Assessing real-world vaccine effectiveness against severe forms of SARS-CoV-2 infection: an observational study from routine surveillance data in Switzerland.

BACKGROUND: In Switzerland, SARS-CoV-2 vaccination campaigns started in early 2021. Vaccine coverage reached 65% of the population in December 2021, mostly with mRNA vaccines from Moderna and Pfizer-BioNtech. Simultaneously, the proportion of vaccinated among COVID-19-related hospitalisations and deaths rose, creating some confusion in the general population. We aimed to assess vaccine effectiveness against severe forms of SARS-CoV-2 infection using routine surveillance data on the vaccination status of COVID-19-related hospitalisations and deaths, and data on vaccine coverage in Switzerland. METHODS: We considered all routine surveillance data on COVID-19-related hospitalisations and deaths received at the Swiss Federal Office of Public Health from 1 July to 1 December 2021. We estimated the relative risk of COVID-19-related hospitalisation or death for not fully vaccinated compared with fully vaccinated individuals, adjusted for the dynamics of vaccine coverage over time, by age and location. We stratified the analysis by age group and by calendar month. We assessed variations in the relative risk of hospitalisation associated with the time since vaccination. RESULTS: We included a total of 5948 COVID-19-related hospitalisations of which 1245 (21%) were fully vaccinated patients, and a total of 739 deaths of which 259 (35%) were fully vaccinated. We found that the relative risk of COVID-19 related hospitalisation was 12.5 (95% confidence interval [CI] 11.7-13.4) times higher for not fully vaccinated than for fully vaccinated individuals. This translates into a vaccine effectiveness against hospitalisation of 92.0% (95% CI 91.4-92.5%). Vaccine effectiveness against death was estimated to be 90.3% (95% CI 88.6-91.8%). Effectiveness appeared to be comparatively lower in age groups over 70 and during the months of October and November 2021. We also found evidence of a decrease in vaccine effectiveness against hospitalisation for individuals vaccinated for 25 weeks or more, but this decrease appeared only in age groups below 70. CONCLUSIONS: The observed proportions of vaccinated among COVD-19-related hospitalisations and deaths in Switzerland were compatible with a high effectiveness of mRNA vaccines from Moderna and Pfizer-BioNtech against hospitalisation and death in all age groups. Effectiveness appears comparatively lower in older age groups, suggesting the importance of booster vaccinations. We found inconclusive evidence that vaccine effectiveness wanes over time. Repeated analyses will be able to better assess waning and the effect of boosters.

An enhanced characterization process for the elimination of very low level radioactive waste in particle accelerators.

The elimination of very low level waste towards the French national repository requires their radiological characterization to estimate the radionuclide inventory and the associated activities within a waste package. Such characterization is performed by means of activation calculations and measurements. Two elimination projects have been identified at CERN, to dispose of bulk metallic waste and cables activated in the CERN accelerator complex. Based on the experience gained over the last 4 years, we develop a large scale elimination process to dispose of such types of activated equipment. A program for quality controls has therefore been developed through a novel software tool whose purpose is to compute the radiological data required by the repository for the acceptance of the waste as well as performing quality controls.

A Bayesian framework to update scaling factors for radioactive waste characterization.

Nuclear power plants and research facilities commonly employ the so-called scaling factor (SF) method to quantify the activity of difficult-to-measure (DTM) radionuclides within their radioactive waste packages. The method relies on the establishment of a relationship between an easy-to-measure (ETM) radionuclide, called key nuclide (KN), and difficult-to-measure radionuclides, after the collection of a representative sample from the waste population. The distribution of the scaling factors, as well as the parameters defining the distribution, can change over time. Therefore, the accuracy of the calculated activity of the DTM radionuclides depends on the capacity of the scaling factor method to follow the time evolution of the waste population. In practice, waste producers collect periodically new samples from the waste population and check the variation and the validity of the scaling factors. In this article, we present a simple Bayesian framework to update scaling factors when a new data set becomes available. The method is tested and validated for radioactive waste produced at CERN (European Organization for Nuclear Research) and can be easily implemented for waste of different origin.

A new approach to characterize very-low-level radioactive waste produced at hadron accelerators.

Radioactive waste is produced as a consequence of preventive and corrective maintenance during the operation of high-energy particle accelerators or associated dismantling campaigns. Their radiological characterization must be performed to ensure an appropriate disposal in the disposal facilities. The radiological characterization of waste includes the establishment of the list of produced radionuclides, called "radionuclide inventory", and the estimation of their activity. The present paper describes the process adopted at CERN to characterize very-low-level radioactive waste with a focus on activated metals. The characterization method consists of measuring and estimating the activity of produced radionuclides either by experimental methods or statistical and numerical approaches. We adapted the so-called Scaling Factor (SF) and Correlation Factor (CF) techniques to the needs of hadron accelerators, and applied them to very-low-level metallic waste produced at CERN. For each type of metal we calculated the radionuclide inventory and identified the radionuclides that most contribute to hazard factors. The methodology proposed is of general validity, can be extended to other activated materials and can be used for the characterization of waste produced in particle accelerators and research centres, where the activation mechanisms are comparable to the ones occurring at CERN.

Radiological characterization of printed circuit boards for future elimination.

Electronic components like printed circuit boards (PCBs) are commonly used in CERN's accelerator complex. During their lifetime some of these PCBs are exposed to a radiation field of protons, neutrons and pions and are activated. In view of their disposal towards the appropriate final repository, a radiological characterization must be performed. The present work proposes a general characterization procedure based on the definition of a reference chemical composition, on the calculation of the corresponding radionuclide inventory and on the measurement of a tracer radionuclide. This method has been validated with real-life cases of electronic boards which were exposed to the typical radiation fields in CERN's accelerators. The activation studies demonstrate that silver is the key element with respect to the radiological characterization of electronic waste due to the production of Ag-110m and Ag-108m. A sensitivity analysis shows that the waiting time is the main parameter affecting the radionuclide inventory. Results also indicate that, as is the case of other families of radioactive waste, an accurate assessment of the radiological inventory of PCBs would require the precise knowledge of their chemical composition, as well as the radiation field to which they were exposed.