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Monitoring COVID-19 vaccine effectiveness against COVID-19 hospitalisation and death using electronic health registries in ≥65-years-old population in six European countries, October 2021 to November 2022
  • +17
  • Irina Kislaya,
  • Alexis Sentís,
  • Jostein Starrfelt,
  • Baltasar Nunes,
  • Iván Martínez-Baz,
  • Katrine Finderup Nielsen,
  • Ala'a AlKerwi,
  • Toon Braeye,
  • Mario Fontán-Vela,
  • Sabrina Bacci,
  • Hinta Meijerink,
  • Jesus Castilla,
  • Hanne-Dorthe Emborg,
  • Christian Holm Hansen,
  • Susanne Schmitz,
  • Marta Valenciano,
  • Izaak Van Evercooren,
  • Anthony Nardone,
  • Nathalie Nicolay,
  • Susana Monge
Irina Kislaya
Instituto Nacional de Saúde Doutor Ricardo Jorge

Corresponding Author:irina.kislaya@bnitm.de

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Alexis Sentís
Epiconcept SAS
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Jostein Starrfelt
Norwegian Institute of Public Health
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Baltasar Nunes
Instituto Nacional de Saude Doctor Ricardo Jorge
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Iván Martínez-Baz
Instituto de Salud Pública y Laboral de Navarra
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Katrine Finderup Nielsen
Statens Serum Institut
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Ala'a AlKerwi
Ministry of Health, Directorate of Health, Service epidemiology and statistics
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Toon Braeye
Sciensano
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Mario Fontán-Vela
Instituto de Salud Carlos III
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Sabrina Bacci
European Centre for Disease Prevention and Control
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Hinta Meijerink
Norwegian Institute of Public Health
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Jesus Castilla
Instituto de Salud Pública y Laboral de Navarra
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Hanne-Dorthe Emborg
Statens Serum Institut
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Christian Holm Hansen
Statens Serum Institut
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Susanne Schmitz
Ministry of Health, Directorate of Health, Service epidemiology and statistics
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Marta Valenciano
Epiconcept SAS
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Izaak Van Evercooren
Sciensano
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Anthony Nardone
Epiconcept SAS
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Nathalie Nicolay
European Centre for Disease Prevention and Control
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Susana Monge
Carlos III Health Institute
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Abstract

Background: Within the ECDC-VEBIS project, we prospectively monitored vaccine effectiveness (VE) against COVID-19 hospitalisation and COVID-19-related death, using electronic health registries (EHR), between October 2021 and November 2022, in community-dwelling residents aged 65–79 and ≥80-years in six European countries. Methods: EHR linkage was used to construct population cohorts in Belgium, Denmark, Luxembourg, Navarre (Spain), Norway and Portugal. Using a common protocol, for each outcome (hospitalisation and death), VE was estimated monthly over eight-week follow-up periods, allowing one month-lag for data consolidation. Cox proportional-hazards regression models were used to estimate adjusted hazard ratios (aHR) and VE=(1 – aHR) x100. Site-specific estimates were pooled using random-effects meta-analysis. Results: For ≥80-years, VE against COVID-19 hospitalisation decreased from 66.9% (95%CI: 60.1; 72.6) to 36.1% (95%CI: -27.3; 67.9) for the primary vaccination and from 95.6% (95%CI: 88.0; 98.4) to 67.7% (95%CI: 45.9; 80.8) for the first booster. Similar trends were observed for 65-79-years. The second booster VE against hospitalisation ranged between 82.0% (95%CI: 75.9; 87.0) and 83.9% (95%CI: 77.7; 88.4) for the ≥80-years and between 39.3% (95%CI: -3.9; 64.5) and 80.6% (95%CI: 67.2; 88.5) for 65-79-years. The first booster VE against COVID-19-related death declined over time for both age groups, while the second booster VE against death remained above 80% for the ≥80-years. Conclusions: Successive vaccine boosters played a relevant role in maintaining protection against COVID-19 hospitalisation and death, in the context of decreasing VE over time. Multi-country data from EHR facilitate robust near-real-time monitoring of VE in the EU/EEA and supports public health decision-making.
27 May 2023Submitted to Influenza and other respiratory viruses
29 May 2023Submission Checks Completed
29 May 2023Assigned to Editor
31 May 2023Reviewer(s) Assigned
20 Jun 2023Review(s) Completed, Editorial Evaluation Pending
07 Jul 2023Editorial Decision: Revise Minor
14 Aug 20231st Revision Received
16 Aug 2023Submission Checks Completed
16 Aug 2023Assigned to Editor
22 Aug 2023Editorial Decision: Accept