The Influence of COVID-19 Vaccination on Daily Cases, Hospitalization, and Death Rate in Tennessee, United States: Case Study

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Abstract

Background

The COVID-19 outbreak highlights our vulnerability to novel infections, and vaccination remains a foreseeable method to return to normal life. However, infrastructure is inadequate for the immediate vaccination of the whole population. Therefore, policies have adopted a strategy to vaccinate older adults and vulnerable populations while delaying vaccination for others.

Objective

This study aimed to understand how age-specific vaccination strategies reduce daily cases, hospitalizations, and death rates using official statistics for Tennessee, United States.

Methods

This study used publicly available data on COVID-19, including vaccination rates, positive cases, hospitalizations, and deaths from the Tennessee Department of Health. Data from the first date of vaccination (December 17, 2020) to March 3, 2021, were retrieved. The rates were adjusted by 2019 data from the US Census Bureau, and age groups were stratified into 10-year intervals starting with 21 years of age.

Results

The findings showed that vaccination strategy can reduce the numbers of patients with COVID-19 in all age groups, with lower hospitalization and death rates in older populations. Older adults had a 95% lower death rate from December to March; no change in the death rate of other age groups was observed. The hospitalization rate was reduced by 80% for people aged ≥80 years, while people who were 50 to 70 years old had nearly the same hospitalization rate as prior to vaccination.

Conclusions

This research indicates that targeting older age groups for vaccination is the optimal way to avoid higher transmissions and reduce hospitalization and death rates.

Related collections

Most cited references 18

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Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Fernando P Polack, Stephen J. Thomas, Nicholas R.E. Kitchin … (2023)

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. Methods In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. Results A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. Conclusions A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)

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Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

Lindsey Baden, Hana El Sahly, Brandon Essink … (2020)

Abstract Background Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle–encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19. Methods This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2. Results The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0); vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P<0.001). Efficacy was similar across key secondary analyses, including assessment 14 days after the first dose, analyses that included participants who had evidence of SARS-CoV-2 infection at baseline, and analyses in participants 65 years of age or older. Severe Covid-19 occurred in 30 participants, with one fatality; all 30 were in the placebo group. Moderate, transient reactogenicity after vaccination occurred more frequently in the mRNA-1273 group. Serious adverse events were rare, and the incidence was similar in the two groups. Conclusions The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.)

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COVID-19 and Racial/Ethnic Disparities

Monica Webb Hooper, Anna Maria Nápoles, Eliseo J. Pérez-Stable (2020)

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Author and article information

Contributors

Ali Roghani:

ORCID: https://orcid.org/0000-0002-9351-0100

Division of EpidemiologyUniversity of Utah383 Colorow DriveSalt Lake City, UT, 84108United States1 210 410 5779ali_roghani@hotmail.com

Journal

Journal ID (nlm-ta): JMIRx Med

Journal ID (iso-abbrev): JMIRx Med

Journal ID (publisher-id): JMIRxMed

Title: Jmirx Med

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2563-6316

Publication date Collection: Jul-Sep 2021

Publication date (Electronic): 12 August 2021

Volume: 2

Issue: 3

Electronic Location Identifier: e29324

Affiliations

[1 ] Division of Epidemiology University of Utah Salt Lake City, UT United States

Author notes

Corresponding Author: Ali Roghani ali_roghani@ 123456hotmail.com

Author information

Ali Roghani https://orcid.org/0000-0002-9351-0100

Article

Publisher ID: v2i3e29324

DOI: 10.2196/29324

PMC ID: 8363125

PubMed ID: 34424255

SO-VID: db688a1e-cefa-425a-8934-41ce88eccadd

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIRx Med, is properly cited. The complete bibliographic information, a link to the original publication on https://med.jmirx.org/, as well as this copyright and license information must be included.

History

Date received : 1 April 2021

Date revision requested : 9 May 2021

Date revision received : 3 June 2021

Date accepted : 25 June 2021

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