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Waning of SARS-Cov-2 vaccine effectiveness against delta variant in COPD patients
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  • Lorinc Polivka,
  • Istvan Valyi-Nagy,
  • Zoltan Szekanecz,
  • Krisztina Bogos,
  • Hajnalka Vago,
  • Anita Kamondi,
  • Ferenc Fekete,
  • Janos Szlavik,
  • György Surjan,
  • Orsolya Surlyan,
  • Peter Nagy,
  • Zsuzsa Schaff,
  • Zoltan Kiss,
  • Cecilia Müller,
  • Miklos Kasler,
  • Veronika Müller
Lorinc Polivka
Semmelweis University

Corresponding Author:[email protected]

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Istvan Valyi-Nagy
Central Hospital of Southern Pest
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Zoltan Szekanecz
University of Debrecen
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Krisztina Bogos
National Korányi Institute of Pulmonology
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Hajnalka Vago
Semmelweis University
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Anita Kamondi
National Institute of mental Health, Neurology and Neurosurgery
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Ferenc Fekete
Heim Pál National Pediatric Institute
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Janos Szlavik
Central Hospital of Southern Pest
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György Surjan
National Center for Public Health
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Orsolya Surlyan
National Center for Public Health
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Peter Nagy
National Institute of Oncology
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Zsuzsa Schaff
Semmelweis University
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Zoltan Kiss
University of Pécs
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Cecilia Müller
National Center for Public Health
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Miklos Kasler
Ministry of Interior
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Veronika Müller
Semmelweis University
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Abstract

Although, the COVID-19 pandemic is profoundly changing, data on the effect of vaccination and duration of protection can still be advantageous, especially for patients with COPD, who are more vulnerable to respiratory infections. The Hungarian-COVID-19 registry was retrospectively investigated for vaccine effectiveness (VE) and daily risk for infection and hospitalization by time since the last vaccination and vaccine type in adults with COPD diagnosis and an exact-matched control group during the Delta VOC wave in Hungary. For the matching sex, age, major comorbidities, vaccination status, and prior infection was used on August 23, 2021. The study population included 373 962 cases divided into COPD patients (age: 66.67±12.66) and a 1:1 matched group (age: 66.73±12.67). In both groups, the female/male ratio was 52.2:47.7. There was no significant difference between the groups in daily risks for infection or hospitalization among the unvaccinated. Regarding vaccinated cases, a faster decline of effectiveness was noted for hospitalization prevention in the COPD group regardless of vaccine type. The VE reduction in this group was from 90.1% (mRNA) and 87.8% (other) to 48.8% and 34.1% respectively in 180 days. Based on the time-stratified multivariate Cox analysis of the vaccinated cases, the hazard ratio was 1.09 (95% CI: 1.05-1.14) for infection and 1.87 (95% CI: 1.59-2.19) for hospitalization in the COPD group. Based on our study COPD patients are at higher risk for SARS-Cov2 VE waning and have altogether a higher risk for infection and need for hospitalization emphasizing suggestion for revaccination measures in this patient population.