On the association between COVID-19 vaccination levels and incidence and lethality rates at a regional scale in Spain.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19), has led to the deepest global health and economic crisis of the current century. This dramatic situation has forced the public health authorities and pharmaceutical companies to develop anti-COVID-19 vaccines in record time. Currently, almost 80% of the population are vaccinated with the required number of doses in Spain. Thus, in this paper, COVID-19 incidence and lethality rates are analyzed through a segmented spatio-temporal regression model that allows studying if there is an association between a certain vaccination level and a change (in mean) in either the incidence or the lethality rates. Spatial dependency is included by considering the Besag-York-Mollié model, whereas natural cubic splines are used for capturing the temporal structure of the data. Lagged effects between the exposure and the outcome are also taken into account. The results suggest that COVID-19 vaccination has not allowed yet (as of September 2021) to observe a consistent reduction in incidence levels at a regional scale in Spain. In contrast, the lethality rates have displayed a declining tendency which has associated with vaccination levels above 50%.