Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study

Abstract Background This study assessed the real-world effectiveness of the ChAdOx1 nCoV-19 vaccine in adults against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic infection, and severe coronavirus disease 2019 (COVID-19) during periods of Beta and Delta variant...

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Main Authors: 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, Adeel A. Butt, Hamad Eid Al-Romaihi, Mohamed H. Al-Thani, Abdullatif Al-Khal, Roberto Bertollini, Laith J. Abu-Raddad
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11410-7
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author 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
Adeel A. Butt
Hamad Eid Al-Romaihi
Mohamed H. Al-Thani
Abdullatif Al-Khal
Roberto Bertollini
Laith J. Abu-Raddad
author_facet 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
Adeel A. Butt
Hamad Eid Al-Romaihi
Mohamed H. Al-Thani
Abdullatif Al-Khal
Roberto Bertollini
Laith J. Abu-Raddad
author_sort Hiam Chemaitelly
collection DOAJ
description Abstract Background This study assessed the real-world effectiveness of the ChAdOx1 nCoV-19 vaccine in adults against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic infection, and severe coronavirus disease 2019 (COVID-19) during periods of Beta and Delta variant dominance in Qatar. Methods A national, matched, test-negative case-control study was conducted using 186,130 PCR-positive tests (cases) and 667,289 PCR-negative tests (controls) collected between January 1 and December 18, 2021. Subgroup analyses were performed to evaluate vaccine effectiveness across key strata. Results The median time between the first and second doses was 61 days (interquartile range, 56–64 days). Two-dose primary-series effectiveness was 66.0% (95% CI, 55.1–74.3%) against any SARS-CoV-2 infection and 73.0% (95% CI, 44.1–87.0%) against symptomatic infection. Effectiveness was estimated at 100% (95% CI, 64.0–100%) against any Beta variant infection and 65.3% (95% CI, 54.2–73.8%) against any Delta infection. Protection against any infection of any variant peaked at 78.4% (95% CI, 50.7–90.5%) within the first month after the second dose, gradually declining to 45.6% (95% CI, 5.5–68.7%) after 150 days. Effectiveness against severe, critical, or fatal COVID-19, irrespective of variant, was 100% (95% CI, 49.3–100%), with no vaccinated individuals progressing to severe, critical, or fatal disease after infection. Effectiveness of a single dose was 59.9% (95% CI, 51.0–67.3%) against any infection—65.0% (95% CI, 49.7–75.6%) against Beta and 55.9% (95% CI, 43.8–65.5%) against Delta—78.4% (95% CI, 60.9–88.0%) against symptomatic infection, and 100% (95% CI, 88.9–100%) against severe, critical, or fatal COVID-19. Conclusion The ChAdOx1 nCoV-19 vaccine provided substantial protection against infection and strong protection against severe outcomes during periods dominated by the Beta and Delta variants, although protection against infection waned within the first few months following the primary series.
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spelling doaj-art-dfcf54cdd3a84b0796b0843bd0d294132025-08-20T03:47:12ZengBMCBMC Infectious Diseases1471-23342025-08-0125111310.1186/s12879-025-11410-7Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide studyHiam Chemaitelly0Houssein H. Ayoub1Peter Coyle2Patrick Tang3Mohammad R. Hasan4Hadi M. Yassine5Asmaa A. Al Thani6Zaina Al-Kanaani7Einas Al-Kuwari8Andrew Jeremijenko9Anvar Hassan Kaleeckal10Ali Nizar Latif11Riyazuddin Mohammad Shaik12Hanan F. Abdul-Rahim13Gheyath K. Nasrallah14Mohamed Ghaith Al-Kuwari15Adeel A. Butt16Hamad Eid Al-Romaihi17Mohamed H. Al-Thani18Abdullatif Al-Khal19Roberto Bertollini20Laith J. Abu-Raddad21Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, Cornell UniversityMathematics Program, Department of Mathematics, Statistics and Physics, College of Arts and Sciences, Qatar UniversityHamad Medical CorporationDepartment of Pathology and Laboratory Medicine, University of British ColumbiaDepartment of Pathology and Molecular Medicine, McMaster UniversityDepartment of Biomedical Science, College of Health Sciences, QU Health, Qatar UniversityDepartment of Biomedical Science, College of Health Sciences, QU Health, Qatar UniversityHamad Medical CorporationHamad Medical CorporationHamad Medical CorporationHamad Medical CorporationHamad Medical CorporationHamad Medical CorporationDepartment of Public Health, College of Health Sciences, QU Health, Qatar UniversityDepartment of Biomedical Science, College of Health Sciences, QU Health, Qatar UniversityPrimary Health Care CorporationDepartment of Population Health Sciences, Weill Cornell Medicine, Cornell UniversityMinistry of Public HealthMinistry of Public HealthHamad Medical CorporationMinistry of Public HealthInfectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, Cornell UniversityAbstract Background This study assessed the real-world effectiveness of the ChAdOx1 nCoV-19 vaccine in adults against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic infection, and severe coronavirus disease 2019 (COVID-19) during periods of Beta and Delta variant dominance in Qatar. Methods A national, matched, test-negative case-control study was conducted using 186,130 PCR-positive tests (cases) and 667,289 PCR-negative tests (controls) collected between January 1 and December 18, 2021. Subgroup analyses were performed to evaluate vaccine effectiveness across key strata. Results The median time between the first and second doses was 61 days (interquartile range, 56–64 days). Two-dose primary-series effectiveness was 66.0% (95% CI, 55.1–74.3%) against any SARS-CoV-2 infection and 73.0% (95% CI, 44.1–87.0%) against symptomatic infection. Effectiveness was estimated at 100% (95% CI, 64.0–100%) against any Beta variant infection and 65.3% (95% CI, 54.2–73.8%) against any Delta infection. Protection against any infection of any variant peaked at 78.4% (95% CI, 50.7–90.5%) within the first month after the second dose, gradually declining to 45.6% (95% CI, 5.5–68.7%) after 150 days. Effectiveness against severe, critical, or fatal COVID-19, irrespective of variant, was 100% (95% CI, 49.3–100%), with no vaccinated individuals progressing to severe, critical, or fatal disease after infection. Effectiveness of a single dose was 59.9% (95% CI, 51.0–67.3%) against any infection—65.0% (95% CI, 49.7–75.6%) against Beta and 55.9% (95% CI, 43.8–65.5%) against Delta—78.4% (95% CI, 60.9–88.0%) against symptomatic infection, and 100% (95% CI, 88.9–100%) against severe, critical, or fatal COVID-19. Conclusion The ChAdOx1 nCoV-19 vaccine provided substantial protection against infection and strong protection against severe outcomes during periods dominated by the Beta and Delta variants, although protection against infection waned within the first few months following the primary series.https://doi.org/10.1186/s12879-025-11410-7COVID-19VaccineEffectivenessVaxzevriaAstrazenecaChAdOx1 nCoV-19
spellingShingle 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
Adeel A. Butt
Hamad Eid Al-Romaihi
Mohamed H. Al-Thani
Abdullatif Al-Khal
Roberto Bertollini
Laith J. Abu-Raddad
Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
BMC Infectious Diseases
COVID-19
Vaccine
Effectiveness
Vaxzevria
Astrazeneca
ChAdOx1 nCoV-19
title Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
title_full Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
title_fullStr Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
title_full_unstemmed Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
title_short Effectiveness of ChAdOx1 nCoV-19 (Vaxzevria) primary series vaccine against SARS-CoV-2 beta and delta variants: a nationwide study
title_sort effectiveness of chadox1 ncov 19 vaxzevria primary series vaccine against sars cov 2 beta and delta variants a nationwide study
topic COVID-19
Vaccine
Effectiveness
Vaxzevria
Astrazeneca
ChAdOx1 nCoV-19
url https://doi.org/10.1186/s12879-025-11410-7
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