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Background Despite high vaccine coverage, an increase in breakthrough coronavirus disease 2019 (COVID-19) infections, prompted administration of a third BNT162b2 dose to people aged &amp;gt;60 years in Israel since July 2021. Here, we report real-world immunogenicity following third dose. Methods Overall, 208 healthcare workers aged &amp;gt;60 years were included. Paired pre– and post–second and/or third dose immunoglobulin G (IgG) and neutralizing antibody titers were compared. A subpopulation of low responders to the second dose was also tested for T-cell activation. For 25 paired serum samples, we tested neutralization of wild-type vs neutralization of Delta and Lambda variants, pre– and post–third dose. Active surveillance of vaccine adverse events was conducted through surveys. Results A pronounced immune response was observed following the third dose, including a 33-fold and 51-fold increase in IgG and neutralizing antibody, respectively. The neutralizing antibody levels post–third dose were 9.34 times higher than post–second dose (geometric mean titer, 2598 [95% confidence interval {CI}, 2085–3237] vs 207 [95% CI, 126–339]). Nine previously low responders had a significant antibody increase post–third dose, and 7 of 9 showed increase in T-cell activation. Additionally, sera obtained post–third dose highly and comparably neutralized the wild-type and Delta and Lambda variants. Of 1056 responders to the adverse-event survey, none had serious events. Conclusions We demonstrate a rapid and broad immune response to the third BNT162b2 dose in individuals &amp;gt;60 years of age.

the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases

Early Immunogenicity and Safety of the Third Dose of BNT162b2 Messenger RNA Coronavirus Disease 2019 Vaccine Among Adults Older Than 60 Years: Real-World Experience