coronavac coronavac coronavac, also known as the sinovac covid-19 vaccine, is a whole inactivated virus covid-19 vaccine developed by the chinese company sinovac biotech. it was phase iii clinical trialled in brazil, chile, indonesia, the philippines, and turkey and relies on traditional technology similar to other inactivated-virus covid-19 vaccines, such as the sinopharm bibp vaccine, another chinese vaccine, and covaxin, an indian vaccine. coronavac does not need to be frozen, and both the final product and the raw material for formulating coronavac can be transported refrigerated at 2–8 °c (36–46 °f), temperatures at which flu vaccines are kept. coronavacan empty vial of the coronavac vaccinevaccine descriptiontargetsars-cov-2vaccine typeinactivatedclinical datatrade namescoronavacother namespicovaccroutes ofadministrationintramuscularatc codej07bx03 (who) legal statuslegal status br: emergency use full list of coronavac authorizations identifiersdrugbankdb15806 part of a series on 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real-world study of tens of millions of chileans who received coronavac found it 66% effective against symptomatic covid-19, 88% effective against hospitalization, 90% effective against icu admissions, and 86% effective against deaths. in brazil, after 75% of the population in serrana, são paulo, received coronavac, preliminary results show deaths fell by 95%, hospitalizations by 86%, and symptomatic cases by 80%. in indonesia, real world data from 128,290 healthcare workers showed 94% protection against symptomatic infection by the vaccine, beating results in clinical trials. phase iii results from turkey, published in the lancet, showed an efficacy of 84% based on 10,218 participants in the trials. phase iii results from brazil previously showed 50.7% efficacy at preventing symptomatic infections and 83.7% effectiveness in preventing mild cases needing treatment. efficacy against symptomatic infections increased to 62.3% with an interval of at least 21 days between the doses. coronavac is being used in vaccination campaigns in various countries in asia, south america, central america, and eastern europe. by april 2021, sinovac had a production capacity of 2 billion doses per year. it is currently being manufactured at several facilities in china, with overseas manufacture planned for brazil in september 2021 and eventually egypt and hungary. on june 1, 2021, the world health organization (who) validated the vaccine for emergency use. sinovac has signed purchase agreements for 380 million doses from covax. as of july 2021, coronavac was the most widely used covid-19 vaccine in the world, with 943 million doses delivered. as of october 14, 2021, coronavac is the covid-19 vaccine with the most doses administered worldwide. it was reported in december, 2021, that a study jointly conducted by the lks faculty of medicine, the university of hong kong (hkumed), and the faculty of medicine, the chinese university of hong kong (cu medicine), showed that a third dose of the comirnaty vaccine given to those who received two doses of either comirnaty or coronavac provides protective levels of measured antibodies against the omicron variant of sars-cov-2. three doses of coronavac, however, did not provide adequate levels of protective antibodies by the same measure, in direct contradiction to claims made by the vaccine manufacturer. in october 2022, a hong kong study found that two doses of coronavac gave a protection of only 64% to 75% for older adults. however an extra booster or a third dose of coronavac was able to raise the level of protection against covid-19 to about 98%. medical uses the vaccine is given by intramuscular injection into the deltoid muscle. the initial course consists of two doses. the world health organization (who) recommends an interval of 4 weeks between doses, with data from chile suggesting that a longer interval provides more robust immunity. early evidence suggested that immunity wanes rapidly, so a booster dose after the initial course might be needed. effectiveness in brazil, a study was conducted in serrana, population 45,000, where authorities attempted to vaccinate the entire adult population with coronavac. after 75% of the adult population received the vaccine, preliminary results show deaths fell by 95%, hospitalizations by 86% and symptomatic cases by 80%. according to ricardo palacios, a director at são paulo's instituto butantan, "the most important result was understanding that we can control the pandemic even without vaccinating the entire population." in july 2021, researchers from the chilean ministry of health published a paper containing real-world data for their vaccination campaign. the study was conducted between 2 february and 1 may 2021, consisting of 10.2 million people. the effectiveness of coronavac vaccine after the second dose was 66% (95% ci, 65–67%) in preventing symptomatic disease, 88% (87–88%) for hospitalization, 90% (89–91%) for icu admission, and 86% (85–88%) in preventing covid-19 related deaths. the effectiveness after the first dose was 16% (95% ci, 14–17%) against symptomatic disease, 37% (35–40%) against hospitalization, 45% (41–48%) against icu admission, and 46% (41–50%) against deaths. the study concluded that the vaccine was effective in preventing covid-19. in may 2021, real-world data from indonesia showed the vaccine was highly effective, with 94% of inoculated health care workers protected against symptomatic infection by the vaccine, besting results of clinical trials. in this study of 128,290 health workers in jakarta, less than 1% of the vaccinated healthcare workers contracted symptomatic covid-19, compared to more than 8% among the unvaccinated healthcare workers. the vaccine reduced the risk of hospitalization and death of the inoculated medical workers by 96% and 98% respectively. uruguay released real-world data based on 795,684 people who have received both doses of coronavac for more than 14 days as of 1 june 2021. in this group, 8,298 tested positive, 45 were admitted to the icu, and 35 died of covid-19. this indicated 64.52% and 61.47% effectiveness in reducing covid-19 cases for people aged 18–49 and 50 and older respectively. the vaccine was 94.95% and 92.18% effective in reducing icu admissions, and 95.35% and 95.2% effective to prevent deaths. among fully-vaccinated healthcare professionals, the vaccine was 66% effective in preventing cases, and 100% effective in preventing icu admissions and deaths. preliminary results from a test-negative case-control study from 19 january to 13 april 2021 in manaus suggest that, after just one dose, the vaccine is 35% (95% ci, −7 to 61%) effective against asymptomatic infections and 50% (95% ci, 11–71%) against symptomatic disease. the one-dose group consisted of 53,176 healthcare professionals. during the study, 66% of the samples were of the gamma variant. the same study found paradoxically reduced effectiveness against symptomatic disease in another group that received two doses, an effect attributed by the authors to unmeasured confounding leading to downward bias in the efficacy estimate. in chile, the effectiveness against symptomatic disease dropped from 67% between february–april 2021 to 58.5% in early july. because of this, on 11 august, chile began giving an additional dose of the oxford–astrazeneca vaccine to people over 55 who were fully vaccinated with coronavac before 31 march. in october 2021, a large scale study in chile with 2,017,878 participants reported that, with a coronavac booster, effectiveness against hospitalization increased from 84% to 88% and effectiveness against symptomatic disease increased from 56% to 80%. the greatest increases were seen with a heterologous oxford–astrazeneca vaccine booster, resulting in 96% effectiveness against hospitalization and 93% against symptomatic disease. a study by the university of hong kong in december 2021 found that a third dose of coronavac does not provide sufficient protection against the omicron variant, directly contradicting the vaccine manufacturer's claim and a study by the pontifical catholic university of chile that it does. in april 2022, a singapore study by infectious diseases experts from the national centre for infectious diseases and the ministry of health found that coronavac recipients were 4.59 times more likely to have severe covid-19 as well as 2.37 times more likely to be infected, compared to those who took the pfizer-biontech vaccine. variants in the following tables, a vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval. effectiveness is generally expected to slowly decrease over time. initial effectiveness by variant doses severity of illness delta gamma 1 asymptomatic not reported 16% (15–17%) symptomatic 14% (−60 to 55%) not reported hospitalization not reported 27% (25–28%) 2 asymptomatic not reported 54% (53–55%) symptomatic 59% (16–82%) not reported moderate 70% (43–96%) not reported hospitalization 100% 73% (72–74%) efficacy from a study with 366 participants. cases with imaging characteristics of pneumonia and also fever and respiratory symptoms. a confidence interval was not provided, so it is not possible to know the accuracy of this measurement. in the elderly a test-negative case-control study from 17 january to 29 april 2021 in the state of são paulo, during which 86% of the collected genotype isolates were of the gamma variant, with 43,774 participants aged 70 years or older, found an effectiveness after two doses of 47% (95% ci, 39–54%) against symptomatic disease, 56% (95% ci, 47–63%) against hospitalization and 61% (95% ci, 49–71%) against death. after a single dose, the effectiveness was only 13% (4–21%) against symptomatic disease, 17% (6–27%) against hospitalization and 31% (18–43%) against death, highlighting the importance of receiving the second dose. the study also found that effectiveness against symptomatic disease decreased with increasing age: initial effectiveness in old age after two doses (brazil) severity of illness age 70–74 age 75–79 age ≥80 symptomatic 59% (44–70%) 56% (43–66%) 33% (17–46%) hospitalization 78% (63–87%) 67% (52–77%) 39% (21–53%) death 84% (59–94%) 78% (59–88%) 44% (20–61%) preliminary data from a large effectiveness study in brazil with 61 million individuals from 18 january to 30 june 2021, when the gamma variant was dominant in the country, indicate that effectiveness is markedly reduced in those aged 90 or older, attributable to immunosenescence: initial effectiveness by age (brazil) doses severity of illness age <60 age 60–69 age 70–79 age 80–89 age ≥90 1 asymptomatic 14% (12–16%) 15% (13–18%) 25% (23–27%) 2% (−3 to 6%) −19% (−31 to 9%) hospitalization 34% (27–40%) 30% (26–33%) 33% (30–35%) 8% (2–14%) −16% (−31 to 3%) death 42% (26–54%) 36% (30–41%) 38% (35–42%) 10% (3–11%) −22% (−41 to 6%) 2 asymptomatic 45% (43–46%) 56% (54–57%) 62% (61–63%) 57% (55–60%) 32% (24–38%) hospitalization 84% (81–87%) 78% (76–80%) 74% (73–75%) 63% (60–66%) 33%