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Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection.
Hall, Victoria; Foulkes, Sarah; Insalata, Ferdinando; Kirwan, Peter; Saei, Ayoub; Atti, Ana; Wellington, Edgar; Khawam, Jameel; Munro, Katie; Cole, Michelle; Tranquillini, Caio; Taylor-Kerr, Andrew; Hettiarachchi, Nipunadi; Calbraith, Davina; Sajedi, Noshin; Milligan, Iain; Themistocleous, Yrene; Corrigan, Diane; Cromey, Lisa; Price, Lesley; Stewart, Sally; de Lacy, Elen; Norman, Chris; Linley, Ezra; Otter, Ashley D; Semper, Amanda; Hewson, Jacqueline; D'Arcangelo, Silvia; Chand, Meera; Brown, Colin S; Brooks, Tim; Islam, Jasmin; Charlett, Andre; Hopkins, Susan.
  • Hall V; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Foulkes S; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Insalata F; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Kirwan P; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Saei A; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Atti A; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Wellington E; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Khawam J; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Munro K; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Cole M; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Tranquillini C; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Taylor-Kerr A; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Hettiarachchi N; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Calbraith D; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Sajedi N; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Milligan I; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Themistocleous Y; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Corrigan D; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Cromey L; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Price L; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Stewart S; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • de Lacy E; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Norman C; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Linley E; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Otter AD; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Semper A; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Hewson J; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • D'Arcangelo S; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Chand M; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Brown CS; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Brooks T; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Islam J; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Charlett A; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
  • Hopkins S; From the U.K. Health Security Agency (V.H., S.F., F.I., P.K., A. Saei, A.A., E.W., J.K., K.M., M. Cole, C.T., A.T.-K., N.H., D. Calbraith, N.S., I.M., Y.T., E. Linley, A.D.O., A. Semper, J.H., S.D., M. Chand, C.S.B., T.B., J.I., A.C., S.H.), Guy's and St. Thomas' NHS Foundation Trust (M. Chand), and
N Engl J Med ; 386(13): 1207-1220, 2022 03 31.
Article in English | MEDLINE | ID: covidwho-1692473
ABSTRACT

BACKGROUND:

The duration and effectiveness of immunity from infection with and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are relevant to pandemic policy interventions, including the timing of vaccine boosters.

METHODS:

We investigated the duration and effectiveness of immunity in a prospective cohort of asymptomatic health care workers in the United Kingdom who underwent routine polymerase-chain-reaction (PCR) testing. Vaccine effectiveness (≤10 months after the first dose of vaccine) and infection-acquired immunity were assessed by comparing the time to PCR-confirmed infection in vaccinated persons with that in unvaccinated persons, stratified according to previous infection status. We used a Cox regression model with adjustment for previous SARS-CoV-2 infection status, vaccine type and dosing interval, demographic characteristics, and workplace exposure to SARS-CoV-2.

RESULTS:

Of 35,768 participants, 27% (9488) had a previous SARS-CoV-2 infection. Vaccine coverage was high 95% of the participants had received two doses (78% had received BNT162b2 vaccine [Pfizer-BioNTech] with a long interval between doses, 9% BNT162b2 vaccine with a short interval between doses, and 8% ChAdOx1 nCoV-19 vaccine [AstraZeneca]). Between December 7, 2020, and September 21, 2021, a total of 2747 primary infections and 210 reinfections were observed. Among previously uninfected participants who received long-interval BNT162b2 vaccine, adjusted vaccine effectiveness decreased from 85% (95% confidence interval [CI], 72 to 92) 14 to 73 days after the second dose to 51% (95% CI, 22 to 69) at a median of 201 days (interquartile range, 197 to 205) after the second dose; this effectiveness did not differ significantly between the long-interval and short-interval BNT162b2 vaccine recipients. At 14 to 73 days after the second dose, adjusted vaccine effectiveness among ChAdOx1 nCoV-19 vaccine recipients was 58% (95% CI, 23 to 77) - considerably lower than that among BNT162b2 vaccine recipients. Infection-acquired immunity waned after 1 year in unvaccinated participants but remained consistently higher than 90% in those who were subsequently vaccinated, even in persons infected more than 18 months previously.

CONCLUSIONS:

Two doses of BNT162b2 vaccine were associated with high short-term protection against SARS-CoV-2 infection; this protection waned considerably after 6 months. Infection-acquired immunity boosted with vaccination remained high more than 1 year after infection. (Funded by the U.K. Health Security Agency and others; ISRCTN Registry number, ISRCTN11041050.).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Adaptive Immunity / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans Country/Region as subject: Europa Language: English Journal: N Engl J Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Adaptive Immunity / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans Country/Region as subject: Europa Language: English Journal: N Engl J Med Year: 2022 Document Type: Article