Frontiers in Immunology (Jun 2022)

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

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

DOI
https://doi.org/10.3389/fimmu.2022.905585
Journal volume & issue
Vol. 13

Abstract

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BackgroundIn Hungary, the pandemic waves in late 2021 and early 2022 were dominated by the Delta and Omicron SARS-CoV-2 variants, respectively. Booster vaccines were offered with one or two doses for the vulnerable population during these periods.Methods and FindingsThe nationwide HUN-VE 2 study examined the effectiveness of primary immunization, single booster, and double booster vaccination in the prevention of Covid-19 related mortality during the Delta and Omicron waves, compared to an unvaccinated control population without prior SARS-CoV-2 infection during the same study periods. The risk of Covid-19 related death was 55% lower during the Omicron vs. Delta wave in the whole study population (n=9,569,648 and n=9,581,927, respectively; rate ratio [RR]: 0.45, 95% confidence interval [CI]: 0.44–0.48). During the Delta wave, the risk of Covid-19 related death was 74% lower in the primary immunized population (RR: 0.26; 95% CI: 0.25–0.28) and 96% lower in the booster immunized population (RR: 0.04; 95% CI: 0.04–0.05), vs. the unvaccinated control group. During the Omicron wave, the risk of Covid-19 related death was 40% lower in the primary immunized population (RR: 0.60; 95% CI: 0.55–0.65) and 82% lower in the booster immunized population (RR: 0.18; 95% CI: 0.16–0.2) vs. the unvaccinated control group. The double booster immunized population had a 93% lower risk of Covid-19 related death compared to those with only one booster dose (RR: 0.07; 95% CI. 0.01–0.46). The benefit of the second booster was slightly more pronounced in older age groups.ConclusionsThe HUN-VE 2 study demonstrated the significantly lower risk of Covid-19 related mortality associated with the Omicron vs. Delta variant and confirmed the benefit of single and double booster vaccination against Covid-19 related death. Furthermore, the results showed the additional benefit of a second booster dose in terms of SARS-CoV-2 infection and Covid-19 related mortality.

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