Background: On July 15, 2020, with 58% of the population fully vaccinated, the start of a COVID-19 surge was observed in Puerto Rico. On July 22, 2021, the government of Puerto Rico started imposing a series of strict vaccine mandates. Two months later, over 70% of the population was vaccinated, more than in any US state, and laboratory-confirmed SARS-CoV-2 had dropped substantially. The decision to impose mandates, as well as current Department of Health recommendations related to boosters, were guided by the data and the effectiveness estimates presented here. Methods: Between December 15, 2020, when the vaccination process began in Puerto Rico, and October 15, 2021, 2,276,966 individuals were fully vaccinated against COVID-19. During this period 112,726 laboratory-confirmed SARS-CoV-2 infections were reported. These data permitted us to quantify the outcomes of the immunization campaign and to compare effectiveness of the mRNA-1273 (Moderna), BNT162b2 (Pfizer), and Ad26.COV2.S (J&J) vaccines. We obtained vaccination status, SARS-CoV-2 test results, and COVID-19 hospitalizations and deaths, from the Department of Health. We fit statistical models that adjusted for time-varying incidence rates and age group to estimate vaccine effectiveness, since the time of vaccination, against lab-confirmed SARS-CoV-2 infection, and COVID-19 hospitalization and death. Results: Two weeks after final dose, the mRNA-1273, BNT162b2, and Ad26.COV2.S vaccines had an effectiveness of 90% (95% CI: 88–91), 87% (85–88), and, 64% (58–69), respectively. After five months, effectiveness waned to about 70%, 50%, and 40%, respectively. We found no evidence that effectiveness was different after the Delta variant became dominant. For those infected, the vaccines provided further protection against COVID-19 hospitalization and deaths across all age groups, and this conditional effect did not wane in time.

Fuente: The Lancet Regional Health – Americas