Waning protection after vaccination and prior infection against COVID-19-related mortality over 18 months

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Dietler, DominikLund University,Lunds universitet,EPI@LUND,Forskargrupper vid Lunds universitet,Lund University Research Groups (author)

Waning protection after vaccination and prior infection against COVID-19-related mortality over 18 months

Article/chapterEnglish2023

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2023

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LIBRIS-ID:oai:lup.lub.lu.se:76df4c4f-5fd6-4e28-a36f-5d624e9f2613
https://lup.lub.lu.se/record/76df4c4f-5fd6-4e28-a36f-5d624e9f2613URI
https://doi.org/10.1016/j.cmi.2023.08.007DOI

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Language:English
Summary in:English

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OBJECTIVES: Evidence on waning patterns in protection from vaccine-induced, infection-induced, and hybrid immunity against death is scarce. The aim of this study is to assess the temporal trends in protection against mortality.METHODS: Population-based case-control study nested in the total population of Scania Region, Sweden using individual-level registry data of COVID-19-related deaths (<30 days after positive SARS-CoV-2 test) between 27 December 2020 and 3 June 2022. Controls were matched for age, sex, and index date. Conditional logistic regression was used to estimate the preventable fraction (PF) from vaccination (PF vac corresponding to vaccine effectiveness; ≥2 vaccine doses vs. 0 doses), prior infection (PF inf), and hybrid immunity (PF hybrid). PF was calculated as one minus odds ratio. Models were adjusted for comorbidities, long-term care facility residence, prior infection (for PF vac), country of birth, socio-economic conditions, and time since last vaccination (for PF inf). RESULTS: In total, 14 936 individuals (1440 COVID-19-related deaths and 13 496 controls) were included in the case-control analyses (45% females, median age: 84 years). PF vac was above 90% during the first month after vaccination, regardless of the number of vaccine doses. After 6 months, PF vac of two doses waned to 34% (95% CI: -30% to 66%). PF inf for people surviving a SARS-CoV-2 infection waned from 88% (-16% to 99%) 3 months after infection to 62% (34-79%) after 9 months. No differences in waning patterns in PF vac were seen between virus variants, gender, and age. DISCUSSION: Given the waning of protection against death, continuous surveillance of population immunity status, particularly among the most vulnerable population groups, could help to further fine-tune vaccination recommendations.

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Kahn, FredrikLund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neutrofiler – nya mekanismer och nya markörer,Forskargrupper vid Lunds universitet,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Neutrophils – new mechanisms and new biomarkers,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medk-fka (author)
Inghammar, MalinLund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-mig (author)
Björk, JonasLund University,Lunds universitet,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,EPI@LUND,Surgery and public health,Lund University Research Groups(Swepub:lu)ymed-jbj (author)
EPI@LUNDForskargrupper vid Lunds universitet (creator_code:org_t)

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In:Clinical Microbiology and Infection29:12, s. 1573-15801469-0691

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By the author/editor: Dietler, Dominik; Kahn, Fredrik; Inghammar, Malin; Björk, Jonas

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Infectious Medic ...

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