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Article History

Received: 17 August 2025

Accepted: 18 May 2026

First Online: 1 June 2026

Competing interests

: H.H.E.Y. reported receiving research grants from the Health Bureau of the Government of the Hong Kong SAR (HMRF) and Viatris, outside the submitted work. E.W.Y.C. reported receiving grants from the National Natural Science Foundation of China during the conduct of the study; nonfinancial support from Wellcome Trust; grants from Research Grants Council (RGC), Health Bureau of the Government of the Hong Kong SAR (HMRF), National Health and Medical Research Council (Australia), Narcotics Division of the Security Bureau of Hong Kong SAR, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Janssen, Pfizer, Takeda and Novartis; and personal fees from Pfizer, Novartis and the Hong Kong SAR Hospital Authority, all outside the submitted work. E.Y.F.W. has received research grants from the Health Bureau, the Hong Kong Research Grants Council, Narcotics Division, Security Bureau, Social Welfare Department, Labour and Welfare Bureau of the Government of the Hong Kong SAR and National Natural Science Foundation of China; serves on member of Core Team for Expert Group on Drug Registration of Pharmacy and Poisons Board. These are outside the submitted work. I.C.K.W. received research grants from Amgen, Janssen, GSK, Novartis, Pfizer, Bayer and Bristol-Myers Squibb and Takeda, Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia, The European Union’s Seventh Framework Programme for research, technological development, Research Grants Council Hong Kong and Health and Medical Research Fund Hong Kong; consulting fees from IQVIA and World Health Organisation; payment for expert testimony for Appeal Court in Hong Kong; serves on advisory committees for Member of Pharmacy and Poisons Board; is a member of the Expert Committee on Clinical Events Assessment Following COVID-19 Immunisation; is a member of the Advisory Panel on COVID-19 Vaccines of the Hong Kong Government; is the non-executive director of Jacobson Pharma Corp. Ltd. in Hong Kong; and is the founder and director of Therakind Limited (UK), Advance Data Analytics for Medical Science (ADAMS) Limited (HK) and OCUS Innovation Limited (HK, Ireland and UK). The remaining authors have nothing to disclose.