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00925njm 22002777a 4500 dc Mazagatos, Clara author Delgado-Sanz, Concepcion author Monge Corella, Susana author Pozo Sanchez, Francisco author Oliva, Jesús author Sandonis-Martin, Virginia author Gandarillas, Ana author Quiñones-Rubio, Carmen author Ruiz-Sopeña, Cristina author Gallardo-García, Virtudes author Basile, Luca author Barranco Boada, María Isabel author Hidalgo-Pardo, Olga author Vazquez-Cancela, Olalla author García-Vázquez, Miriam author Fernández-Sierra, Amelia author Milagro-Beamonte, Ana author Ordobás, María author Martínez-Ochoa, Eva author Fernández-Arribas, Socorro author Lorusso, Nicola author Martínez, Ana author García-Fulgueiras, Ana author Sastre-Palou, Bartolomé author Losada-Castillo, Isabel author Martínez-Cuenca, Silvia author Rodríguez-Del Águila, Mar author Latorre, Miriam author Larrauri, Amparo author SARI surveillance VE group in Spain author Casas Flecha, Inmaculada author Vázquez-Morón, Sonia author Iglesias-Caballero, Maria author 2022-11 Background: With the emergence of SARS-CoV-2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. Methods: Using a test-negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID-19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS-CoV-2 variant. Results: VE was 89% (95% CI: 83-93) against COVID-19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS-CoV-2 variants, although variant-specific VE was slightly higher against Alpha. Conclusions: The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID-19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID-19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS-CoV-2 variants (Alpha vs. Delta). Influenza Other Respir Viruses. 2022 Nov;16(6):1014-1025. 10.1111/irv.13026 1750-2659 Influenza and other respiratory viruses 35880469 http://hdl.handle.net/20.500.12105/15462 COVID-19 COVID-19 vaccine SARI surveillance SARS-CoV-2 Spain Test-negative design Vaccine effectiveness COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain