{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:47:07Z","timestamp":1772160427771,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":7,"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":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Few studies have evaluated COVID\u201019 vaccine effectiveness (VE) in middle\u2010income countries, particularly in eastern Europe. We aimed to estimate COVID\u201019 VE against SARS\u2010CoV\u20102\u2010confirmed hospitalizations and severe outcomes in Kosovo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a test\u2010negative case\u2013control study using data from Kosovo's severe acute respiratory infection (SARI) sentinel surveillance system from January 2022 to June 2024. We enrolled adult patients aged \u2265\u200918\u2009years hospitalized with SARI. From all patients, we collected clinical data, vaccination history, and a nasopharyngeal specimen, which was tested for SARS\u2010CoV\u20102 using RT\u2010PCR. SARS\u2010CoV\u20102\u2010positive patients were cases; those testing negative were controls. We estimated VE overall and against severe outcomes (requiring oxygen, intensive care admission, or in\u2010hospital death) using logistic regression, adjusting for age, sex, and comorbidities, calculating VE as (1\u2013adjusted odds ratio)\u2009\u00d7\u2009100.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 564 SARI patients; 218 (39%) tested positive for SARS\u2010CoV\u20102. Overall, 24% of SARI patients had received at least one COVID\u201019 vaccine dose in the previous 12\u2009months. VE against SARS\u2010CoV\u20102\u2010confirmed SARI hospitalization among all adults was 72% (95% CI: 30%\u201389%) at 14\u2013179\u2010day postvaccination, and 26% (95% CI: \u221233%\u201359%) at 180\u2013364\u2009days. In adults \u2265\u200960\u2009years, VE was 52% (95% CI:\u221231%\u201382%) at 14\u2013179\u2010day postvaccination, and \u221236% (95% CI: \u2212190%\u201336%) at 180\u2013364\u2009days. VE against severe outcomes was 67% (95% CI: \u221214%\u201391%) at 14\u2013179\u2009days, and 17% (95% CI:\u2212111%\u201367%) at 180\u2013364\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that COVID\u201019 vaccination in Kosovo offered substantial protection against hospitalization and severe outcomes within 6\u2009months, though confidence intervals were wide for some subgroups. Effectiveness waned after 6\u2009months, highlighting the need for periodic booster doses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70152","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T03:29:14Z","timestamp":1757388554000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID\u201019 Vaccine Effectiveness Against Hospitalizations and Severe Outcomes in Kosovo, 2022\u20132024: A Test\u2010Negative Case\u2013Control Study"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-0770","authenticated-orcid":false,"given":"Besfort","family":"Kryeziu","sequence":"first","affiliation":[{"name":"National Institute of Public Health of Kosovo  Prishtina Kosovo"},{"name":"The Mediterranean and Black Sea Programme for Intervention Epidemiology Training (MediPIET) European Centre for Disease Prevention and Control (ECDC)  Stockholm 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Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranvera","family":"Ka\u00e7aniku\u2010Gunga","sequence":"additional","affiliation":[{"name":"National Institute of Public Health of Kosovo  Prishtina Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris","family":"Finci","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Europe  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel\u00a0Angel","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Epiconcept  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3789-8309","authenticated-orcid":false,"given":"James","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Epiconcept  Paris 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