Evidence map›Paper›PMID 40573896›Full record

ArticleVaccines2025

Real-World Effectiveness of Boosting Against Omicron Hospitalization in Older Adults, Stratified by Frailty.

Liang En Wee, Enoch Xue Heng Loy, Jue Tao Lim, Wei Hao Kwok, Calvin Chiew, Christopher Lien, Barbara Helen Rosario, Ian Yi Onn Leong, Reshma Aziz Merchant, David Chien Boon Lye and 1 more

Abstract read
In one paragraph

Article in Vaccines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Liang En WeeNational Centre for Infectious Diseases, Singapore 308442, Singapore.ORCID 0000-0001-6428-9999
Enoch Xue Heng LoyNational Centre for Infectious Diseases, Singapore 308442, Singapore.
Jue Tao LimLee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Wei Hao KwokNational Centre for Infectious Diseases, Singapore 308442, Singapore.
Calvin ChiewNational Centre for Infectious Diseases, Singapore 308442, Singapore.ORCID 0000-0002-8217-7971
Christopher LienDepartment of Geriatric Medicine, Changi General Hospital, Singapore 529889, Singapore.
Barbara Helen RosarioDepartment of Geriatric Medicine, Changi General Hospital, Singapore 529889, Singapore.
Ian Yi Onn LeongLee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Reshma Aziz MerchantDivision of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore 119074, Singapore.ORCID 0000-0002-9032-0184
David Chien Boon LyeNational Centre for Infectious Diseases, Singapore 308442, Singapore.ORCID 0000-0003-0324-0205
Kelvin Bryan TanNational Centre for Infectious Diseases, Singapore 308442, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesOlder adults with frailty are at-risk of worse outcomes following respiratory-viral-infections such as COVID-19. Data on effectiveness of vaccination/boosting in frail older adults during Omicron is lacking.

methodsNational healthcare-claims data and COVID-19 registries were utilized to enroll a cohort of older Singaporeans (≥60 years) as of 1 January 2022, divided into low/intermediate/high-risk for frailty; matching weights were utilized to adjust for sociodemographic differences/vaccination uptake at enrolment across frailty categories. Competing-risk-regression (Fine-Gray) taking death as a competing risk, with matching weights applied, was utilized to compare risks of COVID-19-related hospitalizations and severe COVID-19 across frailty levels (low/intermediate/high-risk), with estimates stratified by booster status. Individuals were followed up until study end-date (20 December 2023).

results874,160 older adults were included during Omicron-predominant transmission; ~10% had intermediate/high-frailty-risk. Risk of hospitalization/severe COVID-19 was elevated in those with intermediate/high-frailty-risk up to XBB/JN.1 transmission. Boosting was associated with decreased risk of COVID-19-related hospitalization across all frailty categories in infection-naïve individuals. However, in infection-naïve older adults with high-frailty-risk, while receipt of first boosters was associated with lower risk of COVID-19-hospitalization/severe COVID-19, additional booster doses did not reduce risk. In reinfected older adults, first boosters were still associated with lower hospitalization risk (adjusted-hazards-ratio, aHR = 0.55, 95% CI = 0.33-0.92) among the non-frail, but not in the intermediate/high-frailty-risk minority.

conclusionsFirst boosters were associated with reduced adverse COVID-19 outcomes across all frailty categories in infection-naïve older adults during Omicron. However, in the high-frailty minority, boosting did not additionally reduce risk in reinfected individuals with hybrid immunity, and beyond the first booster for infection-naïve individuals.

Indexed as

boostingfrailtygeriatricsOmicronSARS-CoV-2vaccination

Identifiers

PMID40573896
PMCPMC12197443

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.