Risk-based prediction for optimal timing of booster vaccination for COVID-19 to prevent severe disease

Publication date: Jul 11, 2023

While waning protection from vaccination and natural infection against SARS-CoV-2 infection is well-documented, recent analyses have also found waning of protection against severe COVID-19. This highlights a broader need to understand the optimal timing of COVID-19 booster vaccines specific to an individual to mitigate the risk of severe COVID-19, while accounting for waning of protection and differential risk by age group and immune status. Here we show that more frequent COVID-19 booster vaccination (every 6-12 months) in older age groups and the immunocompromised population would effectively mitigate the burden of severe COVID-19, while frequent boosters in the younger population may only provide modest benefit. Analyzing United States COVID-19 surveillance and seroprevalence data in a microsimulation model, we estimated that in persons 75+ years, annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 311 (277-369) and 578 (494-671) cases, respectively, compared to a one-time bivalent booster dose. In contrast, for persons 18-49 years, the model estimated that annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 20 (13-26) and 37 (24-50) cases per 100,000 persons, respectively, compared to a one-time bivalent booster dose. Persons with prior infection had a much lower benefit of more frequent boosting, while immunocompromised persons had larger benefit. This study underscores the benefit of customizing timing of COVID-19 booster vaccines based on individual risk.


Concepts Keywords
November Annual
Pessimistic Bivalent
Sunny Booster
Vaccination12 Covid
Yale Infection


Type Source Name
disease VO vaccination
disease MESH COVID-19
disease MESH infection
pathway REACTOME SARS-CoV-2 Infection
disease VO population
disease VO time
disease VO dose
disease MESH Park12
disease MESH Infectious Diseases
disease VO USA
disease VO vaccine effectiveness
disease VO vaccine
disease VO frequency
disease IDO history
drug DRUGBANK Ritonavir
disease VO vaccinated
disease VO vaccine dose
disease MESH influenza
disease MESH death
disease VO effectiveness
disease MESH uncertainty
disease MESH long COVID
disease MESH myocarditis
disease MESH reinfections
disease VO monthly
disease VO age
disease VO vaccination frequency
drug DRUGBANK Coenzyme M
disease VO Ad26.COV2.S
disease MESH breakthrough infections
drug DRUGBANK Minaprine
disease MESH coronary artery disease
disease IDO blood
disease VO Canada
disease IDO intervention

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