ArticleRMD open2026
Association between SARS-CoV-2 booster vaccination and hospitalisation and/or death due to COVID-19 in adults with immune-mediated inflammatory diseases: nested case-control study using linked primary-care, hospitalisation and mortality data from England.
Article in RMD open, 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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Abstract
objectivesTo assess the association between COVID-19 booster vaccination and hospitalisation and/or death due to COVID-19 among adults with immune-mediated inflammatory diseases (IMIDs).
methodsAdults with IMIDs prescribed steroid-sparing immune-suppressing drugs in Clinical Practice Research Datalink Aurum linked to hospitalisation and mortality records were included. Cases were hospitalised for or died due to COVID-19. Controls were risk-set matched to cases. Exposures were number of COVID-19 booster vaccinations between 16 September 2021 and 13 March 2023; receipt of autumn 2021, spring 2022, autumn 2022 boosters; and time since last booster. Multivariable logistic regression was used. Adjusted OR (aOR) and 95% CIs and adjusted vaccine effectiveness (1 - aORs × 100%) were calculated.
resultsWe included 2178 cases and 17 750 controls (mean age 65.5 years; 60.2% women). Hospitalisation and/or death due to COVID-19 was negatively associated with receipt of three (aOR (95% CI) 0.20 (0.15 to 0.28)), two (aOR (95% CI) 0.29 (0.23 to 0.36)) or one booster (aOR (95% CI) 0.56 (0.48 to 0.65), respectively, compared with no booster. The aOR (95% CI) across the booster cycles were: autumn 2021 (aOR (95% CI) 0.40 (0.32 to 0.50)), spring 2022 (aOR (95% CI) 0.52 (0.42 to 0.65)) and autumn 2022 (aOR (95% CI) 0.33 (0.25 to 0.43)). Hospitalisation and/or death due to COVID-19 was negatively associated with booster vaccination within 365 days compared with no booster vaccination. There was no statistically significant association for boosters received more than 365 days ago.
conclusionsCOVID-19 booster vaccination was associated with fewer hospitalisation and/or death due to COVID-19 among adults with IMIDs. These findings support regular booster vaccination in this high-risk population.
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