Updated COVID shots cut hospitalisation in over-65s, interim data show

The updated COVID-19 vaccines released for the 2025-2026 season were reformulated to target the LP.8.1 lineage, the descendant of Omicron that regulators picked as the closest match to circulating virus [s1]. An interim US analysis now offers the first real-world estimate of how well two of those updated shots protected the people most likely to be hospitalised: adults aged 65 and over [s1]. The headline is that both worked, and that protection was highest against the most serious outcome in the oldest group.

What the study did

This was a retrospective study using linked electronic health record and administrative claims data through 31 January 2026 [s1]. Adults aged 65 and over who received either the mRNA-1283 or the BNT162b2 2025-2026 vaccine were matched to unvaccinated individuals, and inverse probability of treatment weighting was used to balance the two groups on measured characteristics [s1]. The analysis identified 233,072 mRNA-1283 recipients and 422,610 BNT162b2 recipients aged 65 and over [s1]. Effectiveness was estimated with Cox proportional hazards models, expressed as absolute vaccine effectiveness — the percentage reduction in risk versus the matched unvaccinated comparator [s1].

One design point matters for how you read the numbers. Each vaccine was evaluated independently against its own unvaccinated comparator group [s1]. This was not a head-to-head trial, so the figures below should not be used to rank one product against the other; the comparator populations differ, and the study was not built to detect a difference between vaccines.

What it found

For mRNA-1283, absolute effectiveness against COVID-19-related hospitalisation was 59.3% (95% CI 39.0-72.9) in adults aged 65 and over, rising to 66.9% (45.9-79.8) in those aged 75 and over [s1]. Against medically attended COVID-19 — a broader, less severe outcome — effectiveness was 42.0% (35.0-48.3) in the 65-plus group and 50.2% (42.1-57.2) in the 75-plus group [s1].

For BNT162b2, effectiveness against hospitalisation was 48.3% (32.4-60.5) in the 65-plus group and 45.9% (26.0-60.4) in those aged 75 and over [s1]. Against medically attended COVID-19 it was 41.2% (36.2-45.8) and 44.0% (37.8-49.6) respectively [s1].

Two patterns are worth naming. First, for both vaccines the point estimate against hospitalisation was higher than against milder medically attended illness — the expected shape, because vaccines against COVID-19 have consistently done better at preventing severe disease than infection. Second, the confidence intervals are wide, especially for hospitalisation in the oldest group, where events are fewer; the true effect could sit some way either side of the headline number [s1].

That first pattern also answers a common objection — that the vaccines "don't work" because vaccinated people still catch COVID-19. These shots were never expected to block all infection; their measured job, borne out again here, is to reduce the chance that an infection becomes severe enough to require hospital care [s1]. An effectiveness figure below 100% against milder illness is the normal picture for a respiratory vaccine, not evidence of failure.

How much to trust it

This is observational, interim data, and both of those words carry weight. Observational vaccine studies can be distorted by the "healthy vaccinee" effect — people who seek out a booster tend to be different from those who do not, in ways matching cannot fully erase. The authors used weighting to reduce that bias, but it cannot be assumed to have removed it entirely [s1]. And "interim" means the follow-up is short; durability over a full season is not yet established here.

The mRNA-1283 result is notable in one respect: the authors describe it as the first real-world evidence that this next-generation formulation protects against hospitalisation and medically attended COVID-19 in older adults [s1]. That vaccine had previously been evaluated mainly through immune-response measures — for example, a correlates analysis from the NextCOVE trial linking antibody levels to protection [s2]. Real-world outcome data are a step beyond a correlate, but interim observational estimates are not the same as a randomised efficacy result [s1][s2].

What it means

For an older adult weighing this season's shot, the practical reading is straightforward: the updated 2025-2026 vaccines were associated with meaningful reductions in COVID-19 hospitalisation in exactly the age group at highest risk, and the effect looked strongest in the over-75s [s1]. That is consistent with years of evidence that COVID vaccines earn their keep chiefly by preventing severe disease, not by stopping every infection. The numbers are estimates with real uncertainty, and this is not personalised advice — who should be vaccinated, and when, is a decision for a clinician working from current recommendations. But the direction of the evidence is clear, and it points the same way it has each season: for people at high risk of severe COVID-19, vaccination lowered the odds of ending up in hospital [s1].

Sources

• [s1] Interim Effectiveness of 2025-2026 mRNA-1283 and BNT162b2 COVID-19 Vaccines Against COVID-19-Related Outcomes Among Adults Aged ≥65 Years in the United States. Infectious Diseases and Therapy, 24 Jun 2026. https://doi.org/10.1007/s40121-026-01395-4
• [s2] Immune correlates analysis in NextCOVE trial for a next-generation mRNA-1283 COVID-19 vaccine. Human Vaccines & Immunotherapeutics, 1 Jun 2026. https://doi.org/10.1080/21645515.2026.2679783