Effectiveness of SARS-CoV-2 primary vaccines and boosters in patients with type 2 diabetes mellitus in Hungary (HUN-VE 4 Study).

Autor:	Molnár GA; Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary., Vokó Z; Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary., Sütő G; Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary., Rokszin G; RxTarget Ltd, Szolnok, Hungary., Nagy D; Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.; Syreon Research Institute, Budapest, Hungary., Surján G; Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary., Surján O; National Center for Public Health and Pharmacy, Budapest, Hungary., Nagy P; National Institute of Oncology, Budapest, Hungary.; Institute of Oncochemistry, University of Debrecen, Debrecen, Hungary., Kenessey I; National Institute of Oncology, Budapest, Hungary.; Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary., Wéber A; National Institute of Oncology, Budapest, Hungary., Pálosi M; National Health Insurance Fund, Budapest, Hungary., Müller C; National Center for Public Health and Pharmacy, Budapest, Hungary., Kásler M; National Institute of Oncology, Budapest, Hungary.; Central-Eastern European Academy of Oncology, Budapest, Hungary., Wittmann I; Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary wittmann.istvan@pte.hu., Kiss Z; Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary.
Jazyk:	angličtina
Zdroj:	BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2024 Jan 24; Vol. 12 (1). Date of Electronic Publication: 2024 Jan 24.
DOI:	10.1136/bmjdrc-2023-003777
Abstrakt:	Introduction: Type 2 diabetes mellitus is a risk factor for severe COVID-19 infection and is associated with increased risk of complications. The present study aimed to investigate effectiveness and persistence of different COVID vaccines in persons with or without diabetes during the Delta wave in Hungary. Research Design and Methods: Data sources were the national COVID-19 registry data from the National Public Health Center and the National Health Insurance Fund on the total Hungarian population. The adjusted incidence rate ratios and corresponding 95% CIs were derived from a mixed-effect negative binomial regression model. Results: A population of 672 240 cases with type 2 diabetes and a control group of 2 974 102 non-diabetic persons free from chronic diseases participated. Unvaccinated elderly persons with diabetes had 2.68 (95% CI 2.47 to 2.91) times higher COVID-19-related mortality rate as the 'healthy' controls. Primary immunization effectively equalized the risk of COVID-19 mortality between the two groups. Vaccine effectiveness declined over time, but the booster restored the effectiveness against mortality to over 90%. The adjusted vaccine effectiveness of the primary Pfizer-BioNTech against infection in the 14-120 days of postvaccination period was 71.6 (95% CI 66.3 to 76.1)% in patients aged 65-100 years with type 2 diabetes and 64.52 (95% CI 59.2 to 69.2)% in the controls. Overall, the effectiveness tended to be higher in individuals with diabetes than in controls. The booster vaccines could restore vaccine effectiveness to over 80% concerning risk of infection (eg, patients with diabetes aged 65-100 years: 89.1 (88.1-89.9)% with Pfizer-on-Pfizer, controls 65-100 years old: 86.9 (85.8-88.0)% with Pfizer-on-Pfizer, or patients with diabetes aged 65-100 years: 88.3 (87.2-89.2)% with Pfizer-on-Sinopharm, controls 65-100 years old: 87.8 (86.8-88.7)% with Pfizer-on-Sinopharm). Conclusions: Our data suggest that people with type 2 diabetes may have even higher health gain when getting vaccinated as compared with non-diabetic persons, eliminating the marked, COVID-19-related excess risk of this population. Boosters could restore protection. Competing Interests: Competing interests: ZK is employed by MSD Pharma Hungary. At the time the study was performed, MK served as the Minister of Human Resources. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu