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- Title
Effectiveness Associated With Vaccination After COVID-19 Recovery in Preventing Reinfection.
- Authors
Lewis, Nickolas; Chambers, Laura C.; Chu, Huong T.; Fortnam, Taylor; De Vito, Roberta; Gargano, Lisa M.; Chan, Philip A.; McDonald, James; Hogan, Joseph W.
- Abstract
Key Points: Question: How effective is vaccination against COVID-19 after recovery from prior SARS-CoV-2 infection? Findings: In this cohort study of more than 95 000 Rhode Island residents from March 2020 to December 2021, including residents and employees of long-term congregate care (LTCC) facilities, completion of the primary vaccination series after recovery from COVID-19 was associated with 49% protection from reinfection among LTCC residents, 47% protection among LTCC employees, and 62% protection in the general population during periods when wild type, Alpha, and Delta strains of SARS-CoV-2 were predominant. Meaning: These findings suggest that among people who have recovered from COVID-19, subsequent completion of the primary vaccination series reduced the risk of reinfection by approximately half. This cohort study assesses the association of vaccination with protection against SARS-CoV-2 reinfection among long-term congregate care residents and employees and the general population previously infected with SARS-CoV-2 in Rhode Island. Importance: The benefit of vaccination for preventing reinfection among individuals who have been previously infected with SARS-CoV-2 is largely unknown. Objective: To obtain population-based estimates of the probability of SARS-CoV-2 reinfection and the effectiveness associated with vaccination after recovery from COVID-19. Design, Setting, and Participants: This cohort study used Rhode Island statewide surveillance data from March 1, 2020, to December 9, 2021, on COVID-19 vaccinations, laboratory-confirmed cases, hospitalizations, and fatalities to conduct a population-based, retrospective study during periods when wild type, Alpha, and Delta strains of SARS-CoV-2 were predominant. Participants included Rhode Island residents aged 12 years and older who were previously diagnosed with COVID-19 and unvaccinated at the time of first infection, stratified into 3 subpopulations: long-term congregate care (LTCC) residents, LTCC employees, and the general population (ie, individuals not associated with congregate settings). Data were analyzed from October 2021 to January 2022. Exposures: Completion of the primary vaccination series, defined as 14 days after the second dose of an mRNA vaccine or 1 dose of vector virus vaccine. Main Outcomes and Measures: The main outcome was SARS-CoV-2 reinfection, defined as a laboratory-confirmed positive result on a polymerase chain reaction (PCR) or antigen test at least 90 days after the first laboratory-confirmed positive result on a PCR or antigen test. Results: Overall, 3124 LTCC residents (median [IQR] age, 81 [71-89]; 1675 [53.6%] females), 2877 LTCC employees (median [IQR] age, 41 [30-53]; 2186 [76.0%] females), and 94 516 members of the general population (median [IQR] age, 35 [24-52] years; 45 030 [47.6%] females) met eligibility criteria. Probability of reinfection at 9 months for those who remained unvaccinated after recovery from prior COVID-19 was 13.0% (95% CI, 12.0%-14.0%) among LTCC residents, 10.0% (95% CI, 8.8%-11.5%) among LTCC employees, and 1.9% (95% CI, 1.8%-2.0%) among the general population. Completion of the primary vaccination series after infection was associated with 49% (95% CI, 27%-65%) protection among LTCC residents, 47% (95% CI, 19%-65%) protection among LTCC employees, and 62% (95% CI, 56%-68%) protection in the general population against reinfection, adjusting for potential sociodemographic and clinical confounders and temporal variation in infection rates. Conclusions and Relevance: These findings suggest that risk of SARS-CoV-2 reinfection after recovery from COVID-19 was relatively high among individuals who remained unvaccinated. Vaccination after recovery from COVID-19 was associated with reducing risk of reinfection by approximately half.
- Subjects
RHODE Island; CLINICAL pathology; IMMUNIZATION; COVID-19; CONFIDENCE intervals; COVID-19 vaccines; CONVALESCENCE; REINFECTION; RETROSPECTIVE studies; VACCINE effectiveness; DESCRIPTIVE statistics; KAPLAN-Meier estimator; RESEARCH funding; POLYMERASE chain reaction; DATA analysis software; PROBABILITY theory; LONGITUDINAL method; PROPORTIONAL hazards models; EVALUATION
- Publication
JAMA Network Open, 2022, Vol 5, Issue 7, pe2223917
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.23917