If they were not vaccinated because they were not deemed healthy enough to be able to handle the side-effects of the vaccine, then their inherent susceptibility to hospitalization is higher and the favorable comparison mostly indicates that the vaccinated population is healthier not that the vaccine is effective.
The vaccine might be effective, but to establish its long term efficacy requires people of similar health status assigned to vaccinated/not vaccinated groups. Of course, the control arms of the vaccine studies were busted about nine months ago, so that is not possible.