{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:31:55Z","timestamp":1780576315256,"version":"3.54.1"},"reference-count":49,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["amjmedsci.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of the Medical Sciences"],"published-print":{"date-parts":[[2023,8]]},"DOI":"10.1016\/j.amjms.2023.04.019","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T13:13:36Z","timestamp":1683119616000},"page":"102-113","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical characteristics and comorbidities associated with SARS-CoV-2 breakthrough infection in the University of California Healthcare Systems"],"prefix":"10.1016","volume":"366","author":[{"given":"Michael","family":"Hogarth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Wang-Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaideep","family":"Chakladar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Tse","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay R.","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weg M.","family":"Ongkeko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"27","key":"10.1016\/j.amjms.2023.04.019_bib0001","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N Engl J Med"},{"issue":"25","key":"10.1016\/j.amjms.2023.04.019_bib0002","doi-asserted-by":"crossref","first-page":"e90","DOI":"10.1056\/NEJMoa2106599","article-title":"Effectiveness of mRNA Covid-19 vaccine among U.S. health care personnel","volume":"385","author":"Pilishvili","year":"2021","journal-title":"N Engl J Med"},{"issue":"38","key":"10.1016\/j.amjms.2023.04.019_bib0003","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.15585\/mmwr.mm7038e1","article-title":"Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions - United States, March-August 2021","volume":"70","author":"Self","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"32","key":"10.1016\/j.amjms.2023.04.019_bib0004","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.15585\/mmwr.mm7032e3","article-title":"Effectiveness of COVID-19 vaccines in preventing hospitalization among adults aged \u226565 years - COVID-NET, 13 states, February-April 2021","volume":"70","author":"Moline","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"23","key":"10.1016\/j.amjms.2023.04.019_bib0005","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1056\/NEJMc2113864","article-title":"BNT162b2 and ChAdOx1 nCoV-19 vaccine effectiveness against death from the delta variant","volume":"385","author":"Sheikh","year":"2021","journal-title":"N Engl J Med"},{"issue":"20","key":"10.1016\/j.amjms.2023.04.019_bib0006","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1001\/jama.2021.19499","article-title":"Association between mRNA vaccination and COVID-19 hospitalization and disease severity","volume":"326","author":"Tenforde","year":"2021","journal-title":"JAMA"},{"issue":"24","key":"10.1016\/j.amjms.2023.04.019_bib0007","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1056\/NEJMoa2114114","article-title":"Waning of BNT162b2 vaccine protection against SARS-CoV-2 infection in Qatar","volume":"385","author":"Chemaitelly","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.amjms.2023.04.019_bib0008","doi-asserted-by":"crossref","unstructured":"Puranik A, Lenehan PJ, Silvert E, et al. Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence. medRxiv. Aug 21 2021;doi:10.1101\/2021.08.06.21261707","DOI":"10.1101\/2021.08.06.21261707"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0009","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1056\/NEJMoa2116063","article-title":"COVID-19 vaccine effectiveness in New York state","volume":"386","author":"Rosenberg","year":"2022","journal-title":"N Engl J Med"},{"issue":"10309","key":"10.1016\/j.amjms.2023.04.019_bib0010","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1016\/S0140-6736(21)02183-8","article-title":"Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study","volume":"398","author":"Tartof","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.amjms.2023.04.019_bib0011","article-title":"Dynamics of antibody response to BNT162b2 vaccine after six months: a longitudinal prospective study","volume":"10","author":"Naaber","year":"2021","journal-title":"Lancet Reg Health Eur"},{"issue":"3","key":"10.1016\/j.amjms.2023.04.019_bib0012","doi-asserted-by":"crossref","first-page":"700","DOI":"10.3390\/idr13030065","article-title":"Unusually high risks of COVID-19 mortality with age-related comorbidities: an adjusted meta-analysis method to improve the risk assessment of mortality using the comorbid mortality data","volume":"13","author":"Antos","year":"2021","journal-title":"Infect Dis Rep"},{"issue":"6","key":"10.1016\/j.amjms.2023.04.019_bib0013","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.11182","article-title":"Underlying medical conditions associated with severe COVID-19 illness among children","volume":"4","author":"Kompaniyets","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"7","key":"10.1016\/j.amjms.2023.04.019_bib0014","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1056\/NEJMoa2108891","article-title":"Effectiveness of Covid-19 vaccines against the B.1.617.2 (Delta) variant","volume":"385","author":"Lopez Bernal","year":"2021","journal-title":"N Engl J Med"},{"issue":"24","key":"10.1016\/j.amjms.2023.04.019_bib0015","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.1056\/NEJMoa2114228","article-title":"Waning immunity after the BNT162b2 vaccine in Israel","volume":"385","author":"Goldberg","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.amjms.2023.04.019_bib0016","doi-asserted-by":"crossref","unstructured":"Sharma A, Oda G, Holodniy M. COVID-19 vaccine breakthrough infections in veterans health administration. medRxiv. 2021:2021.09.23.21263864. doi:10.1101\/2021.09.23.21263864","DOI":"10.1101\/2021.09.23.21263864"},{"key":"10.1016\/j.amjms.2023.04.019_bib0017","unstructured":"Rentsch CT, Kidwai-Khan F, Tate JP, et al. Covid-19 by race and ethnicity: a national cohort study of 6 million United States veterans. medRxiv. May 18"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0018","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1001\/jamainternmed.2021.7024","article-title":"Association between immune dysfunction and COVID-19 breakthrough infection after SARS-CoV-2 vaccination in the US","volume":"182","author":"Sun","year":"2022","journal-title":"JAMA Intern Med"},{"issue":"3","key":"10.1016\/j.amjms.2023.04.019_bib0019","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.annonc.2021.12.006","article-title":"COVID-19 vaccination and breakthrough infections in patients with cancer","volume":"33","author":"Schmidt","year":"2022","journal-title":"Ann Oncol"},{"issue":"11","key":"10.1016\/j.amjms.2023.04.019_bib0020","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.37575","article-title":"Risks of SARS-CoV-2 breakthrough infection and hospitalization in fully vaccinated patients with multiple myeloma","volume":"4","author":"Wang","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"4","key":"10.1016\/j.amjms.2023.04.019_bib0021","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"4","key":"10.1016\/j.amjms.2023.04.019_bib0022","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.2307\/2531743","article-title":"Power calculations for matched case-control studies","volume":"44","author":"Dupont","year":"1988","journal-title":"Biometrics"},{"key":"10.1016\/j.amjms.2023.04.019_bib0023","series-title":"Epidemiology: Study Design and Data Analysis","first-page":"24","author":"Woodward","year":"2013"},{"key":"10.1016\/j.amjms.2023.04.019_bib0024","unstructured":"Centers for Disease Control and Prevention. COVID Data Tracker. Atlanta, GA: US Department of Health and Human Services, CDC; 2022, December 20. https:\/\/covid.cdc.gov\/covid-data-tracker"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0025","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.10.020503","article-title":"Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: a systematic review and meta-analysis","volume":"10","author":"Khan","year":"2020","journal-title":"J Glob Health"},{"issue":"7821","key":"10.1016\/j.amjms.2023.04.019_bib0026","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","article-title":"Factors associated with COVID-19-related death using OpenSAFELY","volume":"584","author":"Williamson","year":"2020","journal-title":"Nature"},{"issue":"7","key":"10.1016\/j.amjms.2023.04.019_bib0027","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"1","key":"10.1016\/j.amjms.2023.04.019_bib0028","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.kint.2020.04.031","article-title":"COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain","volume":"98","author":"Goicoechea","year":"2020","journal-title":"Kidney Int"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0029","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1053\/j.ajkd.2020.09.003","article-title":"Characteristics and outcomes of individuals with pre-existing kidney disease and COVID-19 admitted to intensive care units in the United States","volume":"77","author":"Flythe","year":"2021","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"10.1016\/j.amjms.2023.04.019_bib0030","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1186\/s13643-021-01854-8","article-title":"Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review","volume":"10","author":"Lerner","year":"2021","journal-title":"Syst Rev"},{"issue":"1","key":"10.1016\/j.amjms.2023.04.019_bib0031","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1186\/s13054-020-03120-0","article-title":"Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19","volume":"24","author":"Ni","year":"2020","journal-title":"Crit Care"},{"issue":"40","key":"10.1016\/j.amjms.2023.04.019_bib0032","article-title":"The regulation of ACE-2 in the heart and lungs","volume":"9","author":"Jonathan","year":"2021","journal-title":"Southwest Respir Crit Care Chronicles"},{"key":"10.1016\/j.amjms.2023.04.019_bib0033","series-title":"Risk for COVID-19 Infection, Hospitalization, and Death by Age Group","article-title":"Prevention","year":"2021"},{"key":"10.1016\/j.amjms.2023.04.019_bib0034","unstructured":"Provisional COVID-19 Deaths by Sex and Age. https:\/\/data.cdc.gov\/NCHS\/Provisional-COVID-19-Deaths-by-Sex-and-Age\/9bhg-hcku"},{"key":"10.1016\/j.amjms.2023.04.019_bib0035","article-title":"Aging, immunity, and COVID-19: how age influences the host immune response to coronavirus infections?","volume":"11","author":"Bajaj","year":"2020","journal-title":"Front Physiol"},{"issue":"4","key":"10.1016\/j.amjms.2023.04.019_bib0036","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1080\/15476278.2015.1120046","article-title":"Cell therapy strategies to combat immunosenescence","volume":"11","author":"Stahl","year":"2015","journal-title":"Organogenesis"},{"issue":"11","key":"10.1016\/j.amjms.2023.04.019_bib0037","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0241950","article-title":"How does age affect personal and social reactions to COVID-19: results from the national Understanding America Study","volume":"15","author":"Kim","year":"2020","journal-title":"PLoS One"},{"issue":"41","key":"10.1016\/j.amjms.2023.04.019_bib0038","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.15585\/mmwr.mm6941e2","article-title":"Factors influencing risk for COVID-19 exposure among young adults aged 18\u201323 years\u2014Winnebago County, Wisconsin, March\u2013July 2020","volume":"69","author":"Wilson","year":"2020","journal-title":"Morb Mortal Wkly Rep"},{"issue":"6","key":"10.1016\/j.amjms.2023.04.019_bib0039","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1086\/655811","article-title":"Community psychological and behavioral responses through the first wave of the 2009 influenza A(H1N1) pandemic in Hong Kong","volume":"202","author":"Cowling","year":"2010","journal-title":"J Infect Dis"},{"key":"10.1016\/j.amjms.2023.04.019_bib0040","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1186\/1471-2458-14-484","article-title":"What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature","volume":"14","author":"Lin","year":"2014","journal-title":"BMC Public Health"},{"key":"10.1016\/j.amjms.2023.04.019_bib0041","doi-asserted-by":"crossref","unstructured":"Lab B. Self-reported compliance and attitudes about social distancing during the COVID-19 outbreak. 2020.","DOI":"10.31219\/osf.io\/bv28d"},{"key":"10.1016\/j.amjms.2023.04.019_bib0042","doi-asserted-by":"crossref","unstructured":"Yilmazkuday H. COVID-19 and unequal social distancing across demographic groups. Aug 18 2020;doi:10.1111\/rsp3.12329","DOI":"10.2139\/ssrn.3580302"},{"issue":"7","key":"10.1016\/j.amjms.2023.04.019_bib0043","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.mayocp.2013.05.011","article-title":"Vitamin D for health: a global perspective","volume":"88","author":"Hossein-nezhad","year":"2013","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0044","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.ecl.2013.02.004","article-title":"Vitamin D and aging","volume":"42","author":"Gallagher","year":"2013","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"4","key":"10.1016\/j.amjms.2023.04.019_bib0045","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1210\/edrv.22.4.0437","article-title":"Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications","volume":"22","author":"Lips","year":"2001","journal-title":"Endocr Rev"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0046","doi-asserted-by":"crossref","first-page":"60","DOI":"10.12974\/2309-6128.2014.02.02.1","article-title":"The role of vitamin D in the aging adult","volume":"2","author":"Meehan","year":"2014","journal-title":"J Aging Gerontol"},{"key":"10.1016\/j.amjms.2023.04.019_bib0047","doi-asserted-by":"crossref","DOI":"10.1016\/j.jsbmb.2020.105751","article-title":"Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study","volume":"203","author":"Entrenas Castillo","year":"2020","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"9","key":"10.1016\/j.amjms.2023.04.019_bib0048","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0239799","article-title":"Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng\/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection","volume":"15","author":"Maghbooli","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"10.1016\/j.amjms.2023.04.019_bib0049","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/archdischild-2014-307214","article-title":"Sunshine and vitamin D","volume":"101","author":"Saraff","year":"2016","journal-title":"Arch Dis Child"}],"container-title":["The American Journal of the Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002962923011667?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002962923011667?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:42:54Z","timestamp":1757702574000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002962923011667"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["S0002962923011667"],"URL":"https:\/\/doi.org\/10.1016\/j.amjms.2023.04.019","relation":{},"ISSN":["0002-9629"],"issn-type":[{"value":"0002-9629","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Clinical characteristics and comorbidities associated with SARS-CoV-2 breakthrough infection in the University of California Healthcare Systems","name":"articletitle","label":"Article Title"},{"value":"The American Journal of the Medical Sciences","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjms.2023.04.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 The Authors. Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.","name":"copyright","label":"Copyright"}]}}