{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:30:39Z","timestamp":1783524639473,"version":"3.55.0"},"reference-count":53,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: To estimate (a) survival after SARS-CoV-2 infection by COVID-19 vaccination status, and (b) COVID-19 vaccine effectiveness in a middle-income country. Methods: In this retrospective cohort study, secondary analysis of data from the national surveillance and vaccination databases was conducted. The primary outcome was COVID-19 death classified based on the WHO criteria. Data were analysed by vaccination status, age, sex, geographic region, and wave period. Kaplan\u2013Meier curves were plotted; log-rank followed by multiple comparison tests were used to compare survival probabilities. Cox proportional-hazards models with time-varying covariates estimated hazard ratios (HR). Vaccine effectiveness was computed as (1-HR) \u00d7 100. Results: A total of 55,299 COVID-19 cases were captured by the national surveillance system between 1 April and 31 December 2021. Of these, 45,774 (1581 vaccinated, 44,193 unvaccinated) were included in the analysis. After a follow-up of 327 days, there were 22 deaths (case fatality rate (CFR) 1.5%) among 1581 COVID-19 vaccinated cases and 1821 deaths (CFR 4.1%) among 44,193 unvaccinated cases. There was one COVID-19 death per 10,000 person days in vaccinated cases compared with 2.7 COVID-19 deaths per 10,000 person days in unvaccinated cases. After adjustment for age, sex, and geographic region, the effectiveness against COVID-19 death across all vaccine types (ChAdOx1 nCoV-19, BNT162b2, Ad26.COV2.S, or BBIBP-CorV) was 68% (95% CI: 51\u201379). Effectiveness was 75% (95% CI: 59\u201384) for ChAdOx1 nCoV-19. Vaccine effectiveness across all vaccine types was higher in younger cases, (82% (95% CI: 52\u201393), 18\u201364 years vs. 63% (95% CI: 41\u201377), \u226565 years), females (84% (95% CI: 63\u201393), females vs. 53% (95% CI: 24\u201371), males) and those vaccinated in the past 3 months (71% (95% CI: 47\u201385), past 0\u20133 months vs. 56% (95% CI: 23\u201375), 3\u20136 months). Conclusions: COVID-19 vaccines were effective in preventing COVID-19 death in a population with low vaccination coverage. Limitations of the analysis include the use of surveillance data (under-reporting of cases, missing data), exclusion of partially vaccinated cases, and insufficient data on important confounders (circulating variants and comorbidities).<\/jats:p>","DOI":"10.3390\/vaccines13121250","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:32:27Z","timestamp":1765960347000},"page":"1250","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrospective Cohort Analysis of Survival After SARS-CoV-2 Infection by Vaccination Status in Jamaica, April\u2013December 2021"],"prefix":"10.3390","volume":"13","author":[{"given":"Karen","family":"Webster-Kerr","sequence":"first","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriene","family":"Grant","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardene","family":"Harris","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0443-7555","authenticated-orcid":false,"given":"Eon","family":"Campbell","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Henningham","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"Brown","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daidre","family":"Rowe","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Lord","sequence":"additional","affiliation":[{"name":"Family Health Unit, Ministry of Health and Wellness, 10-16 Grenada Way, Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romae","family":"Thorpe","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-5597","authenticated-orcid":false,"given":"Tanielle","family":"Mullings","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovan","family":"Wiggan","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6852-704X","authenticated-orcid":false,"given":"Nicole","family":"Martin-Chen","sequence":"additional","affiliation":[{"name":"National Epidemiology Branch, Ministry of Health and Wellness, 15 Knutsford Boulevard, Kingston 5, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonia","family":"Dawkins-Beharie","sequence":"additional","affiliation":[{"name":"St. Elizabeth Health Department, Southern Regional Health Authority, 3 Brumalia Road, Mandeville, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5968-1179","authenticated-orcid":false,"given":"Jacqueline","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Community Health and Psychiatry, University of the West Indies, Kingston 7, Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, June 27). 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