{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:13:15Z","timestamp":1788401595310,"version":"build-2803163510"},"reference-count":40,"publisher":"European Centre for Disease Control and Prevention (ECDC)","issue":"15","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Vaccinations against COVID-19 were integrated into routine care in Germany in April 2023. However, evidence of the impact of seasonal vaccination remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>AIM<\/jats:title>\n                    <jats:p>To assess the clinical and economic impact of COVID-19 vaccination in routine care during the early SARS-CoV-2-endemic phase in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective cohort study using statutory health insurance data from two German federal states (Saxony and Thuringia), covering over 3 million individuals, was conducted. Adults aged\u2009\u2265\u200918 years vaccinated against COVID-19 between 1 September and 30 November 2023 were matched 1:1 with unvaccinated individuals using propensity scores. Outcomes during the 4-month follow-up included occurrence of SARS-CoV-2 infection, long COVID, other respiratory infections, hospitalisations, mortality, healthcare costs and indirect costs caused by sick leave. Rate and hazard ratios (RR, HR) with 95% confidence intervals (CI) were calculated. Sensitivity analyses tested robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 146,132 individuals (73,066 per group) were matched. COVID-19 vaccination was associated with reduced rates of long COVID (RR:\u202f0.43; 95%\u202fCI:\u202f0.26\u20130.70), respiratory infections (RR:\u202f0.91; 95%\u202fCI:\u202f0.87\u20130.95) and COVID-19-related hospitalisations (RR:\u202f0.41; 95%\u202fCI:\u202f0.31\u20130.54). All-cause mortality was 25% lower among COVID-19-vaccinated individuals (HR:\u202f0.76; 95%\u202fCI:\u202f0.70\u20130.82). Healthcare costs were lower in the vaccinated cohort, particularly for inpatient care, e.g. EUR 1\u202fmillion savings in COVID-19-related hospitalisations. Indirect costs caused by sick leave were also reduced by EUR\u202f1.3 million.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Seasonal COVID-19 vaccinations in routine care settings were associated with substantial clinical and economic benefits. These real-world findings support continued implementation of national immunisation recommendations during the endemic phase of SARS-CoV-2 circulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2807\/1560-7917.es.2026.31.15.2500672","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T10:15:30Z","timestamp":1776420930000},"update-policy":"https:\/\/doi.org\/10.2807\/1560-7917.es.crp2020","source":"Crossref","is-referenced-by-count":2,"title":["Clinical and economic benefits of seasonal COVID-19 vaccination in Germany: results from the ROUTINE-COV19 Study, September 2022 to March 2024"],"prefix":"10.2807","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-9382","authenticated-orcid":false,"given":"Andrea","family":"Schmetz","sequence":"first","affiliation":[{"name":"BioNTech SE, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Knaul","sequence":"additional","affiliation":[{"name":"BioNTech SE, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-3058","authenticated-orcid":false,"given":"Sabrina","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"GIPAM GmbH, Wismar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8932-6426","authenticated-orcid":false,"given":"Thomas","family":"Wilke","sequence":"additional","affiliation":[{"name":"The Institute for Pharmacoeconomics and Drug Logistics (IPAM), University of Wismar, Wismar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-649X","authenticated-orcid":false,"given":"Jingyan","family":"Yang","sequence":"additional","affiliation":[{"name":"Pfizer Inc., New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3875-5367","authenticated-orcid":false,"given":"Christoph","family":"Spinner","sequence":"additional","affiliation":[{"name":"Technical University of Munich (TUM) School of Medicine and Health \u2013 Clinical Department of Internal Medicine II, TUM University Hospital, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7042-1578","authenticated-orcid":false,"given":"Clara","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany"},{"name":"Center for Molecular Medicine Cologne (CMMC), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany"},{"name":"German Center for Infection Research (DZIF), Bonn-Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7995","reference":[{"key":"#cr-split#-r1.1","unstructured":"World Health Organization (WHO). 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