Association of Prior COVID-19 Infection with Risk of Breakthrough Infection Following Vaccination: A Cohort Study in Isfahan, Iran.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Preventive Medicine Pub Date : 2024-07-17 eCollection Date: 2024-01-01 DOI:10.4103/ijpvm.ijpvm_173_23
Amirreza Manteghinejad, Sina Rasti, Maryam Nasirian, Shaghayegh Haghjooy Javanmard
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Abstract

Background: Many people worldwide have developed a combination of natural and vaccine-induced immunity to COVID-19. This study investigated whether exposure to SARS-CoV-2 before full vaccination promotes protection against a breakthrough infection.

Methods: We studied a total of 2,902,545 people in the Isfahan COVID-19 Registry. All the participants had received two doses of either Sinopharm BIBP, ChAdOx1-nCoV-19, Gam-COVID-Vac, or BIV1-CovIran vaccines. A cohort study examined the association between prior COVID-19 infection and the risk of a breakthrough infection for each vaccine. Cohorts in each pair were matched by gender, age group, calendar week of the first dose, the interval between the first and second doses, and the proportion of healthcare workers. The probable virus variant for the previous infections was also considered. Each individual's follow-up started 14 days after their second vaccine dose until either the end of the study censoring date, occurrence of a COVID-19 infection, or death. The breakthrough infection risk was compared between each cohort pair by using the hazard ratio (HR) and incidence rate ratio (IRR).

Results: Total breakthrough HRs (95% confidence interval) (previously infected over infection-naïve matched cohort) were 0.36 (0.23-0.55), 0.35 (0.32-0.40), 0.37 (0.30-0.46), and 0.43 (0.32-0.56) for the BIV1-CovIran, Sinopharm BIBP, Gam-COVID-Vac, and ChAdOx1-nCoV-19 vaccine groups, respectively. The breakthrough infection IRRs were approximately similar to the total HRs mentioned above.

Conclusion: Prior SARS-CoV-2 infection conferred additive immunity against breakthrough after vaccination, no matter which vaccine brand was injected. Such a result could guide health authorities to codify low-cost high-benefit vaccination protocols and protect the community's well-being.

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曾感染 COVID-19 与接种疫苗后发生突破性感染风险的关系:伊朗伊斯法罕队列研究。
背景:全世界有许多人对COVID-19产生了天然免疫和疫苗诱导免疫。本研究调查了在完全接种疫苗之前暴露于 SARS-CoV-2 是否会促进对突破性感染的保护:我们对伊斯法罕 COVID-19 登记处的 2,902,545 人进行了研究。所有参与者都接种过两剂国药集团的 BIBP、ChAdOx1-nCoV-19、Gam-COVID-Vac 或 BIV1-CovIran 疫苗。一项队列研究考察了每种疫苗之前的 COVID-19 感染与突破性感染风险之间的关系。按性别、年龄组、首次接种的日历周、首次接种与第二次接种的间隔时间以及医护人员的比例对每对组群进行了配对。之前感染的可能病毒变种也在考虑之列。每个人在接种第二剂疫苗 14 天后开始随访,直至研究结束、COVID-19 感染或死亡。通过使用危险比(HR)和发病率比(IRR)对每对队列的突破性感染风险进行比较:BIV1-CovIran组、国药集团BIBP组、Gam-COVID-Vac组和ChAdOx1-nCoV-19组的突破性感染总HR(95%置信区间)分别为0.36(0.23-0.55)、0.35(0.32-0.40)、0.37(0.30-0.46)和0.43(0.32-0.56)。突破性感染IRR与上述总HR大致相似:结论:无论注射哪种品牌的疫苗,之前感染过 SARS-CoV-2 的人在接种疫苗后都会获得针对突破性感染的附加免疫力。这一结果可以指导卫生部门制定低成本高收益的疫苗接种方案,保护社区的健康。
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来源期刊
International Journal of Preventive Medicine
International Journal of Preventive Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
4.80%
发文量
107
期刊介绍: International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.
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