{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:25:20Z","timestamp":1786965920987,"version":"build-2736575974"},"reference-count":6,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. bras. epidemiol."],"abstract":"<jats:p>ABSTRACT  Objective: The study evaluated the association between COVID-19 vaccination and in-hospital mortality among immunocompromised older adults hospitalized for COVID-19 in Brazil during the 2024 epidemiologic year.  Methods: This retrospective hospital-based surveillance study used data from the Brazilian SIVEP-Gripe database. All hospitalized cases of COVID-19-related severe acute respiratory syndrome in immunocompromised individuals aged \u226560 years reported during epidemiological weeks 1\u201352 of 2024 were included. Multivariable logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95%CI) for the association between COVID-19 vaccination (number of doses) and in-hospital mortality, adjusting for clinical and sociodemographic covariates.  Results: Among 474 patients, in-hospital mortality was 36% (171\/474). Only 56 (12%) were unvaccinated. Compared with unvaccinated individuals, adjusted ORs for mortality were 0.67 (95%CI 0.32\u20131.39) for 1\u20132 doses, 0.67 (95%CI 0.31\u20131.42) for 3 doses, 0.54 (95%CI 0.26\u20131.15) for 4 doses, and 0.56 (95%CI 0.26\u20131.17) for 5\u20136 doses. Mechanical ventilation (OR 12.55; 95%CI 6.39\u201326.33) and lower educational attainment (elementary education: OR 2.94; 95%CI 1.39\u20136.44) were independent predictors of death. COVID-19 vaccination was not significantly associated with reduced in-hospital mortality among immunocompromised older adults hospitalized for the disease in Brazil in 2024. However, all adjusted ORs were below unity, suggesting a trend toward protection with increasing doses.  Conclusions: The strong association of mortality with mechanical ventilation and social determinants highlights the need for timely boosters and comprehensive preventive strategies for this vulnerable population.<\/jats:p>","DOI":"10.1590\/1980-549720260041","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:44:13Z","timestamp":1786963453000},"source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 vaccine effectiveness against in-hospital mortality in immunocompromised older adults: a Brazilian hospital surveillance study, 2024"],"prefix":"10.1590","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1623-259X","authenticated-orcid":false,"given":"Rodrigo Poubel Vieira de","family":"Rezende","sequence":"first","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6680-7470","authenticated-orcid":false,"given":"Jo\u00e3o Felipe Nicolaci","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3091-1472","authenticated-orcid":false,"given":"Bruno Santos","family":"Caxias","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5939-201X","authenticated-orcid":false,"given":"Caio Moreira","family":"Salgueiro","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0386-9151","authenticated-orcid":false,"given":"Lucas Tanikawa de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8337-6095","authenticated-orcid":false,"given":"Lu\u00eds Fernando de Ara\u00fajo","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9327-1898","authenticated-orcid":false,"given":"Caroline Pimentel","family":"Pessanha","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6486-8380","authenticated-orcid":false,"given":"Vitoria Xavier","family":"Tracierra","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8581-4960","authenticated-orcid":false,"given":"Michael Gunter","family":"Sim\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7032-912X","authenticated-orcid":false,"given":"Mario Gustavo de Aranda","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-2929","authenticated-orcid":false,"given":"Vitor Alves","family":"Cruz","sequence":"additional","affiliation":[{"name":"Universidade Federal de Goi\u00e1s,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2814-8318","authenticated-orcid":false,"given":"Luiz Eduardo da Costa","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"9","key":"ref1","doi-asserted-by":"crossref","first-page":"e206","DOI":"10.1093\/cid\/ciaa1012","article-title":"Risk factors for intensive care unit admission and in-hospital mortality among hospitalized adults identified through the US coronavirus disease 2019 (COVID-19)-associated hospitalization surveillance network (COVID-NET)","volume":"72","author":"Kim L","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s42358-022-00234-7","article-title":"Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force","volume":"62","author":"Tavares ACFMG","year":"2022","journal-title":"Adv Rheumatol"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1136\/annrheumdis-2021-222006","article-title":"EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update","volume":"81","author":"Landew\u00e9 RBM","year":"2022","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1002\/art.42372","article-title":"American College of Rheumatology Guidance for COVID-19 vaccination in patients with rheumatic and musculoskeletal diseases: version 5","volume":"75","author":"Curtis JR","year":"2023","journal-title":"Arthritis Rheumatol"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1186\/s12916-024-03457-1","article-title":"Uptake, effectiveness and safety of COVID-19 vaccines in individuals at clinical risk due to immunosuppressive drug therapy or transplantation procedures: a population-based cohort study in England","volume":"22","author":"Chen DTH","year":"2024","journal-title":"BMC Med"},{"issue":"27","key":"ref6","doi-asserted-by":"crossref","first-page":"878","DOI":"10.15585\/mmwr.mm7127a3","article-title":"Factors associated with severe outcomes among immunocompromised adults hospitalized for COVID-19 - COVID-NET, 10 States, March 2020-February 2022","volume":"71","author":"Singson JRC","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["Revista Brasileira de Epidemiologia"],"original-title":["Efetividade da vacina\u00e7\u00e3o contra a COVID-19 na mortalidade hospitalar em idosos imunocomprometidos: um estudo brasileiro de vigil\u00e2ncia hospitalar, 2024"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1415-790X2026000102602&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:44:15Z","timestamp":1786963455000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1415-790X2026000102602&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":6,"alternative-id":["S1415-790X2026000102602"],"URL":"https:\/\/doi.org\/10.1590\/1980-549720260041","relation":{},"ISSN":["1980-5497","1415-790X"],"issn-type":[{"value":"1980-5497","type":"electronic"},{"value":"1415-790X","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e260041"}}