoronaVac (B vs C)	BNT162b2 (A vs C)	CoronaVac (B vs C)
Symptomatic COVID-19	20 (23.5%)	25 (29.8%)	47 (36.2%)	62.0%* (23.0–81.3%)	31.7% (−28.4–63.6%)	44.5% (0.4–66.6%)*	30.2% (−15 – 57.6%)
COVID-19 related hospitalization	2 (2.4%)	3 (3.6%)	19 (14.6%)	79.3%* (3.8–95.7%)	81.1%* (28.6–95.0%)	80.0%* (11.3–95.3%)	77.0%* (20.1–93.3%)
COVID-19 related respiratory failure	1 (1.2%)	2 (2.4%)	17 (13.1%)	90.7%* (17.3–98.9%)	87.2%* (36.2–97.4%)	87.9%* (8.30–98.4%)	82.5%* (24.2–95.9%)

Notes: ^aVaccinated with 2 doses of inactivated or mRNA vaccine for at least 14 days. *P <0.05. Method 1: vaccine effectiveness was calculated with the formula, (1-adjusted odds ratio) x 100. The odds ratios were adjusted for age, gender, smoking status, residential area, underlying respiratory disease and baseline FEV1, calendar time of COVID-19 infection (biweekly interval, from 1 Jan 2022 onwards) and number of co-morbidities by a multivariate analysis model; Method 2: sensitivity analysis was performed and used multivariate Cox-regression to estimate hazard ratio (HR) of developing the composite end points. Vaccine effectiveness was calculated by the formula (1- adjusted HR) x 100.