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- 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 among older adultsPublication . Laniece Delaunay, Charlotte; Mateo-Urdiales, Alberto; Pérez-Gimeno, Gloria; O'Reilly, Karen; Uras, Marina; Erdwiens, Annika; Mlinaric, Ivan; Túri, Gergo; Martínez-Baz, Iván; Meijer, Adam; Rodrigues, Ana Paula; Lazar, Mihaela; Latorre-Margalef, Neus; Lucaccioni, Héloïse; Verdasca, Nuno; Bella, Antonino; Rafael de la Cruz Lopez, Maria Angeles; Kelly, Eva; Enouf, Vincent; Tolksdorf, Kristin; Puzelli, Simona; Ibáñez Pérez, Ana Carmen; Fitzgerald, Margaret; Masse, Shirley; Oh, Djin-Ye; Kaczmarek, Marlena; Bacci, Sabrina; Kissling, Esther; VEBIS Primary Care Vaccine Effectiveness GroupIntroduction: From September to November 2025, many European countries launched COVID-19 vaccination campaigns, when SARS-CoV-2 incidence was decreasing after a period of high circulation.1 These campaigns targeted specific groups, including older adults (ie, individuals aged at or above a minimum threshold that varied from age 60 to 70 years across countries). We estimated the effectiveness of COVID-19 vaccines administered during these seasonal vaccination campaigns in Europe against medically attended, symptomatic SARS-CoV-2 infection among older adults, from September 29, 2025, to January 10, 2026.
- Influenza vaccine effectiveness in Europe and the birth cohort effect against influenza A(H1N1)pdm09: VEBIS primary care multicentre study, 2023/24Publication . Kissling, Esther; Maurel, Marine; Pozo, Francisco; Pérez-Gimeno, Gloria; Buda, Silke; Sève, Noémie; Domegan, Lisa; Hooiveld, Mariëtte; Oroszi, Beatrix; Martínez-Baz, Iván; Guiomar, Raquel; Latorre-Margalef, Neus; Mlinarić, Ivan; Lazar, Mihaela; Giménez Duran, Jaume; Dürrwald, Ralf; Enouf, Vincent; McKenna, Adele; de Lange, Marit; Túri, Gergő; Trobajo-Sanmartín, Camino; GOMEZ TEIXEIRA PINTO, VERÓNICA DEL PILAR; Samuelsson Hagey, Tove; Višekruna Vučina, Vesna; Cherciu, Maria Carmen; García Vazquez, Miriam; Erdwiens, Annika; Masse, Shirley; Bennett, Charlene; Meijer, Adam; Kristóf, Katalin; Castilla, Jesús; Rodrigues, Ana Paula; Kurečić Filipović, Sanja; Ivanciuc, Alina Elena; Bacci, Sabrina; Kaczmarek, MarlenaIntroduction: Influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe in 2023/24, with A(H1N1)pdm09 dominance. First influenza infections in childhood may lead to different vaccine effectiveness (VE) in subsequent years. Aim: The VEBIS primary care network estimated influenza VE in Europe using a multicentre test-negative study. Methods: Primary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We estimated VE against influenza (sub)type and clade, by age group and by year of age for A(H1N1)pdm09, using logistic regression. Results: We included 29,958 patients, with 3,054, 1,053 and 311 influenza A(H1N1)pdm09, A(H3N2) and B cases, respectively. All-age VE against influenza A(H1N1)pdm09 was 52% (95% CI: 44-59). By year of age, VE was 27% (95% CI: -2 to 47) at 44 years with peaks at 72% (95% CI: 52-84) and 54% (95% CI: 41-64) among children and those 65 years and older, respectively. All-age A(H1N1)pdm09 VE against clade 5a.2a was 41% (95% CI: 24-54) and -11% (95% CI: -69 to 26) against clade 5a.2a.1. The A(H3N2) VE was 35% (95% CI: 20-48) among all ages and ranged between 34% and 40% by age group. All-age VE against clade 2a.3a.1 was 38% (95% CI: 1-62). All-age VE against B/Victoria was 83% (95% CI: 65-94), ranging between 70 and 92% by age group. Discussion: The 2023/24 VEBIS primary care VE against medically attended symptomatic influenza infection was high against influenza B/Victoria, but lower against influenza A(H1N1)pdm09 and A(H3N2). Clade- and age-specific effects may have played a role in the lower A(H1N1)pdm09 VE.
- The potential bias introduced into COVID-19 vaccine effectiveness studies at primary care level due to the availability of SARS-CoV-2 tests in the general populationPublication . Lanièce Delaunay, Charlotte; Nunes, Baltazar; Monge, Susana; de Lange, Marit; Túri, Gergő; Machado, Ausenda; Latorre-Margalef, Neus; Mlinarić, Ivan; Lazar, Mihaela; Botella Rocamora, Paloma; Erdwiens, Annika; Sève, Noémie; Domegan, Lisa; Martínez-Baz, Iván; Hooiveld, Mariëtte; Oroszi, Beatrix; Guiomar, Raquel; Sperk, Maike; Kurečić Filipović, Sanja; Pascu, Catalina; Linares Dopido, Juan Antonio; Dürrwald, Ralf; Rameix-Welti, Marie-Anne; McKenna, Adele; Castilla, Jesús; van Hagen, Cheyenne; Knol, Mirjam; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, Esther; VEBIS Primary Care Vaccine Effectiveness GroupBackground: With SARS-CoV-2 self-tests, persons with acute respiratory infections (ARI) can know their COVID-19 status. This may alter their decision to consult a general practitioner (GP), potentially biasing COVID-19 vaccine effectiveness (VE) studies. We explore bias mechanisms, simulate magnitude, and verify control methods. Methods: We used directed acyclic graphs (DAGs) to illustrate the bias mechanisms. Based on the European primary care VEBIS multicentre test-negative design (TND) study, we simulated populations with varying true VE (20%-60%), proportions of persons with ARI self-testing (10%-30%), effect of COVID-19 vaccination on self-testing (1.5-2.5), and effect of self-test result on GP consultation (0.5-2). We performed 5000 runs per scenario, estimating VE among those consulting a GP. We calculated bias as true VE minus mean simulated VE, unadjusted and adjusted for self-testing, using logistic regression. Results: DAGs suggested collider stratification bias if vaccination had an effect on self-testing and if self-test results affected GP consultation. Bias was -12% to 18% at 20% true VE, with the most extreme associations and 30% self-testing. With 60% true VE and 10%-20% self-testing, bias was lower. Bias was higher (-18% to 45%) if both positive and negative self-test results affected GP consultation. Adjusting for self-testing removed the bias. Conclusions: Self-testing may bias COVID-19 VE TND studies in primary care if self-testing is high, particularly with low VE. We recommend primary care TND VE studies collect self-testing information to eliminate potential bias. Observational studies are needed to understand the relationship between vaccination, self-testing, and GP consultation, in these studies' source population.
- Vaccine effectiveness against medically attended, laboratory-confirmed influenza in the I-MOVE primary care network in Europe, VEBIS project, 2024/25Publication . Lucaccioni, Héloïse; Pozo, Francisco; Pérez-Gimeno, Gloria; Dürrwald, Ralf; Uras, Marina; Domegan, Lisa; Oroszi, Beatrix; Meijer, Adam; Trobajo-Sanmartín, Camino; Ujvari, Dorina; Rodrigues, Ana Paula; Mlinarić, Ivan; Lazar, Mihaela; Rivas Wagner, Eva; Erdwiens, Annika; Enouf, Vincent; McKenna, Adele; Túri, Gergő; de Lange, Marit; Martínez-Baz, Iván; Latorre-Margalef, Neus; Guiomar, Raquel; Kurečić Filipovic, Sanja; Dinu, Sorin; Mokoroa, Olatz; Tolksdorf, Kristin; Masse, Shirley; Bennett, Charlene; Kristóf, Katalin; Hooiveld, Mariette; Castilla, Jesús; Santos Almeida, João; Višekruna Vučina, Vesna; Popescu, Rodica; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, EstherBackground: We conducted a multicenter test-negative study to estimate vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in primary care, Europe, 2024/25. Research design and methods: Specimens were collected from patients with acute respiratory infection. All or a random sample of viruses were sequenced. VE was (1-odds ratio) × 100, adjusted for confounders. Results: We included 7275 cases and 17,516 controls (weeks 40-2024-18-2025). The overall VE was 46% (95% CI: 40-52), lowest in adults ≥65 years at 28% (95% CI: 12-42). VE against influenza A(H1N1)pdm09 was 30% (95% CI: 19-40); ranging 16-34% by age and vaccination target group. Most (88%) circulating clades were 5a.2a, distinct from the vaccine clade. VE was 28% (95% CI: 7-45) against 5a.2a (C.1.9), and 6% (95% CI: -62-45) against the vaccine-matched clade 5a.2a.1 (D). VE against influenza A(H3N2) was 38% (95% CI: 26-49); ranging 20-66% by age and target group. Circulating viruses belonged to the vaccine clade 2a.3a.1, with 88% subclade (J.2). VE against influenza B was 76% (95% CI: 69-81); ranging 70-80% by age and target group; all viruses belonged to the vaccine clade V1A.3a.2, with diverse subclades. Conclusions: Influenza vaccination protected approximately one in two vaccinated individuals against medically attended infection in primary care in Europe, 2024/25, varying by (sub)type and age.