ArticlePublic health in practice (Oxford, England)2026
Inadvertent post-expiry COVID-19 vaccination in 282 seniors: Safety, efficacy, and implications for extended off-label stability data.
Article in Public health in practice (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Objectives: To describe safety and clinical outcomes after inadvertent post-expiry administration of Pfizer-BioNTech SARS-CoV-2 vaccine to adults aged ≥80 years in Swedish primary care; indicate what can (and cannot) be inferred about efficacy from real-world follow-up; and identify system needs for clearer expiry labelling and producer-led, longer-horizon post-expiry evidence. The study was not designed to estimate vaccine effectiveness. Study design: Service evaluation; observational single-arm cohort (ambispective). Methods: After discovery that 282 recipients had received doses 3-5 months past the labelled expiry, 280 survivors were informed and offered in-date revaccination within ∼4 weeks. Clinicians recorded revaccination uptake, adverse events exceeding expected post-mRNA symptoms after expired and (if applicable) in-date doses, and any confirmed/strongly suspected COVID-19 prior to revaccination; deaths were attributed via records. A change in manufacturer presentation of shortened/altered expiry encountered locally at point of care was documented. Results: 208/280 accepted revaccination; 72/280 declined. Two deaths occurred from age-related/pre-existing illness (not vaccination-related). No serious or unexpected adverse events were recorded after expired or in-date doses. A small number reported mild, self-limited illness compatible with COVID-19; there were no hospitalisations and no laboratory-confirmed cases. Conclusions: In this cohort of older seniors, inadvertent post-expiry vaccination was followed by no safety signal and no COVID-19 hospitalisations; effectiveness cannot be quantified from this design. Given recurring human error and cold-chain stress, clearer expiry labelling and transparent, real-life post-expiry stability/efficacy data (weeks-months; including temperature-excursion profiles) are needed to support patient safety, reduce wastage, and strengthen preparedness.
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