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4th COVID vaccination resulted in no decreased deaths (Austria) - Nov 2023

Effectiveness of a fourth SARS-CoV-2 vaccine dose in previously infected individuals from Austria

European Journal of Clinical Invetigation https://doi.org/10.1111/eci.14136
Alena Chalupka, Lukas Richter, Ali Chakeri, Ziad El-Khatib, Verena Theiler-Schwetz, Christian Trummer, Robert Krause, Peter Willeit …

Evidence is limited on the effectiveness of a fourth vaccine dose against coronavirus disease 2019 (COVID-19) in populations with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. We estimated the risk of COVID-19 deaths and SARS-CoV-2 infections according to vaccination status in previously infected individuals in Austria.

This is a nationwide retrospective observational study. We calculated age and gender adjusted Cox proportional hazard ratios (HRs) of COVID-19 deaths (primary outcome) and SARS-CoV-2 infections (secondary outcome) from 1 November to 31 December 2022, primarily comparing individuals with four versus three vaccine doses. Relative vaccine effectiveness (rVE) was calculated as (1-HR) X 100.

Among 3,986,312 previously infected individuals, 281,291 (7,1%) had four and 1,545,242 (38.8%) had three vaccinations at baseline. We recorded 69 COVID-19 deaths and 89,056 SARS-CoV-2 infections. rVE for four versus three vaccine doses was −24% (95% CI: −120 to 30) against COVID-19 deaths, and 17% (95% CI: 14–19) against SARS-CoV-2 infections. This latter effect rapidly diminished over time and infection risk with four vaccinations was higher compared to less vaccinated individuals during extended follow-up until June 2023. Adjusted HR (95% CI) for all-cause mortality for four versus three vaccinations was 0.79 (0.74–0.85).

In previously infected individuals, a fourth vaccination was not associated with COVID-19 death risk, but with transiently reduced risk of SARS-CoV-2 infections and reversal of this effect in longer follow-up. All-cause mortality data suggest healthy vaccinee bias.
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Attached files

ID Name Comment Uploaded Size Downloads
20480 COVID Austria.png admin 13 Dec, 2023 40.79 Kb 39
20479 4th COVID Austria_CompressPdf.pdf admin 13 Dec, 2023 116.21 Kb 21