We conducted a multicentre test-negative case-control study covering the period from October 2023 to January 2024 among adult patients aged ≥18 years hospitalised with severe acute respiratory infection in Europe. We provide early estimates of the effectiveness of the newly adapted XBB.1.5 COVID-19 vaccines against PCR-confirmed SARS-CoV-2 hospitalisation. Vaccine effectiveness was 48% overall, ranging between 68% at 14–29 days and 40% at 60–105 days post vaccination. The adapted XBB.1.5 COVID-19 vaccines conferred protection against COVID-19 hospitalisation in the first 3.5 months post vaccination, with VE >70% in older adults (≥65 years) up to 1 month post vaccination.