COVID-19 vaccines have achieved a significant reduction in mortality, yet objective es-timates are needed in specific settings. We aimed to determine the effectiveness of COVID-19 vaccination at a referral hospital in Lambayeque, Peru. We conducted a retrospective cohort study from February to September 2021. We included hospitalized patients with COVID-19, whose data were stored in NotiWeb, a patient data system of the Peruvian Ministry of Health. We applied a propensity score-weighting method according to baseline characteristics of patients, and estimated hazard ratios (HR) using Cox regression models. Of 1553 participants, the average age was 55 years (SD: 16.8), 907 (58%) were male, and 592 (38%) deceased at 28-day follow-up. Before hospital admis-sion, 74 (4.8%) had been immunized with at least one vaccine dose. Effectiveness against death in vaccinated patients was 50% at 90-day follow-up (weighted HR 0.50, 95% CI 0.28–0.89). Our results support the effectiveness of COVID-19 vaccination against death and provide information after early immunization in Peru.