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Fact check: What are the current hospitalization rates for vaccinated and unvaccinated individuals with COVID-19 as of 2025?
Executive Summary
The available analyses show that 2024–2025 COVID-19 vaccines reduced risk of hospitalization and the most severe in-hospital outcomes but provided partial protection: estimated vaccine effectiveness (VE) against hospitalization ranged from roughly 33–45% in interim surveillance to 40% in a multicenter hospital network, while protection against invasive mechanical ventilation or death reached 79% in one study. Comparative hospital-series analyses found no large mortality differences between vaccinated and unvaccinated inpatients but noted trends toward greater respiratory support needs and longer stays among the unvaccinated [1] [2] [3].
1. Why these studies matter and what they claim about hospitalization rates
The recent IVY Network and VISION surveillance analyses focus on real-world vaccine performance during the 2024–2025 season and report modest-to-moderate effectiveness against hospitalization: an IVY analysis estimated VE of 40% against hospitalization and 79% against invasive mechanical ventilation or death, reflecting continued protection against the worst outcomes despite variant circulation. Interim VISION/IVY estimates indicated 33% VE for ED/urgent care visits and 45% VE for hospitalization among older adults, signaling that vaccines reduced but did not eliminate hospitalization risk, especially among older and high-risk populations [1] [2].
2. Hospitalized patient comparisons — similar mortality but different clinical courses
Hospital-series data from a Brazilian cohort compared vaccinated and unvaccinated hospitalized patients and found no statistically significant difference in overall mortality, yet observed trends toward greater need for respiratory assistance and longer lengths of stay among unvaccinated patients. This suggests vaccines may not always change in-hospital survival in every dataset but appear to reduce the severity of respiratory compromise and resource use, an important difference for healthcare capacity and patient trajectories [3].
3. Temporal and population context that shapes the numbers
The VE estimates derive from surveillance covering September 2024–January/April 2025 and reflect circulation of multiple JN.1 descendant lineages, not a single viral context; effectiveness figures therefore represent average protection across these variants and across heterogeneous populations. Older adults (≥65 years) showed measurable protection in the interim estimates, emphasizing that age and comorbidities remain major determinants of hospitalization risk and that VE numbers should be interpreted as population averages, not absolutes for every individual [1] [2].
4. How to interpret “hospitalization rates” versus vaccine effectiveness
The analyses report vaccine effectiveness metrics, which measure proportional reduction in risk (e.g., 40% fewer hospitalizations among vaccinated versus unvaccinated) rather than raw hospitalization rates per 100,000 people. Surveillance programs use different denominators and methods — emergency-department-based case counts, hospitalized case series, or test-negative designs — so apparent discrepancies across studies can reflect methodological differences as much as true epidemiologic variation [1] [2] [3].
5. Strengths, limitations, and possible biases across these analyses
The IVY and VISION networks provide multicenter, surveillance-based evidence with recent time frames, but such observational designs are susceptible to confounding by health-seeking behavior, prior infection, and underlying frailty. The hospital-series comparison may underpower mortality differences and could reflect selection bias if vaccinated patients differ systematically from unvaccinated in unmeasured ways. All sources must be treated as potentially biased and interpreted collectively rather than singly [1] [3] [2].
6. Practical implications for clinicians, policymakers, and the public
Taken together, the evidence supports that 2024–2025 vaccines reduce the likelihood of hospitalization and markedly reduce the risk of very severe outcomes, but they are not fully protective against hospitalization, particularly for older or immunocompromised people. This argues for continued promotion of vaccination to reduce severe outcomes and healthcare burden, continued monitoring of variant-specific VE, and layering of nonpharmaceutical measures for high-risk settings during surges [1] [2] [3].
7. Where gaps remain and what to watch next
Key gaps include precise age-stratified hospitalization rates per 100,000 for vaccinated versus unvaccinated populations, the role of prior infection and hybrid immunity in observed VE, and variant-specific effectiveness beyond JN.1 lineage descendants. Future surveillance updates and peer-reviewed publications with stratified denominators and longer follow-up will clarify absolute rates; for now, the consistent finding across datasets is partial but meaningful vaccine protection against hospitalization and strong protection against the most severe outcomes [1] [2] [3].