FOURTH REPORT ISS-MINISTRY OF HEALTH– The report is based on data from 29 million people. For mRna vaccines, there is one in subjects with multiple pathologies reduced protection from infection: from 75% risk reduction after 28 days from the second dose, to 52% after about 7 months. In general, comparing the January-June 2021 data (with a predominance of the Alpha variant), with those of July-August (with a Delta prevalence), a reduction in efficacy against infection emerges from 84.8% to 67.1%. On the other hand, the effectiveness against hospitalizations remains high (91.7% against 88.7%)