{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:39:41Z","timestamp":1792172381694,"version":"4.4.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsmedizin Greifswald"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>This study (<jats:italic>n<\/jats:italic>\u2009=\u2009668) investigated the effect of vaccination on SARS-CoV-2 infection among individuals with type 2 diabetes mellitus (T2DM), cancer, and smoking in a prospective cohort study in Northern Germany. Participants from the SHIP-COVID cohort were followed from October 2020 to October 2022 using repeated questionnaires and serological tests. Infection was defined by anti-nucleocapsid (anti-NCP) antibodies\u2019 detection, self-reported Real Time Polymerase Chain Reaction (RT-PCR) or rapid antigen test. Vaccine efficacy was evaluated using risk differences (RD), risk ratios (RR), p-values, and 95% confidence intervals. Infection risk decreased with more vaccine doses; the 3rd (RR\u2009=\u20090.68) and 4th (RR\u2009=\u20090.29) doses offered significant protection. Both sexes showed protection with 3rd and 4th doses (RR\u2009=\u20090.67 and 0.20 in women and 0.68 and 0.39 in men, respectively). Logistic regression showed higher infection odds in individuals with T2DM (14%) and cancer (68% in SHIP-START-3 dataset and 45% in SHIP-START-4 dataset), while current smokers had 47% and 45% lower odds than non-smokers in SHIP-START-3 and SHIP-START-4 datasets respectively. No significant interactions were found between vaccination and T2DM, cancer, or smoking.<\/jats:p>","DOI":"10.1038\/s41598-025-22334-2","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T19:42:33Z","timestamp":1759866153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["COVID-19 vaccination lowers SARS-CoV-2 infection risk independent of diabetes, cancer and smoking in SHIP-COVID cohort, Northern Germany"],"prefix":"10.1038","volume":"15","author":[{"given":"Muhammad Nasir Khan","family":"Khattak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefin Pauline","family":"Ha\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Ittermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"D\u00f6rr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Sidahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Ole","family":"Kristiansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Ulm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tillman","family":"G\u00f6rig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils-Olaf","family":"H\u00fcbner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"V\u00f6lzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"22334_CR1","doi-asserted-by":"publisher","first-page":"1070272","DOI":"10.3389\/fpubh.2023.1070272","volume":"11","author":"S Sterl","year":"2023","unstructured":"Sterl, S. et al. COVID-19 vaccination status in germany: Factors and reasons for not being vaccinated (yet). Front. Public. Health. 11, 1070272 (2023).","journal-title":"Front. Public. Health"},{"key":"22334_CR2","unstructured":"European Centre for Disease Prevention and Control COVID-19 Vaccination and Prioritisation Strategies in the EU\/EEA (Stockholm, 2020)."},{"key":"22334_CR3","unstructured":"WHO. COVID-19 dashboard. (2023)."},{"issue":"6","key":"22334_CR4","doi-asserted-by":"publisher","first-page":"892","DOI":"10.4239\/wjd.v14.i6.892","volume":"14","author":"YF He","year":"2023","unstructured":"He, Y. F. et al. Correlation between COVID-19 vaccination and diabetes mellitus: A systematic review. World J. Diabetes. 14 (6), 892\u2013918 (2023).","journal-title":"World J. Diabetes"},{"issue":"9","key":"22334_CR5","doi-asserted-by":"publisher","first-page":"738","DOI":"10.4239\/wjd.v13.i9.738","volume":"13","author":"G Vasilev","year":"2022","unstructured":"Vasilev, G. et al. Effectiveness and safety of COVID-19 vaccines in patients with diabetes as a factor for vaccine hesitancy. World J. Diabetes. 13 (9), 738\u2013751 (2022).","journal-title":"World J. Diabetes"},{"issue":"8","key":"22334_CR6","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1016\/S2213-8587(24)00159-1","volume":"12","author":"K Taylor","year":"2024","unstructured":"Taylor, K. et al. Incidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: A retrospective cohort study of 16 million people. Lancet Diabetes Endocrinol. 12 (8), 558\u2013568 (2024).","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"1","key":"22334_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2023-003777","volume":"12","author":"AM Gerg\u0151","year":"2024","unstructured":"Gerg\u0151, A. M. et al. Effectiveness of SARS-CoV-2 primary vaccines and boosters in patients with type 2 diabetes mellitus in Hungary (HUN-VE 4 Study). BMJ Open Diabetes Res. Care. 12 (1), e003777 (2024).","journal-title":"BMJ Open Diabetes Res. Care"},{"issue":"3","key":"22334_CR8","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/S1470-2045(20)30096-6","volume":"21","author":"W Liang","year":"2020","unstructured":"Liang, W. et al. Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China. Lancet Oncol. 21 (3), 335\u2013337 (2020).","journal-title":"Lancet Oncol."},{"issue":"13","key":"22334_CR9","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1200\/JCO.21.02419","volume":"40","author":"Q Song","year":"2022","unstructured":"Song, Q. et al. Risk and outcome of breakthrough COVID-19 infections in vaccinated patients with cancer: Real-world evidence from the National COVID cohort collaborative. J. Clin. Oncol. 40 (13), 1414\u20131427 (2022).","journal-title":"J. Clin. Oncol."},{"issue":"3","key":"22334_CR10","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1001\/jamaoncol.2022.6815","volume":"9","author":"IY Gong","year":"2023","unstructured":"Gong, I. Y. et al. Association of COVID-19 vaccination with breakthrough infections and complications in patients with cancer. JAMA Oncol. 9 (3), 386\u2013394 (2023).","journal-title":"JAMA Oncol."},{"issue":"3","key":"22334_CR11","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.annonc.2021.12.006","volume":"33","author":"AL Schmidt","year":"2022","unstructured":"Schmidt, A. L. et al. COVID-19 vaccination and breakthrough infections in patients with cancer. Ann. Oncol. 33 (3), 340\u2013346 (2022).","journal-title":"Ann. Oncol."},{"key":"22334_CR12","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.ejim.2023.05.026","volume":"115","author":"G Lippi","year":"2023","unstructured":"Lippi, G., Henry, B. M. & Sanchis-Gomar, F. COVID-19 and smoking: Considerations after two years. Eur. J. Intern. Med. 115, 34\u201336 (2023).","journal-title":"Eur. J. Intern. Med."},{"issue":"8","key":"22334_CR13","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1007\/s11739-024-03713-5","volume":"19","author":"X Hou","year":"2024","unstructured":"Hou, X. et al. Protecting effects of smoking against COVID-19: A community-based retrospective cohort study in middle- and older-aged adults. Intern. Emerg. Med. 19 (8), 2141\u20132149 (2024).","journal-title":"Intern. Emerg. Med."},{"issue":"10","key":"22334_CR14","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.1016\/j.jiph.2020.07.006","volume":"13","author":"AE Iyanda","year":"2020","unstructured":"Iyanda, A. E. et al. A retrospective cross-national examination of COVID-19 outbreak in 175 countries: A multiscale geographically weighted regression analysis (January 11-June 28, 2020). J. Infect. Public. Health. 13 (10), 1438\u20131445 (2020).","journal-title":"J. Infect. Public. Health"},{"issue":"9","key":"22334_CR15","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1093\/ntr\/ntaa121","volume":"22","author":"P Tsigaris","year":"2020","unstructured":"Tsigaris, P., Teixeira da Silva, J. A. Smoking prevalence and COVID-19 in Europe. Nicotine Tob. Res. 22 (9), 1646\u20131649 (2020).","journal-title":"Nicotine Tob. Res."},{"issue":"7821","key":"22334_CR16","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","volume":"584","author":"EJ Williamson","year":"2020","unstructured":"Williamson, E. J. et al. Factors associated with COVID-19-related death using opensafely. Nature 584 (7821), 430\u2013436 (2020).","journal-title":"Nature"},{"issue":"e2","key":"22334_CR17","doi-asserted-by":"publisher","first-page":"e111","DOI":"10.1136\/tobaccocontrol-2020-055933","volume":"30","author":"SE Jackson","year":"2021","unstructured":"Jackson, S. E. et al. COVID-19, smoking and inequalities: A study of 53 002 adults in the UK. Tob. Control. 30 (e2), e111\u2013e121 (2021).","journal-title":"Tob. Control"},{"issue":"9","key":"22334_CR18","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1097\/CM9.0000000000000775","volume":"133","author":"W Liu","year":"2020","unstructured":"Liu, W. et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin. Med. J. (Engl). 133 (9), 1032\u20131038 (2020).","journal-title":"Chin. Med. J. (Engl)"},{"key":"22334_CR19","first-page":"58","volume":"18","author":"EJ Grundy","year":"2020","unstructured":"Grundy, E. J. et al. Smoking, SARS-CoV-2 and COVID-19: A review of reviews considering implications for public health policy and practice. Tob. Induc. Dis. 18, 58 (2020).","journal-title":"Tob. Induc. Dis."},{"issue":"5","key":"22334_CR20","first-page":"442","volume":"16","author":"A Berbudi","year":"2020","unstructured":"Berbudi, A. et al. Type 2 diabetes and its impact on the immune system. Curr. Diabetes Rev. 16 (5), 442\u2013449 (2020).","journal-title":"Curr. Diabetes Rev."},{"issue":"2","key":"22334_CR21","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1093\/cid\/ciaa1079","volume":"72","author":"G Chamilos","year":"2021","unstructured":"Chamilos, G., Lionakis, M. S. & Kontoyiannis, D. P. Are all patients with cancer at heightened risk for severe coronavirus disease 2019 (COVID-19)? Clin. Infect. Dis. 72 (2), 351\u2013356 (2021).","journal-title":"Clin. Infect. Dis."},{"issue":"6","key":"22334_CR22","doi-asserted-by":"publisher","first-page":"e372","DOI":"10.1093\/ije\/dyac034","volume":"51","author":"H V\u00f6lzke","year":"2022","unstructured":"V\u00f6lzke, H. et al. Cohort profile update: The study of health in Pomerania (SHIP). Int. J. Epidemiol. 51 (6), e372\u2013e383 (2022).","journal-title":"Int. J. Epidemiol."},{"issue":"2","key":"22334_CR23","doi-asserted-by":"publisher","first-page":"2245916","DOI":"10.1080\/22221751.2023.2245916","volume":"12","author":"C Kohler","year":"2023","unstructured":"Kohler, C. et al. Neighbourhood watch: Genomic epidemiology of SARS-CoV-2 variants circulating in a german federal state, Mecklenburg-Western Pomerania, in 2020\u20132022. Emerg. Microbes Infect. 12 (2), 2245916 (2023).","journal-title":"Emerg. Microbes Infect."},{"issue":"1","key":"22334_CR24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s00406-021-01262-y","volume":"272","author":"P Alexopoulos","year":"2022","unstructured":"Alexopoulos, P. et al. Hospital workforce mental reaction to the pandemic in a low COVID-19 burden setting: A cross-sectional clinical study. Eur. Arch. Psychiatry Clin. NeuroSci. 272 (1), 95\u2013105 (2022).","journal-title":"Eur. Arch. Psychiatry Clin. NeuroSci."},{"key":"22334_CR25","doi-asserted-by":"publisher","first-page":"584251","DOI":"10.3389\/fmicb.2020.584251","volume":"11","author":"E Brochot","year":"2020","unstructured":"Brochot, E. et al. Anti-spike, anti-nucleocapsid and neutralizing antibodies in SARS-CoV-2 inpatients and asymptomatic individuals. Front. Microbiol. 11, 584251 (2020).","journal-title":"Front. Microbiol."},{"key":"22334_CR26","unstructured":"Euroimmun COVID-19-Diagnostik. (2023)."},{"issue":"9","key":"22334_CR27","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1016\/S1473-3099(22)00320-6","volume":"22","author":"OJ Watson","year":"2022","unstructured":"Watson, O. J. et al. Global impact of the first year of COVID-19 vaccination: A mathematical modelling study. Lancet. Infect. Dis. 22 (9), 1293\u20131302 (2022).","journal-title":"Lancet. Infect. Dis"},{"issue":"10316","key":"22334_CR28","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1016\/S0140-6736(21)02249-2","volume":"398","author":"N Barda","year":"2021","unstructured":"Barda, N. et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: An observational study. Lancet 398 (10316), 2093\u20132100 (2021).","journal-title":"Lancet"},{"issue":"15","key":"22334_CR29","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1056\/NEJMoa2114255","volume":"385","author":"YM Bar-On","year":"2021","unstructured":"Bar-On, Y. M. et al. Protection of BNT162b2 vaccine booster against Covid-19 in Israel. N. Engl. J. Med. 385 (15), 1393\u20131400 (2021).","journal-title":"N. Engl. J. Med."},{"issue":"1","key":"22334_CR30","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1038\/s41467-022-29858-5","volume":"13","author":"JG Waxman","year":"2022","unstructured":"Waxman, J. G. et al. Comparing COVID-19-related hospitalization rates among individuals with infection-induced and vaccine-induced immunity in Israel. Nat. Commun. 13 (1), 2202 (2022).","journal-title":"Nat. Commun."},{"issue":"4","key":"22334_CR31","doi-asserted-by":"publisher","first-page":"e00626","DOI":"10.34172\/jrhs.2024.161","volume":"24","author":"F Mostafavi","year":"2024","unstructured":"Mostafavi, F. et al. COVID-19 vaccine effectiveness of booster doses against delta and omicron variants over follow-up times using longitudinal meta-analysis. J. Res. Health Sci. 24 (4), e00626 (2024).","journal-title":"J. Res. Health Sci."},{"issue":"1","key":"22334_CR32","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3390\/microorganisms12010089","volume":"12","author":"B Black","year":"2023","unstructured":"Black, B. & Thaw, D. B. Vaccinating against a novel pathogen: A critical review of COVID-19 vaccine effectiveness evidence. Microorganisms 12 (1), 89. (2023).","journal-title":"Microorganisms"},{"issue":"3","key":"22334_CR33","doi-asserted-by":"publisher","first-page":"513","DOI":"10.2337\/dc17-2131","volume":"41","author":"IM Carey","year":"2018","unstructured":"Carey, I. M. et al. Risk of infection in type 1 and type 2 diabetes compared with the general population: A matched cohort study. Diabetes Care. 41 (3), 513\u2013521 (2018).","journal-title":"Diabetes Care"},{"key":"22334_CR34","doi-asserted-by":"publisher","first-page":"101319","DOI":"10.1016\/j.pmedr.2021.101319","volume":"21","author":"MR Alam","year":"2021","unstructured":"Alam, M. R., Kabir, M. R. & Reza, S. Comorbidities might be a risk factor for the incidence of COVID-19: Evidence from a web-based survey. Prev. Med. Rep. 21, 101319 (2021).","journal-title":"Prev. Med. Rep."},{"issue":"3","key":"22334_CR35","doi-asserted-by":"publisher","first-page":"211","DOI":"10.21037\/atm-20-5958","volume":"9","author":"SC Park","year":"2021","unstructured":"Park, S. C. et al. Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections: A nationwide population-based study. Annals Transl. Med., 9 (3), 211. (2021).","journal-title":"Annals Transl. Med."},{"key":"22334_CR36","doi-asserted-by":"publisher","first-page":"600439","DOI":"10.3389\/fendo.2020.600439","volume":"11","author":"AB Crouse","year":"2021","unstructured":"Crouse, A. B. et al. Metformin use is associated with reduced mortality in a diverse population with COVID-19 and diabetes. Front. Endocrinol. 11, 600439 (2021).","journal-title":"Front. Endocrinol."},{"issue":"10","key":"22334_CR37","doi-asserted-by":"publisher","first-page":"e0240394","DOI":"10.1371\/journal.pone.0240394","volume":"15","author":"JP Gutierrez","year":"2020","unstructured":"Gutierrez, J. P. & Bertozzi, S. M. Non-communicable diseases and inequalities increase risk of death among COVID-19 patients in Mexico. PloS One. 15 (10), e0240394 (2020).","journal-title":"PloS One"},{"key":"22334_CR38","doi-asserted-by":"publisher","first-page":"148970","DOI":"10.1016\/j.gene.2024.148970","volume":"934","author":"P Kumari","year":"2025","unstructured":"Kumari, P., Singh, H. P. & Singh, S. Mathematical model for understanding the relationship between diabetes and novel coronavirus. Gene 934, 148970 (2025).","journal-title":"Gene"},{"issue":"Pt 2","key":"22334_CR39","doi-asserted-by":"publisher","first-page":"114252","DOI":"10.1016\/j.envres.2022.114252","volume":"215","author":"N Mallah","year":"2022","unstructured":"Mallah, N. et al. Effectiveness of COVID-19 vaccine booster in the general population and in subjects with comorbidities. A population-based study in Spain. Environ. Res. 215 (Pt 2), 114252 (2022).","journal-title":"Environ. Res."},{"issue":"5","key":"22334_CR40","doi-asserted-by":"publisher","first-page":"e3666","DOI":"10.1002\/dmrr.3666","volume":"39","author":"F D\u2019Souza","year":"2023","unstructured":"D\u2019Souza, F., Buzzetti, R. & Pozzilli, P. Diabetes, COVID-19, and questions unsolved. Diabetes Metab. Res. Rev. 39 (5), e3666 (2023).","journal-title":"Diabetes Metab. Res. Rev."},{"issue":"1","key":"22334_CR41","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1111\/dom.14547","volume":"24","author":"R Marfella","year":"2022","unstructured":"Marfella, R. et al. Does poor glycaemic control affect the immunogenicity of the COVID-19 vaccination in patients with type 2 diabetes: The CAVEAT study. Diabetes Obes. Metabolism. 24 (1), 160\u2013165 (2022).","journal-title":"Diabetes Obes. Metabolism"},{"issue":"5","key":"22334_CR42","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1111\/dom.14643","volume":"24","author":"C Sourij","year":"2022","unstructured":"Sourij, C. et al. Humoral immune response to COVID-19 vaccination in diabetes is age\u2010dependent but independent of type of diabetes and glycaemic control: The prospective COVAC\u2010DM cohort study. Diabetes Obes. Metabolism. 24 (5), 849\u2013858 (2022).","journal-title":"Diabetes Obes. Metabolism"},{"issue":"6","key":"22334_CR43","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1016\/j.kint.2021.04.008","volume":"99","author":"RE Billany","year":"2021","unstructured":"Billany, R. E. et al. Seroprevalence of antibody to S1 Spike protein following vaccination against COVID-19 in patients receiving hemodialysis: A call to arms. Kidney Int. 99 (6), 1492\u20131494 (2021).","journal-title":"Kidney Int."},{"issue":"5","key":"22334_CR44","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.jinf.2021.12.044","volume":"84","author":"HJ Whitaker","year":"2022","unstructured":"Whitaker, H. J. et al. Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response amongst individuals in clinical risk groups. J. Infect. 84 (5), 675\u2013683 (2022).","journal-title":"J. Infect."},{"issue":"8","key":"22334_CR45","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1016\/j.annonc.2021.04.019","volume":"32","author":"J Barri\u00e8re","year":"2021","unstructured":"Barri\u00e8re, J. et al. Impaired immunogenicity of BNT162b2 anti-SARS-CoV-2 vaccine in patients treated for solid tumors. Ann. Oncol. 32 (8), 1053\u20131055 (2021).","journal-title":"Ann. Oncol."},{"issue":"8","key":"22334_CR46","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/j.annonc.2021.04.020","volume":"32","author":"R Palich","year":"2021","unstructured":"Palich, R. et al. Weak immunogenicity after a single dose of SARS-CoV-2 mRNA vaccine in treated cancer patients. Ann. Oncol. 32 (8), 1051\u20131053 (2021).","journal-title":"Ann. Oncol."},{"issue":"6","key":"22334_CR47","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/S1470-2045(21)00213-8","volume":"22","author":"L Monin","year":"2021","unstructured":"Monin, L. et al. Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer: Interim analysis of a prospective observational study. Lancet Oncol. 22 (6), 765\u2013778 (2021).","journal-title":"Lancet Oncol."},{"issue":"8","key":"22334_CR48","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1016\/j.ccell.2021.06.002","volume":"39","author":"A Thakkar","year":"2021","unstructured":"Thakkar, A. et al. Seroconversion rates following COVID-19 vaccination among patients with cancer. Cancer cell. 39 (8), 1081\u20131090 (2021). e2.","journal-title":"Cancer cell."},{"issue":"3","key":"22334_CR49","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1097\/EDE.0000000000000984","volume":"30","author":"L Han","year":"2019","unstructured":"Han, L. et al. Smoking and influenza-associated morbidity and mortality: A systematic review and meta-analysis. Epidemiology 30 (3), 405\u2013417 (2019).","journal-title":"Epidemiology"},{"key":"22334_CR50","unstructured":"US Department of Health and Human Services. The Health Consequences of smoking\u201450 Years of Progress: A Report of the Surgeon General (US Department of Health and Human Services, Centers for Disease, 2014)."},{"issue":"5","key":"22334_CR51","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.3390\/ijerph15051033","volume":"15","author":"A Strzelak","year":"2018","unstructured":"Strzelak, A. et al. Tobacco smoke induces and alters immune responses in the lung triggering inflammation, allergy, asthma and other lung diseases: A mechanistic review. Int. J. Environ. Res. Public Health. 15 (5), 1033 (2018).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"11","key":"22334_CR52","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1055\/a-1503-1744","volume":"75","author":"M Raspe","year":"2021","unstructured":"Raspe, M. et al. COVID-19 and smoking\u2014A position paper by the DGP taskforce for smoking cessation. Pneumologie 75 (11), 846\u2013855. (2021).","journal-title":"Pneumologie"},{"issue":"6","key":"22334_CR53","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1111\/add.15276","volume":"116","author":"D Simons","year":"2021","unstructured":"Simons, D. et al. The association of smoking status with SARS-CoV\u20102 infection, hospitalization and mortality from COVID\u201019: A living rapid evidence review with bayesian meta\u2010analyses (version 7). Addiction 116 (6), 1319\u20131368 (2021).","journal-title":"Addiction"},{"issue":"10","key":"22334_CR54","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1093\/ntr\/ntab079","volume":"23","author":"SC Lee","year":"2021","unstructured":"Lee, S. C. et al. Smoking and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nicotine Tob. Res. 23 (10), 1787\u20131792 (2021).","journal-title":"Nicotine Tob. Res."},{"issue":"1","key":"22334_CR55","doi-asserted-by":"publisher","first-page":"2001560","DOI":"10.1183\/13993003.01560-2020","volume":"56","author":"D Lutchman","year":"2020","unstructured":"Lutchman, D. Could the smoking gun in the fight against COVID-19 be the (rh)ACE-2?. Eur. Respir J. 56 (1), 2001560. (2020).","journal-title":"Eur. Respir J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22334-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22334-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22334-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T21:08:08Z","timestamp":1759871288000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22334-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["22334"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-22334-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,7]]},"assertion":[{"value":"7 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted according to the guidelines laid down in the Declaration of Helsinki, and the protocol was approved by the Ethical Review Board of the University Medicine Greifswald (BB118\/20). All subjects gave their informed consent to be included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"35032"}}