Keywords congenital malformations -hepatitis Bhepatitis C -perinatal mortality -pregnancy outcome -premature rupture of membranes -preterm delivery Correspondence

IMPORTANCE Administration of a BNT162b2 booster dose (Pfizer-BioNTech) to fully vaccinated individuals aged 60 years and older was significantly associated with lower risk of SARS-CoV-2 infection and severe illness. Data are lacking on the effectiveness of booster doses for younger individuals and health care workers.OBJECTIVE To estimate the association of a BNT162b2 booster dose with SARS-CoV-2 infections among health care workers who were previously vaccinated with a 2-dose series of BNT162b2. DESIGN, SETTING, AND PARTICIPANTSThis was a prospective cohort study conducted at a tertiary medical center in Tel Aviv, Israel. The study cohort included 1928 immunocompetent health care workers who were previously vaccinated with a 2-dose series of BNT162b2, and had enrolled between August 8 and 19, 2021, with final follow-up reported through September 20, 2021. Screening for SARS-CoV-2 infection was performed every 14 days. Anti-spike protein receptor binding domain IgG titers were determined at baseline and 1 month after enrollment. Cox regression with time-dependent analysis was used to estimate hazard ratios of SARS-CoV-2 infection between booster-immunized status and 2-dose vaccinated (booster-nonimmunized) status.EXPOSURES Vaccination with a booster dose of BNT162b2 vaccine. MAIN OUTCOMES AND MEASURESThe primary outcome was SARS-CoV-2 infection, as confirmed by reverse transcriptase-polymerase chain reaction. RESULTS Among 1928 participants, the median age was 44 years (IQR, 36-52 years) and 1381 were women (71.6%). Participants completed the 2-dose vaccination series a median of 210 days (IQR, 205-213 days) before study enrollment. A total of 1650 participants (85.6%) received the booster dose. During a median follow-up of 39 days (IQR, 35-41 days), SARS-CoV-2 infection occurred in 44 participants (incidence rate, 60.2 per 100 000 person-days); 31 (70.5%) were symptomatic. Five SARS-CoV-2 infections occurred in booster-immunized participants and 39 in booster-nonimmunized participants (incidence rate, 12.8 vs 116 per 100 000 person-days, respectively). In a time-dependent Cox regression analysis, the adjusted hazard ratio of SARS-CoV-2 infection for booster-immunized vs booster-nonimmunized participants was 0.07 (95% CI, 0.02-0.20).CONCLUSIONS AND RELEVANCE Among health care workers at a single center in Israel who were previously vaccinated with a 2-dose series of BNT162b2, administration of a booster dose compared with not receiving one was associated with a significantly lower rate of SARS-CoV-2 infection over a median of 39 days of follow-up. Ongoing surveillance is required to assess durability of the findings.

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Background Delayed inflammatory reactions (DIRs) to hyaluronic acid (HA)‐based dermal fillers following COVID‐19 vaccination has been reported in a few anecdotal reports and small series of cases. Aim To evaluate the clinical characteristics, incidence and management options relevant to BNT162b2 vaccination‐associated DIR – A nationwide survey was conducted. Methods An online self‐administered survey was sent to physicians who actively practice tissue filler injections. The data acquired included demographic and clinical characteristics of relevant DIR cases. Results Out of 262 responders, 20 cases with DIR following the vaccination were reported. 35% and 65% occurred shortly after the first and second vaccination dose, respectively. Overall, 65% of the DIRs appeared ≤5 days after vaccine administration and most DIRs resolved within 21 days. The filler's volume ( P = .016) was associated with higher DIR severity, and the same tendency was noted among some filler types and locations of injection. Medical intervention was provided in 12 (60%) cases. Conclusion DIR associated with BNT162b2 vaccination is rare and tends to resolve spontaneously or with short‐term medical intervention.