ArticleBMJ (Clinical research ed.)2023
Comparative effectiveness of heterologous third dose vaccine schedules against severe covid-19 during omicron predominance in Nordic countries: population based cohort analyses.
Article in BMJ (Clinical research ed.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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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.
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Who cites it
19 citing papers in PubMed, 25 citations in OpenAlex.
- Interchangeability of different COVID-19 vaccine platforms as booster doses: A phase 3 study mimicking real-world practice.Vaccine · 2024Trial
- Overview of adult immunization in Finland: Successes, lessons learned and the way forward.Human vaccines & immunotherapeutics · 2026Review
- Optimizing COVID-19 vaccination for older adults: superior efficacy of heterologous regimens in reducing infection and mortality rates among patients aged 80 years and older during the Omicron BA.5/BF.7 outbreak.BMC infectious diseases · 2026Article
- 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
- Association of SARS-CoV-2 vaccination status with risk of influenza-like illness and loss of workdays in healthcare workers.Communications medicine · 2025Article
- Worldwide SARS-CoV-2 Omicron variant infection: Emerging sub-variants and future vaccination perspectives.Journal of the Formosan Medical Association = Taiwan yi zhi · 2025Review
- Viral sepsis-induced mortality of older patients infected by the Omicron subvariant BA.5 of SARS-CoV-2: a retrospective study.BMC infectious diseases · 2025Article
- Overview of approved COVID-19 vaccines in the EU, recommendations for use in Sweden and vaccine uptake over time: Report from the Swedish Medical Products Agency and the Public Health Agency of Sweden.Upsala journal of medical sciences · 2025Review
- Relative effectiveness of a heterologous booster dose with adenovirus type 5 vectored COVID-19 vaccine versus three doses of inactivated COVID-19 vaccine in adults during a nationwide outbreak of omicron predominance, in China: a retrospective, individually matched cohort-control study.Emerging microbes & infections · 2024Article
- Pulmonary embolism after SARS-CoV-2 vaccination.Vaccine: X · 2024Article
- A Letter to the Editor Regarding 'Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-analysis Using the GRADE Framework'.Infectious diseases and therapy · 2024Article
- A Response to: A Letter to the Editor Regarding 'Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework'.Infectious diseases and therapy · 2024Article
- Comparison of long-term anti-RBD SARS-CoV-2 antibody response following different vaccination schemes in Tunisia.La Tunisie medicale · 2024Article
- Article
- COVID-19: On the threshold of the fifth year. The situation in Spain.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data.BMJ medicine · 2024Article
- A dose escalation study to evaluate the safety of an aerosol BCG infection in previously BCG-vaccinated healthy human UK adults.Frontiers in immunology · 2024Article
- Relative vaccine effectiveness of mRNA COVID-19 boosters in people aged at least 75 years during the spring-summer (monovalent vaccine) and autumn-winter (bivalent vaccine) booster campaigns: a prospective test negative case-control study, United Kingdom, 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- COVID-19 Vaccination Effectiveness in the General Population of an Italian Province: Two Years of Follow-Up.Vaccines · 2023Article
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Authors and funding
18 authors at 9 institutions in 5 countries.
Funding
Abstract
objectiveTo investigate the comparative vaccine effectiveness of heterologous booster schedules (ie, three vaccine doses) compared with primary schedules (two vaccine doses) and with homologous mRNA vaccine booster schedules (three vaccine doses) during a period of omicron predominance.
designPopulation based cohort analyses.
settingDenmark, Finland, Norway, and Sweden, 27 December 2020 to 31 December 2022.
participantsAll adults aged ≥18 years who had received at least a primary vaccination schedule of AZD1222 (Oxford-AstraZeneca) or monovalent SARS-CoV-2 wild type (ancestral) strain based mRNA vaccines BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna), in any combination.
main outcome measuresThe main outcome measure was country combined risks of covid-19 related hospital admission and death with covid-19 and additional outcomes of covid-19 related admission to an intensive care unit and SARS-CoV-2 infection. During a period of omicron predominance, these outcomes were compared in those who received a heterologous booster versus primary schedule (matched analyses) and versus those who received a homologous mRNA vaccine booster (weighted analyses). Follow-up was for 75 days from day 14 after the booster dose; comparative vaccine effectiveness was calculated as 1-risk ratio.
resultsAcross the four Nordic countries, 1 086 418 participants had received a heterologous booster schedule of AZD1222+BNT162b2 or mRNA-1273 and 2 505 093 had received a heterologous booster schedule of BNT162b2+mRNA-1273. Compared with the primary schedule only (two doses), the vaccine effectiveness of heterologous booster schedules comprising AZD1222+BNT162b2 or mRNA-1273 and BNT162b2+mRNA-1273 was 82.7% (95% confidence interval 77.1% to 88.2%) and 81.5% (78.9% to 84.2%) for covid-19 related hospital admission and 95.9% (91.6% to 100.0%) and 87.5% (82.5% to 92.6%) for death with covid-19, respectively. Homologous mRNA booster schedules were similarly associated with increased protection against covid-19 related hospital admission (≥76.5%) and death with covid-19 (≥84.1%) compared with previous primary course vaccination only. When a heterologous booster schedule was compared with the homologous booster schedule, vaccine effectiveness was 27.2% (3.7% to 50.6%) for AZD1222+BNT162b2 or mRNA-1273 and 23.3% (15.8% to 30.8%) for BNT162b2+mRNA-1273 schedules against covid-19 related hospital admission and 21.7% (-8.3% to 51.7%) and 18.4% (-15.7% to 52.5%) against death with covid-19, respectively.
conclusionHeterologous booster schedules are associated with increased protection against severe, omicron related covid-19 outcomes compared with primary course schedules and homologous booster schedules.
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