Vaccination hesitancy as a cause of COVID-related mortality
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222255Keywords:
COVID-19, ICU, Vaccination hesitancy, VaccineAbstract
Background: In this study, our aim was to draw attention to the vaccine hesitation as a cause of unvaccination and evaluate the vaccinated and unvaccinated patients in the intensive care unit in terms of morbidity and mortality.
Methods: A hundred and ninety-nine patients between the May 2021-September 2021 admitted to the intensive care units in our hospital were included in this study. We included the patients with COVID-19 infection as assessed by reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay.
Results: Despite the availability of eligible vaccines in our region, the most of included patients in this study were unvaccinated (n:119). Eighty patients were vaccinated. The vaccinated patients were divided into six groups according to their vaccination status such as subgroup 1: one-dose Coronavac, subgroup 2: two-doses Coronavac, subgroup 3: three-doses Coronavac, subgroup 4: 2-doses Coronavac+ One-dose BNT162b2, subgroup 5: one-dose BNT162b2, subgroup 6: two-doses BNT162b2 (Numbers of patients: 7-61-3-1-10-0 respectively for each group). Between the vaccinated and unvaccinated groups, there was no significant difference in terms of mortality (p>0,05). The majority of patients in the vaccinated group were the patients vaccinated with Coronavac (subgroup 2:59), and there was no full dose vaccinated patient with BNT162b2.
Conclusions: While both vaccines are effective to reduce the morbidities and mortality related to COVID-19, there might not be efficacy in these vaccines, particularly Coronavac, following the admission to the intensive care unite in the more vulnerable population. And despite the availability of vaccines, vaccine-hesitancy may be one of the significant reasons for the hospitalization process.
Metrics
References
World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. Available from: http://www.who.int/dg/speeches/detail/whdirectorgeneral-s-remarks-at-the-mediabriefingon2019ncovon-11-february-2020. Accessed on 12 February 2020.
World Health Organization. Draft landscape of COVID-19 candidate vaccines. Available from: https://www.who.int/docs/default-source/blue-print/novel-coronavirus-landscape-covid-19-(7).pdf. Accessed on 20 October 2020.
Tartof SY, Slezak JM, Fischer H, Hong V, Ackerson BK, Ranasinghe ON, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. Lancet. 2021 Oct 16;398(10309):1407-16.
Wang GL, Wang ZY, Duan LJ, Meng QC, Jiang MD, Cao J, et al. Susceptibility of circulating SARS-CoV-2 variants to neutralization. N Engl J Med. 2021;384(24):2354-6.
Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, et al. Effect of 2 inactivated SARS-CoV-2 vaccines on symptomatic COVID-19 infection in adults: a randomized clinical trial. JAMA. 2021;326(1):35-45..
Zhang Y, Zeng G, Pan H, Li C, Hu Y, Chu K, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis. 2021;21(2):181-92.
US Food and Drug Administration. Emergency use authorization for vaccines to prevent COVID-19: Guidance for industry. February 2021. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/emergency-use-authorization-vaccines-prevent-covid-19. Accessed on 20 October 2020.
Tang P, Hasan MR, Chemaitelly H, Yassine HM, Benslimane FM, Al Khatib HA, et al. BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the SARS-CoV-2 Delta variant in Qatar. Nat Med. 2021;27(12):2136-43.
WHO. SAGE Working Group on Vaccine Hesitancy, 2015. Available at: http://www.who.int/immunization/sage/sage_wg_vaccine_hesitancy_apr12/e. Accessed on 12 February 2020.
Iboi EA, Ngonghala CN, Gumel AB. Will an imperfect vaccine curtail the COVID-19 pandemic in the US? Infect Dis Model. 2020;5:510-24.
Kim JH, Marks F, Clemens JD. Looking beyond COVID-19 vaccine phase 3 trials. Nat Med. 2021;27(2):205-11.
Soysal A, Gönüllü E, Karabayır N, Alan S, Atıcı S, Yıldız İ, et al. Comparison of immunogenicity and reactogenicity of inactivated SARS-CoV-2 vaccine (CoronaVac) in previously SARS-CoV-2 infected and uninfected health care workers. Hum Vaccine Immunotherap. 2021;17(11):3876-80.
Jara A, Undurraga EA, González C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med. 2021;385(10):875-84.
Kumar S, Thambiraja TS, Karuppanan K, Subramaniam G. Omicron and delta variant of SARS‐CoV‐2: a comparative computational study of spike protein. J Med Virol. 2022;94(4):1641-9.
Bian L, Gao Q, Gao F, Wang Q, He Q, Wu X, et al. Impact of the Delta variant on vaccine efficacy and response strategies. Exp Rev Vaccines. 2021;20(10):1201-9.
MacDonald NE. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34):4161-4.
Nguyen KH, Srivastav A, Razzaghi H, Williams W, Lindley MC, Jorgensen C, et al. COVID‐19 vaccination intent, perceptions, and reasons for not vaccinating among groups prioritized for early vaccination- United States, September and December 2020. Am J Transplant. 2021;21(4):1650-6.
Akarsu B, Canbay Özdemir D, Ayhan Baser D, Aksoy H, Fidancı İ, Cankurtaran M. While studies on COVID‐19 vaccine is ongoing, the public’s thoughts and attitudes to the future COVID‐19 vaccine. Int J Clin Pract. 2021;75(4):e13891.
Republic of Turkey Ministry of Health COVID-19 vaccination information platform. Available from: <https://covid19asi.saglik.gov.tr/?_Dil=1>. Accessed on 17 November 2021.
Yildiz Y, Telatar TG, Baykal M, Yurtsever BA, Yildiz İE. Evaluation of vaccine rejection during the COVID-19 pandemic. J Duzce Univ Inst Health Sci. 2021;11(2):200-5.
Mistik R. The epidemiology of viral hepatitis in Turkey: analysis of published data. Viral Hepatit. 2007;1(1).
Toy M, Önder FO, Wörmann T, Bozdayi AM, Schalm SW, Borsboom GJ, et al. Age-and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC Infect Dis. 2011;11(1):1-2.
Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect. 2015;21(11):1020-6.
Tosun S. Epidemiology of viral hepatitis in Turkey: a meta-analysis of all published papers. Viral Hepatitis. Istanbul: Istanbul Tıp; 2013:27-79.
World Health Organization. Ten threats to global health in 2019. Available from: https://www.who.int/news-room/spotlight/tthreatto-global-health-in-2019. Accessed on 12 November 2020.
Hitchings MD, Ranzani OT, Torres MS, de Oliveira SB, Almiron M, Said R, et al. Effectiveness of CoronaVac in the setting of high SARS-CoV-2 P. 1 variant transmission in Brazil: A test-negative case-control study. MedRxiv. 2021.
Bar-On YM, Goldberg Y, Mandel M, Bodenheimer O, Freedman L, Kalkstein N, et al. Protection of BNT162b2 vaccine booster against Covid-19 in Israel. N Engl J Med. 2021;385(15):1393-400.
Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, Elbaz M, Nesher L, Stein M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021;27(11):1652-1657.
Karagiannidis C, Mostert C, Hentschker C, Voshaar T, Malzahn J, Schillinger G, et al. Case characteristics, resource use, and outcomes of 10 021 patients with COVID-19 admitted to 920 German hospitals: an observational study. Lancet Respirat Med. 2020;8(9):853-62.
Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369.
Downloads
Published
How to Cite
Issue
Section
