Vaccine effectiveness against COVID-19 related hospital admission in the Netherlands: A test-negative case-control study
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Abstract
INTRODUCTION: Real-world vaccine effectiveness (VE) estimates are essential to identify potential groups at higher risk of break-through infections and to guide policy. We assessed the VE of COVID-19 vaccination against COVID-19 hospitalization, while adjusting and stratifying for patient characteristics. METHODS: We performed a test-negative case-control study in six Dutch hospitals. The study population consisted of adults eligible for COVID-19 vaccination hospitalized between May 1 and June 28, 2021 with respiratory symptoms. Cases were defined as patients who tested positive for SARS-CoV-2 by PCR during the first 48 h of admission or within 14 days prior to hospital admission. Controls were patients tested negative at admission and did not have a positive test during the 2 weeks prior to hospitalization. VE was calculated using multivariable logistic regression, adjusting for calendar week, sex, age, comorbidity and nursing home residency. Subgroup analysis was performed for age, sex and different comorbidities. Secondary endpoints were ICU-admission and mortality. RESULTS: 379 cases and 255 controls were included of whom 157 (18%) were vaccinated prior to admission. Five cases (1%) and 40 controls (16%) were fully vaccinated (VE: 93%; 95% CI: 81 - 98), and 40 cases (11%) and 70 controls (27%) were partially vaccinated (VE: 70%; 95% CI: 50-82). A strongly protective effect of vaccination was found in all comorbidity subgroups. No ICU-admission or mortality were reported among fully vaccinated cases. Of unvaccinated cases, mortality was 10% and 19% was admitted at the ICU. CONCLUSION: COVID-19 vaccination provides a strong protective effect against COVID-19 related hospital admission, in patients with and without comorbidity.
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- Authors
- Niessen, F. A., Knol, M. J., Hahné, S. J. M., Bonten, M. J. M., & Bruijning-Verhagen, P. C. J. L.
- Affiliations
- University Medical Center Utrecht (NL)
- National Institute for Public Health and the Environment (NL)
- Corresponding author
- Niessen, F.A.
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 40
- Issue
- 34
- Pages
- 5044-5049
- ISSN
- 0264-410X (ISSN-L)
- PMC
- PMC9174354
- OpenAlex
- W4286767582
- Cited by
- 15
- References
- 19
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 2 · 2022: 4
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Vaccine (publishedVersion, cc-by-nc-nd)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Funders
- St. Antonius Ziekenhuis
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- COVID-19 vaccine effectiveness, SARS-CoV-2, COVID-19 hospitalization, breakthrough infection, comorbidities, intensive care unit admission, mortality, partial vaccination, nursing home residents, test-negative case-control
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, Vaccine Efficacy, Adult, Hospitalization, Hospitals, Humans, Netherlands, Case-Control Studies
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