Nationwide Effectiveness of First and Second SARS-CoV2 Booster Vaccines during the Delta and Omicron Pandemic Waves in Hungary (HUN-VE 2 Study)

Kiss, Zoltán; Wittmann, István; Polivka, Lőrinc; Surján, György; Surján, Orsolya; Barcza, Zsófia; Molnár, Gergő Attila; Nagy, Dávid; Müller, Veronika; Bogos, Krisztina; Kenessey, István; Wéber, András; Pálosi, Mihály; Szlávik, János; Schaff, Zsuzsa; Szekanecz, Zoltán; Müller, Cecília; Kásler, Miklós; Vokó, Zoltán

doi:10.1101/2022.03.27.22273000

Cited by 10 publications

(11 citation statements)

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“…Improved protection against all Covid-19 related outcomes with booster vaccines compared to primary immunization has been demonstrated by a number of studies (6)(7)(8). In a recently published preprint of HUN-VE 2 study from Hungary, booster vaccination provided 96% vaccine effectiveness against SARS-CoV-2 related death as an overall result in comparison to those, having only primary immunization during the Delta wave, where these VE was only 73% (26). Another study from Israel was among the first to report a 93% lower risk of Covid-19 related hospitalization and an 81% lower risk of Covid-19 related death among patients who had received three doses of the Pfizer-BioNTech vaccine compared to those who had received only two doses at least 5 months earlier (7).…”

Section: Discussionmentioning

confidence: 97%

Effectiveness and Waning of Protection With Different SARS-CoV-2 Primary and Booster Vaccines During the Delta Pandemic Wave in 2021 in Hungary (HUN-VE 3 Study)

et al. 2022

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BackgroundIn late 2021, the pandemic wave was dominated by the Delta SARS-CoV-2 variant in Hungary. Booster vaccines were offered for the vulnerable population starting from August 2021.MethodsThe nationwide HUN-VE 3 study examined the effectiveness and durability of primary immunization and single booster vaccinations in the prevention of SARS-CoV-2 infection, Covid-19 related hospitalization and mortality during the Delta wave, compared to an unvaccinated control population without prior SARS-CoV-2 infection.ResultsThe study population included 8,087,988 individuals who were 18–100 years old at the beginning of the pandemic. During the Delta wave, after adjusting for age, sex, calendar day, and chronic diseases, vaccine effectiveness (VE) of primary vaccination against registered SARS-CoV-2 infection was between 11% to 77% and 18% to 79% 14–120 days after primary immunization in the 16–64 and 65–100 years age cohort respectively, while it decreased to close to zero in the younger age group and around 40% or somewhat less in the elderly after 6 months for almost all vaccine types. In the population aged 65–100 years, we found high, 88.1%–92.5% adjusted effectiveness against Covid-19 infection after the Pfizer-BioNTech, and 92.2%–95.6% after the Moderna booster dose, while Sinopharm and Janssen booster doses provided 26.5%–75.3% and 72.9%–100.0% adjusted VE, respectively. Adjusted VE against Covid-19 related hospitalization was high within 14–120 days for Pfizer-BioNTech: 76.6%, Moderna: 83.8%, Sputnik-V: 78.3%, AstraZeneca: 73.8%, while modest for Sinopharm: 45.7% and Janssen: 26.4%. The waning of protection against Covid-19 related hospitalization was modest and booster vaccination with mRNA vaccines or the Janssen vaccine increased adjusted VE up to almost 100%, while the Sinopharm booster dose proved to be less effective. VE against Covid-19 related death after primary immunization was high or moderate: for Pfizer-BioNTech: 81.5%, Moderna: 93.2%, Sputnik-V: 100.0%, AstraZeneca: 84.8%, Sinopharm: 58.6%, Janssen: 53.3%). VE against this outcome also showed a moderate decline over time, while booster vaccine types restored effectiveness up to almost 100%, except for the Sinopharm booster.ConclusionsThe HUN-VE 3 study demonstrated waning VE with all vaccine types for all examined outcomes during the Delta wave and confirmed the outstanding benefit of booster vaccination with the mRNA or Janssen vaccines, and this is the first study to provide clear and comparable effectiveness results for six different vaccine types after primary immunization against severe during the Delta pandemic wave.

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Section: Discussionmentioning

confidence: 97%

Effectiveness and Waning of Protection With Different SARS-CoV-2 Primary and Booster Vaccines During the Delta Pandemic Wave in 2021 in Hungary (HUN-VE 3 Study)

et al. 2022

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“…Improved protection against all Covid-19 related outcomes with booster vaccines compared to primary immunization has been demonstrated by a number of studies (9,10,11). In a recently published preprint of HUN-VE 2 study from Hungary, booster vaccination provided 96% vaccine effectiveness against SARS-CoV-2 related death as an overall result in comparison to those, having only primary immunization during the Delta wave, where these VE was only 73% (29). Another study from Israel was among the first to report a 93% lower risk of Covid-19 related hospitalization and an 81% lower risk of Covid-19 related death among patients who had received three doses of the Pfizer-BioNTech vaccine compared to those who had received only two doses at least 5 months earlier (30).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and waning of protection with different SARS-CoV-2 primary and booster vaccines during the Delta pandemic wave in 2021 in Hungary (HUN-VE 3 study)

Vokó

Kiss

Surján

et al. 2022

Preprint

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BackgroundIn late 2021, the pandemic wave was dominated by the Delta SARS-CoV-2 variant in Hungary. Booster vaccines were offered starting from August 2021.MethodsThe nationwide HUN-VE 3 study examined the effectiveness and durability of primary immunization and single booster vaccinations on SARS-CoV-2-related infection, hospitalization and mortality during the Delta wave.ResultsThe study population included 8,087,988 individuals aged 18–100 years at the beginning of the pandemic. During the Delta wave, after adjusting for age, sex, calendar day, and chronic diseases, vaccine effectiveness (VE) of primary vaccination against registered SARS-CoV-2 infection was between 11% to 77% and 18% to 79% 14–120 days after primary immunization in the 16–64 and 65–100 years age cohort respectively, while it decreased to close to zero in the younger age group and around 40% or somewhat less in the elderly after 6 months for almost all vaccine types. In the population aged 65–100 years, we found high, 88.1%–92.5% adjusted effectiveness against Covid-19 infection after the Pfizer-BioNTech, and 92.2%–95.6% after the Moderna booster dose, while Sinopharm and Janssen booster doses provided 26.5%–75.3% and 72.9%–100.0% adjusted VE, respectively. Adjusted VE against Covid-19 related hospitalization was high within 14–120 days for Pfizer-BioNTech: 76.6%, Moderna: 83.8%, Sputnik-V: 78.3%, AstraZeneca: 73.8%, while modest for Sinopharm: 45.7% and Janssen: 26.4%. The waning of protection against Covid-19 related hospitalization was modest and booster vaccination with mRNA vaccines or the Janssen vaccine increased adjusted VE up to almost 100%, while the Sinopharm booster dose proved to be less effective. VE against Covid-19 related death after primary immunization was high or moderate: for Pfizer-BioNTech: 81.5%, Moderna: 93.2%, Sputnik-V: 100.0%, AstraZeneca: 84.8%, Sinopharm: 58.6%, Janssen: 53.3%). VE against this outcome also showed moderate decline over time, while booster vaccines restored effectiveness up to almost 100%, except for the Sinopharm booster.ConclusionsThe HUN-VE 3 study demonstrated waning VE with all vaccine types for all examined outcomes during the Delta wave and confirmed the outstanding benefit of booster vaccination with the mRNA or Janssen vaccines. This is the first study to provide comparable effectiveness results for six different booster types during the Delta pandemic wave.

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“…These data are in line with our previous results regarding data from the alpha VOC and with international studies, clinical trials, and real-word settings [ 1 , 3 , 12 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. However, results from different studies should be carefully compared due to potential confounders including vaccine doses, vaccine types, and differences of VOCs [ 1 , 8 ]. Despite high overall primary immunization of the elderly population, an additional booster (mainly mRNA) did significantly decrease the hospital admission rate in this population.…”

Section: Discussionmentioning

confidence: 99%

“…The vaccination program has already been in place with a large proportion of the population having primary immunization (2× vaccinated by mRNA vaccines Pfizer-BioNTech or Moderna, or 2× vaccinated by Sputnik or Sinopharm, or 1× Janssen vaccinated), which has resulted in decreased infection and hospitalization rates in Hungary [ 1 ]. Differences in VOC and the falloff of immunity following baseline immunization led to the introduction of booster vaccinations in different countries including Hungary [ 8 ]. Infections from the delta VOC were of particular interest, as vaccination was already performed on a large proportion of the Hungarian population, and booster vaccinations were started as a result of observed immunity loss following primary immunization in this time period [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Booster Vaccination Decreases 28-Day All-Cause Mortality of the Elderly Hospitalized Due to SARS-CoV-2 Delta Variant

et al. 2022

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(1) Background: SARS-CoV-2 infections are associated with an increased risk of hospital admissions especially in the elderly (age ≥ 65 years) and people with multiple comorbid conditions. (2) Methods: We investigated the effect of additional booster vaccinations following the primary vaccination series of mRNA, inactivated whole virus, or vector vaccines on infections with the SARS-CoV-2 delta variant in the total Hungarian elderly population. The infection, hospital admission, and 28-day all-cause mortality of elderly population was assessed. (3) Results: A total of 1,984,176 people fulfilled the criteria of elderly including 299,216 unvaccinated individuals, while 1,037,069 had completed primary vaccination and 587,150 had obtained an additional booster. The primary vaccination series reduced the risk of infection by 48.88%, the risk of hospital admission by 71.55%, and mortality by 79.87%. The booster vaccination had an additional benefit, as the risk of infection, hospital admission, and all-cause mortality were even lower (82.95%; 92.71%; and 94.24%, respectively). Vaccinated patients needing hospitalization suffered significantly more comorbid conditions, indicating a more vulnerable population. (4) Conclusions: Our data confirmed that the primary vaccination series and especially the booster vaccination significantly reduced the risk of the SARS-CoV-2 delta-variant-associated hospital admission and 28-day all-cause mortality in the elderly despite significantly more severe comorbid conditions.

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Nationwide Effectiveness of First and Second SARS-CoV2 Booster Vaccines during the Delta and Omicron Pandemic Waves in Hungary (HUN-VE 2 Study)

Cited by 10 publications

References 36 publications

Effectiveness and Waning of Protection With Different SARS-CoV-2 Primary and Booster Vaccines During the Delta Pandemic Wave in 2021 in Hungary (HUN-VE 3 Study)

Effectiveness and Waning of Protection With Different SARS-CoV-2 Primary and Booster Vaccines During the Delta Pandemic Wave in 2021 in Hungary (HUN-VE 3 Study)

Effectiveness and waning of protection with different SARS-CoV-2 primary and booster vaccines during the Delta pandemic wave in 2021 in Hungary (HUN-VE 3 study)

Booster Vaccination Decreases 28-Day All-Cause Mortality of the Elderly Hospitalized Due to SARS-CoV-2 Delta Variant

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