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The bivalent SARS-CoV-2 mRNA vaccines containing ancestral and Omicron BA4/5 strains replaced monovalent vaccines in September 2022 in the U.S. and elsewhere. To evaluate the effectiveness of these vaccines, investigators in Israel performed a retrospective, population-based analysis of medical records covering most of the Israeli public between September 2022 and January 2023, when the BA5 and BQ.1 strains predominated. Of 569,519 eligible participants, the 24% who received the bivalent booster were more likely to be older, male, of higher socioeconomic status, in the general Jewish population, and to have previously received booster doses. Relative risk reductions were 72% for COVID-19 hospitalization and 68% for COVID-19 death, and absol…