Fourth Dose of BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting
Open accessAbstract
BACKGROUND: With large waves of infection driven by the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), alongside evidence of waning immunity after the booster dose of coronavirus disease 2019 (Covid-19) vaccine, several countries have begun giving at-risk persons a fourth vaccine dose. METHODS: To evaluate the early effectiveness of a fourth dose of the BNT162b2 vaccine for the prevention of Covid-19-related outcomes, we analyzed data recorded by the largest health care organization in Israel from January 3 to February 18, 2022. We evaluated the relative effectiveness of a fourth vaccine dose as compared with that of a third dose given at least 4 months earlier among persons 60 years of age or older. We compared outcomes in persons who had received a fourth dose with those in persons who had not, individually matching persons from these two groups with respect to multiple sociodemographic and clinical variables. A sensitivity analysis was performed with the use of parametric Poisson regression. RESULTS: The primary analysis included 182,122 matched pairs. Relative vaccine effectiveness in days 7 to 30 after the fourth dose was estimated to be 45% (95% confidence interval [CI], 44 to 47) against polymerase-chain-reaction-confirmed SARS-CoV-2 infection, 55% (95% CI, 53 to 58) against symptomatic Covid-19, 68% (95% CI, 59 to 74) against Covid-19-related hospitalization, 62% (95% CI, 50 to 74) against severe Covid-19, and 74% (95% CI, 50 to 90) against Covid-19-related death. The corresponding estimates in days 14 to 30 after the fourth dose were 52% (95% CI, 49 to 54), 61% (95% CI, 58 to 64), 72% (95% CI, 63 to 79), 64% (95% CI, 48 to 77), and 76% (95% CI, 48 to 91). In days 7 to 30 after a fourth vaccine dose, the difference in the absolute risk (three doses vs. four doses) was 180.1 cases per 100,000 persons (95% CI, 142.8 to 211.9) for Covid-19-related hospitalization and 68.8 cases per 100,000 persons (95% CI, 48.5 to 91.9) for severe Covid-19. In sensitivity analyses, estimates of relative effectiveness against documented infection were similar to those in the primary analysis. CONCLUSIONS: A fourth dose of the BNT162b2 vaccine was effective in reducing the short-term risk of Covid-19-related outcomes among persons who had received a third dose at least 4 months earlier. (Funded by the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute.).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Plenty of articles have demonstrated the efficacy of two-dose vaccination and additional boosters in reducing mortality and severe cases.
“As plenty of articles have demonstrated the efficacy of two-dose vaccination and additional boosters in reducing mortality and severe cases [13,14,35-37]”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [35]
The Discussion reports that a fourth dose provided early protection against severe Covid-19 and Covid-19-related death compared with a third dose given at least four months earlier in people aged 60 or older. The paper does not demonstrate that two-dose vaccination reduces those outcomes; its introduction instead describes two doses as offering limited protection against omicron. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBooster vaccines seem promising both in preventing infection and severe progression.
“Since booster vaccines seem promising both in preventing infection and severe progression [35-37]”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Dagan, N., Barda, N., Kepten, E., Miron, O., Perchik, S., Katz, M. A., Hernán, M. A., Lipsitch, M., Reis, B., & Balicer, R. D. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2101765 · Cited by 2,527 · see citing works
Self-citationNegative Controls: A Tool for Detecting Confounding and Bias in Observational Studies
Lipsitch, M., Tchetgen Tchetgen, E., & Cohen, T. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181d61eeb · Cited by 1,583 · see citing works
Self-citationProtection of BNT162b2 Vaccine Booster against Covid-19 in Israel
Bar-On, Y. M., Goldberg, Y., Mandel, M., Bodenheimer, O., Freedman, L., Kalkstein, N., Mizrahi, B., Alroy-Preis, S., Ash, N., Milo, R., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2114255 · Cited by 1,169 · see citing works
Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting
Barda, N., Dagan, N., Ben-Shlomo, Y., Kepten, E., Waxman, J., Ohana, R., Hernán, M. A., Lipsitch, M., Kohane, I., Netzer, D., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2110475 · Cited by 1,027 · see citing works
Self-citationBarda, N., Dagan, N., Cohen, C., Hernán, M. A., Lipsitch, M., Kohane, I. S., Reis, B. Y., & Balicer, R. D. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02249-2 · Cited by 860 · see citing works
Self-citationFerdinands, J. M., Rao, S., Dixon, B. E., Mitchell, P. K., DeSilva, M. B., Irving, S. A., Lewis, N., Natarajan, K., Stenehjem, E., Grannis, S. J., et al. (2022) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7107e2 · Cited by 435 · see citing works
Protection by a Fourth Dose of BNT162b2 against Omicron in Israel
(2022) · doi:10.1056/nejmoa2201570 · Cited by 376 · see citing works
SARS-CoV-2 Vaccines Based on the Spike Glycoprotein and Implications of New Viral Variants
Martínez-Flores, D., Zepeda–Cervantes, J., Cruz-Reséndiz, A., Aguirre‐Sampieri, S., Sampieri, A., & Vaca, L. A. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.701501 · Cited by 237 · see citing works
Sheikh, A., Kerr, S., Woolhouse, M. E. J., McMenamin, J., Robertson, C., Simpson, C. R., Millington, T., Shi, T., Agrawal, U., Hameed, S. S., et al. (2022) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(22)00141-4 · Cited by 230 · see citing works
Pitfalls of the healthy vaccinee effect
Mahmud, S. M., & Righolt, C. H. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30017-5 · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Wolter N, Jassat W, Walaza S, et al. Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa. December 21, 2021 (https://www . medrxiv . org/ content/ 10 . 1101/ 2021 . 12 . 21 . 21268116v1). preprint. · DOI
- Gardner BJ, Kilpatrick AM. Estimates of reduced vaccine effectiveness against hospitalization, infection, transmission and symptomatic disease of a new SARS- CoV-2 variant, Omicron (B.1.1.529), using neutralizing antibody titers. December 12, 2021 (https://www . medrxiv . org/ content/ 10 . 1101/ 2021 . 12 . 10 . 21267594v2). preprint. · DOI
- CDC recommends Pfizer booster at 5 months, additional primary dose for certain immunocompromised children. Press release, January 4, 2022 (https:// www . cdc . gov/ media/ releases/ 2022/ s0104 -Pfizer -Booster . html).
- All adults to be offered COVID-19 boosters by end of January. Press release, November 30, 2021 (https://www . gov . uk/ government/ news/ all -adults -to -be -offered -covid -19 -boosters -by -end -of -january).
- Cohen R, Rabin G. National Insur- ance Institute R and PA. Membership in sick funds 2016. Period Surv 2017; 289: 104. (In Hebrew.)
- EMA regular press briefing on COVID- 19. European Medicines Agency, January 11, 2022 (https://www . ema . europa . eu/ en/ events/ ema -regular -press -briefing -covid -19 -11#event -summary -section).
Cited by
Sorted by citations
Watanabe, A., Iwagami, M., Yasuhara, J., Takagi, H., & Kuno, T. (2023) · Vaccine · doi:10.1016/j.vaccine.2023.02.008 · Cited by 304 · see citing works
Chi, W.-Y., Li, Y.-D., Huang, H., Chan, T. E. H., Chow, S.-Y., Su, J.-H., Ferrall, L., Hung, C., & Wu, T. ‐. (2022) · Journal of Biomedical Science · doi:10.1186/s12929-022-00853-8 · Cited by 216 · see citing works
Effects of the COVID-19 pandemic on mental health, anxiety, and depression
Kupcová, I., Danišovič, Ľ., Klein, M., & Harsányi, Š. (2023) · BMC Psychology · doi:10.1186/s40359-023-01130-5 · Cited by 206 · see citing works
Lau, J. J., Cheng, S. M. S., Leung, K., Lee, C. K., Hachim, A., Tsang, L. C. H., Yam, K. W. H., Chaothai, S., Kwan, K. K. H., Chai, Z. Y. H., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02219-5 · Cited by 198 · see citing works
Munro, A. P. S., Feng, S., Janani, L., Cornelius, V., Aley, P. K., Babbage, G., Baxter, D., Bula, M., Cathie, K., Chatterjee, K., et al. (2022) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(22)00271-7 · Cited by 175 · see citing works
Arbel, R., Peretz, A., Sergienko, R., Friger, M., Beckenstein, T., Duskin-Bitan, H., Yaron, S., Hammerman, A., Bilenko, N., & Netzer, D. (2023) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(23)00122-6 · Cited by 145 · see citing works
Au, W. Y., & Cheung, P. P.-H. (2022) · BMJ · doi:10.1136/bmj-2022-069989 · Cited by 143 · see citing works
CD8 T cells contribute to vaccine protection against SARS-CoV-2 in macaques
Liu, J., Yu, J., McMahan, K., Jacob-Dolan, C., He, X., Giffin, V., Wu, C., Sciacca, M., Powers, O., Nampanya, F., et al. (2022) · Science Immunology · doi:10.1126/sciimmunol.abq7647 · Cited by 132 · see citing works
Jurdi, A. A., Morená, L., Cote, M., Bethea, E. D., Azzi, J. R., & Riella, L. V. (2022) · American Journal of Transplantation · doi:10.1111/ajt.17128 · Cited by 132 · see citing works
SARS-CoV-2 in immunocompromised individuals
DeWolf, S., Laracy, J. C., Perales, M., Kamboj, M., van den Brink, M. R. M., & Vardhana, S. A. (2022) · Immunity · doi:10.1016/j.immuni.2022.09.006 · Cited by 132 · see citing works
Gilboa, M., Regev-Yochay, G., Mandelboim, M., Indenbaum, V., Asraf, K., Fluss, R., Amit, S., Mendelson, E., Doolman, R., Afek, A., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.31778 · Cited by 128 · see citing works
Adams, K., Rhoads, J. P., Surie, D., Gaglani, M., Ginde, A. A., McNeal, T., Talbot, H. K., Casey, J. D., Zepeski, A., Shapiro, N. I., et al. (2022) · BMJ · doi:10.1136/bmj-2022-072065 · Cited by 115 · see citing works
Yu, W., Guo, Y., Zhang, S., Kong, Y., Shen, Z., & Zhang, J. (2022) · Journal of Medical Virology · doi:10.1002/jmv.28066 · Cited by 114 · see citing works
Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials
Hansford, H. J., Cashin, A. G., Jones, M. D., Swanson, S. A., Islam, N., Douglas, S. R. G., Rizzo, R. R. N., Devonshire, J. J., Williams, S. A., Dahabreh, I. J., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.36023 · Cited by 107 · see citing works
Self-citationTseng, H. F., Ackerson, B. K., Bruxvoort, K. J., Sy, L. S., Tubert, J. E., Lee, G. S., Ku, J. H., Florea, A., Luo, Y., Qiu, S., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-35815-7 · Cited by 105 · see citing works
Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger than 5 Years of Age
Muñoz, F. M., Sher, L., Sabharwal, C., Gurtman, A., Xu, X., Kitchin, N. R. E., Lockhart, S. P., Riesenberg, R. A., Sexter, J. M., Czajka, H., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2211031 · Cited by 105 · see citing works
Andersson, N. W., Thiesson, E. M., Baum, U., Pihlström, N., Starrfelt, J., Faksová, K., Poukka, E., Meijerink, H., Ljung, R., & Hviid, A. P. (2023) · BMJ · doi:10.1136/bmj-2022-075286 · Cited by 92 · see citing works
Assessment of Efficacy and Safety of mRNA COVID-19 Vaccines in Children Aged 5 to 11 Years
Watanabe, A., Kani, R., Iwagami, M., Takagi, H., Yasuhara, J., & Kuno, T. (2023) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2022.6243 · Cited by 91 · see citing works
Lam, I. C. H., Zhang, R., Man, K. K. C., Wong, C. K. H., Chui, C. S. L., Lai, F. T. T., Li, X., Chan, E. W., Lau, C. S., Wong, I. C. K., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-45953-1 · Cited by 80 · see citing works
Martín‐Sánchez, F. J., Martínez‐Sellés, M., Molero, J., Guillén, S. M., Rodríguez‐Artalejo, F., Ruiz‐Galiana, J., Cantón, R., Ramos, P. D. L., Botella, A. G., García‐Lledó, A., et al. (2022) · Revista Española de Quimioterapia · doi:10.37201/req/122.2022 · Cited by 78 · see citing works
Rappuoli, R., Alter, G., & Pulendran, B. (2024) · Cell · doi:10.1016/j.cell.2024.07.021 · Cited by 78 · see citing works
Wang, W., Lusvarghi, S., Subramanian, R., Epsi, N. J., Wang, R., Goguet, E., Fries, A. C., Echegaray, F., Vassell, R., Coggins, S., et al. (2022) · doi:10.1101/2022.07.05.498883 · Cited by 68 · see citing works
Patients with CLL have a lower risk of death from COVID-19 in the Omicron era
Niemann, C. U., da Cunha‐Bang, C., Helleberg, M., Ostrowski, S. R., & Brieghel, C. (2022) · Blood · doi:10.1182/blood.2022016147 · Cited by 66 · see citing works
Nordström, P., Ballin, M., & Nordström, A. (2022) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2022.100466 · Cited by 62 · see citing works
Zhang, B., Upadhyay, R., Hao, Y., Samanovic, M. I., Herati, R. S., Blair, J. D., Axelrad, J. E., Mulligan, M. J., Littman, D. R., & Satija, R. (2023) · Nature Immunology · doi:10.1038/s41590-023-01608-9 · Cited by 61 · see citing works
Wang, W., Lusvarghi, S., Subramanian, R., Epsi, N. J., Wang, R., Goguet, E., Fries, A. C., Echegaray, F., Vassell, R. A., Coggins, S. A., et al. (2022) · Cell Host & Microbe · doi:10.1016/j.chom.2022.10.012 · Cited by 59 · see citing works
Abebe, E. C., & Dejenie, T. A. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1055457 · Cited by 56 · see citing works
Bates, T. A., Leier, H. C., McBride, S. K., Schoen, D., Lyski, Z. L., Lee, D. X., Messer, W. B., Curlin, M. E., & Tafesse, F. (2023) · JCI Insight · doi:10.1172/jci.insight.165265 · Cited by 55 · see citing works
Six-Month Follow-up after a Fourth BNT162b2 Vaccine Dose
Canetti, M., Barda, N., Gilboa, M., Indenbaum, V., Asraf, K., Gonen, T., Weiss-Ottolenghi, Y., Amit, S., Doolman, R., Mendelson, E., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmc2211283 · Cited by 51 · see citing works
The impact of COVID-19 and COVID vaccination on cardiovascular outcomes
Akhtar, Z., Trent, M. J., Moa, A., Tan, T. C., Fröbert, O., & MacIntyre, C. R. (2023) · European Heart Journal Supplements · doi:10.1093/eurheartjsupp/suac123 · Cited by 51 · see citing works
Solante, R., Álvarez, C., Burhan, E., Chariyalertsak, S., Chiu, N., Chuenkitmongkol, S., Dung, D. V., Hwang, K., Ibarra, J. O., Kiertiburanakul, S., et al. (2022) · Expert Review of Vaccines · doi:10.1080/14760584.2023.2143347 · Cited by 49 · see citing works
Wang, C. Y., Peng, W., Kuo, B.-S., Ho, Y.-H., Wang, M.-S., Yang, Y.-T., Chang, P.-Y., Shen, Y.-H., & Hwang, K. (2023) · PLoS Pathogens · doi:10.1371/journal.ppat.1010870 · Cited by 48 · see citing works
Muhsen, K., Maimon, N., Mizrahi, A., Boltyansky, B., Bodenheimer, O., Diamant, Z. H., Gaon, L., Cohen, D., & Dagan, R. (2022) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2022.2658 · Cited by 45 · see citing works
Tarke, A., Ramezani-Rad, P., Neto, T. A. P., Lee, Y., Silva‐Moraes, V., Goodwin, B., Bloom, N. I., Siddiqui, L., Avalos, L., Frazier, A., et al. (2024) · Cell Reports Medicine · doi:10.1016/j.xcrm.2024.101583 · Cited by 37 · see citing works
Galanis, P., Vraka, I. S., Katsiroumpa, A., Siskou, O. C., Konstantakopoulou, O., Katsoulas, T. A., Mariolis-Sapsakos, T. D., & Καϊτελίδου, Δ. (2022) · Vaccines · doi:10.3390/vaccines10071061 · Cited by 36 · see citing works
Evidence-Based Policies in Public Health to Address COVID-19 Vaccine Hesitancy
Chirico, F., & da Silva, J. A. T. (2023) · Future Virology · doi:10.2217/fvl-2022-0028 · Cited by 36 · see citing works
Gilboa, M., Gonen, T., Barda, N., Cohn, S., Indenbaum, V., Weiss-Ottolenghi, Y., Amit, S., Asraf, K., Joseph, G., Levin, T., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.14757 · Cited by 36 · see citing works
Correlates of protection for booster doses of the SARS-CoV-2 vaccine BNT162b2
Hertz, T., Levy, S., Ostrovsky, D. A., Oppenheimer, H., Zismanov, S., Kuzmina, A., Friedman, L. M., Trifkovic, S., Brice, D. C., Chun-Yang, L., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-39816-4 · Cited by 36 · see citing works
Ntanasis‐Stathopoulos, I., Karalis, V. D., Gavriatopoulou, M., Malandrakis, P., Sklirou, A. D., Eleutherakis‐Papaiakovou, E., Migkou, M., Ρούσσου, Μ., Fotiou, D., Alexopoulos, H., et al. (2022) · HemaSphere · doi:10.1097/hs9.0000000000000764 · Cited by 35 · see citing works
Perrier, Q., Lupo, J., Gerster, T., Augier, C., Falque, L., Rostaing, L. P. E., Pelletier, L., Bedouch, P., Blanc, M., Saint‐Raymond, C., et al. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.08.065 · Cited by 33 · see citing works
Tartof, S. Y., Slezak, J. M., Puzniak, L., Hong, V. X., Xie, F., Ackerson, B. K., Valluri, S. R., Jódar, L., & McLaughlin, J. M. (2022) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(22)00170-9 · Cited by 33 · see citing works
Favresse, J., Gillot, C., Bayart, J., David, C., Simon, G., Wauthier, L., Closset, M., Dogné, J., & Douxfils, J. (2022) · Journal of Medical Virology · doi:10.1002/jmv.28164 · Cited by 33 · see citing works
Lin, D. Y., Xu, Y., Gu, Y., Zeng, D., Wheeler, B., Young, H., Moore, Z., & Sunny, S. K. (2023) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(23)00272-4 · Cited by 33 · see citing works
Rahman, M. O., Kamigaki, T., Thandar, M. M., Haruyama, R., Yan, F., Shibamura-Fujiogi, M., Khin Maung Soe, J., Islam, M. R., Yoneoka, D., Miyahara, R., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-076892 · Cited by 29 · see citing works
Vaccination status and long COVID symptoms in patients discharged from hospital
Nascimento, T. C. D. C., Costa, L. D. V., Ruiz, A., Ledo, C. B., Fernandes, V. P. L., Cardoso, L. F., Vieira, J. M., Saretta, R., Filho, R. K., & Drager, L. F. (2023) · Scientific Reports · doi:10.1038/s41598-023-28839-y · Cited by 29 · see citing works
Hogan, A. B., Wu, S. L., Toor, J., Mesa, D. O., Doohan, P., Watson, O. J., Winskill, P., Charles, G. D., Barnsley, G., Riley, E. M., et al. (2023) · PLoS Medicine · doi:10.1371/journal.pmed.1004195 · Cited by 27 · see citing works
Cohen, D., Izak, M., Stoyanov, E., Mandelboim, M., Perlman, S., Amir, Y., Goren, S., Bialik, A., Kliker, L., Atari, N., et al. (2023) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2023.04.395 · Cited by 24 · see citing works
Bruel, T., Pinaud, L., Tondeur, L., Planas, D., Staropoli, I., Porrot, F., Guivel‐Benhassine, F., Attia, M., Pelleau, S., Woudenberg, T., et al. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101576 · Cited by 24 · see citing works
Zarębska‐Michaluk, D., Hu, C., Brzdęk, M., Flisiak, R., & Rzymski, P. (2022) · Vaccines · doi:10.3390/vaccines10081223 · Cited by 24 · see citing works
Redondo, E., Calle, I. R., Mascarós, E., Ocaña, D., Jimeno, I., de Miguel, Á. G., Díaz-Maroto, J. L., Linares, M., Onieva-García, M. Á., González‐Romo, F., et al. (2023) · Antibiotics · doi:10.3390/antibiotics12010138 · Cited by 24 · see citing works
Martinelli, S., Pascucci, D., & Laurenti, P. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1108546 · Cited by 24 · see citing works
Immunogenicity of SARS-CoV-2 vaccines in patients with cancer
Kakkassery, H., Carpenter, E., Patten, P., & Irshad, S. (2022) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2022.07.006 · Cited by 23 · see citing works
Bjørlykke, K. H., Ørbo, H. S., Tveter, A. T., Jyssum, I., Sexton, J., Tran, T. T., Christensen, I. E., Kro, G. B., Kvien, T. K., Jahnsen, J., et al. (2022) · The Lancet Rheumatology · doi:10.1016/s2665-9913(22)00330-7 · Cited by 23 · see citing works
Acute macular neuroretinopathy and COVID-19 vaccination: Case report and literature review
Fekri, S., Khorshidifar, M., Dehghani, M. S., Nouri, H., & Abtahi, S.-H. (2022) · Journal Français d Ophtalmologie · doi:10.1016/j.jfo.2022.09.008 · Cited by 23 · see citing works
COVID-19 clinical presentation, management, and epidemiology: a concise compendium
Maison, D. P., Tasissa, H., Deitchman, A. N., Peluso, M. J., Deng, Y., Miller, F. D., Henrich, T. J., & Gerschenson, M. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1498445 · Cited by 22 · see citing works
Kislaya, I., Machado, A., Magalhães, S., Rodrigues, A. P., Franco, R., Leite, P. P., Dias, C. M., & Nunes, B. (2022) · Eurosurveillance · doi:10.2807/1560-7917.es.2022.27.37.2200697 · Cited by 22 · see citing works
Kim, Y.-Y., Choe, Y. J., Kim, J., Kim, R. K., Jang, E. J., Park, S. K., Lim, D., Yi, S., Lee, S., Kwon, G., et al. (2022) · Emerging infectious diseases · doi:10.3201/eid2811.220918 · Cited by 22 · see citing works
Kong, W., Zhong, Q., Chen, M., Yu, P., Xu, R., Zhang, L., Lai, C., Deng, M., Zhou, Q., Xiong, S., et al. (2022) · Journal of Medical Virology · doi:10.1002/jmv.28163 · Cited by 21 · see citing works
Zhang, H., Xu, N., Xu, Y. S., Qin, P., Dai, R., Xu, B., Wang, S., Ding, L., Fu, J., Zhang, S., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-40489-2 · Cited by 21 · see citing works
COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness
Kherabi, Y., Launay, O., & Nguyen, L. B. L. (2022) · Viruses · doi:10.3390/v14102086 · Cited by 20 · see citing works
Sritipsukho, P., Khawcharoenporn, T., Siribumrungwong, B., Damronglerd, P., Suwantarat, N., Satdhabudha, A., Chaiyakulsil, C., Sinlapamongkolkul, P., Tangsathapornpong, A., Bunjoungmanee, P., et al. (2023) · Emerging Microbes & Infections · doi:10.1080/22221751.2023.2174779 · Cited by 20 · see citing works
He, Y., Zhang, F., Liu, Y., Xiong, Z., Zheng, S., Liu, W., & Liu, L. (2023) · Vaccines · doi:10.3390/vaccines11050968 · Cited by 20 · see citing works
Covid-19 Boosters — Where from Here?
Offit, P. A. (2022) · New England Journal of Medicine · doi:10.1056/nejme2203329 · Cited by 20 · see citing works
Cao, X., Manhas, A., Chen, Y. M., Caudal, A., Mondéjar‐Parreño, G., Zhu, W., Liu, W., Kong, X., Zeng, W., Liu, L., et al. (2025) · Science Translational Medicine · doi:10.1126/scitranslmed.adq0143 · Cited by 18 · see citing works
Florea, A., Sy, L. S., Qian, L., Ackerson, B. K., Luo, Y., Tubert, J. E., Lee, G. S., Ku, J. H., Bruxvoort, K. J., Talarico, C. A., et al. (2022) · Clinical Infectious Diseases · doi:10.1093/cid/ciac785 · Cited by 18 · see citing works
Méndez, C., Peñaloza, H. F., Schultz, B. M., Piña-Iturbe, A., Ríos, M., Moreno‐Tapia, D., Pereira-Sánchez, P., Leighton, D., Orellana, C., Covarrubias, C., et al. (2023) · EBioMedicine · doi:10.1016/j.ebiom.2023.104563 · Cited by 18 · see citing works
Hanberg, J. S., Fu, X., Wang, X., Patel, N. J., Kawano, Y., Schiff, A. E., Kowalski, E. N., Cook, C., Vanni, K. M. M., Guzzo, K., et al. (2023) · The Lancet Rheumatology · doi:10.1016/s2665-9913(23)00272-2 · Cited by 18 · see citing works
Neutralizing Efficacy of Encapsulin Nanoparticles against SARS-CoV2 Variants of Concern
Khaleeq, S., Sengupta, N., Kumar, S., Patel, U. R., Rajmani, R., Reddy, P., Pandey, S., Singh, R., Dutta, S., Ringe, R. P., et al. (2023) · Viruses · doi:10.3390/v15020346 · Cited by 18 · see citing works
Chan, P. S.-F., Lee, M. L.-T., Fang, Y., Yu, F.-Y., Ye, D., Chen, S., Kawuki, J., Liang, X., & Wang, Z. J. (2023) · Vaccines · doi:10.3390/vaccines11020392 · Cited by 18 · see citing works
Design and Implementation of Observational Studies Emulating a Target Trial
Ren, Y., Jia, Y., Liu, L., Lyv, H., Tao, L., Li, Y., Zhao, P., Xiong, Y., Li, G., Xu, J., et al. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.58262 · Cited by 17 · see citing works
Jain, M., Est-Witte, S. E., Shannon, S. R., Neshat, S. Y., Yu, X., Dunham, S., Tian, T. M., Cheng, L., Harris, J. J., Konig, M. F., et al. (2026) · Science Advances · doi:10.1126/sciadv.adz1722 · Cited by 17 · see citing works
Tan, C. Y., Chiew, C. J., Lee, V. J., Ong, B. K. C., Lye, D. C., & Tan, K. B. (2022) · Annals of Internal Medicine · doi:10.7326/m22-2042 · Cited by 17 · see citing works
Cellular and humoral response to the fourth BNT162b2 mRNA COVID‐19 vaccine dose in patients with CLL
Benjamini, O., Gershon, R., Bar‐Haim, E., Lustig, Y., Cohen, H., Doolman, R., Kedmi, M., Ribakovsky, E., Kneller, A., Hod, T., et al. (2022) · European Journal Of Haematology · doi:10.1111/ejh.13878 · Cited by 17 · see citing works
Li, H., Zhu, X., Yu, R., Qian, X., Huang, Y., Chen, X., Lin, H., Zheng, H., Zhang, Y., Lin, J.-R., et al. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.988694 · Cited by 17 · see citing works
Mazarakis, N., Toh, Z. Q., Neal, E. F. G., Bright, K., Luu, S., Quah, L., Ng, Y. Y., Nguyen, C. D., Hart, J., Do, L. A. H., et al. (2025) · Journal of Infection · doi:10.1016/j.jinf.2025.106447 · Cited by 16 · see citing works
Fan, X., Lü, S., Bai, L., Liu, H., Fu, J., Jin, X., He, Y., Lu, J., & Dong, X. (2022) · PubMed Central · doi:10.46234/ccdcw2022.081 · Cited by 16 · see citing works
Krekeler, C., Reitnauer, L. E., Bacher, U., Khandanpour, C., Steger, L., Boeckel, G. R., Klosner, J., Tepasse, P., Kemper, M., Hennies, M. T., et al. (2022) · Cancers · doi:10.3390/cancers14225512 · Cited by 16 · see citing works
The Efficacy of SARS-CoV-2 Vaccination in the Elderly: A Systemic Review and Meta-analysis
Yang, X. H., Bao, W. J., Zhang, H., Fu, S. K., & Jin, H. M. (2023) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08254-9 · Cited by 16 · see citing works
Chenchula, S., Chandra, M. B., Adusumilli, M. B., Ghanta, S. N., Bommasani, A., Anitha, K., Padmavathi, R., Amerneni, K. C., Chikatipalli, R., Ghanta, M. K., et al. (2024) · Reviews in Medical Virology · doi:10.1002/rmv.2515 · Cited by 16 · see citing works
Acute myocarditis following a third dose of COVID-19 mRNA vaccination in adults
Simone, A., Herald, J., Chen, A., Nayak, R., Shen, Y.-J. A., & Lee, M. S. (2022) · International Journal of Cardiology · doi:10.1016/j.ijcard.2022.07.031 · Cited by 16 · see citing works
Challenges in Emerging Vaccines and Future Promising Candidates against SARS‐CoV‐2 Variants
Ghildiyal, T., Rai, N., Rawat, J. M., Singh, M., Anand, J., Pant, G., Kumar, G., & Shidiki, A. (2024) · Journal of Immunology Research · doi:10.1155/2024/9125398 · Cited by 15 · see citing works
Public health impact of UK COVID-19 booster vaccination programs during Omicron predominance
Mendes, D., Chapman, R., Aruffo, E., Gal, P., Nguyen, J. L., Hamson, L., Fusco, M. D., Czudek, C., & Yang, J. (2022) · Expert Review of Vaccines · doi:10.1080/14760584.2023.2158816 · Cited by 15 · see citing works
Effectiveness of the second COVID-19 booster against Omicron: a large-scale cohort study in Chile
Jara, A., Cuadrado, C., Undurraga, E. A., García, C., Nájera, M., Bertoglia, M. P., Vergara, V., Fernández, J., García-Escorza, H., & Rafael Araos, B. (2023) · Nature Communications · doi:10.1038/s41467-023-41942-y · Cited by 15 · see citing works
Early Mortality After the First Dose of COVID-19 Vaccination: A Target Trial Emulation
McConeghy, K. W., Hur, K., Dahabreh, I. J., Jiang, R., Pandey, L., Gellad, W. F., Glassman, P. A., Good, C. B., Miller, D. R., Zullo, A. R., et al. (2023) · Clinical Infectious Diseases · doi:10.1093/cid/ciad604 · Cited by 14 · see citing works
The Omicron-transformer: Rise of the subvariants in the age of vaccines
Chia, T. R. T., Young, B. E., & Chia, P. Y. (2022) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.2022294 · Cited by 14 · see citing works
Lai, F. T. T., Yan, V. K. C., Ye, X., Ma, T., Qin, X. S., Chui, C. S. L., Li, X., Wan, E. Y. F., Wong, C. K. H., Cheung, C. L., et al. (2023) · Canadian Medical Association Journal · doi:10.1503/cmaj.221068 · Cited by 14 · see citing works
Qin, C., Du, M., Wang, Y., Liu, Q., Yan, W., Tao, L., Liu, M., & Liu, J. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2023.2186108 · Cited by 14 · see citing works
Ciesla, A. A., Wiegand, R. E., Smith, Z., Britton, A., Fleming-Dutra, K. E., Miller, J. H., Accorsi, E. K., Verani, J. R., Shang, N., Derado, G., et al. (2023) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofad187 · Cited by 14 · see citing works
Petrie, J. G., King, J. P., McClure, D. L., Rolfes, M. A. R., Meece, J. K., Pattinson, D., Neumann, G., Kawaoka, Y., Belongia, E. A., & McLean, H. Q. (2023) · Influenza and Other Respiratory Viruses · doi:10.1111/irv.13104 · Cited by 13 · see citing works
Abuhasira, R., Burrack, N., Nesher, L., Ostrovsky, D. A., & Novack, V. (2023) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2023.05.017 · Cited by 13 · see citing works
Zhang, X., Xia, J., Jin, L., Wu, Y., Zheng, X., Cao, X., Meng, X., Li, J., & Zhu, F. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2023.2221146 · Cited by 13 · see citing works
Impact of multiple doses of vaccination on epidemiological spread in multiple networks
Li, L., Dong, G., Zhu, H., & Tian, L. (2024) · Applied Mathematics and Computation · doi:10.1016/j.amc.2024.128617 · Cited by 13 · see citing works
The Four Ws of the Fourth Dose COVID-19 Vaccines: Why, Who, When and What
Khong, K.-W., Zhang, R., & Hung, I. F. (2022) · Vaccines · doi:10.3390/vaccines10111924 · Cited by 13 · see citing works
Lewis, N. M., Murray, N. L., Adams, K., Surie, D., Gaglani, M., Ginde, A. A., McNeal, T., Ghamande, S. A., Douin, D. J., Talbot, H. K., et al. (2022) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofac698 · Cited by 13 · see citing works
Tamandjou, C. R. T., Auvigne, V., Schaeffer, J., Vaux, S., & du Châtelet, I. P. (2023) · Vaccine · doi:10.1016/j.vaccine.2023.03.031 · Cited by 13 · see citing works
Wang, M., Zhou, B., Fan, Q., Zhou, X., Liao, X., Lin, J., Ma, Z., Dong, J., Wang, H., Ge, X., et al. (2022) · Emerging Microbes & Infections · doi:10.1080/22221751.2022.2151381 · Cited by 12 · see citing works
- Authors
- Magen, O., Waxman, J. G., Makov-Assif, M., Vered, R., Dicker, D., Hernán, M. A., Lipsitch, M., Reis, B. Y., Balicer, R. D., & Dagan, N.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- From the Clalit Research Institute, Innovation Division (O.M., J.G.W., M.M.-A., R.D.B., N.D.), and the Tel-Aviv District, Community Division (R.V.), Clalit Health Services, and the Sackler Faculty of Medicine, Tel-Aviv University (D.D.), Tel Aviv, the Department of Internal Medicine D, Hasharon Hospital Rabin Medical Center, Petah Tikva (D.D.), and the School of Public Health, Faculty of Health Sciences (R.D.B.), and the Department of Software and Information Systems Engineering (N.D.), Ben Gurion University of the Negev, Be’er Sheva — all in Israel; and the Departments of Epidemiology and Biostatistics and CAUSALab (M.A.H.) and the Center for Communicable Disease Dynamics, Departments of Epidemiology and of Immunology and Infectious Diseases (M.L.), Harvard T.H. Chan School of Public Health, the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (B.Y.R., R.D.B., N.D.), the Predictive Medicine Group, Computational Health Informatics P...
- Corresponding author
- Dagan, Noa
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2022-04-28
- Volume
- 386
- Issue
- 17
- Pages
- 1603-1614
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC9020581
- OpenAlex
- W4223907450
- Cited by
- 279
- References
- 10
- Citations by year
- 2026: 15 · 2025: 14 · 2024: 45 · 2023: 113 · 2022: 92
- FWCI
- 32.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute
- Morris-Singer Fund
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- BNT162b2 mRNA vaccine, fourth vaccine dose, COVID-19 vaccine effectiveness, Omicron variant, waning immunity, booster vaccination, older adults, COVID-19 hospitalization, COVID-19 mortality, symptomatic COVID-19, Israel, matched cohort analysis, sensitivity analysis, Poisson regression
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, Humans, Immunization, Secondary, Israel, Middle Aged, RNA, Messenger, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
