Risk of COVID-19 after natural infection or vaccination

the NIAID-funded COVID-19 Prevention Network (CoVPN)

doi:10.1016/j.ebiom.2023.104799

Risk of COVID-19 after natural infection or vaccination

the NIAID-funded COVID-19 Prevention Network (CoVPN)

Mailman School of Public Health

Résultat de recherche › examen par les pairs

3 Citations (Scopus)

Résumé

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.

Langue d'origine	English
Numéro d'article	104799
Journal	eBioMedicine
Volume	96
DOI	https://doi.org/10.1016/j.ebiom.2023.104799
Statut de publication	Published - oct. 2023

Financement

Bailleurs de fonds	Numéro du bailleur de fonds
National Institutes of Health	UM1 AI069412, P30 AI50410, K23AI159399, 3UM1AI148575-01S2, UM1 AI068635, UM1 AI068614
AstraZeneca
Johnson and Johnson
Biomedical Advanced Research and Development Authority

ASJC Scopus Subject Areas

General Biochemistry,Genetics and Molecular Biology

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

Accès au document

10.1016/j.ebiom.2023.104799

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@article{99c139eecb2a4eff9017820bded5707f,

title = "Risk of COVID-19 after natural infection or vaccination",

abstract = "Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.",

author = "{the NIAID-funded COVID-19 Prevention Network (CoVPN)} and Rick, {Anne Marie} and Laurens, {Matthew B.} and Ying Huang and Chenchen Yu and Martin, {Thomas C.S.} and Rodriguez, {Carina A.} and Rostad, {Christina A.} and Maboa, {Rebone M.} and Baden, {Lindsey R.} and {El Sahly}, {Hana M.} and Beatriz Grinsztejn and Gray, {Glenda E.} and Gay, {Cynthia L.} and Gilbert, {Peter B.} and Janes, {Holly E.} and Kublin, {James G.} and Yunda Huang and Brett Leav and Ian Hirsch and Frank Struyf and Dunkle, {Lisa M.} and Neuzil, {Kathleen M.} and Lawrence Corey and Goepfert, {Paul A.} and Walsh, {Stephen R.} and Dean Follmann and Kotloff, {Karen L.} and Atoya Adams and Eric Miller and Rankin, {Bruce G.} and Steven Shinn and Marshall Nash and Green, {Sinikka L.} and Colleen Jacobsen and Jayasree Krishnankutty and Sikhongi Phungwayo and Glover, {Richard M.} and Stacy Slechta and Troy Holdeman and Robyn Hartvickson and Amber Grant and Poling, {Terry L.} and Klein, {Terry D.} and Klein, {Thomas C.} and Klein, {Tracy R.} and Smith, {William B.} and Gibson, {Richard L.} and Jennifer Winbigler and Elizabeth Parker and Justman, {Jessica E.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = oct,

doi = "10.1016/j.ebiom.2023.104799",

language = "English",

volume = "96",

journal = "eBioMedicine",

issn = "2352-3964",

publisher = "Elsevier BV",

}

TY - JOUR

T1 - Risk of COVID-19 after natural infection or vaccination

AU - the NIAID-funded COVID-19 Prevention Network (CoVPN)

AU - Rick, Anne Marie

AU - Laurens, Matthew B.

AU - Huang, Ying

AU - Yu, Chenchen

AU - Martin, Thomas C.S.

AU - Rodriguez, Carina A.

AU - Rostad, Christina A.

AU - Maboa, Rebone M.

AU - Baden, Lindsey R.

AU - El Sahly, Hana M.

AU - Grinsztejn, Beatriz

AU - Gray, Glenda E.

AU - Gay, Cynthia L.

AU - Gilbert, Peter B.

AU - Janes, Holly E.

AU - Kublin, James G.

AU - Huang, Yunda

AU - Leav, Brett

AU - Hirsch, Ian

AU - Struyf, Frank

AU - Dunkle, Lisa M.

AU - Neuzil, Kathleen M.

AU - Corey, Lawrence

AU - Goepfert, Paul A.

AU - Walsh, Stephen R.

AU - Follmann, Dean

AU - Kotloff, Karen L.

AU - Adams, Atoya

AU - Miller, Eric

AU - Rankin, Bruce G.

AU - Shinn, Steven

AU - Nash, Marshall

AU - Green, Sinikka L.

AU - Jacobsen, Colleen

AU - Krishnankutty, Jayasree

AU - Phungwayo, Sikhongi

AU - Glover, Richard M.

AU - Slechta, Stacy

AU - Holdeman, Troy

AU - Hartvickson, Robyn

AU - Grant, Amber

AU - Poling, Terry L.

AU - Klein, Terry D.

AU - Klein, Thomas C.

AU - Klein, Tracy R.

AU - Smith, William B.

AU - Gibson, Richard L.

AU - Winbigler, Jennifer

AU - Parker, Elizabeth

AU - Justman, Jessica E.

PY - 2023/10

Y1 - 2023/10

N2 - Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.

AB - Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.

UR - http://www.scopus.com/inward/record.url?scp=85174937855&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85174937855&partnerID=8YFLogxK

U2 - 10.1016/j.ebiom.2023.104799

DO - 10.1016/j.ebiom.2023.104799

M3 - Article

C2 - 37738833

AN - SCOPUS:85174937855

SN - 2352-3964

VL - 96

JO - eBioMedicine

JF - eBioMedicine

M1 - 104799

ER -

Risk of COVID-19 after natural infection or vaccination

Résumé

Financement

ASJC Scopus Subject Areas

ODD de l’ONU

Accès au document

Autres fichiers et liens

Empreinte numérique

Citer