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A study in Ontario suggests that, compared with a third dose of mRNA COVID vaccine, a fourth dose improved protection against infection and severe outcomes among long-term care residents during the Omicron wave. The study was published today in The BMJ. (7/6)

In a laboratory study, the scientists found that the highly transmissible BA.4 and BA.5 sublineages of the virus, which are now dominant in the U.S., were at least four times more resistant to three doses of vaccine — the original shots plus one booster — than was the earlier BA.2. (The study group didn’t include people with two booster shots.) (Vaziri, 7/6)

The latest Omicron subvariants behind new COVID-19 surges in the United States and abroad have an enhanced ability to escape immunity conferred by three vaccine doses and all but one antibody therapy tested, finds a laboratory study published yesterday in Nature. ... Relative to BA.2, the BA.2.12.1 subvariant was about 80% more resistant (1.8-fold) after three vaccine doses, but BA.4 and BA.5 were at least 4.2 times more resistant, increasing the likelihood of breakthrough infections. (Van Beusekom, 7/6)

A proposed amendment to the Ohio Constitution that would limit vaccine mandates imposed by businesses, health care providers and governments is a step closer to the statewide ballot. The proposal would prohibit those entities from discriminating against people based on vaccination status or mandating any vaccine, medical procedure, treatment or medical device. (Hendrickson, 7/6)

For the second time, a California judge has ruled that the state — not individual school districts — has the authority to require students get the COVID-19 vaccine to attend classes on campus, putting in doubt similar mandates in the Bay Area that have been delayed. (Woolfolk, 7/6)