Association between SARS-CoV-2 booster vaccination and hospitalisation and/or death due to COVID-19 in adults with immune-mediated inflammatory diseases: nested case-control study using linked primary-care, hospitalisation and mortality data from England.
To assess the association between COVID-19 booster vaccination and hospitalisation and/or death due to COVID-19 among adults with immune-mediated inflammatory diseases (IMIDs).
Adults with IMIDs prescribed steroid-sparing immune-suppressing drugs in Clinical Practice Research Datalink Aurum linked to hospitalisation and mortality records were included. Cases were hospitalised for or died due to COVID-19. Controls were risk-set matched to cases. Exposures were number of COVID-19 booster vaccinations between 16 September 2021 and 13 March 2023; receipt of autumn 2021, spring 2022, autumn 2022 boosters; and time since last booster. Multivariable logistic regression was used. Adjusted OR (aOR) and 95% CIs and adjusted vaccine effectiveness (1 - aORs × 100%) were calculated.
We included 2178 cases and 17 750 controls (mean age 65.5 years; 60.2% women). Hospitalisation and/or death due to COVID-19 was negatively associated with receipt of three (aOR (95% CI) 0.20 (0.15 to 0.28)), two (aOR (95% CI) 0.29 (0.23 to 0.36)) or one booster (aOR (95% CI) 0.56 (0.48 to 0.65), respectively, compared with no booster. The aOR (95% CI) across the booster cycles were: autumn 2021 (aOR (95% CI) 0.40 (0.32 to 0.50)), spring 2022 (aOR (95% CI) 0.52 (0.42 to 0.65)) and autumn 2022 (aOR (95% CI) 0.33 (0.25 to 0.43)). Hospitalisation and/or death due to COVID-19 was negatively associated with booster vaccination within 365 days compared with no booster vaccination. There was no statistically significant association for boosters received more than 365 days ago.
COVID-19 booster vaccination was associated with fewer hospitalisation and/or death due to COVID-19 among adults with IMIDs. These findings support regular booster vaccination in this high-risk population.
Adults with IMIDs prescribed steroid-sparing immune-suppressing drugs in Clinical Practice Research Datalink Aurum linked to hospitalisation and mortality records were included. Cases were hospitalised for or died due to COVID-19. Controls were risk-set matched to cases. Exposures were number of COVID-19 booster vaccinations between 16 September 2021 and 13 March 2023; receipt of autumn 2021, spring 2022, autumn 2022 boosters; and time since last booster. Multivariable logistic regression was used. Adjusted OR (aOR) and 95% CIs and adjusted vaccine effectiveness (1 - aORs × 100%) were calculated.
We included 2178 cases and 17 750 controls (mean age 65.5 years; 60.2% women). Hospitalisation and/or death due to COVID-19 was negatively associated with receipt of three (aOR (95% CI) 0.20 (0.15 to 0.28)), two (aOR (95% CI) 0.29 (0.23 to 0.36)) or one booster (aOR (95% CI) 0.56 (0.48 to 0.65), respectively, compared with no booster. The aOR (95% CI) across the booster cycles were: autumn 2021 (aOR (95% CI) 0.40 (0.32 to 0.50)), spring 2022 (aOR (95% CI) 0.52 (0.42 to 0.65)) and autumn 2022 (aOR (95% CI) 0.33 (0.25 to 0.43)). Hospitalisation and/or death due to COVID-19 was negatively associated with booster vaccination within 365 days compared with no booster vaccination. There was no statistically significant association for boosters received more than 365 days ago.
COVID-19 booster vaccination was associated with fewer hospitalisation and/or death due to COVID-19 among adults with IMIDs. These findings support regular booster vaccination in this high-risk population.