*Communication* **High Effectiveness of SARS-CoV-2 Vaccines in Reducing COVID-19-Related Deaths in over 75-Year-Olds, Ceará State, Brazil**

**Carlos Henrique Alencar 1,2,\*, Luciano Pamplona de Góes Cavalcanti 1,2,3, Magda Moura de Almeida 1,4, Patrícia Pereira Lima Barbosa 1, Kellyn Kessiene de Sousa Cavalcante 1,4, Déborah Nunes de Melo 1, Bruno Cavalcante Fales de Brito Alves 3 and Jorg Heukelbach 1**


**Abstract:** In Brazil, the SARS-CoV-2 vaccination program has so far prioritized people over 75 years of age. By the end of March 2021, in Ceará State, a total of 313,328 elderly people had received at least one dose of vaccine (45% Oxford-AstraZeneca/Fiocruz and 55% CoronaVac-Sinovac/Butantan), and 159,970 had received two doses (83% CoronaVac-Sinovac/Butantan and 17% Oxford-AstraZeneca/ Fiocruz). After a single dose, there was already a significant reduction in COVID 19-related deaths (protection ratio: 19.31 (95% CI: 18.20–20.48), attributable protection ratio: 94.8%); higher protection ratios were observed after the application of two doses of the vaccine (132.67; 95% CI: 109.88–160.18), with an attributable protection ratio of 99.2%. SARS-CoV-2 vaccines are highly effective in reducing the number of COVID-19-related deaths in over 75-year-olds in Brazil, one of the hardest hit countries by the current pandemic.

**Keywords:** COVID-19; SARS-CoV-2; COVID-19 vaccines; mortality; epidemiology; public health
