Effectiveness and durability of protection against future SARS-CoV-2 infection conferred by COVID-19 vaccination and previous infection; findings from the UK SIREN prospective cohort study of healthcare workers March 2020 to September 2021
Effectiveness and durability of protection against future SARS-CoV-2 infection conferred by COVID-19 vaccination and previous infection; findings from the UK SIREN prospective cohort study of healthcare workers March 2020 to September 2021
ABSTRACT BackgroundUnderstanding the duration and effectiveness of infection and vaccine-acquired SARS-CoV-2 immunity is essential to inform pandemic policy interventions, including the timing of vaccine-boosters. We investigated this in our large prospective cohort of UK healthcare workers undergoing routine asymptomatic PCR testing. MethodsWe assessed vaccine effectiveness (VE) (up to 10-months after first dose) and infection-acquired immunity by comparing time to PCR-confirmed infection in vaccinated and unvaccinated individuals using a Cox regression-model, adjusted by prior SARS-CoV-2 infection status, vaccine-manufacturer/dosing-interval, demographics and workplace exposures. ResultsOf 35,768 participants, 27% (n=9,488) had a prior SARS-CoV-2 infection. Vaccine coverage was high: 97% had two-doses (79% BNT162b2 long-interval, 8% BNT162b2 short-interval, 8% ChAdOx1). There were 2,747 primary infections and 210 reinfections between 07/12/2020 and 21/09/2021. Adjusted VE (aVE) decreased from 81% (95% CI 68%-89%) 14-73 days after dose-2 to 46% (95% CI 22%-63%) >6-months; with no significant difference for short-interval BNT162b2 but significantly lower aVE (50% (95% CI 18%-70%) 14-73 days after dose-2 from ChAdOx1. Protection from infection-acquired immunity showed evidence of waning in unvaccinated follow-up but remained consistently over 90% in those who received two doses of vaccine, even in those infected over 15-months ago. ConclusionTwo doses of BNT162b2 vaccination induce high short-term protection to SARS-CoV-2 infection, which wanes significantly after six months. Infection-acquired immunity boosted with vaccination remains high over a year after infection. Boosters will be essential to maintain protection in vaccinees who have not had primary infection to reduce infection and transmission in this population. Trial registration numberISRCTN11041050
Milligan Iain、Cromey Lisa、Stewart Sally、Foulkes Sarah、Kirwan Peter、Tranquillini Caio、Taylor-Kerr Andrew、Calbraith Davina、Linley Ezra、D?ˉArcangelo Silvia、Brown Colin S、Islam Jasmin、Hopkins Susan、Norman Chris、the SIREN Study Group、Price Lesley、Charlett Andre、Wellington Edgar、Insalata Ferdinando、Semper Amanda、Hettiarachchi Nipunadi、Atti Ana、Chand Meera、Khawam Jameel、Saei Ayoub、Themistocleous Yrene、Brooks Tim、Cole Michelle、Otter Ashley David、Hewson Jacqueline、Corrigan Diane、Munro Katie、Sajedi Noshin、Hall Victoria、de Lacy Elen
UK Health Security AgencyPublic Health Agency Northern IrelandGlasgow Caledonian University||Public Health ScotlandUK Health Security AgencyUK Health Security Agency||Medical Research Council Biostatistics Unit, University of CambridgeUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security Agency||The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of OxfordUK Health Security AgencyUK Health Security Agency||The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of OxfordHealth and Care Research WalesGlasgow Caledonian University||Public Health ScotlandUK Health Security Agency||NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol in partnership with Public Health England||NIHR Health Protection Research Unit in Immunisation at the London School of Hygiene and Tropical Medicine in partnership with Public Health EnglandUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security Agency||Guys and Thomas?ˉs NHS TrustUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyUK Health Security AgencyPublic Health Agency Northern IrelandUK Health Security AgencyUK Health Security AgencyUK Health Security Agency||The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of OxfordPublic Health Wales
预防医学医学研究方法医药卫生理论
Milligan Iain,Cromey Lisa,Stewart Sally,Foulkes Sarah,Kirwan Peter,Tranquillini Caio,Taylor-Kerr Andrew,Calbraith Davina,Linley Ezra,D?ˉArcangelo Silvia,Brown Colin S,Islam Jasmin,Hopkins Susan,Norman Chris,the SIREN Study Group,Price Lesley,Charlett Andre,Wellington Edgar,Insalata Ferdinando,Semper Amanda,Hettiarachchi Nipunadi,Atti Ana,Chand Meera,Khawam Jameel,Saei Ayoub,Themistocleous Yrene,Brooks Tim,Cole Michelle,Otter Ashley David,Hewson Jacqueline,Corrigan Diane,Munro Katie,Sajedi Noshin,Hall Victoria,de Lacy Elen.Effectiveness and durability of protection against future SARS-CoV-2 infection conferred by COVID-19 vaccination and previous infection; findings from the UK SIREN prospective cohort study of healthcare workers March 2020 to September 2021[EB/OL].(2025-03-28)[2025-08-02].https://www.medrxiv.org/content/10.1101/2021.11.29.21267006.点此复制
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