Observational studyEndocrine2026
Impact of chronic cholecalciferol supplementation and vitamin D status on risk of post-vaccination SARS-CoV-2 breakthrough infection.
Observational study in Endocrine, 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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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionVitamin D has been implicated in modulating immune responses to COVID-19 and anti-SARS-CoV-2 vaccination. However, whether chronic cholecalciferol supplementation influences the risk of post-vaccination breakthrough infection remains unclear. This retrospective observational study investigated the role of chronic vitamin D supplementation and circulating 25(OH) vitamin D concentrations on SARS-CoV-2 breakthrough infection after mRNA vaccination.
methodsAdult patients vaccinated with two doses of BNT162b2 and without prior SARS-CoV-2 infection were included. Individuals chronically supplemented with cholecalciferol were compared with non-supplemented subjects and subsequently matched 1:1 for age, sex, and comorbidities. Breakthrough infection within 12 months after vaccination was recorded.
resultsA total of 114 patients were evaluated; 70 (61.4%) received chronic cholecalciferol supplementation and 27 (23.7%) developed breakthrough infection. Infection occurred less frequently among supplemented patients (17% vs. 34%, p = 0.044). Circulating 25(OH) vitamin D concentrations were significantly lower in patients with infection (p < 0.001) and showed a significant predictive performance (AUROC 75.6%, p < 0.001), with an optimal cut-off of 18.5 ng/mL. In multivariable analysis, 25(OH) vitamin D concentrations emerged as the only independent predictor of breakthrough infection (OR 0.86, p = 0.003). In the matched cohort (n = 78), breakthrough infection remained numerically lower among supplemented individuals (18% vs. 36%, p = 0.125); lower 25(OH) vitamin D concentrations were independently associated with infection risk (OR 0.88, p = 0.007), with similar ROC performance (AUROC 77%, p < 0.001).
conclusionsAdequate vitamin D status, predominantly achieved through chronic cholecalciferol supplementation, was independently associated with reduced risk of SARS-CoV-2 breakthrough infection after vaccination. Maintaining sufficient 25(OH) vitamin D concentrations may represent a simple and potentially relevant strategy to optimize post-vaccination protection.
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