Effect of COVID-19 vaccination on mortality by COVID-19 and on mortality by other causes, the Netherlands, January 2021–January 2022

Brechje de Gier*, Liselotte van Asten, Tjarda M. Boere, Annika van Roon, Caren van Roekel, Joyce Pijpers, C. H.Henri van Werkhoven, Caroline van den Ende, Susan J.M. Hahné, Hester E. de Melker, Mirjam J. Knol, Susan van den Hof

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: We aimed to estimate vaccine effectiveness (VE) against COVID-19 mortality, and to explore whether an increased risk of non-COVID-19 mortality exists in the weeks following a COVID-19 vaccine dose. Methods: National registries of causes of death, COVID-19 vaccination, specialized health care and long-term care reimbursements were linked by a unique person identifier using data from 1 January 2021 to 31 January 2022. We used Cox regression with calendar time as underlying time scale to, firstly, estimate VE against COVID-19 mortality after primary and first booster vaccination, per month since vaccination and, secondly, estimate risk of non-COVID-19 mortality in the 5 or 8 weeks following a first, second or first booster dose, adjusting for birth year, sex, medical risk group and country of origin. Results: VE against COVID-19 mortality was > 90 % for all age groups two months after completion of the primary series. VE gradually decreased thereafter, to around 80 % at 7–8 months post-primary series for most groups, and around 60 % for elderly receiving a high level of long-term care and for people aged 90+ years. Following a first booster dose, the VE increased to > 85 % in all groups. The risk of non-COVID-19 mortality was lower or similar in the 5 or 8 weeks following a first dose compared to no vaccination, as well as following a second dose compared to one dose and a booster compared to two doses, for all age and long-term care groups. Conclusion: At the population level, COVID-19 vaccination greatly reduced the risk of COVID-19 mortality and no increased risk of death from other causes was observed.

Original languageEnglish
Article numberdoi.org/10.1016/j.vaccine.2023.06.005
Pages (from-to)4488-4496
Number of pages9
JournalVaccine
Volume41
Issue number31
DOIs
Publication statusPublished - 12 Jul 2023

Keywords

  • COVID-19
  • Mortality
  • SARS-CoV-2
  • Vaccine effectiveness

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