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. 2024 Sep;12(9):714-727.
doi: 10.1016/S2213-2600(24)00179-6. Epub 2024 Aug 7.

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 study

Margaux M I Meslé  1 , Jeremy Brown  2 , Piers Mook  2 , Mark A Katz  2 , José Hagan  2 , Roberta Pastore  2 , Bernhard Benka  3 , Monika Redlberger-Fritz  4 , Nathalie Bossuyt  5 , Veerle Stouten  5 , Catharina Vernemmen  5 , Elisabet Constantinou  6 , Marek Maly  7 , Jan Kynčl  8 , Ondrej Sanca  9 , Tyra Grove Krause  10 , Lasse Skafte Vestergaard  10 , Tuija Leino  11 , Eero Poukka  11 , Kassiani Gkolfinopoulou  12 , Kassiani Mellou  12 , Maria Tsintziloni  12 , Zsuzsanna Molnár  13 , Gudrun Aspelund  14 , Marianna Thordardottir  14 , Lisa Domegan  15 , Eva Kelly  15 , Joan O'Donell  15 , Alberto-Mateo Urdiales  16 , Flavia Riccardo  16 , Chiara Sacco  16 , Viktoras Bumšteinas  17 , Rasa Liausediene  17 , Joël Mossong  18 , Anne Vergison  18 , Maria-Louise Borg  19 , Tanya Melillo  19 , Dragan Kocinski  20 , Enkela Pollozhani  20 , Hinta Meijerink  21 , Diana Costa  22 , João Paulo Gomes  23 , Pedro Pinto Leite  24 , Alina Druc  25 , Veaceslav Gutu  25 , Valentin Mita  25 , Mihaela Lazar  26 , Rodica Popescu  27 , Odette Popovici  27 , Monika Musilová  28 , Maja Mrzel  29 , Maja Socan  29 , Veronika Učakar  29 , Aurora Limia  30 , Clara Mazagatos  31 , Carmen Olmedo  30 , Gavin Dabrera  32 , Meaghan Kall  32 , Mary Sinnathamby  32 , Graham McGowan  33 , Jim McMenamin  33 , Kirsty Morrison  33 , Dorit Nitzan  2 , Marc-Alain Widdowson  2 , Catherine Smallwood  2 , Richard Pebody  2 ; WHO European Respiratory Surveillance Network
Collaborators, Affiliations

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 study

Margaux M I Meslé et al. Lancet Respir Med. 2024 Sep.

Abstract

Background: 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.

Funding: US Centers for Disease Control and Prevention.

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Conflict of interest statement

Declaration of interests GD reports that the predecessor of the organisation he works for, Public Health England, received an unrestricted grant from GSK to undertake a study on the outcome of patients who received parenteral zanamavir. The funder received data and interim reports from Public Health England but did not influence analysis and reporting of the study. GD had no involvement in the GSK-funded study on parenteral zanamavir. Furthermore, the currently submitted work was part of the public health response activities to COVID-19 and had no relationship to GSK or the study on parenteral zanamivir. EP has received a personal grant from the Finnish Medical Foundation for PhD studies. JM declares that Public Health Scotland received funding from the EU Horizon 2020 programme for work in describing the epidemiology of COVID-19 and its impact on primary and secondary care as a partner in the IMOVE-COVID-19 project. MK declares having received consulting fees from Gilead Sciences for advising on development of a clinical module for collection of patient-reported outcome data from people living with HIV, and having received an honoraria from GESIDA for speaking at an annual conference on patient-reported outcome measures for people with HIV. All other authors declare no competing interests.

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