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Real World Estimate of Vaccination Protection in Individuals Hospitalized for COVID-19

Authors :
Antonella d’Arminio Monforte
Alessandro Tavelli
Sara De Benedittis
Francesca Bai
Camilla Tincati
Lidia Gazzola
Ottavia Viganò
Marina Allegrini
Debora Mondatore
Daniele Tesoro
Diletta Barbanotti
Giovanni Mulé
Roberto Castoldi
Anna De Bona
Teresa Bini
Davide Chiumello
Stefano Centanni
Sabrina Passarella
Nicola Orfeo
Giulia Marchetti
Alessandro Cozzi-Lepri
for the SPID Group
Source :
Vaccines, Vol 10, Iss 4, p 550 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Whether vaccination confers a protective effect against progression after hospital admission for COVID-19 remains to be elucidated. Observational study including all the patients admitted to San Paolo Hospital in Milan for COVID-19 in 2021. Previous vaccination was categorized as: none, one dose, full vaccination (two or three doses >14 days before symptoms onset). Data were collected at hospital admission, including demographic and clinical variables, age-unadjusted Charlson Comorbidity index (CCI). The highest intensity of ventilation during hospitalization was registered. The endpoints were in-hospital death (primary) and mechanical ventilation/death (secondary). Survival analysis was conducted by means of Kaplan-Meier curves and Cox regression models. Effect measure modification by age was formally tested. We included 956 patients: 151 (16%) fully vaccinated (18 also third dose), 62 (7%) one dose vaccinated, 743 (78%) unvaccinated. People fully vaccinated were older and suffering from more comorbidities than unvaccinated. By 28 days, the risk of death was of 35.9% (95%CI: 30.1–41.7) in unvaccinated, 41.5% (24.5–58.5) in one dose and 28.4% (18.2–38.5) in fully vaccinated (p = 0.63). After controlling for age, ethnicity, CCI and month of admission, fully vaccinated participants showed a risk reduction of 50% for both in-hospital death, AHR 0.50 (95%CI: 0.30–0.84) and for mechanical ventilation or death, AHR 0.49 (95%CI: 0.35–0.69) compared to unvaccinated, regardless of age (interaction p > 0.56). Fully vaccinated individuals in whom vaccine failed to keep them out of hospital, appeared to be protected against critical disease or death when compared to non-vaccinated. These data support universal COVID-19 vaccination.

Details

Language :
English
ISSN :
2076393X
Volume :
10
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Vaccines
Publication Type :
Academic Journal
Accession number :
edsdoj.05a5f2c79b554f6eaf3396495957f4c5
Document Type :
article
Full Text :
https://doi.org/10.3390/vaccines10040550