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- 2015/16 I-MOVE/I-MOVE+ multicentre case control study in Europe: moderate vaccine effectiveness estimates against influenza A(H1N1)pdm09 and low estimates against lineage mismatched influenza B among childrenPublication . Kissling, Esther; Valenciano, Marta; Pozo, Francisco; Vilcu, Ana-Maria; Reuss, Annicka; Rizzo, Caterina; Larrauri, Amparo; Horváth, Judit Krisztina; Brytting, Mia; Domegan, Lisa; Korczyńska, Monika; Meijer, Adam; Machado, Ausenda; Ivanciuc, Alina; Višekruna Vučina, Vesna; van der Werf, Sylvie; Schweiger, Brunhilde; Bella, Antonino; Gherasim, Alin; Ferenczi, Annamária; Zakikhany, Katherina; O Donnell, Joan; Paradowska-Stankiewicz, Iwona; Dijkstra, Frederika; Guiomar, Raquel; Lazar, Mihaela; Kurečić Filipović, Sanja; Johansen, Kari; Moren, Alain; I-MOVE/I-MOVE+ study teamBackground:During the 2015/16 influenza season in Europe, the co-circulating influenza viruses were A(H1N1)pdm09 and B/Victoria, which was antigenically distinct from the B/Yamagata component in the trivalent influenza vaccine. Methods:We used the test negative design in a multicentre case–control study in twelve European countries to measure 2015/16 influenza vaccine effectiveness (VE) against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. General practitioners swabbed a systematic sample of consulting ILI patients ainfluenza Vaccinend a random sample of influenza positive swabs were sequenced. We calculated adjusted VE against influenza A(H1N1)pdm09, A(H1N1)pdm09 genetic group 6B.1 and influenza B overall and by age group. Results: We included 11,430 ILI patients, of which 2272 were influenza A(H1N1)pdm09 and 2901 were influenza B cases. Overall VE against influenza A(H1N1)pdm09 was 32.9% (95% CI: 15.5-46.7). Among those aged 0–14, 15–64 and ≥65 years VE against A(H1N1)pdm09 was 31.9% (95% CI: -32.3-65.0), 41.4% (95%CI: 20.5-56.7) and 13.2% (95% CI: -38.0-45.3) respectively. Overall VE against influenza A(H1N1)pdm09 genetic group 6B.1 was 32.8% (95%CI: -4.1-56.7). Among those aged 0–14, 15–64 and ≥65 years VE against influenza B was -47.6% (95%CI: -124.9-3.1), 27.3% (95%CI: -4.6-49.4), and 9.3% (95%CI: -44.1-42.9) respectively. Conclusions: VE against influenza A(H1N1)pdm09 and its genetic group 6B.1 was moderate in children and adults, and low among individuals ≥65 years. VE against influenza B was low and heterogeneous among age groups. More information on effects of previous vaccination and previous infection are needed to understand the VE results against influenza B in the context of a mismatched vaccine.
- COVID-19 Vaccine Effectiveness Against Hospitalization in Older Adults, VEBIS Hospital Network, Europe, September 2024-May 2025Publication . Rojas-Castro, Madelyn; Verdasca, Nuno; Monge, Susana; De Mot, Laurane; Trobajo-Sanmartín, Camino; Duffy, Róisín; Túri, Gergő; Kuliese, Monika; Duerrwald, Ralf; Borg, Maria-Louise; Popovici, Odette; Gomez, Verónica; Makarić, Zvjezdana Lovrić; Launay, Odile; Marques, Diogo F.P.; Pozo, Francisco; Witdouck, Arne; Martínez-Baz, Iván; Fitzgerald, Margaret; Oroszi, Beatrix; Jančorienė, Ligita; Buda, Silke; Dziugyte, Ausra; Lazăr, Mihaela; Machado, Ausenda; Tabain, Irena; Nguyen, Liem Binh Luong; Wagner, Eva Rivas; Dufrasne, François; Castilla, Jesús; Domegan, Lisa; Velkey, Viktória; Majauskaite, Fausta; Hackmann, Carolin; Nicolay, Nathalie; Bacci, Sabrina; Rose, Angela M.C.; European Hospital Vaccine Effectiveness GroupWe estimated COVID-19 vaccine effectiveness (VE) against PCR-confirmed SARS-CoV-2 hospitalization in patients ≥ 60 years with severe acute respiratory infection, using a multicenter, test-negative, case-control study across seven sites in six European countries between September 2024 and May 2025. We included 352 cases (115 vaccinated; 33%) and 9980 controls (5024 vaccinated; 50%). VE was 42% (95% CI: 15; 61) 14-59 days post-vaccination, 32% (95% CI: -1; 54) at 60-119 days, and 36% (95% CI: 2; 60) at 120-179 days, and no effect thereafter. Among adults aged 60-79 and ≥ 80 years, we observed moderate VE against COVID-19 hospitalization for up to 2 and 4 months, respectively.
- COVID-19 Vaccine Effectiveness Against Medically Attended Symptomatic SARS-CoV-2 Infection Among Target Groups in Europe, October 2024-January 2025, VEBIS Primary Care NetworkPublication . Delaunay, Charlotte Laniece; Verdasca, Nuno; Monge, Susana; Domegan, Lisa; Sève, Noémie; Buda, Silke; Meijer, Adam; Lucaccioni, Héloïse; Torrijos, Miriam López; McKenna, Adele; Enouf, Vincent; Dürrwald, Ralf; In't Velt, Eline; Laiglesia, Mª Ángel de Valcárcel; Bennett, Charlene; Masse, Shirley; Erdwiens, Annika; Hooiveld, Mariette; Mlinarić, Ivan; Túri, Gergő; Rodrigues, Ana Paula; Martínez-Baz, Iván; Lazar, Mihaela; Latorre-Margalef, Neus; Borges, Vitor; Kaczmarek, Marlena; Bacci, Sabrina; Kissling, Esther; European primary care VE groupWe estimated the effectiveness of 2024/25 COVID-19 vaccination against medically attended SARS-CoV-2 infection in Europe, among target groups. We included 3204 patients (8/139 cases vaccinated: 6%; 517/3065 controls vaccinated: 17%) from a multicentre, test-negative design study at primary care level. Vaccine effectiveness was 66% (95% CI: 34-85) overall, 73% (95% CI: 21-94) and 54% (95% CI: -3 to 83) in the first and second months post-vaccination, respectively. Overall vaccine effectiveness was 67% (95% CI: 33-86) among older adults (≥ 60 or ≥ 65 years). This relatively high COVID-19 VE (compared with previous seasons), as well as trends by time since vaccination, should be confirmed with additional data, as sample size was low.
- COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 BA.1/BA.2 lineages among adults and adolescents in a multicentre primary care study, Europe, December 2021 to June 2022Publication . Lanièce Delaunay, Charlotte; Martínez-Baz, Iván; Sève, Noémie; Domegan, Lisa; Mazagatos, Clara; Buda, Silke; Meijer, Adam; Kislaya, Irina; Pascu, Catalina; Carnahan, AnnaSara; Oroszi, Beatrix; Ilić, Maja; Maurel, Marine; Melo, Aryse; Sandonis Martín, Virginia; Trobajo-Sanmartín, Camino; Enouf, Vincent; McKenna, Adele; Pérez-Gimeno, Gloria; Goerlitz, Luise; de Lange, Marit; Rodrigues, Ana Paula; Lazar, Mihaela; Latorre-Margalef, Neus; Túri, Gergő; Castilla, Jesús; Falchi, Alessandra; Bennett, Charlene; Gallardo, Virtudes; Dürrwald, Ralf; Eggink, Dirk; Guiomar, Raquel; Popescu, Rodica; Riess, Maximilian; Horváth, Judit Krisztina; Casado, Itziar; García, M. del Carmen; Hooiveld, Mariëtte; Machado, Ausenda; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, EstherBackground: Scarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants. Aim: We aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases. Methods: This European test-negative multicentre study tested primary care patients with acute respiratory symptoms for SARS-CoV-2 in the BA.1/BA.2-dominant period. We estimated PS and booster VE among adults and adolescents (PS only) for all products combined and for Comirnaty alone, by time since vaccination, age and chronic condition. We investigated potential bias due to correlation between COVID-19 and influenza vaccination and explored effect modification and confounding by prior SARS-CoV-2 infection. Results: Among adults, PS VE was 37% (95% CI: 24–47%) overall and 60% (95% CI: 44–72%), 43% (95% CI: 26–55%) and 29% (95% CI: 13–43%) < 90, 90–179 and ≥ 180 days post vaccination, respectively. Booster VE was 42% (95% CI: 32–51%) overall and 56% (95% CI: 47–64%), 22% (95% CI: 2–38%) and 3% (95% CI: −78% to 48%), respectively. Primary series VE was similar among adolescents. Restricting analyses to Comirnaty had little impact. Vaccine effectiveness was higher among older adults. There was no signal of bias due to correlation between COVID-19 and influenza vaccination. Confounding by previous infection was low, but sample size precluded definite assessment of effect modification. Conclusion: Primary series and booster VE against symptomatic infection with BA.1/BA.2 ranged from 37% to 42%, with similar waning post vaccination. Comprehensive data on previous SARS-CoV-2 infection would help disentangle vaccine- and infection-induced immunity.
- COVID-19 Vaccine Effectiveness in Autumn and Winter 2022 to 2023 Among Older EuropeansPublication . Laniece Delaunay, Charlotte; Mazagatos, Clara; Martínez-Baz, Iván; Túri, Gergő; Goerlitz, Luise; Domegan, Lisa; Meijer, Adam; Rodrigues, Ana Paula; Sève, Noémie; Ilić, Maja; Latorre-Margalef, Neus; Lazar, Mihaela; Maurel, Marine; Melo, Aryse; Andreu Ivorra, Blanca; Casado, Itziar; Horváth, Judit Krisztina; Buda, Silke; Bennett, Charlene; de Lange, Marit; Guiomar, Raquel; Enouf, Vincent; Mlinarić, Ivan; Samuelsson Hagey, Tove; Dinu, Sorin; Rumayor, Mercedes; Castilla, Jesús; Oroszi, Beatrix; Dürrwald, Ralf; O’Donnell, Joan; Hooiveld, Mariëtte; Gómez, Verónica; Falchi, Alessandra; Kurečić Filipović, Sanja; Dillner, Lena; Popescu, Rodica; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, Esther; Gallardo García, Virtudes; Perez Morilla, Esteban; Pedrosa Corral, Irene; García Vázquez, Miriam; Milagro-Beamonte, Ana; Fernandez Ibañez, Ana; Margolles Martins, Mario; Giménez Duran, Jaume; Sastre Palou, Bartolomé; López Causapé, Carla; Viloria Raymundo, Luis Javier; Vega Alonso, Tomás; Ordax Díez, Ana; Lozano Alonso, Jose Eugenio; Rojo Bello, Silvia; Mendioroz, Jacobo; Basile, Luca; Martínez Mateo, Ana Isabel; Ruiz de Porras, Carlota; Moya Garcés, Alba; Marcos, Mª Ángeles; López Maside, Aurora; Botella Quijal, Francesc; Miralles Espi, Maite; Andreu Salete, Cristina; García Rodríguez, María del Carmen; Linares, Juan Antonio; García Comas, Luis; Barranco, Mª Isabel; Chirlaque, María-Dolores; Moreno Docón, Antonio; Ramos Marín, Violeta; Castrillejo, Daniel; Gómez Anés, Atanasio; Larrauro, Amparo; Pérez-Gimeno, Gloria; Lozano Álvarez, Marcos; Vega, Lorena; Galindo, Silvia; Puma, Tania; Monge, Susana; Pozo, Francisco; Casas, Inmaculada; Sandonis, Virginia; Vázquez-Morón, Sonia; Echeverría, Aitziber; Trobajo-Sanmartín, Camino; García Cenoz, Manuel; Ezpeleta, Guillermo; Ezpeleta, Carmen; Navascués, Ana; Krisztalovics, Katalin; Mucsányiné Juhász, Krisztina; Kristóf, Katalin; Preuss, Ute; Wedde, Marianne; Biere, Barbara; Reiche, Janine; Oh, Djin-Ye; McKenna, Adele; Connell, Jeff; Joyce, Michael; Bagheri, Mariam; Bos, Sanne; van den Brink, Sharon; Dijkstra, Frederika; Eggink, Dirk; van Gageldonk-Lafeber, Rianne; Goderski, Gabriel; Herrebrugh, Chantal; Jenniskens, Liz; Reukers, Daphne; Sluimer, John; Sprong, Tara; Teirlinck, Anne; Veldhijzen, Nienke; van der Burgh, Ruben; Kager, Cathrien; Klinkhamer, Mayra; Knottnerus, Bart; Riethof, Marloes; van den Broek, Ruud; Wortel, Safira; Machado, Ausenda; Kislaya, Irina; Aniceto, Carlos; Gomes, Licínia; Verdasca, Nuno; Henriques, Camila; Dias, Daniela; Lança, Miguel; Blanchon, Thierry; Guerrisi, Caroline; Renard, Aubane; Launay, Titouan; Masse, Shirley; Chazelle, Marie; Ferenčak, Ivana; Kaić, Bernard; Višekruna Vučina, Vesna; Čusek Adamić, Katica; Kosanović Ličina, Mirjana Lana; Lakošeljac, Danijela; Mihin Huskić, Ivana; Nonković, Diana; Carnahan, Annasara; Hansson-Pihlainen, Eva; Arvesen, Elin; Nid, Nora; Hansen, Anna-Lena; Andersson, Emmi; Dillner, Lena; Jidovu, Adrian; Timnea, Olivia Carmen; Pascu, Cătălina; Oprea, Mihaela; Bistriceanu, Iulia; Ivanciuc, Alina; Mihai, Maria Elena; VEBIS Primary Care Vaccine Effectiveness GroupKey Points: - Question: What was the effectiveness of COVID-19 vaccines administered in autumn and winter 2022 to 2023 against symptomatic SARS-CoV-2 infection among people aged 60 years or older in Europe, and how did different exposed or reference groups affect effectiveness? - Findings: In this case-control study of 9308 primary care patients at 11 European sites, within 3 months of vaccination, all COVID-19 vaccine effectiveness (CVE) estimates were 29% to 39% against SARS-CoV-2 viruses and 44% to 52% against the XBB variants. All point estimates decreased by time after vaccination, with no vaccine protection after 6 months. - Meaning: Findings of this study suggest that COVID-19 vaccination campaigns should precede peaks in SARS-CoV-2 incidence and that effectiveness of new vaccines against emerging variants should be continually monitored using seasonal CVE approaches.
- Determinants of fatal outcome in patients admitted to intensive care units with influenza, European Union 2009–2017Publication . Penttinen, Pasi; Snacken, René; Lyytikäinen, Outi; Ikonen, Niina; Melillo, Tanya; Melillo, Jackie M.; Staroňová, Edita; Mikas, Ján; Popow-Kraupp, Theresia; Orta Gomes, Carlos M.; Guiomar, Raquel; Slezák, Pavel; Kynčl, Jan; Meijer, Adam; Van Gageldonk-Lafeber, Arianne B.; Domegan, Lisa; O’Donnell, Joan; Lupulescu, Emilia; Popovici, Odette; Carnahan, Annasara; Brytting, Mia; Delgado-Sanz, Concepción; Oliva Domínguez, Jesús A.; Larrauri, Amparo; Hubert, Bruno; Bonmarin, Isabelle; Gomes Dias, Joana; Adlhoch, CorneliaBackground: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
- Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021Publication . Kissling, Esther; Hooiveld, Mariëtte; Martínez-Baz, Iván; Mazagatos, Clara; William, Naoma; Vilcu, Ana-Maria; Kooijman, Marjolein N.; Ilić, Maja; Domegan, Lisa; Machado, Ausenda; de Lusignan, Simon; Lazar, Mihaela; Meijer, Adam; Brytting, Mia; Casado, Itziar; Larrauri, Amparo; Murray, Josephine-L.K.; Behillil, Sylvie; de Gier, Brechje; Mlinarić, Ivan; O’Donnell, Joan; Rodrigues, Ana Paula; Tsang, Ruby; Timnea, Olivia; de Lange, Marit; Riess, Maximilian; Castilla, Jesús; Pozo, Francisco; Hamilton, Mark; Falchi, Alessandra; Knol, Mirjam J.; Kurečić Filipović, Sanja; Dunford, Linda; Guiomar, Raquel; Cogdale, Jade; Cherciu, Carmen; Jansen, Tessa; Enkirch, Theresa; Basile, Luca; Connell, Jeff; Gómez, Verónica; Sandonis Martín, Virginia; Bacci, Sabrina; Rose, Angela M.C.; Pastore Celentano, Lucia; Valenciano, Marta; I-MOVE-COVID-19 and ECDC primary care study teamsIntroduction: In July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe. Aim: Using a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection. Methods: Individuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination. Results: Overall VE was 74% (95% CI: 69–79), 76% (95% CI: 71–80), 63% (95% CI: 48–75) and 63% (95% CI: 16–83) among those aged 30–44, 45–59, 60–74 and ≥ 75 years, respectively. VE among those aged 30–59 years was 78% (95% CI: 75–81), 66% (95% CI: 58–73), 91% (95% CI: 87–94) and 52% (95% CI: 40–61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52–77), 65% (95% CI: 48–76) and 83% (95% CI: 64–92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30–59 years was 87% (95% CI: 83–89) at 14–29 days and 65% (95% CI: 56–71%) at ≥ 90 days between vaccination and onset of symptoms. Conclusions: VE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
- Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016-17 and 2017-18)Publication . Kissling, Esther; Pozo, Francisco; Buda, Silke; Vilcu, Ana-Maria; Rizzo, Caterina; Gherasim, Alin; Krisztina Horváth, Judit; Brytting, Mia; Domegan, Lisa; Meijer, Adam; Paradowska-Stankiewicz, Iwona; Machado, Ausenda; Višekruna Vučina, Vesna; Lazar, Mihaela; Johansen, Kari; Dürrwald, Ralf; van der Werf, Sylvie; Bella, Antonino; Larrauri, Amparo; Ferenczi, Annamária; Zakikhany, Katherina; O'Donnell, Joan; Dijkstra, Frederika; Bogusz, Joanna; Guiomar, Raquel; Kurečić Filipović, Sanja; Pitigoi, Daniela; Penttinen, Pasi; Valenciano, Marta; Gomez, Veronica; Kislaya, Irina; Nunes, Baltazar; I-MOVE/I-MOVE+ study teamIntroduction: Influenza A(H3N2) viruses predominated in Europe in 2016–17. In 2017–18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017–18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity. Methods: We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016–17 and 2017–18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group. Results: During the 2017–18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47–69). Among those aged 0–14, 15–64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37–79), 50% (95% CI: 28–66) and 66% (95% CI: 42–80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17–38) in 2016–17 and 13% (95% CI: -15 to 34) in 2017–18. Among 0–14-year-olds VE against A(H3N2) was 28% (95%CI: -10 to 53) and 29% (95% CI: -87 to 73), among 15–64-year-olds 34% (95% CI: 18–46) and 33% (95% CI: -3 to 56) and among those aged ≥65 years 15% (95% CI: -10 to 34) and -9% (95% CI: -74 to 32) in 2016–17 and 2017–18, respectively. Conclusions: Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016–17 and 2017–18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
- Estimated number of lives directly saved by COVID-19 vaccination programmes in the WHO European Region from December, 2020, to March, 2023: a retrospective surveillance studyPublication . Meslé, Margaux M.I.; Brown, Jeremy; Mook, Piers; Katz, Mark A.; Hagan, José; Pastore, Roberta; Benka, Bernhard; Redlberger-Fritz, Monika; Bossuyt, Nathalie; Stouten, Veerle; Vernemmen, Catharina; Constantinou, Elisabet; Maly, Marek; Kynčl, Jan; Sanca, Ondrej; Krause, Tyra Grove; Vestergaard, Lasse Skafte; Leino, Tuija; Poukka, Eero; Gkolfinopoulou, Kassiani; Mellou, Kassiani; Tsintziloni, Maria; Molnár, Zsuzsanna; Aspelund, Gudrun; Thordardottir, Marianna; Domegan, Lisa; Kelly, Eva; O'Donell, Joan; Urdiales, Alberto-Mateo; Riccardo, Flavia; Sacco, Chiara; Bumšteinas, Viktoras; Liausediene, Rasa; Mossong, Joël; Vergison, Anne; Borg, Maria-Louise; Melillo, Tanya; Kocinski, Dragan; Pollozhani, Enkela; Meijerink, Hinta; Costa, Diana; Gomes, João Paulo; Leite, Pedro Pinto; Druc, Alina; Gutu, Veaceslav; Mita, Valentin; Lazar, Mihaela; Popescu, Rodica; Popovici, Odette; Musilová, Monika; Mrzel, Maja; Socan, Maja; Učakar, Veronika; Limia, Aurora; Mazagatos, Clara; Olmedo, Carmen; Dabrera, Gavin; Kall, Meaghan; Sinnathamby, Mary; McGowan, Graham; McMenamin, Jim; Morrison, Kirsty; Nitzan, Dorit; Widdowson, Marc-Alain; Smallwood, Catherine; Pebody, Richard; WHO European Respiratory Surveillance NetworkBackground: By March, 2023, 54 countries, areas, and territories (hereafter CAT) in the WHO European Region had reported more than 2·2 million COVID-19-related deaths to the WHO Regional Office for Europe. Here, we estimated how many lives were directly saved by vaccinating adults in the WHO European Region from December, 2020, to March, 2023. Methods: In this retrospective surveillance study, we estimated the number of lives directly saved by age group, vaccine dose, and circulating variant-of-concern (VOC) period, regionally and nationally, using weekly data on COVID-19 mortality and infection, COVID-19 vaccination uptake, and SARS-CoV-2 virus characterisations by lineage downloaded from The European Surveillance System on June 11, 2023, as well as vaccine effectiveness data from the literature. We included data for six age groups (25-49 years, 50-59 years, ≥60 years, 60-69 years, 70-79 years, and ≥80 years). To be included in the analysis, CAT needed to have reported both COVID-19 vaccination and mortality data for at least one of the four older age groups. Only CAT that reported weekly data for both COVID-19 vaccination and mortality by age group for 90% of study weeks or more in the full study period were included. We calculated the percentage reduction in the number of expected and reported deaths. Findings: Between December, 2020, and March, 2023, in 34 of 54 CAT included in the analysis, COVID-19 vaccines reduced deaths by 59% overall (CAT range 17-82%), representing approximately 1·6 million lives saved (range 1·5-1·7 million) in those aged 25 years or older: 96% of lives saved were aged 60 years or older and 52% were aged 80 years or older; first boosters saved 51% of lives, and 60% were saved during the Omicron period. Interpretation: Over nearly 2·5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among the most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures.
- Evaluation of European severe acute respiratory infection (SARI) surveillance, 27 European countries, 2022/23Publication . Marques, Diogo Fp; Kovacs, Dory; Sanchez-Ruiz, Miguel-Angel; Rodrigues, Ana Paula; Machado, Ausenda; Mazagatos, Clara; Monge, Susana; Domegan, Lisa; O'Donnell, Joan; Hooiveld, Mariette; Emborg, Hanne-Dorthe; Nunes, Baltazar; Carvalho, Carlos; Rose, Angela McBackground: Between 2020 and 2023, ECDC has supported 21 of 30 EU/EEA and six Western Balkan countries by enhancing severe acute respiratory infection (SARI) surveillance to monitor trends, detect unexpected events, evaluate public health interventions, identify risk factors and support vaccine effectiveness studies. Using diverse strategies, countries have implemented SARI surveillance and reported data at national/European levels.AimWe evaluated European-level SARI surveillance and provided recommendations to achieve objectives and improve key attribute performance.MethodsWe analysed 2022/23 surveillance data for completeness. We administered a questionnaire, targeting country-level representatives, to evaluate surveillance attributes (meeting objectives, usefulness, acceptability, timeliness, representativeness) and identify strengths, weaknesses, opportunities and threats.ResultsThirteen countries (13/27) reported data at European level. Data showed good overall completeness but varied across countries and some variables need improvement (vaccination, sequencing). The questionnaire was completed by all 27 countries. Most countries (23/27) reported that the system effectively monitored trends and considered it useful and acceptable (25/27), but only 16 found it timely and 14 representative. Challenges included insufficient case-based data, data linkage issues and insufficient data completeness. Slow/inefficient manual data extraction affected timeliness, while insufficient geographical coverage affected representativeness. Multi-pathogen surveillance was identified as the main strength, heterogeneity of systems the main weakness, improvements of hospital information systems the main opportunity, and lack of sustainable funding the main threat.ConclusionsSARI surveillance was perceived as effective in monitoring trends, useful and acceptable. To achieve additional objectives and enhance timeliness and representativeness, we recommend improving data completeness, digitalisation/automation and geographical coverage.
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