Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: A population-based cohort study (COVIDENCE UK).
Lancet Reg Health Eur
; 22: 100501, 2022 Nov.
Article
in English
| MEDLINE | ID: covidwho-2042003
ABSTRACT
Background:
Little is known about how demographic, behavioural, and vaccine-related factors affect risk of post-vaccination SARS-CoV-2 infection. We aimed to identify risk factors for SARS-CoV-2 infection after primary and booster vaccinations.Methods:
This prospective, population-based, UK study in adults (≥16 years) vaccinated against SARS-CoV-2 assessed risk of breakthrough SARS-CoV-2 infection up to February, 2022, for participants who completed a primary vaccination course (ChAdOx1 nCoV-19 or BNT162b2) and those who received a booster dose (BNT162b2 or mRNA-1273). Cox regression models explored associations between sociodemographic, behavioural, clinical, pharmacological, and nutritional factors and test-positive breakthrough infection, adjusted for local weekly SARS-CoV-2 incidence.Findings:
1051 (7·1%) of 14 713 post-primary participants and 1009 (9·5%) of 10 665 post-booster participants reported breakthrough infection, over a median follow-up of 203 days (IQR 195-216) and 85 days (66-103), respectively. Primary vaccination with ChAdOx1 (vs BNT162b2) was associated with higher risk of infection in both post-primary analysis (adjusted hazard ratio 1·63, 95% CI 1·41-1·88) and after an mRNA-1273 booster (1·26 [1·00-1·57] vs BNT162b2 primary and booster). Lower risk of infection was associated with older age (post-primary 0·97 [0·96-0·97] per year; post-booster 0·97 [0·97-0·98]), whereas higher risk of infection was associated with lower educational attainment (post-primary 1·78 [1·44-2·20] for primary/secondary vs postgraduate; post-booster 1·46 [1·16-1·83]) and at least three weekly visits to indoor public places (post-primary 1·36 [1·13-1·63] vs none; post-booster 1·29 [1·07-1·56]).Interpretation:
Vaccine type, socioeconomic status, age, and behaviours affect risk of breakthrough infection after primary and booster vaccinations.Funding:
Barts Charity, UK Research and Innovation Industrial Strategy Challenge Fund.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal:
Lancet Reg Health Eur
Year:
2022
Document Type:
Article
Affiliation country:
J.lanepe.2022.100501
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