{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:23:48Z","timestamp":1783513428258,"version":"3.55.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN-143266"],"award-info":[{"award-number":["FDN-143266"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["GA1-177697"],"award-info":[{"award-number":["GA1-177697"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["VS2-175581"],"award-info":[{"award-number":["VS2-175581"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["VS1-175536"],"award-info":[{"award-number":["VS1-175536"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["VR5-172683"],"award-info":[{"award-number":["VR5-172683"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Empirical evidence on the indirect herd benefits of COVID-19 vaccination and\/or prior infection is limited. We examined how area-level immunity interacts with individual-level immunity to affect COVID-19 diagnoses and deaths. Ontario residents aged \u226518\u00a0years were followed from August 1, 2021, to January 30, 2022. Individual-level immunity was defined as receipt of a primary series of COVID-19 vaccines or a positive SARS-CoV-2 test in the past 165\u00a0days. Area-level immunity was based on the proportion of immune individuals in an individual's residing area. Logistic regression and cause-specific hazard models were used to examine the relationship between immunity and COVID-19 diagnosis, and between immunity and COVID-19 death, with an interaction term between individual-level and area-level immunity. Of 11\u2009122\u2009816 adults, 7\u2009518\u2009015 (67.6%) were classified as having individual-level immunity at baseline. After accounting for potential confounders, area-level immunity (highest vs. lowest quintiles) was associated with lower odds of COVID-19 diagnosis. Higher area-level immunity (highest vs. lowest quintiles) was also associated with lower hazard of COVID-19 death among non-immune individuals (hazard ratio, 0.77 [0.60, 1.00]). Findings provide evidence supporting the herd benefits of vaccination or prior infection on COVID-19 diagnosis and deaths, and provide insights for interpreting vaccine effectiveness estimates in the context of herd immunity.<\/jats:p>","DOI":"10.1093\/aje\/kwag047","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T12:44:45Z","timestamp":1772714685000},"page":"2020-2028","source":"Crossref","is-referenced-by-count":0,"title":["Examining the interaction between area-level immunity coverage and individual-level immunity to help quantify indirect herd benefits: a population-based retrospective cohort study of COVID-19 diagnoses and deaths"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5406-1034","authenticated-orcid":false,"given":"Linwei","family":"Wang","sequence":"first","affiliation":[{"name":"MAP-Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto , Toronto, ON 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,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4288-7258","authenticated-orcid":false,"given":"Hind","family":"Sbihi","sequence":"additional","affiliation":[{"name":"BC Centre for Disease Control, UBC BCCDC , Vancouver, BC ,","place":["Canada"]},{"name":"University of British Columbia, School of Population and Public Health , Vancouver, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7820-2046","authenticated-orcid":false,"given":"Jeffrey C","family":"Kwong","sequence":"additional","affiliation":[{"name":"Populations & Public Health Research Program, ICES , Toronto, ON ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, University of Toronto , Toronto, ON ,","place":["Canada"]},{"name":"Health Systems and Policy Research Collaborative Centre, University Health Network , Toronto ,","place":["Canada"]},{"name":"Communicable Disease 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