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An Observational Cohort Study on the Incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and B.1.1.7 Variant Infection in Healthcare Workers by Antibody and Vaccination Status.
Lumley, Sheila F; Rodger, Gillian; Constantinides, Bede; Sanderson, Nicholas; Chau, Kevin K; Street, Teresa L; O'Donnell, Denise; Howarth, Alison; Hatch, Stephanie B; Marsden, Brian D; Cox, Stuart; James, Tim; Warren, Fiona; Peck, Liam J; Ritter, Thomas G; de Toledo, Zoe; Warren, Laura; Axten, David; Cornall, Richard J; Jones, E Yvonne; Stuart, David I; Screaton, Gavin; Ebner, Daniel; Hoosdally, Sarah; Chand, Meera; Crook, Derrick W; O'Donnell, Anne-Marie; Conlon, Christopher P; Pouwels, Koen B; Walker, A Sarah; Peto, Tim E A; Hopkins, Susan; Walker, Timothy M; Stoesser, Nicole E; Matthews, Philippa C; Jeffery, Katie; Eyre, David W.
  • Lumley SF; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Rodger G; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Constantinides B; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  • Sanderson N; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.
  • Chau KK; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Street TL; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • O'Donnell D; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Howarth A; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  • Hatch SB; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Marsden BD; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Cox S; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  • James T; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Warren F; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Peck LJ; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Ritter TG; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • de Toledo Z; Kennedy Institute of Rheumatology Research, University of Oxford, United Kingdom.
  • Warren L; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Axten D; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Cornall RJ; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Jones EY; Medical School, University of Oxford, Oxford, United Kingdom.
  • Stuart DI; Medical School, University of Oxford, Oxford, United Kingdom.
  • Screaton G; Medical School, University of Oxford, Oxford, United Kingdom.
  • Ebner D; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Hoosdally S; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Chand M; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Crook DW; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • O'Donnell AM; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Conlon CP; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Pouwels KB; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Walker AS; Target Discovery Institute, University of Oxford, Oxford, United Kingdom.
  • Peto TEA; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Hopkins S; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  • Walker TM; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.
  • Stoesser NE; National Infection Service, Public Health England Colindale, United Kingdom.
  • Matthews PC; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Jeffery K; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  • Eyre DW; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.
Clin Infect Dis ; 74(7): 1208-1219, 2022 Apr 09.
Article in English | MEDLINE | ID: covidwho-1704072
ABSTRACT

BACKGROUND:

Natural and vaccine-induced immunity will play a key role in controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. SARS-CoV-2 variants have the potential to evade natural and vaccine-induced immunity.

METHODS:

In a longitudinal cohort study of healthcare workers (HCWs) in Oxfordshire, United Kingdom, we investigated the protection from symptomatic and asymptomatic polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection conferred by vaccination (Pfizer-BioNTech BNT162b2, Oxford-AstraZeneca ChAdOx1 nCOV-19) and prior infection (determined using anti-spike antibody status), using Poisson regression adjusted for age, sex, temporal changes in incidence and role. We estimated protection conferred after 1 versus 2 vaccinations and from infections with the B.1.1.7 variant identified using whole genome sequencing.

RESULTS:

In total, 13 109 HCWs participated; 8285 received the Pfizer-BioNTech vaccine (1407 two doses), and 2738 the Oxford-AstraZeneca vaccine (49 two doses). Compared to unvaccinated seronegative HCWs, natural immunity and 2 vaccination doses provided similar protection against symptomatic infection no HCW vaccinated twice had symptomatic infection, and incidence was 98% lower in seropositive HCWs (adjusted incidence rate ratio 0.02 [95% confidence interval {CI} < .01-.18]). Two vaccine doses or seropositivity reduced the incidence of any PCR-positive result with or without symptoms by 90% (0.10 [95% CI .02-.38]) and 85% (0.15 [95% CI .08-.26]), respectively. Single-dose vaccination reduced the incidence of symptomatic infection by 67% (0.33 [95% CI .21-.52]) and any PCR-positive result by 64% (0.36 [95% CI .26-.50]). There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7.

CONCLUSIONS:

Natural infection resulting in detectable anti-spike antibodies and 2 vaccine doses both provide robust protection against SARS-CoV-2 infection, including against the B.1.1.7 variant.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Vaccines / Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Vaccines / Variants Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid