COVID-19 continues to pose a significant threat to public health.

  • COVID-19 continues to circulate widely across Europe. Detected cases across the EU/EEA show repeated waves of SARS-CoV-2 transmission. This ongoing circulation underpins the continued impact of COVID-19 on health systems.

  • Reported case numbers substantially underestimate the true burden of infection. The figures shown reflect detected cases only and are strongly influenced by testing practices, which have declined markedly since the pandemic phase. With far less routine testing in place, a significant proportion of infections now go undetected, meaning the true burden of COVID-19 is likely considerably higher than surveillance data alone suggest.

COVID-19 cases

  • This continued circulation is also having an impact on hospitalisations, mortality and other longer-term outcomes. These indicators are crucial to understand the full public health impact of COVID-19.

COVID-19 remains associated with severe outcomes.

  • COVID-19 continues to be associated with substantial mortality among patients requiring hospital care. During the 2023–2024 winter season, thirty-day mortality among hospitalised patients was 5.7% (Xie et al., JAMA 2024).

  • Comparative evidence shows that outcomes for COVID-19 remain more severe than for some other respiratory infections in similar settings. In the same period, thirty-day mortality among patients hospitalised with seasonal influenza was 4.2%, corresponding to a 35% higher risk of death for COVID-19 (Xie et al., JAMA 2024).

  • Beyond hospital settings, COVID-19 is also associated with elevated longer-term mortality, even among people who were not hospitalised during the acute infection. Evidence shows that people infected with COVID-19 had a measurably higher likelihood of death over the following six months compared with influenza and RSV (Bajema et al., JAMA Intern Med 2025).

  • Taken together, these findings show that COVID-19 continues to contribute meaningfully to the burden of severe respiratory disease in the post-pandemic phase, particularly for vulnerable populations, alongside other important respiratory infections.

5.7%

mortality among hospitalised patients

35%

higher mortality among hospitalised COVID-19 patients compared to seasonal influenza

The impact of COVID-19 extends well beyond the acute infection.

  • Evidence shows that COVID-19 is linked to significant longer-term health consequences, particularly cardiovascular disease.

  • Over the year following infection, people who had COVID-19 experienced a markedly higher risk of conditions such as heart disease, stroke, heart failure and blood clots, even if they were not hospitalised initially (Xie et al., Nat Med 2022).

  • The estimated excess burden was around 45 additional cardiovascular events per 1,000 people in the year after COVID-19 compared with uninfected individuals, with risks increasing further among those who had more severe initial illness (Xie et al., Nat Med 2022).

  • This underscores that COVID-19 should be understood as a longer-term health risk, not just an acute respiratory infection.

45

additional cardiovascular events per 1,000 people in the year after COVID-19

Vaccination continues to deliver meaningful protection.

  • COVID-19 vaccination continues to provide important protection against symptomatic infection.

  • During the 2024–2025 respiratory virus season in Europe, vaccines were around 66% effective overall at preventing medically attended symptomatic COVID-19 (Laniece Delaunay et al., Influenza Other Respir Viruses 2025).

  • Protection was highest shortly after vaccination (around 73%) and declined over time (to around 54%), with similar effectiveness observed among older adults, who remain at higher risk of severe outcomes (Laniece Delaunay et al., Influenza Other Respir Viruses 2025).

  • European monitoring shows that annual COVID-19 vaccination restores protection against hospitalisation and death, but that protection declines over time since the last vaccination, particularly among older adults. This highlights the importance of regular vaccination strategies to maintain protection in higher-risk groups (European Centre for Disease Prevention and Control, Interim Analysis 2024).

  • These findings confirm that vaccination plays an ongoing role in reducing disease burden and pressure on healthcare systems, even as population immunity evolves.

Exact strain matching is not essential for public health benefit.

  • Evidence from recent seasons shows that vaccines targeting closely related variants have delivered similar real-world effectiveness, even when the specific targeted strain was no longer dominant by the time of peak circulation (Sharff et al., Vaccine 2025).

  • For example, vaccines targeting JN.1- and KP.2-lineage variants showed comparable protection, despite rapid changes in circulating strains during the season (Sharff et al., Vaccine 2025; Laniece Delaunay et al., 2025).

  • Broad, lineage-level vaccine updates that prioritise cross-protection, rather than precise strain matching, may therefore offer more robust and reliable population-level protection (Sharff et al., Vaccine 2025).

Clear strategy matters for tackling low vaccine uptake.

  • The use of different variant targets within the same season risks confusing healthcare professionals and the public, particularly when differences are subtle and not linked to clear outcome benefits (Sharff et al., Vaccine 2025).

  • This matters in a context of very low COVID-19 booster uptake, especially among those most at risk. During the 2024–2025 season, only around 7–9% of adults aged ≥60 years received an annual COVID-19 vaccine in Europe (ECDC 2025).

  • Clear, consistent vaccination strategies that emphasise protection against severe disease and long-term consequences, rather than technical differences between variants, are likely to be critical for maintaining confidence and improving coverage in the post-pandemic phase.

  1. Xie Y, et al. Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall–Winter 2023–2024. JAMA. 2024;331(22):1963–1965.

  2. Bajema KL, et al. Severity and Long-Term Mortality of COVID-19, Influenza, and Respiratory Syncytial Virus. JAMA Internal Medicine. 2025. DOI: 10.1001/jamainternmed.2024.7452.

  3. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nature Medicine. 2022;28:583–590.

  4. Laniece Delaunay C, et al. COVID-19 Vaccine Effectiveness Against Medically Attended Symptomatic SARS-CoV-2 Infection Among Target Groups in Europe, October 2024–January 2025, VEBIS Primary Care Network. Influenza and Other Respiratory Viruses. 2025;19(11):e70120.

  5. European Centre for Disease Prevention and Control (ECDC). Interim analysis of COVID-19 vaccine effectiveness against hospitalisation and death using electronic health records in eight European countries: first update, April 2022–July 2023. Stockholm: ECDC; 2024. DOI: 10.2900/78799.

  6. Sharff KA, Haslam A, Nealon J. COVID-19 vaccine variant target: how should we choose? Vaccine. 2025;68:127917.

  7. Coalition for Life-Course Immunisation (CLCI) & European Scientific Working Group on Influenza (ESWI). Winter Respiratory Diseases in Europe: COVID-19, Influenza, RSV, Pneumococcal Disease, and Human Metapneumovirus — Policy Brief. December 2025.

  8. European Centre for Disease Prevention and Control (ECDC). COVID-19 vaccination coverage in the EU/EEA during the 2024–25 season campaigns: 1 August 2024 to 28 March 2025. Stockholm: ECDC; 2025. doi: 10.2900/2239152

  9. Lasrado N, et al. Immunogenicity of JN.1 and KP.2 COVID-19 mRNA vaccine boosters and implications for vaccine strain updates. Vaccine. 2025; in press.

Specific footnotes for COVID-19 vaccine coverage % by target group:

* 12 of 21 countries report data for Aug 2024 - Feb 2025. Countries reporting data for different periods include Bulgaria (Aug 2024 - Dec 2024), Denmark (Aug 2024 - Oct 2024), Estonia (Aug 2024 - Dec 2024), Italy (Sep 2024 - Mar 2025), Netherlands (Aug 2024 - Jan 2025), Portugal (Aug 2024 - Mar 2025), Spain (Aug 2024 - Mar 2025), Sweden (Aug 2024 - Nov 2024), Cyprus (Aug 2024 - Mar 2025), UK (Oct 2024 - Feb 2025).

** COVID-19 vaccine coverage by target group: In some reporting countries, the COVID-19 vaccine was only recommended in people aged 65 years and above (Belgium, Denmark, Finland, Norway, Slovenia, Lithuania, Latvia, and possibly others). Therefore, the vaccination coverage in this age group (60–69 years) needs to be interpreted with caution.

*** UK data refers specifically to immunosupressed individuals in England.