Raíssa de Fátima Silva-Afonso , Guillermo Platas-Abenza , María Guerrero-Soler , Pilar Gallardo-Rodríguez , Francisco Gil-Sánchez , Gonzalo Pérez-Paz , Lidia Cartagena-Llopis , Marina Fuster-Pérez , María Sánchez-Valero , Ana Esclapez-Martínez , Noemí Solís-Aniorte , Yamilet Fernández-Martínez , Elena Ronda-Pérez , Isabel Escribano-Cañadas , Juan Carlos Rodríguez-Díaz , Esperanza Merino De Lucas , Pablo Chico-Sánchez , José Sánchez-Payá , Paula Gras-Valentí
{"title":"Effectiveness of immunization strategies for preventing severe acute respiratory infection during the 2023/2024 season in a Spanish health department","authors":"Raíssa de Fátima Silva-Afonso , Guillermo Platas-Abenza , María Guerrero-Soler , Pilar Gallardo-Rodríguez , Francisco Gil-Sánchez , Gonzalo Pérez-Paz , Lidia Cartagena-Llopis , Marina Fuster-Pérez , María Sánchez-Valero , Ana Esclapez-Martínez , Noemí Solís-Aniorte , Yamilet Fernández-Martínez , Elena Ronda-Pérez , Isabel Escribano-Cañadas , Juan Carlos Rodríguez-Díaz , Esperanza Merino De Lucas , Pablo Chico-Sánchez , José Sánchez-Payá , Paula Gras-Valentí","doi":"10.1016/j.eimce.2025.03.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>A public funded immunization program targeting influenza, COVID-19 and respiratory syncytial virus (RSV), was introduced in Spain for the 2023/2024 season. Effective immunization strategies depend on product coverage and effectiveness.</div></div><div><h3>Objectives</h3><div>Estimate of the impact of three severe acute respiratory infections (SARI) immunization strategies, during the 2023/2024 respiratory illness season in a Spanish health department.</div></div><div><h3>Methods</h3><div>We conducted an ecological study to compare cumulative hospitalization rates of SARI between the 2022/2023 and 2023/2024 seasons. Subsequently, a cross-sectional study was conducted to describe immunization coverage. Three observational test-negative case–control studies were carried out to evaluate the vaccine effectiveness (VE) against influenza and COVID-19 and the effectiveness of immunization with nirsevimab.</div></div><div><h3>Results</h3><div>During the 2023/2024 season 2952 patients were hospitalized due to SARI, representing hospitalization rates of 322.6/100,000 inhabitants (RR<!--> <!-->=<!--> <!-->0.78), indicating a 21.8% (CI: 14.8–28.1) overall effectiveness of the immunization strategies (EIS) against SARI. The global EIS for influenza was 26.7% (CI: 15.2–36.7), with 5.9% (CI: −10.1–19.5) for influenza A and 94.0% (CI: 86.4–97.4) for influenza B. For COVID-19, the EIS was 19.3% (CI: 7.2–29.3). The EIS for RSV was 52.5% (CI: 35.4–65.0) in children <1 year-old. For the 2023/2024 season, influenza vaccination in those aged >64 decreased 7.9%, while COVID-19 vaccination fell by 40.6% in individuals >60 years. Nirsevimab reached high coverage of 94.78%. The aVE was 28.2% (CI: 4.7–45.9) for influenza and 29.2% (CI: 7.1–46.0) for COVID-19. The overall adjusted effectiveness of nirsevimab was 63.8% (CI: 9.6–85.5).</div></div><div><h3>Conclusion</h3><div>The observed EIS was likely due to RSV immunization in infants’ high coverage with good effectiveness and low influenza B circulation.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 7","pages":"Pages 435-443"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Enfermedades infecciosas y microbiologia clinica (English ed.)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2529993X2500139X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
A public funded immunization program targeting influenza, COVID-19 and respiratory syncytial virus (RSV), was introduced in Spain for the 2023/2024 season. Effective immunization strategies depend on product coverage and effectiveness.
Objectives
Estimate of the impact of three severe acute respiratory infections (SARI) immunization strategies, during the 2023/2024 respiratory illness season in a Spanish health department.
Methods
We conducted an ecological study to compare cumulative hospitalization rates of SARI between the 2022/2023 and 2023/2024 seasons. Subsequently, a cross-sectional study was conducted to describe immunization coverage. Three observational test-negative case–control studies were carried out to evaluate the vaccine effectiveness (VE) against influenza and COVID-19 and the effectiveness of immunization with nirsevimab.
Results
During the 2023/2024 season 2952 patients were hospitalized due to SARI, representing hospitalization rates of 322.6/100,000 inhabitants (RR = 0.78), indicating a 21.8% (CI: 14.8–28.1) overall effectiveness of the immunization strategies (EIS) against SARI. The global EIS for influenza was 26.7% (CI: 15.2–36.7), with 5.9% (CI: −10.1–19.5) for influenza A and 94.0% (CI: 86.4–97.4) for influenza B. For COVID-19, the EIS was 19.3% (CI: 7.2–29.3). The EIS for RSV was 52.5% (CI: 35.4–65.0) in children <1 year-old. For the 2023/2024 season, influenza vaccination in those aged >64 decreased 7.9%, while COVID-19 vaccination fell by 40.6% in individuals >60 years. Nirsevimab reached high coverage of 94.78%. The aVE was 28.2% (CI: 4.7–45.9) for influenza and 29.2% (CI: 7.1–46.0) for COVID-19. The overall adjusted effectiveness of nirsevimab was 63.8% (CI: 9.6–85.5).
Conclusion
The observed EIS was likely due to RSV immunization in infants’ high coverage with good effectiveness and low influenza B circulation.
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