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Bejko D, Ernst C, Vergison A, Stranges S, Zeegers MP, Mossong J. High vaccine effectiveness against severe COVID-19 outcomes and population preventable fraction during the Omicron era in Luxembourg: A nationwide retrospective risk factor analysis. Vaccine 2024:S0264-410X(24)00636-4. [PMID: 38825555 DOI: 10.1016/j.vaccine.2024.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Luxembourg experienced major consecutive SARS-CoV-2 infection waves due to Omicron variants during 2022 while having achieved a high vaccination coverage in 2021. We investigated the risk factors associated to severe outcomes (i.e., hospitalisation, deaths) and estimated vaccine effectiveness (VE) as well as the role of immunity conferred by prior infections against severe outcomes in adults. METHODS We linked reported SARS-CoV-2 cases among residents aged ≥ 20 years with vaccination data and SARS-CoV-2 related hospitalisations and deaths. Cases were followed-up until day 14 for COVID-19 related hospital admission and up to day 28 for mortality after a positive test. We analysed the association between the vaccination status and severe forms using proportional Cox regression, adjusting for previous infection, age, sex and nursing homes residency. VE was measured as 1-adjusted hazard ratio of vaccinated vs unvaccinated individuals. The population preventable fraction was computed using the adjusted hazard ratio and the proportion of cases within the vaccination category. RESULTS Between December 2021, and March 2023, we recorded 187143 SARS-CoV-2 cases, 1728 (0.93%) hospitalizations and 611 (0.33%) deaths. The risk of severe outcomes increased with age, was higher among men and nursing home residents. Compared to unvaccinated adults, VE against hospitalization was 38.8% (95%CI: 28.1%-47.8%) for a complete primary cycle of vaccination, 62.1% (95%CI: 57.0%-66.7%) for one booster, and 71.6% (95%CI: 66.7%-76.2%) for two booster doses. VE against death was respectively 49.5% (95%CI: 30.8%-63.3%), 69.0% (95%CI: 61.2%-75.3%) and 76.2% (95%CI: 68.4%-82.2%). Previous infection was not associated with lower risk of hospitalisation or mortality. The vaccination lowered mortality by 55.8 % (95%CI: 46.3%-62.8%) and reduced hospital admissions by 49.1% (95%CI: 43.4%-54.4%). CONCLUSIONS Complete vaccination and booster but not previous infection were protective against hospitalization and death. The vaccination program in Luxembourg led to substantial reductions in SARS-CoV-2-related mortality and hospitalizations at the population level.
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Affiliation(s)
- Dritan Bejko
- Health Inspectorate, Health Directorate, Luxembourg; Department of Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
| | | | | | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, Canada; Department of Family Medicine, Western University, London, Canada; Department of Medicine, Western University, London, Canada; Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maurice P Zeegers
- Department of Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Joël Mossong
- Health Inspectorate, Health Directorate, Luxembourg
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Antunes L, Mazagatos C, Martínez-Baz I, Gomez V, Borg ML, Petrović G, Duffy R, Dufrasne FE, Dürrwald R, Lazar M, Jancoriene L, Oroszi B, Husa P, Howard J, Melo A, Pozo F, Pérez-Gimeno G, Castilla J, Machado A, Džiugytė A, Karabuva S, Fitzgerald M, Fierens S, Tolksdorf K, Popovici SO, Mickienė A, Túri G, Součková L, Nicolay N, Rose AM. Effectiveness of the adapted bivalent mRNA COVID-19 vaccines against hospitalisation in individuals aged ≥ 60 years during the Omicron XBB lineage-predominant period: VEBIS SARI VE network, Europe, February to August, 2023. Euro Surveill 2024; 29:2300708. [PMID: 38240061 PMCID: PMC10797659 DOI: 10.2807/1560-7917.es.2024.29.3.2300708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/18/2024] [Indexed: 01/22/2024] Open
Abstract
We conducted a multicentre hospital-based test-negative case-control study to measure the effectiveness of adapted bivalent COVID-19 mRNA vaccines against PCR-confirmed SARS-CoV-2 infection during the Omicron XBB lineage-predominant period in patients aged ≥ 60 years with severe acute respiratory infection from five countries in Europe. Bivalent vaccines provided short-term additional protection compared with those vaccinated > 6 months before the campaign: from 80% (95% CI: 50 to 94) for 14-89 days post-vaccination, 15% (95% CI: -12 to 35) at 90-179 days, and lower to no effect thereafter.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Verónica Gomez
- Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Maria-Louise Borg
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - François E Dufrasne
- National Influenza Centre Laboratory of Viral Diseases, Sciensano, Brussels, Belgium
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Mihaela Lazar
- Cantacuzino National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Lithuania
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Petr Husa
- University Hospital Brno, Masaryk University, Brno, Czechia
| | | | - Aryse Melo
- Infectious Diseases Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Gloria Pérez-Gimeno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ausenda Machado
- Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Aušra Džiugytė
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | | | - Margaret Fitzgerald
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Sébastien Fierens
- Service Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - Kristin Tolksdorf
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Silvia-Odette Popovici
- National Institute of Public Health, National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | - Auksė Mickienė
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Lenka Součková
- University Hospital Brno, Masaryk University, Brno, Czechia
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Baruch J, Denayer S, Seyler L, Domegan L, Launay O, Machado A, Burgui C, Vaikutyte R, Niessen FA, Loghin II, Husa P, Aouali N, Panagiotakopoulos G, Tolksdorf K, Horváth JK, Howard J, Pozo F, Gallardo V, Nonković D, Džiugytė A, Bossuyt N, Demuyser T, Duffy R, Luong Nguyen LB, Kislaya I, Martínez-Baz I, Gefenaite G, Knol MJ, Popescu C, Součková L, Simon M, Michelaki S, Reiche J, Ferenczi A, Delgado-Sanz C, Lovrić Makarić Z, Cauchi JP, Barbezange C, Van Nedervelde E, O'Donnell J, Durier C, Guiomar R, Castilla J, Jonikaite I, Bruijning-Verhagen PC, Lazar M, Demlová R, Wirtz G, Amerali M, Dürrwald R, Kunstár MP, Kissling E, Bacci S, Valenciano M. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Omicron-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021 to 2022. Euro Surveill 2023; 28:2300187. [PMID: 37997665 PMCID: PMC10668256 DOI: 10.2807/1560-7917.es.2023.28.47.2300187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period).MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case-control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition.ResultsWe included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29-54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51-66) after addition of one booster dose. The VE was 85% (95% CI: 78-89), 70% (95% CI: 61-77) and 36% (95% CI: 17-51) for those with onset 14-59 days, 60-119 days and 120-179 days after booster vaccination, respectively.ConclusionsOur results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giedre Gefenaite
- Faculty of Medicine, Lund University, Lund, Sweden
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | | | - Annamária Ferenczi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - John Paul Cauchi
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | | | - Gil Wirtz
- Centre Hospitalier de Luxembourg, Luxembourg
| | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Mihály Pál Kunstár
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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