Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis
<h4>Background</h4> The benefit of primary and booster vaccination in people who experienced a prior Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains unclear. The objective of this study was to estimate the effectiveness of primary (two-dose series) and boos...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-12-01
|
| Series: | PLoS Medicine |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714718/?tool=EBI |
| _version_ | 1811185204943912960 |
|---|---|
| author | Margaret L. Lind Alexander J. Robertson Julio Silva Frederick Warner Andreas C. Coppi Nathan Price Chelsea Duckwall Peri Sosensky Erendira C. Di Giuseppe Ryan Borg Mariam O. Fofana Otavio T. Ranzani Natalie E. Dean Jason R. Andrews Julio Croda Akiko Iwasaki Derek A. T. Cummings Albert I. Ko Matt D. T. Hitchings Wade L. Schulz |
| author_facet | Margaret L. Lind Alexander J. Robertson Julio Silva Frederick Warner Andreas C. Coppi Nathan Price Chelsea Duckwall Peri Sosensky Erendira C. Di Giuseppe Ryan Borg Mariam O. Fofana Otavio T. Ranzani Natalie E. Dean Jason R. Andrews Julio Croda Akiko Iwasaki Derek A. T. Cummings Albert I. Ko Matt D. T. Hitchings Wade L. Schulz |
| author_sort | Margaret L. Lind |
| collection | DOAJ |
| description | <h4>Background</h4> The benefit of primary and booster vaccination in people who experienced a prior Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains unclear. The objective of this study was to estimate the effectiveness of primary (two-dose series) and booster (third dose) mRNA vaccination against Omicron (lineage BA.1) infection among people with a prior documented infection. <h4>Methods and findings</h4> We conducted a test-negative case–control study of reverse transcription PCRs (RT-PCRs) analyzed with the TaqPath (Thermo Fisher Scientific) assay and recorded in the Yale New Haven Health system from November 1, 2021, to April 30, 2022. Overall, 11,307 cases (positive TaqPath analyzed RT-PCRs with S-gene target failure [SGTF]) and 130,041 controls (negative TaqPath analyzed RT-PCRs) were included (median age: cases: 35 years, controls: 39 years). Among cases and controls, 5.9% and 8.1% had a documented prior infection (positive SARS-CoV-2 test record ≥90 days prior to the included test), respectively. We estimated the effectiveness of primary and booster vaccination relative to SGTF-defined Omicron (lineage BA.1) variant infection using a logistic regression adjusted for date of test, age, sex, race/ethnicity, insurance, comorbidities, social venerability index, municipality, and healthcare utilization. The effectiveness of primary vaccination 14 to 149 days after the second dose was 41.0% (95% confidence interval (CI): 14.1% to 59.4%, p 0.006) and 27.1% (95% CI: 18.7% to 34.6%, p < 0.001) for people with and without a documented prior infection, respectively. The effectiveness of booster vaccination (≥14 days after booster dose) was 47.1% (95% CI: 22.4% to 63.9%, p 0.001) and 54.1% (95% CI: 49.2% to 58.4%, p < 0.001) in people with and without a documented prior infection, respectively. To test whether booster vaccination reduced the risk of infection beyond that of the primary series, we compared the odds of infection among boosted (≥14 days after booster dose) and booster-eligible people (≥150 days after second dose). The odds ratio (OR) comparing boosted and booster-eligible people with a documented prior infection was 0.79 (95% CI: 0.54 to 1.16, p 0.222), whereas the OR comparing boosted and booster-eligible people without a documented prior infection was 0.54 (95% CI: 0.49 to 0.59, p < 0.001). This study’s limitations include the risk of residual confounding, the use of data from a single system, and the reliance on TaqPath analyzed RT-PCR results. <h4>Conclusions</h4> In this study, we observed that primary vaccination provided significant but limited protection against Omicron (lineage BA.1) infection among people with and without a documented prior infection. While booster vaccination was associated with additional protection against Omicron BA.1 infection in people without a documented prior infection, it was not found to be associated with additional protection among people with a documented prior infection. These findings support primary vaccination in people regardless of documented prior infection status but suggest that infection history may impact the relative benefit of booster doses. Using a Test-Negative Case-Control Analysis, Dr Margaret L. Lind and colleagues, investigate the association between primary or booster COVID-19 mRNA vaccination and omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection. Author summary <h4>Why was this study done?</h4> mRNA COVID-19 vaccines provide lower levels of protection against Omicron (BA.1 lineage) infections than previously circulating variants. Prior to the emergence of the Omicron variant, primary vaccination (first two mRNA vaccine doses) afforded protection against reinfection among people with prior infections. The benefit of primary and booster vaccination against Omicron (BA.1 lineage) infections remains unclear among people with prior infections. <h4>What did the researchers do and find?</h4> We evaluated the benefit of primary series and booster mRNA vaccine doses against Omicron (BA.1 lineage, defined by S-gene target failure) infection among people with and without documented prior infections. We found that primary vaccination was associated with statistically significant but low levels of protection against Omicron (BA.1 lineage) infection among people with and without a documented prior infection. Booster vaccination was found to be associated with protection beyond that afforded by the primary series among people without a documented prior infection, but we did not observe a significant increase in protection among people with a documented prior infection. <h4>What do these findings mean?</h4> Primary vaccination provides limited but significant protection against Omicron (BA.1 lineage) infection regardless of prior infection history. The relative benefits of a booster dose may be affected by a person’s history of prior SARS-CoV-2 infection. |
| first_indexed | 2024-04-11T13:25:26Z |
| format | Article |
| id | doaj.art-35b9df92fcf8467a81cb952d7b4cbf6f |
| institution | Directory Open Access Journal |
| issn | 1549-1277 1549-1676 |
| language | English |
| last_indexed | 2024-04-11T13:25:26Z |
| publishDate | 2022-12-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj.art-35b9df92fcf8467a81cb952d7b4cbf6f2022-12-22T04:22:05ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762022-12-011912Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysisMargaret L. LindAlexander J. RobertsonJulio SilvaFrederick WarnerAndreas C. CoppiNathan PriceChelsea DuckwallPeri SosenskyErendira C. Di GiuseppeRyan BorgMariam O. FofanaOtavio T. RanzaniNatalie E. DeanJason R. AndrewsJulio CrodaAkiko IwasakiDerek A. T. CummingsAlbert I. KoMatt D. T. HitchingsWade L. Schulz<h4>Background</h4> The benefit of primary and booster vaccination in people who experienced a prior Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains unclear. The objective of this study was to estimate the effectiveness of primary (two-dose series) and booster (third dose) mRNA vaccination against Omicron (lineage BA.1) infection among people with a prior documented infection. <h4>Methods and findings</h4> We conducted a test-negative case–control study of reverse transcription PCRs (RT-PCRs) analyzed with the TaqPath (Thermo Fisher Scientific) assay and recorded in the Yale New Haven Health system from November 1, 2021, to April 30, 2022. Overall, 11,307 cases (positive TaqPath analyzed RT-PCRs with S-gene target failure [SGTF]) and 130,041 controls (negative TaqPath analyzed RT-PCRs) were included (median age: cases: 35 years, controls: 39 years). Among cases and controls, 5.9% and 8.1% had a documented prior infection (positive SARS-CoV-2 test record ≥90 days prior to the included test), respectively. We estimated the effectiveness of primary and booster vaccination relative to SGTF-defined Omicron (lineage BA.1) variant infection using a logistic regression adjusted for date of test, age, sex, race/ethnicity, insurance, comorbidities, social venerability index, municipality, and healthcare utilization. The effectiveness of primary vaccination 14 to 149 days after the second dose was 41.0% (95% confidence interval (CI): 14.1% to 59.4%, p 0.006) and 27.1% (95% CI: 18.7% to 34.6%, p < 0.001) for people with and without a documented prior infection, respectively. The effectiveness of booster vaccination (≥14 days after booster dose) was 47.1% (95% CI: 22.4% to 63.9%, p 0.001) and 54.1% (95% CI: 49.2% to 58.4%, p < 0.001) in people with and without a documented prior infection, respectively. To test whether booster vaccination reduced the risk of infection beyond that of the primary series, we compared the odds of infection among boosted (≥14 days after booster dose) and booster-eligible people (≥150 days after second dose). The odds ratio (OR) comparing boosted and booster-eligible people with a documented prior infection was 0.79 (95% CI: 0.54 to 1.16, p 0.222), whereas the OR comparing boosted and booster-eligible people without a documented prior infection was 0.54 (95% CI: 0.49 to 0.59, p < 0.001). This study’s limitations include the risk of residual confounding, the use of data from a single system, and the reliance on TaqPath analyzed RT-PCR results. <h4>Conclusions</h4> In this study, we observed that primary vaccination provided significant but limited protection against Omicron (lineage BA.1) infection among people with and without a documented prior infection. While booster vaccination was associated with additional protection against Omicron BA.1 infection in people without a documented prior infection, it was not found to be associated with additional protection among people with a documented prior infection. These findings support primary vaccination in people regardless of documented prior infection status but suggest that infection history may impact the relative benefit of booster doses. Using a Test-Negative Case-Control Analysis, Dr Margaret L. Lind and colleagues, investigate the association between primary or booster COVID-19 mRNA vaccination and omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection. Author summary <h4>Why was this study done?</h4> mRNA COVID-19 vaccines provide lower levels of protection against Omicron (BA.1 lineage) infections than previously circulating variants. Prior to the emergence of the Omicron variant, primary vaccination (first two mRNA vaccine doses) afforded protection against reinfection among people with prior infections. The benefit of primary and booster vaccination against Omicron (BA.1 lineage) infections remains unclear among people with prior infections. <h4>What did the researchers do and find?</h4> We evaluated the benefit of primary series and booster mRNA vaccine doses against Omicron (BA.1 lineage, defined by S-gene target failure) infection among people with and without documented prior infections. We found that primary vaccination was associated with statistically significant but low levels of protection against Omicron (BA.1 lineage) infection among people with and without a documented prior infection. Booster vaccination was found to be associated with protection beyond that afforded by the primary series among people without a documented prior infection, but we did not observe a significant increase in protection among people with a documented prior infection. <h4>What do these findings mean?</h4> Primary vaccination provides limited but significant protection against Omicron (BA.1 lineage) infection regardless of prior infection history. The relative benefits of a booster dose may be affected by a person’s history of prior SARS-CoV-2 infection.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714718/?tool=EBI |
| spellingShingle | Margaret L. Lind Alexander J. Robertson Julio Silva Frederick Warner Andreas C. Coppi Nathan Price Chelsea Duckwall Peri Sosensky Erendira C. Di Giuseppe Ryan Borg Mariam O. Fofana Otavio T. Ranzani Natalie E. Dean Jason R. Andrews Julio Croda Akiko Iwasaki Derek A. T. Cummings Albert I. Ko Matt D. T. Hitchings Wade L. Schulz Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis PLoS Medicine |
| title | Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis |
| title_full | Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis |
| title_fullStr | Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis |
| title_full_unstemmed | Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis |
| title_short | Association between primary or booster COVID-19 mRNA vaccination and Omicron lineage BA.1 SARS-CoV-2 infection in people with a prior SARS-CoV-2 infection: A test-negative case–control analysis |
| title_sort | association between primary or booster covid 19 mrna vaccination and omicron lineage ba 1 sars cov 2 infection in people with a prior sars cov 2 infection a test negative case control analysis |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714718/?tool=EBI |
| work_keys_str_mv | AT margaretllind associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT alexanderjrobertson associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT juliosilva associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT frederickwarner associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT andreasccoppi associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT nathanprice associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT chelseaduckwall associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT perisosensky associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT erendiracdigiuseppe associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT ryanborg associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT mariamofofana associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT otaviotranzani associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT natalieedean associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT jasonrandrews associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT juliocroda associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT akikoiwasaki associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT derekatcummings associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT albertiko associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT mattdthitchings associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis AT wadelschulz associationbetweenprimaryorboostercovid19mrnavaccinationandomicronlineageba1sarscov2infectioninpeoplewithapriorsarscov2infectionatestnegativecasecontrolanalysis |