Vaccine effectiveness of heterologous CoronaVac plus BNT162b2 in Brazil

There is considerable interest in the waning of effectiveness of coronavirus disease 2019 (COVID-19) vaccines and vaccine effectiveness (VE) of booster doses. Using linked national Brazilian databases, we undertook a test-negative design study involving almost 14 million people (~16 million tests) to estimate VE of CoronaVac over time and VE of BNT162b2 booster vaccination against RT-PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death). Compared with unvaccinated individuals, CoronaVac VE at 14-30 d after the second dose was 55.0% (95% confidence interval (CI): 54.3-55.7) against confirmed infection and 82.1% (95% CI: 81.4-82.8) against severe outcomes. VE decreased to 34.7% (95% CI: 33.1-36.2) against infection and 72.5% (95% CI: 70.9-74.0) against severe outcomes over 180 d after the second dose. A BNT162b2 booster, 6 months after the second dose of CoronaVac, improved VE against infection to 92.7% (95% CI: 91.0-94.0) and VE against severe outcomes to 97.3% (95% CI: 96.1-98.1) 14-30 d after the booster. Compared with younger age groups, individuals 80 years of age or older had lower protection after the second dose but similar protection after the booster. Our findings support a BNT162b2 booster vaccine dose after two doses of CoronaVac, particularly for the elderly

Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review

OBJECTIVE Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. METHODS This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. RESULTS Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. CONCLUSIONS Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis

Differentials in death count records by databases in Brazil in 2010

OBJECTIVE To compare the death counts from three sources of information on mortality available in Brazil in 2010, the Mortality Information System (SIM - Sistema de Informações sobre Mortalidade ), Civil Registration Statistic System (RC - Sistema de Estatísticas de Resgistro Civil ), and the 2010 Demographic Census at various geographical levels, and to confirm the association between municipal socioeconomic characteristics and the source which showed the highest death count. METHODS This is a descriptive and comparative study of raw data on deaths in the SIM, RC and 2010 Census databases, the latter held in Brazilian states and municipalities between August 2009 and July 2010. The percentage of municipalities was confirmed by the database showing the highest death count. The association between the source of the highest death count and socioeconomic indicators - the Índice de Privação Brasileiro (IBP – Brazilian Deprivation Index) and Índice de Desenvolvimento Humano Municipal (IHDM – Municipal Human Development Index) - was performed by bivariate choropleth and Moran Local Index of Spatial Association (LISA) cluster maps. RESULTS Confirmed that the SIM is the database with the highest number of deaths counted for all Brazilian macroregions, except the North, in which the highest coverage was from the 2010 Census. Based on the indicators proposed, in general, the Census showed a higher coverage of deaths than the SIM and the RC in the most deprived (highest IBP values) and less developed municipalities (lowest IDHM values) in the country. CONCLUSION The results highlight regional inequalities in how the databases chosen for this study cover death records, and the importance of maintaining the issue of mortality on the basic census questionnaire

Two-dose ChAdOx1 nCoV-19 vaccine protection against COVID-19 hospital admissions and deaths over time : a retrospective, population-based cohort study in Scotland and Brazil

Funding Information: This study is part of the EAVE II project. EAVE II is funded by the MRC (MC_PC_19075) with the support of BREATHE—The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (11/46/23). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the UK government. The Brazilian component is part of the Fiocruz VigiVac project on continuous digital evaluation of the national anti-COVID-19 immunisation programme. SVK and SA acknowledge funding from an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). This partnership between Brazil and Scotland was established through funding from the NIHR (GHRG /16/137/99) using UK aid from the UK Government to support global health research. This study was partially supported by a donation from the Fazer o Bem Faz Bem programme. The authors thank DATASUS for its excellent work in providing unidentified databases. GLW, MLB, and MB-N are research fellows from the Brazilian National Research Council. GLW acknowledges funding from FAPERJ (Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; E-26/210.180/2020). We thank Dave Kelly from Albasoft (Inverness, UK) for his support with making primary care data available; Wendy Inglis-Humphrey, Vicky Hammersley, and Laura Brook (University of Edinburgh, Edinburgh, UK); and Pam McVeigh, Amanda Burridge, and Afshin Dastafshan (Public Health Scotland, Glasgow, UK) for their support with project management and administration. Funding Information: SVK is a member of the UK Government's Scientific Advisory Group on Emergencies subgroup on ethnicity, the Cabinet Office's International Best Practice Advisory Group, and was co-chair of the Scottish Government's Expert Reference Group on Ethnicity and COVID-19. CR reports grants from the Medical Research Council (MRC) and Public Health Scotland, during the conduct of the study, and is a member of the Scottish Government Chief Medical Officer's COVID-19 Advisory Group, Scientific Pandemic Influenza Group on Modelling, and Medicines and Healthcare products Regulatory Agency Vaccine Benefit and Risk Working Group. AS is a member of the Scottish Government Chief Medical Officer's COVID-19 Advisory Group and its Standing Committee on Pandemics; he is also a member of the UK Government's New and Emerging Respiratory Virus Threats Risk Stratification Subgroup and a member of AstraZeneca's Thrombotic Thrombocytopenic Taskforce. All roles are unremunerated. VdAO, VB, MLB, and MB-N are employees of Fiocruz, a federal public institution, which manufactures Vaxzevria in Brazil, through a full technology transfer agreement with AstraZeneca. Fiocruz allocates all its manufactured products to the Ministry of Health for the public health service use. All other authors declare no competing interests. Funding Information: This study is part of the EAVE II project. EAVE II is funded by the MRC (MC_PC_19075) with the support of BREATHE?The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (11/46/23). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the UK government. The Brazilian component is part of the Fiocruz VigiVac project on continuous digital evaluation of the national anti-COVID-19 immunisation programme. SVK and SA acknowledge funding from an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). This partnership between Brazil and Scotland was established through funding from the NIHR (GHRG /16/137/99) using UK aid from the UK Government to support global health research. This study was partially supported by a donation from the Fazer o Bem Faz Bem programme. The authors thank DATASUS for its excellent work in providing unidentified databases. GLW, MLB, and MB-N are research fellows from the Brazilian National Research Council. GLW acknowledges funding from FAPERJ (Funda??o Carlos Chagas Filho de Amparo ? Pesquisa do Estado do Rio de Janeiro; E-26/210.180/2020). We thank Dave Kelly from Albasoft (Inverness, UK) for his support with making primary care data available; Wendy Inglis-Humphrey, Vicky Hammersley, and Laura Brook (University of Edinburgh, Edinburgh, UK); and Pam McVeigh, Amanda Burridge, and Afshin Dastafshan (Public Health Scotland, Glasgow, UK) for their support with project management and administration. Publisher Copyright: © 2022 The author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licensePeer reviewedPublisher PD

Evaluating the health effect of a Social Housing programme, Minha Casa Minha Vida, using the 100 million Brazilian Cohort: a natural experiment study protocol.

INTRODUCTION: Social housing programmes have been shown to influence health, but their effects on cardiovascular mortality and incidence of infectious diseases, such as leprosy and tuberculosis, are unknown. We will use individual administrative data to evaluate the effect of the Brazilian housing programme Minha Casa Minha Vida (MCMV) on cardiovascular disease (CVD) mortality and incidence of leprosy and tuberculosis. METHODS AND ANALYSIS: We will link the baseline of the 100 Million Brazilian Cohort (2001-2015), which includes information on socioeconomic and demographic variables, to the MCMV (2009-2015), CVD mortality (2007-2015), leprosy (2007-2015) and tuberculosis (2007-2015) registries. We will define our exposed population as individuals who signed the contract to receive a house from MCMV, and our non-exposed group will be comparable individuals within the cohort who have not signed a contract for a house at that time. We will estimate the effect of MCMV on health outcomes using different propensity score approaches to control for observed confounders. Follow-up time of individuals will begin at the date of exposure ascertainment and will end at the time a specific outcome occurs, date of death or end of follow-up (31 December 2015). In addition, we will conduct stratified analyses by the follow-up time, age group, race/ethnicity, gender and socioeconomic position. ETHICS AND DISSEMINATION: The study was approved by the ethic committees from Instituto Gonçalo Muniz-Oswaldo Cruz Foundation and University of Glasgow Medical, Veterinary and Life Sciences College. Data analysis will be carried out using an anonymised dataset, accessed by researchers in a secure computational environment according to the Centre for Integration of Data and Health Knowledge procedures. Study findings will be published in high quality peer-reviewed research journals and will also be disseminated to policy makers through stakeholder events and policy briefs

Entramado productivo minero en San Juan. Herramientas de intervención desde un abordaje territorial.

Esta investigación es un proyecto de desarrollo tecnológico social (PDTS) orientado a generar por un lado, conocimiento sobre la dinámica socio-técnica de la principal actividad económica en la provincia y por otro, realizar propuestas innovadoras que aprovechen y fortalezcan las capacidades territoriales generadas y acumuladas por la minería en San Juan.EEA San JuanFil: Moscheni, Margarita. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Ureta, Adriana Alimé. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Checcarelli Pintor, Angelo Emmanuel. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Heredia Flores, Augusto Marcos. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: De la Torre, Delia Inés. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Funes Poblete, Eliana Gabriela. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Esquivel, Fabiana Eugenia. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Hernández, Juan Jesús. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Juan; ArgentinaFil: Neffa, Julio César. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: De los Ríos, Leonardo. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Doncel Ramallo, Lourdes Romina. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Perez, Marta Lidia. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Godoy, María Victoria. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Grimalt, Miguel. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Luna, Pedro. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Ortiz Flores, Renzo Federico. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; ArgentinaFil: Gili Diez, Valeria. Universidad Nacional de San Juan. Facultad de Ciencias Sociales; Argentin

Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil.

The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available

Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review

Objective: Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. Methods: This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. Results: Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. Conclusions: Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis

Differentials in death count records by databases in Brazil in 2010

Objective: To compare the death counts from three sources of information on mortality available in Brazil in 2010, the Mortality Information System (SIM – Sistema de Informações sobre Mortalidade ), Civil Registration Statistic System (RC – Sistema de Estatísticas de Resgistro Civil ), and the 2010 Demographic Census at various geographical levels, and to confirm the association between municipal socioeconomic characteristics and the source which showed the highest death count. Methods: This is a descriptive and comparative study of raw data on deaths in the SIM, RC and 2010 Census databases, the latter held in Brazilian states and municipalities between August 2009 and July 2010. The percentage of municipalities was confirmed by the database showing the highest death count. The association between the source of the highest death count and socioeconomic indicators – the Índice de Privação Brasileiro (IBP – Brazilian Deprivation Index) and Índice de Desenvolvimento Humano Municipal (IHDM – Municipal Human Development Index) – was performed by bivariate choropleth and Moran Local Index of Spatial Association (LISA) cluster maps. Results: Confirmed that the SIM is the database with the highest number of deaths counted for all Brazilian macroregions, except the North, in which the highest coverage was from the 2010 Census. Based on the indicators proposed, in general, the Census showed a higher coverage of deaths than the SIM and the RC in the most deprived (highest IBP values) and less developed municipalities (lowest IDHM values) in the country. Conclusion: The results highlight regional inequalities in how the databases chosen for this study cover death records, and the importance of maintaining the issue of mortality on the basic census questionnaire