Hong Kong's first real-world data on the protection of vaccines for the elderly has just been disclosed: for the elderly aged 60 and above, the effective rate of three doses of Coxing vaccine to prevent severe illness and death exceeded 98%, while the effective rate of two doses of Coxing vaccine to prevent severe illness and death reached 74.1%.
"This data lays the foundation for China to get out of the epidemic in the future." On March 24, @Dr. Zhang Wenhong posted a Weibo review.
At present, the local epidemic situation in the mainland is still in the high platform stage, and many places have entered a difficult period of anti-epidemic. As of March 23, more than 45,000 cases of indigenous infection had been reported nationwide, affecting 28 provinces. Faced with the current situation of asymptomatic and mild disease accounting for more than 90%, the elderly with severe illness and high risk of death have become the most vulnerable group.
According to the data revealed by the State Council's new office on March 18, there are still 52 million elderly people over the age of 60 on the mainland who have not completed the full vaccination, accounting for nearly 20%. The proportion of elderly people without a booster injection is even greater, with 43.6% at the age of 60-69 and 51.6% at the age of 70-79.
On March 23, virology expert Chang Rongshan said in an interview with the surging news that although the new crown virus is susceptible to the whole population, there are still group differences, "the elderly are the most susceptible people, the elderly have the highest proportion of pneumonia symptoms after infection, and the risk of severe illness or death is the greatest." ”
"The whole process of vaccination and strengthening vaccination are of particular significance to the elderly, especially the elderly." Lei Zhenglong, deputy director of the Disease Control Bureau of the National Health Commission and a first-level inspector, said publicly on March 22.
What happens when older people lack vaccine protection
The Seminykron BA.2 sub-variant is stirring up the epidemic situation in Hong Kong, with more than 90% of the deaths being elderly.
According to data from the Centre for Health Protection of the Department of Health of the Hong Kong Special Administrative Region, from 31 December 2021 to 00:00 on 23 March 2022, the cumulative number of infections reported by the fifth wave of the epidemic in Hong Kong exceeded 1.07 million.
The data also shows that as of 00:00 on March 23, the cumulative number of deaths in Hong Kong reached 6356, of which 95.8% were elderly people aged 60 and above, and the vast majority of them had not been vaccinated or had not completed two full doses of vaccination.
The data show that of those aged 80 years and older who died, 72% were not vaccinated and 18% were vaccinated with only one dose. Of the 70-79 years of age who died, 64 percent were not vaccinated and 21 percent were given only one dose.
As of 00:00 on 23 March, statistics of the fifth wave of covid-19 deaths in Hong Kong. Image courtesy of the Centre for Health Protection of the Department of Health of the HKSAR
Hong Kong residential homes for the elderly have suffered a more severe impact than the previous four waves of the epidemic under the fifth wave of the epidemic.
On March 5, Dagong Net reported that 72% of nursing homes for the elderly and 60% of disabled homes in Hong Kong were infected, and at least 680 residents died in a month, accounting for more than half of the deaths from the epidemic. The elderly are weak, once infected, from mild to severe disease quickly, there are elderly people in the morning only have a sore throat, in the afternoon has been dehydrated, sent to the hospital for several hours after treatment.
At the same time, the Hong Kong SAR government is also vigorously promoting vaccination for the elderly. According to the news of Wenhui Network on March 23,
Nie Tak-kuen, secretary for the Civil Service of the Hong Kong SAR Government, who is responsible for coordinating the vaccination plan, said that before March 18, all 1,100 elderly homes in Hong Kong had outreach vaccination teams to get injections, and now the proportion of elderly people in the homes is 55%; about 40% have been diagnosed and cannot be injected temporarily; and about 10% of family members are still opposed to elderly vaccination.
Regarding the overall vaccination rate of the elderly, Nie Dequan said that at present, more than 80% of the population over the age of 12 in Hong Kong has received 2 injections, but the vaccination rate of the elderly needs to be improved as soon as possible. He said that among the elderly, about 90% of 60-69 years old have received an injection; 80% of 70-79 years old have received an injection; and about 56% of those over 80 years old have received an injection.
In the outbreak of the epidemic in the mainland, there have also been cases of low vaccination rates and concentrated severe diseases among the elderly.
At the press conference held by the State Council New Office on March 18 to strictly grasp the prevention and control of the epidemic, Zeng Yixin, deputy director of the National Health Commission, introduced that in the Yangzhou epidemic caused by the Delta mutation in August last year, the proportion of the elderly was very high, so the proportion of severe diseases was relatively large. There are a total of 1388 cases of infection in Yangzhou, of which 67 cases of severe illness occur among the elderly over 60 years old, and of the 67 cases of severe illness, 65 cases are not vaccinated or have not completed the whole process of vaccination.
Zeng Yixin said that compared with young people, the elderly themselves have weaker immune function, and most of them have various underlying diseases, once infected with the new crown virus, the risk of severe illness and death in the elderly is much higher than that of young people. "Our elderly and people with underlying diseases are the most in need of protection and the most in need of vaccination."
How is vaccination progressing for the elderly
According to the press conference of the joint prevention and control mechanism of the State Council held on the afternoon of March 22, as of March 21, 1.24 billion people have been vaccinated in the whole country, accounting for 87.98% of the total population. Strengthen immunization of 659.20 million people. Among them, the number of people over 60 years old who are vaccinated against the new crown virus reached 222.302 million people, and 211.966 million people were vaccinated.
More detailed elderly vaccination data were released on March 18. At the press conference held by the State Council New Office on the same day to strictly grasp the epidemic prevention and control work, Zeng Yixin, deputy director of the National Health Commission, introduced that as of March 17, as of March 17, there were 264 million people over the age of 60 in the mainland, of which 211.76 million elderly people had completed the full vaccination, and 52 million elderly people over the age of 60 had not completed the full vaccination. In terms of the proportion of completed intensive vaccination, 56.4% were 60-69 years old, 48.4% were 70-79 years old and 19.7% were over 80 years old.
Based on this data, nearly 20% of the elderly over the age of 60 in the mainland have not completed the full vaccination; the proportion without reinforcement injections is even greater, 43.6% for 60-69 years old, 51.6% for 70-79 years old, and 80.3% for 80 years old and over 80 years old.
"Only 50.7% of those over 80 years old have completed the whole process of vaccination, and only 19.7% have completed the strengthening of immunization, which is still relatively low." Zeng Yixin said.
Chang Rongshan said in an interview with the surging news, "In European and American countries, such as the United Kingdom, the elderly are the first priority when vaccination is initially carried out, which is different from the domestic healthy adults who are vaccinated first. ”
Taking the UK as an example, at the end of 2020, the Uk Joint Commission on Vaccination and Immunization (JCVI) issued "11 steps" priority guidance on "who to vaccinate first", and the elderly and staff in nursing homes will be vaccinated first, followed by the elderly over 80 years old and frontline health care workers, followed by the younger elderly. Subsequently, from September 2021, the UK began offering booster needles to the elderly population.
Screenshot of the paper
On 18 March, a study published on the medRxiv preprint platform reviewed the effectiveness of vaccination among older people in the UK. The study, from the Health Security Agency-funded Vivaldi Institute, monitored staff and residents in 331 nursing homes in England between December 2020 and December 2021.
The researchers found that within 2 to 12 weeks after the second dose of vaccination, the two doses were 85 percent effective at preventing hospitalizations of nursing home residents and 94 percent against their deaths. But 3 to 7 months after vaccination, those two numbers fell to 54 percent and 64 percent, a much greater decline than among young people.
In countries where older people are given priority vaccination, intensive vaccination, and even a second round of intensive vaccination, tends to arrive faster.
At present, the UK has entered the second round of enhanced immunization. The UK Health and Safety Agency's official website posted guidelines on March 18 that will provide a second booster (fourth dose) to the elderly aged 75 and older, nursing home residents and people with weakened immune systems.
How effective are vaccines in the real world for the elderly
The other side of the spread of the epidemic is the continuous accumulation of research data.
Recently, real-world data on the protection of vaccines against the elderly have been introduced. On March 22, a real-world study in Hong Kong revealed that the effectiveness of three doses of Coxing vaccine to prevent severe illness and death exceeded 98%, and on March 18, the Argentine real-world study disclosed that the effectiveness of two doses of chinese medicine inactivated vaccines to prevent deaths was 85%. Both inactivated vaccines have been widely administered on the mainland since late 2020.
Hong Kong Real-World Research was published on March 22 on the preprint platform medRxiv, with a research team from the University of Hong Kong. Using hong Kong individual case data from 31 December 2021 and 8 March 2022, including mild/normal, severe/critical and critically ill hospitalization cases, as well as census information and vaccine coverage data, the researchers also used population census information and vaccine coverage data to assess the effectiveness of one, two and three doses of CoronaVac and BioNTech/Fosun mRNA vaccine (BNT162b2).
According to the study, 7.3 million people in Hong Kong received a total of 12.7 million doses of the vaccine. The analysis results showed that in the population aged 60 years and older, the effective rate of two doses of Koxing inactivated vaccine for the prevention of severe illness and death was 74.1%, and the effective rate of two doses of mRNA vaccine for the prevention of severe illness and death was 88.2%, which was better.
It is worth noting that for the elderly aged 60 and over, the two vaccines and three doses provide a high level of protection against severe illness, with an effective rate of 98.1%.
"The results were heavy." On March 24, Dr. @Zhang Wenhong posted a Weibo comment on the study, "This data lays the foundation for China to get out of the epidemic in the future." ”
HKU researchers say a third dose of these two vaccines provides substantial additional protection and should be prioritized, especially for older adults who have only completed the basic immunization of the Coxing inactivated vaccine.
The first real-world data on the protection of the elderly by inactivated chinese medicine vaccines was also disclosed earlier, a large sample study from Argentina, published on March 15 in The Lancet, an internationally authoritative medical journal.
The study, led by Analía Rearte, director of Argentina's National Bureau of Epidemiology and National Strategic Information, began mass vaccination of SINEC inactivated vaccines for older people aged 60 years and older in the country since March 2021, with a total of 237,330 SINE vaccinators included.
The study found that for the elderly aged 60 years and older, after two doses, the effect of the vaccine in reducing the risk of death was more significant than the effect of reducing the risk of infection, and the indirect estimated effectiveness of the two doses of inactivated chinese medicine vaccine to reduce the risk of death was 85%.
The sequential booster immunization, which was launched in February this year, will also provide a better immunization strategy. Sequential immunization is targeted at people over 18 years of age.
Zeng Yixin, deputy director of the National Health Commission, introduced at the press conference of the State Council New Office on March 18 that the sequential strengthening of immunization refers to a vaccine that can be strengthened with a different technical route from the original basic immunization, and what is currently approved is that on the basis of inactivated vaccines, adenovirus vector vaccines can be used to strengthen, and can also be strengthened with recombinant protein vaccines.
Previously, Shao Yiming, a member of the expert group of the vaccine research and development special class of the scientific research group of the joint prevention and control mechanism of the State Council, said that there are two main purposes for strengthening immunization by using sequences: one is that different vaccines can complement each other's advantages, and the other is that different personal constitutions may produce more side effects on a certain type of vaccine, and vaccination with different technical routes can avoid side effects.
"Sequential immunity can preferably optimize recombinant protein vaccines, which have the advantage of small side reactions, the titer of antibodies rising the fastest, and are safe for the elderly and children." The hepatitis B vaccine and cervical cancer vaccine that are now being used on a large scale are both recombinant protein technologies. Chang Rongshan said in an interview with The Paper.
"The whole process of vaccination and strengthening vaccination are of particular significance to the elderly, especially the elderly." Lei Zhenglong, deputy director of the Disease Control Bureau of the National Health Commission and a first-level inspector, said publicly on March 22, "We will continue to guide all localities to strengthen the implementation of vaccination organizations to ensure the safety of vaccination, and we also hope that those who have not yet completed the whole process of vaccination will complete the vaccination as soon as possible according to the procedures, and those who meet the conditions for strengthening immunization will complete the enhanced immunization in a timely manner." ”