Persistent Health Issues, Adverse Events, and Effectiveness of Vaccines during the Second Wave of COVID-19: A Cohort Study from a Tertiary Hospital in North India
Upinder Kaur,
Sapna Bala,
Aditi Joshi,
Noti Taruni Srija Reddy,
Chetan Japur,
Mayank Chauhan,
Nikitha Pedapanga,
Shubham Kumar,
Anurup Mukherjee,
Vaibhav Mishra,
Dolly Talda,
Rohit Singh,
Rohit Kumar Gupta,
Ashish Kumar Yadav,
Poonam Jyoti Rana,
Jyoti Srivastava,
Shobha Bhat K.,
Anup Singh,
Naveen Kumar P.G.,
Manoj Pandey,
Kishor Patwardhan,
Sangeeta Kansal,
Sankha Shubhra Chakrabarti
Affiliations
Upinder Kaur
Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Sapna Bala
Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Aditi Joshi
Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Noti Taruni Srija Reddy
Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Chetan Japur
Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Mayank Chauhan
Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Nikitha Pedapanga
Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Shubham Kumar
Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Anurup Mukherjee
Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Vaibhav Mishra
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Dolly Talda
Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Rohit Singh
Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Rohit Kumar Gupta
Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Ashish Kumar Yadav
Center for Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Poonam Jyoti Rana
College of Nursing, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Jyoti Srivastava
College of Nursing, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Shobha Bhat K.
Department of Agad Tantra, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Anup Singh
Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Naveen Kumar P.G.
Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Manoj Pandey
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Kishor Patwardhan
Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Sangeeta Kansal
Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Sankha Shubhra Chakrabarti
Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India
Background There is paucity of real-world data on COVID-19 vaccine effectiveness from cohort designs. Variable vaccine performance has been observed in test-negative case-control designs. There is also scarce real-world data of health issues in individuals receiving vaccines after prior COVID-19, and of adverse events of significant concern (AESCs) in the vaccinated. Methods: A cohort study was conducted from July 2021 to December 2021 in a tertiary hospital of North India. The primary outcome was vaccine effectiveness against COVID-19 during the second wave in India. Secondary outcomes were AESCs, and persistent health issues in those receiving COVID-19 vaccines. Regression analyses were performed to determine risk factors of COVID-19 outcomes and persistent health issues. Results: Of the 2760 health care workers included, 2544 had received COVID-19 vaccines, with COVISHIELD (rChAdOx1-nCoV-19 vaccine) received by 2476 (97.3%) and COVAXIN (inactivated SARS-CoV-2 vaccine) by 64 (2.5%). A total of 2691 HCWs were included in the vaccine effectiveness analysis, and 973 COVID-19 events were reported during the period of analysis. Maximum effectiveness of two doses of vaccine in preventing COVID-19 occurrence was 17% across three different strategies of analysis adopted for robustness of data. One-dose recipients were at 1.27-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate–severe COVID-19 by 57%. Those with lung disease were at 2.54-times increased risk of moderate–severe COVID-19, independent of vaccination status. AESCs were observed in 33/2544 (1.3%) vaccinees, including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times higher risk and those receiving a vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues. Conclusions: COVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. The possible relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. With independent protection of SARS-CoV-2 infection, and high-risk of persistent health issues in individuals receiving vaccine after recovery from SARS-CoV-2 infection, the recommendation of vaccinating those with prior SARS-CoV-2 infection needs reconsideration.
