Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data

Objective To estimate the effectiveness of vaccination with a monovalent covid-19 mRNA vaccine containing the omicron XBB.1.5 subvariant against severe covid-19 disease in Denmark, Finland, and Sweden.Design Target trial emulation based on registry data.Setting Denmark, Finland, and Sweden, 1 Octobe...

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Main Authors: Anders Hviid, Niklas Worm Andersson, Rickard Ljung, Emilia Myrup Thiesson, Nicklas Pihlström, Kristýna Faksová, Eero Poukka, Jori Perälä, Mie Agermose Gram, Tuija Leino
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Language:English
Published: BMJ Publishing Group 2024-08-01
Series:BMJ Medicine
Online Access:https://bmjmedicine.bmj.com/content/3/1/e001074.full
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author Anders Hviid
Niklas Worm Andersson
Rickard Ljung
Emilia Myrup Thiesson
Nicklas Pihlström
Kristýna Faksová
Eero Poukka
Jori Perälä
Mie Agermose Gram
Tuija Leino
author_facet Anders Hviid
Niklas Worm Andersson
Rickard Ljung
Emilia Myrup Thiesson
Nicklas Pihlström
Kristýna Faksová
Eero Poukka
Jori Perälä
Mie Agermose Gram
Tuija Leino
author_sort Anders Hviid
collection DOAJ
description Objective To estimate the effectiveness of vaccination with a monovalent covid-19 mRNA vaccine containing the omicron XBB.1.5 subvariant against severe covid-19 disease in Denmark, Finland, and Sweden.Design Target trial emulation based on registry data.Setting Denmark, Finland, and Sweden, 1 October 2023 to 21 April 2024.Participants Source population of 3 898 264 individuals eligible for vaccination with the XBB.1.5 containing covid-19 mRNA vaccine at the start of the study on 1 October 2023. Study cohort comprised 1 876 282 recipients of an XBB.1.5 containing vaccine during the study period matched with 1 876 282 non-recipients. Individuals were aged ≥65 years (mean age 75.4 years, standard deviation 7.4 years) and had received at least four doses of a previous covid-19 vaccine.Main outcome measures Cumulative incidences of hospital admissions and deaths related to covid-19 in a follow-up period of 24 weeks after immunisation (defined as one week after vaccination) in recipients of an XBB.1.5 containing covid-19 mRNA vaccine and matched non-recipients. Cumulative incidences were used to calculate comparative vaccine effectiveness (1−risk ratio) and risk differences.Results The associated comparative vaccine effectiveness was 57.9% (95% confidence interval (CI) 49.9% to 65.8%) against hospital admission for covid-19 (1085 v 2635 events) and 75.2% (70.6% to 79.9%) against deaths related to covid-19 disease (348 v 1458 events) after 24 weeks of follow-up. This result corresponded to 154.7 (95% CI 78.3 to 231.0) hospital admissions for covid-19 and 120.3 (110.5 to 130.2) deaths prevented per 100 000 individuals who were vaccinated with an XBB.1.5 containing vaccine. The associated comparative vaccine effectiveness was similar irrespective of sex, age group (65-74 v ≥75 years), number of doses of previous covid-19 vaccines, subgroup of co-administered seasonal influenza vaccines, and period of when either the omicron XBB or BA.2.86 sublineage was predominant. Although the observed reduction in risk was highest during the first weeks after vaccination, comparative vaccine effectiveness was well maintained after 24 weeks of follow-up.Conclusions In this study, in adults aged ≥65 years, vaccination with a monovalent XBB.1.5 containing covid-19 mRNA vaccine was associated with reduced rates of hospital admissions for covid-19 and deaths related to covid-19, during the autumn and winter of 2023-24 in Denmark, Finland, and Sweden.
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spelling doaj-art-e6b9c4b1e63f41faa18b07f4971dc0322024-12-28T16:10:07ZengBMJ Publishing GroupBMJ Medicine2754-04132024-08-013110.1136/bmjmed-2024-001074Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry dataAnders Hviid0Niklas Worm Andersson1Rickard Ljung2Emilia Myrup Thiesson3Nicklas Pihlström4Kristýna Faksová5Eero Poukka6Jori Perälä7Mie Agermose Gram8Tuija Leino9Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, DenmarkDivision of Use and Information, Swedish Medical Products Agency, Uppsala, SwedenDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, DenmarkInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, DenmarkInfectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, FinlandInfectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, FinlandDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, DenmarkInfectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, FinlandObjective To estimate the effectiveness of vaccination with a monovalent covid-19 mRNA vaccine containing the omicron XBB.1.5 subvariant against severe covid-19 disease in Denmark, Finland, and Sweden.Design Target trial emulation based on registry data.Setting Denmark, Finland, and Sweden, 1 October 2023 to 21 April 2024.Participants Source population of 3 898 264 individuals eligible for vaccination with the XBB.1.5 containing covid-19 mRNA vaccine at the start of the study on 1 October 2023. Study cohort comprised 1 876 282 recipients of an XBB.1.5 containing vaccine during the study period matched with 1 876 282 non-recipients. Individuals were aged ≥65 years (mean age 75.4 years, standard deviation 7.4 years) and had received at least four doses of a previous covid-19 vaccine.Main outcome measures Cumulative incidences of hospital admissions and deaths related to covid-19 in a follow-up period of 24 weeks after immunisation (defined as one week after vaccination) in recipients of an XBB.1.5 containing covid-19 mRNA vaccine and matched non-recipients. Cumulative incidences were used to calculate comparative vaccine effectiveness (1−risk ratio) and risk differences.Results The associated comparative vaccine effectiveness was 57.9% (95% confidence interval (CI) 49.9% to 65.8%) against hospital admission for covid-19 (1085 v 2635 events) and 75.2% (70.6% to 79.9%) against deaths related to covid-19 disease (348 v 1458 events) after 24 weeks of follow-up. This result corresponded to 154.7 (95% CI 78.3 to 231.0) hospital admissions for covid-19 and 120.3 (110.5 to 130.2) deaths prevented per 100 000 individuals who were vaccinated with an XBB.1.5 containing vaccine. The associated comparative vaccine effectiveness was similar irrespective of sex, age group (65-74 v ≥75 years), number of doses of previous covid-19 vaccines, subgroup of co-administered seasonal influenza vaccines, and period of when either the omicron XBB or BA.2.86 sublineage was predominant. Although the observed reduction in risk was highest during the first weeks after vaccination, comparative vaccine effectiveness was well maintained after 24 weeks of follow-up.Conclusions In this study, in adults aged ≥65 years, vaccination with a monovalent XBB.1.5 containing covid-19 mRNA vaccine was associated with reduced rates of hospital admissions for covid-19 and deaths related to covid-19, during the autumn and winter of 2023-24 in Denmark, Finland, and Sweden.https://bmjmedicine.bmj.com/content/3/1/e001074.full
spellingShingle Anders Hviid
Niklas Worm Andersson
Rickard Ljung
Emilia Myrup Thiesson
Nicklas Pihlström
Kristýna Faksová
Eero Poukka
Jori Perälä
Mie Agermose Gram
Tuija Leino
Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
BMJ Medicine
title Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
title_full Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
title_fullStr Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
title_full_unstemmed Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
title_short Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
title_sort comparative effectiveness of monovalent xbb 1 5 containing covid 19 mrna vaccines in denmark finland and sweden target trial emulation based on registry data
url https://bmjmedicine.bmj.com/content/3/1/e001074.full
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