{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:23:48Z","timestamp":1776414228498,"version":"3.51.2"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Updated regional data on COVID\u201019 epidemiology and vaccination can inform vaccine policies and implementation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used surveillance data on patients hospitalized from the European SARI Vaccine Effectiveness (EuroSAVE) network to describe COVID\u201019 epidemiology and COVID\u201019 vaccine uptake among adults hospitalized with severe acute respiratory infection (SARI) in six middle\u2010income countries and areas (CAs) in the WHO European region during 2022\u20132024. For SARI patients, we collected data on demographics, comorbidities, vaccination status, and hospital course, and a respiratory specimen, which was tested for SARS\u2010CoV\u20102 by RT\u2010PCR. In October 2024, we surveyed national public health institute staff on national COVID\u201019 vaccine guidelines and availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of SARI patients, 833\/3982 (20.9%) and 367\/3752 (9.8%) tested positive for SARS\u2010CoV\u20102 during May 2022\u2013April 2023 and May 2023\u2013April 2024, respectively. Of COVID\u201019 patients, 857 (71.4%) were \u226560 years old and 713 (59.4%) had \u22651 comorbidity. A higher proportion of COVID\u201019 patients required mechanical ventilation (30 [8.2%] vs. 23 [2.8%], p &lt;0.001) and intensive care (70 [8.4%] vs. 48 [13.1%], p =0.016) during May 2023\u2013April 2024 compared to May 2022\u2013April 2023. COVID\u201019 vaccination in the last 12 months decreased from 25% in 2022\u20132023 to 3% in 2023\u20132024. Most CAs had not updated their COVID\u201019 vaccination guidelines to recommend annual vaccination, and only two had vaccines available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although COVID\u201019 was associated with severe disease among SARI patients, COVID\u201019 vaccination uptake was low among priority populations recommended for vaccination by WHO guidance. Continued efforts to understand reasons for low vaccine uptake and improve vaccine access will help protect those at greatest risk for COVID\u201019\u2010associated morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70126","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T20:04:48Z","timestamp":1750277088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["COVID\u201019 Hospitalizations, Vaccine Uptake, Vaccination Guidelines, and Vaccine Availability in Six Middle\u2010Income Countries and Areas in Europe, May 2022\u2013April 2024"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5158-0282","authenticated-orcid":false,"given":"Erin\u00a0Rachel","family":"Whitehouse","sequence":"first","affiliation":[{"name":"United States Centers for Disease Control and Prevention  Atlanta Georgia 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