Reviews of "Assessing Healthy Vaccinee Bias in COVID-19 Vaccine Effectiveness Studies: A National Cohort Study in Qatar"

Thiago Cerqueira Silva; Mario Coccia

doi:doi:10.1162/2e3983f5.4354046b

Reviews of "Assessing Healthy Vaccinee Bias in COVID-19 Vaccine Effectiveness Studies: A National Cohort Study in Qatar"

Reviewers: T C Silva (London School of Hygiene and Tropical Medicine) | 📗📗📗📗◻️ • M Coccia (National Research Council of Italy) | 📗📗📗📗◻️

by Thiago Cerqueira Silva and Mario Coccia

Published onOct 17, 2024

This Pub is a Review of

Assessing Healthy Vaccinee Effect in COVID-19 Vaccine Effectiveness Studies: A National Cohort Study in Qatar

by Hiam Chemaitelly, Houssein H. Ayoub, Peter Coyle, Patrick Tang, Mohammad R. Hasan, Hadi M. Yassine, Asmaa A. Al Thani, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul-Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al-Kuwari, Hamad Eid Al-Romaihi, Mohamed H. Al-Thani, Abdullatif Al-Khal, Roberto Bertollini, Adeel A. Butt, and Laith J. Abu-Raddad

Show Description
Published on Sep 03, 2024
www.medrxiv.org

Description

Abstract Background This study investigated the presence of the healthy vaccinee effect—the imbalance in health status between vaccinated and unvaccinated individuals—in two COVID-19 vaccine effectiveness studies involving primary series and booster vaccinations. It also examined the temporal patterns and variability of this effect across different subpopulations by analyzing the association between COVID-19 vaccination and non-COVID-19 mortality in Qatar.Methods Two matched, retrospective cohort studies assessed the incidence of non-COVID-19 death in national cohorts of individuals with a primary series vaccination versus no vaccination (two-dose analysis), and individuals with three-dose (booster) vaccination versus primary series vaccination (three-dose analysis), from January 5, 2021, to April 9, 2024.Results The adjusted hazard ratio (aHR) for non-COVID-19 death was 0.76 (95% CI: 0.64-0.90) in the two-dose analysis and 0.85 (95% CI: 0.67-1.07) in the three-dose analysis. In the first six months of follow-up in the two-dose analysis, the aHR was 0.35 (95% CI: 0.27-0.46); however, the combined analysis of all subsequent periods showed an aHR of 1.52 (95% CI: 1.19-1.94). In the first six months of follow-up in the three-dose analysis, the aHR was 0.31 (95% CI: 0.20-0.50); however, the combined analysis of all subsequent periods showed an aHR of 1.37 (95% CI: 1.02-1.85). The overall effectiveness of the primary series and third-dose vaccinations against severe, critical, or fatal COVID-19 was 95.9% (95% CI: 94.0-97.1) and 34.1% (95% CI: −46.4-76.7), respectively. Subgroup analyses showed that the healthy vaccinee effect is pronounced among those aged 50 years and older and among those more clinically vulnerable to severe COVID-19.Conclusion A strong healthy vaccinee effect was observed in the first six months following vaccination. This effect may have stemmed from a lower likelihood of vaccination among seriously ill, end-of-life individuals, and less mobile elderly populations.

To read the original manuscript, click the link above.

Summary of Reviews: The reviewers agree that the study helps validate an issue that is already known; despite this, the paper and other relevant literature highlights that COVID-19 vaccines and their boosters still show evidence of conferring protective effects against acquiring severe COVID-19 infection. The reviewers were critical of the overall validity of results as the study did not account for potential additional biases that may have been introduced in the follow-up period. As well, the reviewers pointed out that the study has a significant amount of self-citations, and did not incorporate much of the known existing literature that support its research questions. The reviewers were also critical of the prose of the manuscript, stating that its aims were not clear. The overall conclusions that the existence of the healthy vaccinee bias within this cohort is helpful to incorporate when critiquing vaccine effectiveness studies.

Reviewer 1 (Thiago Cerqueira S…) | 📗📗📗📗◻️

Reviewer 2 (Mario C…) | 📗📗📗📗◻️

RR\ID Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

To read the reviews, click the links below.

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A Supplement to this Pub

Review 1: "Assessing Healthy Vaccinee Bias in COVID-19 Vaccine Effectiveness Studies: A National Cohort Study in Qatar"

by Thiago Cerqueira Silva

Show Description
Published on Oct 17, 2024
rrid.mitpress.mit.edu

Description

The overall conclusions that the existence of the healthy vaccinee bias within this cohort is helpful to incorporate when critiquing vaccine effectiveness studies.

A Supplement to this Pub

Review 2: "Assessing Healthy Vaccinee Bias in COVID-19 Vaccine Effectiveness Studies: A National Cohort Study in Qatar"

by Mario Coccia

Show Description
Published on Oct 17, 2024
rrid.mitpress.mit.edu

Description

The overall conclusions that the existence of the healthy vaccinee bias within this cohort is helpful to incorporate when critiquing vaccine effectiveness studies.

License

Creative Commons Attribution 4.0 International License (CC-BY 4.0)

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