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Item Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19–Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021(CDC, 2021-11) Bozio, Catherine H.; Grannis, Shaun J.; Naleway, Allison L.; Ong, Toan C.; Butterfield, Kristen A.; DeSilva, Malini B.; Natarajan, Karthik; Yang, Duck-Hye; Rao, Suchitra; Klein, Nicola P.; Irving, Stephanie A.; Dixon, Brian E.; Dascomb, Kristin; Liao, I.-Chia; Reynolds, Sue; McEvoy, Charlene; Han, Jungmi; Reese, Sarah E.; Lewis, Ned; Fadel, William F.; Grisel, Nancy; Murthy, Kempapura; Ferdinands, Jill; Kharbanda, Anupam B.; Mitchell, Patrick K.; Goddard, Kristin; Embi, Peter J.; Arndorfer, Julie; Raiyani, Chandni; Patel, Palak; Rowley, Elizabeth A.; Fireman, Bruce; Valvi, Nimish R.; Griggs, Eric P.; Levy, Matthew E.; Zerbo, Ousseny; Porter, Rachael M.; Birch, Rebecca J.; Blanton, Lenee; Ball, Sarah W.; Steffens, Andrea; Olson, Natalie; Williams, Jeremiah; Dickerson, Monica; McMorrow, Meredith; Schrag, Stephanie J.; Verani, Jennifer R.; Fry, Alicia M.; Azziz-Baumgartner, Eduardo; Barron, Michelle; Gaglani, Manjusha; Thompson, Mark G.; Stenehjem, Edward; Family Medicine, School of MedicineWhat is already known about this topic? Previous infection with SARS-CoV-2 or COVID-19 vaccination can provide immunity and protection against subsequent SARS-CoV-2 infection and illness. What is added by this report? Among COVID-19–like illness hospitalizations among adults aged ≥18 years whose previous infection or vaccination occurred 90–179 days earlier, the adjusted odds of laboratory-confirmed COVID-19 among unvaccinated adults with previous SARS-CoV-2 infection were 5.49-fold higher than the odds among fully vaccinated recipients of an mRNA COVID-19 vaccine who had no previous documented infection (95% confidence interval = 2.75–10.99). What are the implications for public health practice? All eligible persons should be vaccinated against COVID-19 as soon as possible, including unvaccinated persons previously infected with SARS-CoV-2.