ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2023
Booster vaccination with inactivated whole-virus or mRNA vaccines and COVID-19-related deaths among people with multimorbidity: a cohort study.
Erratum issuedOpen access · goldAbstract read
In one paragraph
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.4field-weighted citation impact, top 7% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- mRNA lipid nanoparticle vaccines: current status, challenges and future prospects.Molecular biomedicine · 2026Review
- Durability of protection of ancestral-strain COVID-19 third- and fourth-dose vaccine boosters against Omicron XBB/XBB.1 and JN.1 symptomatic infection, hospitalisation and mortality in Indonesian adults (2023-2024): a test-negative case-control study.The Lancet regional health. Southeast Asia · 2025Article
- Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.Family medicine and community health · 2024Article
- Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan.Emerging infectious diseases · 2024Observational
- Effectiveness and Respiratory Adverse Events Following Inactivated and mRNA COVID-19 Vaccines in Patients with COPD and Asthma: A Chinese Population-Based Study.Drug safety · 2024Article
- Article
- Association of Demographic, Clinical, and Vaccination Characteristics with COVID-19 Viral Load Assessed by qRT-PCR.Archives of Iranian medicine · 2023Article
- Clinical characteristics and short-term outcomes of acute pancreatitis among patients with COVID-19.European journal of medical research · 2023Observational
- Correction to "Booster vaccination with inactivated whole-virus or mRNA vaccines and COVID-19-related deaths among people with multimorbidity: a cohort study".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 5 institutions in 4 countries.
Francisco Tsz Tsun LaiCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Vincent Ka Chun YanCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Xuxiao YeCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Tiantian MaCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Xiwen QinCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Celine Sze Ling ChuiCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Xue LiCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Eric Yuk Fai WanCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Carlos King Ho WongCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Ching Lung CheungCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Philip Hei LiCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Bernard Man Yung CheungCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Chak Sing LauCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Ian Chi Kei WongCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK.
Esther Wai Yin ChanCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK ewchan@hku.hk.
University of Hong Kong · HKAston University · GBHong Kong Science and Technology Parks Corporation · CNCAE (Canada) · CALaboratory of Data Discovery for Health
Funding
Wellcome Trust
Abstract
backgroundMultimorbidity is a prevalent risk factor for COVID-19-related complications and death. We sought to evaluate the association of homologous booster vaccination using BNT162b2 (Pfizer-BioNTech) or CoronaVac (Sinovac) with COVID-19-related deaths among people with multimorbidity during the initial Omicron wave of the COVID-19 pandemic.
methodsUsing routine clinical records from public health care facilities in Hong Kong, we conducted a territory-wide retrospective cohort study comparing people aged 18 years or older with 2 or more chronic conditions who received a homologous booster (third) dose with those who received only 2 doses, between Nov. 11, 2021, and Mar. 31, 2022. The primary outcome was death related to COVID-19.
resultsWe included 120 724 BNT162b2 recipients (including 87 289 who received a booster), followed for a median of 34 (interquartile range [IQR] 20-63) days and 127 318 CoronaVac recipients (including 94 977 who received a booster), followed for a median of 38 (IQR 22-77) days. Among BNT162b2 recipients, booster-vaccinated people had fewer COVID-19-related deaths than those who received 2 doses (5 v. 34, incidence rate 1.3 v. 23.4 per million person-days, weighted incidence rate ratio [IRR] 0.05, 95% confidence interval [CI] 0.02-0.16). We observed similar results among recipients of CoronaVac booster vaccination compared with those who received only 2 doses (26 v. 88, incidence rate 5.3 v. 53.1 per million person-days, weighted IRR 0.08, 95% CI 0.05-0.12).
interpretationAmong people with multimorbidity, booster vaccination with BNT162b2 or CoronaVac was associated with reductions of more than 90% in COVID-19-related mortality rates compared with only 2 doses. These results highlight the crucial role of booster vaccination for protecting vulnerable populations as the COVID-19 pandemic continues to evolve.
Indexed as
COVID-19mRNA VaccinesBNT162 VaccineCohort StudiesCOVID-19 VaccinesHumansMultimorbidityPandemicsRetrospective StudiesVaccinationVaccines, InactivatedBNT162 VaccineCOVID-19 VaccinesmRNA Vaccinessinovac COVID-19 vaccineVaccines, Inactivated
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