Recent changes in the seasonal timing (phenology) of familiar biological events have been one of the most conspicuous signs of climate change. However, the lack of a standardized approach to analysing change has hampered assessment of consistency in such changes among different taxa and trophic levels and across freshwater, terrestrial and marine environments. We present a standardized assessment of 25 532 rates of phenological change for 726 UK terrestrial, freshwater and marine taxa. The majority of spring and summer events have advanced, and more rapidly than previously documented. Such consistency is indicative of shared large scale drivers. Furthermore, average rates of change have accelerated in a way that is consistent with observed warming trends. Less coherent patterns in some groups of organisms point to the agency of more local scale processes and multiple drivers. For the first time we show a broad scale signal of differential phenological change among trophic levels; across environments advances in timing were slowest for secondary consumers, thus heightening the potential risk of temporal mismatch in key trophic interactions. If current patterns and rates of phenological change are indicative of future trends, future climate warming may exacerbate trophic mismatching, further disrupting the functioning, persistence and resilience of many ecosystems and having a major impact on ecosystem services.

in all months, and mean precipitation increased in most months (Fig. 2a). 68Spatial variability in climatic change (Fig. 2b,c), necessitates local matching of phenological 69 and climatic datasets rather than the use of regionally-averaged climate data (e.g. Central 70England Temperatures) or large-scale climatic indicators (e.g. North Atlantic Oscillation). 71We did not make the restrictive assumption that biological events would be related to annual CSP precip varied less among trophic levels than the upper limit (Fig. 3d,f) consumers were less than those for primary consumers (Fig. 5a). This occurred because, 195averaged across species, the opposing climate responses of primary producers and secondary 196consumers are more similar in magnitude than are those for primary consumers (Fig. 3), 197 effectively "cancelling each other out". Our models suggest greater average advances for 198 crustacea, fish and insects than for other groups, such as freshwater phytoplankton, birds and 199 mammals (Fig. 5b). However, response-variation is high for crustacea (Fig. 5b). not estimated for marine plankton data (see above), and so the second-phase LME models 441 were run twice: once to examine correlations with temperature and precipitation for all but 442 the marine plankton phenological series (9,800 series), and once to examine only correlations 443 with temperature for the whole data set (10,003 series).

Key PointsQuestionDoes prior COVID-19 vaccination reduce hospitalizations for COVID-19, and among patients hospitalized for COVID-19, does prior vaccination reduce disease severity?FindingsIn a case-control study that included 4513 hospitalized adults in 18 US states, hospitalization for a COVID-19 diagnosis compared with an alternative diagnosis was associated with an adjusted odds ratio (aOR) of 0.15 for full vaccination with an authorized or approved mRNA COVID-19 vaccine. Among adults hospitalized for COVID-19, progression to death or invasive mechanical ventilation was associated with an aOR of 0.33 for full vaccination; both ORs were statistically significant.MeaningVaccination with an mRNA COVID-19 vaccine was significantly less likely among patients with COVID-19 hospitalization and with disease progression, consistent with risk reduction among vaccine breakthrough infections.

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