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65/100

✓ Peer-reviewed alzhub usefulness score 65 out of 100. Prevention and risk

Topic: Brain proteins, microglia and lab models

Objectives The mRNA coronavirus disease 2019 (COVID-19) vaccines have shown high effectiveness in the prevention of symptomatic COVID-19, hospitalization, severe disease and death. Nevertheless, a minority of vaccinated individuals might become infected and experience significant morbidity. Characteristics of vaccine breakthrough infections have not been studied. We sought to portray the population of Israeli patients, who were hospitalized with COVID-19 despite full vaccination. Methods A retrospective multicentre cohort study of 17 hospitals included patients fully vaccinated with Pfizer/BioNTech's BNT162b2 vaccine who developed COVID-19 more than 7 days after the second vaccine dose and required hospitalization. The risk for poor outcome, defined as a composite of mechanical ventilation or death, was assessed. Results A total of 152 patients were included, accounting for half of hospitalized fully vaccinated patients in Israel. Poor outcome was noted in 38 patients and mortality rate reached 22% (34/152). Notably, the cohort was characterized by a high rate of co-morbidities predisposing to severe COVID-19, including hypertension (108; 71%), diabetes (73; 48%), congestive heart failure (41; 27%), chronic kidney and lung diseases (37; 24% each), dementia (29; 19%) and cancer (36; 24%), and only six (4%) had no co-morbidities. Sixty (40%) of the patients were immunocompromised. Higher viral load was associated with a significant risk for poor outcome. Risk also appeared higher in patients receiving anti-CD20 treatment and in patients with low titres of anti-Spike IgG, but these differences did not reach statistical significance. Conclusions We found that severe COVID-19 infection, associated with a high mortality rate, might develop in a minority of fully vaccinated individuals with multiple co-morbidities. Our patients had a higher rate of co-morbidities and immunosuppression compared with previously reported non-vaccinated hospitalized individuals with COVID-19. Further characterization of this vulnerable population may help to develop guidance to augment their protection, either by continued social distancing, or by additional active or passive vaccinations.

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APA 7th

Brosh-Nissimov, T., Orenbuch-Harroch, E., Chowers, M., Elbaz, M., Nesher, L., Stein, M., et al. (2021). BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. https://doi.org/10.1016/j.cmi.2021.06.036

Vancouver

Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, Elbaz M, Nesher L, Stein M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2021. doi:10.1016/j.cmi.2021.06.036. PMID: 34245907.

BibTeX

@article{broshnissimov2021-34245907,
  author  = {Brosh-Nissimov, T. and Orenbuch-Harroch, E. and Chowers, M. and Elbaz, M. and Nesher, L. and Stein, M. and Maor, Y. and Cohen, R. and others},
  title   = {{BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel}},
  journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases},
  year    = {2021},
  doi     = {10.1016/j.cmi.2021.06.036},
  pmid    = {34245907},
  url     = {https://doi.org/10.1016/j.cmi.2021.06.036}
}

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Key findings

Nevertheless, a minority of vaccinated individuals might become infected and experience significant morbidity.
Results A total of 152 patients were included, accounting for half of hospitalized fully vaccinated patients in Israel.
Higher viral load was associated with a significant risk for poor outcome.
Conclusions We found that severe COVID-19 infection, associated with a high mortality rate, might develop in a minority of fully vaccinated individuals with multiple co-morbidities.
Our patients had a higher rate of co-morbidities and immunosuppression compared with previously reported non-vaccinated hospitalized individuals with COVID-19.

Why it matters

This study describes 152 fully vaccinated patients hospitalized with COVID-19 in Israel, noting that 19% had dementia among their co-morbidities. It concerns COVID-19 outcomes in vaccinated people and provides no information on treating, curing, or preventing Alzheimer's disease.

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Study details

Study designcohort study
Participants152
Evidence strengthModerate

How this study scored 65/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases)
Journal's citation record	3 / 4	Clinical Microbiology and Infection: journal h-index 251 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2021 — within 6 year(s) of the newest study here
Sample size	2 / 4	152 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 331 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	47.3 citations a year over 7 year(s) since 2021
Impact for its field and year	5 / 6	Cited 23.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	2 / 4	Cited 41 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Yonit Wiener‐Well: h-index 25 (OpenAlex, whole career)
Institution's track record	1 / 3	Tel Aviv University: institution h-index 1,018 (OpenAlex)
Multicenter collaboration	3 / 3	OpenAlex lists 20 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 34245907)
Free to read	2 / 2	Free to read
Total	65 / 100	—

What each of these 20 components measures, and what this score is not →

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