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Comparative effectiveness of bivalent BA.4-5 and BA.1 mRNA booster vaccines among adults aged ≥50 years in Nordic countries: nationwide cohort study

Objective To estimate the effectiveness of the bivalent mRNA booster vaccines containing the original SARS-CoV-2 and omicron BA.4-5 or BA.1 subvariants as the fourth dose against severe covid-19.

Design Nationwide cohort analyses, using target trial emulation.

Setting Denmark, Finland, Norway, and Sweden, from 1 July 2022 to 10 April 2023.

Participants People aged ≥50 years who had received at least three doses of covid-19 vaccine (that is, a primary course and a first booster).

Main outcome measures The Kaplan-Meier estimator was used to compare the risk of hospital admission and death related to covid-19 in people who received a bivalent Comirnaty (Pfizer-BioNTech) or Spikevax (Moderna) BA.4-5 or BA.1 mRNA booster vaccine as a fourth dose (second booster) with three dose (first booster) vaccinated people and between four dose vaccinated people.

Results A total of 1 634 199 people receiving bivalent BA.4-5 fourth dose booster and 1 042 124 ....

United Kingdom , North Carolina , United States , Nicklas Pihlstr , Ulrike Baum , Hinta Meijerink , Emilia Myrup Thiesson , Rickard Ljung , Jostein Starrfelt , Spikevax Moderna , Eero Poukka , Anders Hviid , European Medicines Agency , Finnish Medical Foundation , Sanofi Aventis , Niklas Worm Andersson , Myrup Thiesson , Conclusion Vaccination , European Medicines , Open Access , Creative Commons Attribution Non Commercial ,