Abstract
ABSTRACT Objective: To investigate the relation between COVID-19 vaccine coverage and COVID-19-related mortality by age groups in Brazil in 2021. Methods: Secondary data on COVID-19 deaths and vaccination coverage were retrieved to investigate COVID-19 mortality rate (MR) evolution as the vaccination against COVID-19 advanced in Brazil in 2021. Poisson regression with adjustment for age and Brazilian states was used to calculate the MR. Results: By mid-April 2021, MR increased 2 – 3 times compared with the already high level in January for people aged 60 years or older, reaching the highest epidemic level of 5 – 15 per 100,000 inhabitants in this age group. Despite the following decline trend, by the end of May, the MR level was still about 50% and 80% higher for the age groups of 40 – 79 years and 80 years or older. The coverage concerning the first dose of COVID-19 vaccine reached 80% for people aged 60 – 69 years and exceeded 95% for those aged 70 years or older, but the second dose was only given to 26, 76 and 64% of the age groups of 60 – 69, 70 – 79, and 80 years or older, respectively. The age-standardized average MR over the study period was the highest in northern Brazilian states of Rondônia, Amazonas, Acre, and Roraima (range 6-8.4 per 100,000 inhabitants). Conclusions: COVID-19 vaccination coverage was below the level necessary to protect Brazilians from rising MR between January and May 2021. Urgent measures are necessary to increase the vaccine supply and the adherence to non-pharmacological protective measures.
Highlights
The dramatic rise of Coronavirus Disease 2019 (COVID-19) cases and deaths in Brazil in 20211 coincided with the spread of the P.1 variant[2,3] and a large increase in the proportion of the non-elderly population being hospitalized and even succumbing to the disease
A British simulation study showed that mortality rate (MR) rapidly drops in the vaccinated population compared with the non-vaccinated one, but the latter benefits from the group immunity, especially after having 50% of the adult population vaccinated[6]
MR rapidly increased over the first period up to mid-April, significantly decreased for all age groups of 60 years or older
Summary
The dramatic rise of Coronavirus Disease 2019 (COVID-19) cases and deaths in Brazil in 20211 coincided with the spread of the P.1 variant[2,3] and a large increase in the proportion of the non-elderly population being hospitalized and even succumbing to the disease. The demand for oxygen and intensive care exponentially increased and overreached the installed capacity, with subsequent chaos and many patients waiting to receive adequate medical care for too long. This was a nationwide problem, it was critical in the state of Amazonas[4]. By the end of May 2021, almost all Brazilians aged 70 years or older received at least one dose of the vaccine against COVID-195, but in the age group of 60 – 69 years this figure was down to 80%. The objective of this report is to investigate the evolution of COVID-19 MR, taking into account the age distribution in the population, as COVID-19 vaccination advanced in Brazil in 2021, both nationwide and across states
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