Fully Vaccinated and Boosted Patients Requiring Hospitalization for COVID-19

There were four fatalities among 65 fully vaccinated and boosted (FV&BCOVID-19 patients at an acute-care hospital system in Southeastern Michigan. In the FV&B cohort that required ICU-level care (n=11), 7 (63.6%) were male with a median age of 71 (66.5, 76.5). 5 (45.5%) were vaccinated with three consecutive Pfizer immunizations, 4 (36.4%) received three doses of the Moderna vaccine, and 2 (18.2%) received two Janssen vaccines. 4 (36.4%) died, 3 (27.2%) were discharged to a Skilled Nursing Facility (SNF), and 2 (18.2%) were discharged home.

This data was collected between August 12th, 2021 and December 6th, 2021, for 4,571 patients with a primary diagnosis of COVID-19 who required inpatient treatment at an acute-care hospital system in Southeastern Michigan.

Of the 4,571 encounters requiring hospitalization, 65(1.4%) were FV&B and 2,935(64%) were UV Despite older age (median 74 vs 58 years old), higher rate of pre-existing ESRD (18.5% vs 1.8%), higher proportion of immunocompromised state (32.3% vs 10.4%).

Despite a significantly higher baseline risk in the vaccinated & boosted group (Elixhauser 16 vs 8 (p <0.001)), there was a trend toward lower in-hospital mortality (7.7% vs 12.1%; p=0.38) among FV&B patients. Other severe outcomes followed this same trend, with 7.7% of FV&B vs 11.1% UV patients needing mechanical ventilation and 4.6% vs 10.6% of patients needing vasopressors in each group, respectively (p=0.5 and 0.17). 

As COVID-19 continues to spread, larger expansive trials are needed to further identify risk factors for severe outcomes among the FV&B population.


Nicholas Mielke, Steven Johnson, Amit Bahl,
Boosters reduce in-hospital mortality in patients with COVID-19: An observational cohort analysis,
The Lancet Regional Health - Americas,
Volume 8,
ISSN 2667-193X,

Fully Vaccinated and Boosted Patients Requiring Hospitalization for COVID-19: an Observational Cohort Analysis
Nicholas MielkeSteven JohnsonAmit Bahl


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