Although the COVID-19 pandemic is profoundly changing, data on the effect of vaccination
and duration of protection against infection and severe disease 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 risk of infection
and hospitalization by time since the last vaccination, and vaccine effectiveness
(VE) was calculated in adults with COPD diagnosis and an exact-matched control group
during the Delta variant of concern (VOC) wave in Hungary (September–December 2021).
For the matching, sex, age, major co-morbidities, vaccination status, and prior infection
data were obtained on 23 August 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, respectively. Among
the unvaccinated, there was no difference between groups in risk for infection or
hospitalization. Regarding vaccinated cases, in the COPD group, a slightly faster
decline in effectiveness was noted for hospitalization prevention, although in both
groups, the vaccine lost its significant effect between 215 and 240 days after the
last dose of vaccination. Based on a time-stratified multivariate Cox analysis of
the vaccinated cases, the hazard was constantly higher in the COPD group, with an
HR of 1.09 (95%: 1.05–1.14) for infection and 1.87 (95% CI: 1.59–2.19) for hospitalization.
In our study, COPD patients displayed lower vaccine effectiveness against SARS-CoV-2
infection and hospitalization but a similar waning trajectory, as vaccines lost their
preventive effect after 215 days. These data emphasize revaccination measures in the
COPD patient population.
