Six-month sequelae of post-vaccination SARS-CoV-2 infection: A retrospective cohort study of 10,024 breakthrough infections
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Abstract
Vaccination has proven effective against infection with SARS-CoV-2, as well as death and hospitalisation following COVID-19 illness. However, little is known about the effect of vaccination on other acute and post-acute outcomes of COVID-19. Data were obtained from the TriNetX electronic health records network (over 81 million patients mostly in the USA). Using a retrospective cohort study and time-to-event analysis, we compared the incidences of COVID-19 outcomes between individuals who received a COVID-19 vaccine (approved for use in the USA) at least 2 weeks before SARS-CoV-2 infection and propensity score-matched individuals unvaccinated for COVID-19 but who had received an influenza vaccine. Outcomes were ICD-10 codes representing documented COVID-19 sequelae in the 6 months after a confirmed SARS-CoV-2 infection (recorded between January 1 and August 31, 2021, i.e. before the emergence of the Omicron variant). Associations with the number of vaccine doses (1 vs. 2) and age (<60 vs. ≥ 60 years-old) were assessed. Among 10,024 vaccinated individuals with SARS-CoV-2 infection, 9479 were matched to unvaccinated controls. Receiving at least one COVID-19 vaccine dose was associated with a significantly lower risk of respiratory failure, ICU admission, intubation/ventilation, hypoxaemia, oxygen requirement, hypercoagulopathy/venous thromboembolism, seizures, psychotic disorder, and hair loss (each as composite endpoints with death to account for competing risks; HR 0.70-0.83, Bonferroni-corrected p < 0.05), but not other outcomes, including long-COVID features, renal disease, mood, anxiety, and sleep disorders. Receiving 2 vaccine doses was associated with lower risks for most outcomes. Associations between prior vaccination and outcomes of SARS-CoV-2 infection were marked in those <60 years-old, whereas no robust associations were observed in those ≥60 years-old. In summary, COVID-19 vaccination is associated with lower risk of several, but not all, COVID-19 sequelae in those with breakthrough SARS-CoV-2 infection. The findings may inform service planning, contribute to forecasting public health impacts of vaccination programmes, and highlight the need to identify additional interventions for COVID-19 sequelae.
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- Authors
- Taquet, M., Dercon, Q., & Harrison, P. J.
- Affiliations
- Oxford Health NHS Foundation Trust (GB)
- MRC Cognition and Brain Sciences Unit (GB)
- Corresponding author
- Taquet, Maxime
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 103
- Pages
- 154-162
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC9013695
- OpenAlex
- W4225562523
- Cited by
- 246
- References
- 37
- Citations by year
- 2026: 8 · 2025: 28 · 2024: 68 · 2023: 79 · 2022: 60 · 2021: 2 · 2013: 1
- FWCI
- 28.72
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- National Institute for Health and Care Research
- AXA Research Fund (G102329)
- NIHR Oxford Biomedical Research Centre (BRC-1215-20005)
- Medical Research Council (SUAG/077 G101400)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- breakthrough infection, SARS-CoV-2, post-COVID-19 sequelae, long COVID, respiratory failure, intensive care unit admission, intubation and mechanical ventilation, hypoxemia, venous thromboembolism, hypercoagulability, seizures, psychosis, hair loss, vaccine dose number, older adults, Omicron variant
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, Post-Acute COVID-19 Syndrome, Humans, Middle Aged, Retrospective Studies, Vaccination, Disease Progression
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