Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study
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Abstract
Objective: To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination. Design: Observational cohort study. Setting: Community dwelling population, UK. Participants: 28 356 participants in the Office for National Statistics COVID-19 Infection Survey aged 18-69 years who received at least one dose of an adenovirus vector or mRNA covid-19 vaccine after testing positive for SARS-CoV-2 infection. Main outcome measure: Presence of long covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021. Results: Mean age of participants was 46 years, 55.6% (n=15 760) were women, and 88.7% (n=25 141) were of white ethnicity. Median follow-up was 141 days from first vaccination (among all participants) and 67 days from second vaccination (83.8% of participants). 6729 participants (23.7%) reported long covid symptoms of any severity at least once during follow-up. A first vaccine dose was associated with an initial 12.8% decrease (95% confidence interval −18.6% to −6.6%, P<0.001) in the odds of long covid, with subsequent data compatible with both increases and decreases in the trajectory (0.3% per week, 95% confidence interval −0.6% to 1.2% per week, P=0.51). A second dose was associated with an initial 8.8% decrease (95% confidence interval −14.1% to −3.1%, P=0.003) in the odds of long covid, with a subsequent decrease by 0.8% per week (−1.2% to −0.4% per week, P<0.001). Heterogeneity was not found in associations between vaccination and long covid by sociodemographic characteristics, health status, hospital admission with acute covid-19, vaccine type (adenovirus vector or mRNA), or duration from SARS-CoV-2 infection to vaccination. Conclusions: The likelihood of long covid symptoms was observed to decrease after covid-19 vaccination and evidence suggested sustained improvement after a second dose, at least over the median follow-up of 67 days. Vaccination may contribute to a reduction in the population health burden of long covid, although longer follow-up is needed.
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A longitudinal survey demonstrated favorable trajectories of long COVID after vaccination.
“A longitudinal survey demonstrated favorable trajectories of long COVID after vaccination [18].”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [18]
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Cites
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Moreira, E. D., Zerbini, C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2034577 · Cited by 14,592 · see citing works
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine
Baden, L. R., El Sahly, H. M., Essink, B., Kotloff, K., Frey, S., Novak, R., Diemert, D., Spector, S. A., Rouphael, N., Creech, C. B., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2035389 · Cited by 10,119 · see citing works
Austin, P. C. (2009) · Statistics in Medicine · doi:10.1002/sim.3697 · Cited by 6,758 · see citing works
Characterizing long COVID in an international cohort: 7 months of symptoms and their impact
Davis, H. E., Assaf, G. S., McCorkell, L., Wei, H., Low, R. J., Re'em, Y., Redfield, S., Austin, J. P., & Akrami, A. (2021) · eClinicalMedicine · doi:10.1016/j.eclinm.2021.101019 · Cited by 2,881 · see citing works
Menni, C., Klaser, K., May, A., Polidori, L., Capdevila, J., Louca, P., Sudre, C. H., Nguyen, L. H., Drew, D. A., Merino, J., et al. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(21)00224-3 · Cited by 1,031 · see citing works
Phase 3 Safety and Efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 Vaccine
Falsey, A. R., Sobieszczyk, M. E., Hirsch, I., Sproule, S., Robb, M. L., Corey, L., Neuzil, K. M., Hahn, W., Hunt, J., Mulligan, M. J., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2105290 · Cited by 670 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- Ziauddeen N, Gurdasani D, O'Hara ME, et al. Characteristics of Long Covid: findings from a social media survey.medRxiv 2021. www.medrxiv.org/content/10.1101/2021.03.21.21253968v2. doi:10.1136/jech-2021-SSMabstracts.194 · DOI
- Voysey M, Clemens SAC, Madhi SA, et al, Oxford COVID Vaccine Trial Group. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 2021;397:99-111. doi:10. 1016/S0140-6736(20)32661-1 · DOI · Paper page
- Pritchard E, Matthews PC, Stoesser N, et al. Impact of vaccination on new SARS-CoV-2 infections in the United Kingdom. Nat Med 2021;27:1370-8. doi:10. 1038/s41591-021-01410-w · DOI
- Harris RJ, Hall JA, Zaidi A, Andrews NJ, Dunbar JK, Dabrera G. Effect of Vaccination on Household Transmission of SARS-CoV-2 in England. N Engl J Med 2021;385:759-60. doi:10. 1056/NEJMc2107717 · DOI
- Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of the Pfizer- BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ 2021;373:n1088. doi:10. 1136/bmj.n1088 · DOI · Paper page
- Office for National Statistics. Deaths involving COVID-19 by vaccination status, England: deaths occurring between 2 January and 24 September 2021. 2021. www.ons.gov.uk/ peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/ bulletins/deathsinvolvingcovid19byvaccinationstatusengland/ deathsoccurringbetween2januaryand24september2021 on 25 May 2022 at University of Southampton Libraries. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj-2021-069676 on 18 May 2022. Downloaded from
- Antonelli M, Penfold RS, Merino J, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis 2022;22:43-55. doi:10. 1016/ S1473-3099(21)00460-6 · DOI · Paper page
- Massey D, Berrent D, Akrami A, et al. Change in Symptoms and Immune Response in People with Post-Acute Sequelae of SARS-Cov-2 Infection (PASC) After SARS-Cov-2 Vaccination. medRxiv 2021. www.medrxiv.org/content/10.1101/2021.07.21.21260391v2. doi:10.1101/2021.07.21.21260391 · DOI
- Arnold DT, Milne A, Samms E, Stadon L, Maskell NA, Hamilton FW. Are vaccines safe in patients with Long COVID? A prospective observational study.medRxiv 2021. www. medrxiv.org/content/10.1101/2021.03.11.21253225v3. doi:10.1101/2021.03.11.21253225 · DOI
- Tran V-T, Perrodeau E, Saldanha J, Pane I, Ravaud P. Efficacy of COVID-19 Vaccination on the Symptoms of Patients With Long COVID: A Target Trial Emulation Using Data From the ComPaRe e-Cohort in France.SSRN 2021. https://papers.ssrn.com/sol3/papers. cfm?abstract_id=3932953
- Miyake E, Martin S. Long Covid: Online patient narratives, public health communication and vaccine hesitancy. Digit Health 2021;7:20552076211059649. doi:10. 1177/20552076211059649 · DOI
- Michelen M, Manoharan L, Elkheir N, et al. Characterising long COVID: a living systematic review. BMJ Glob Health 2021;6:e005427. doi:10. 1136/bmjgh-2021-005427 · DOI
- Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol 2017;46:348-55. doi:10. 1093/ije/dyw098 · DOI · Paper page
- Alwan NA. Lessons from Long COVID: working with patients to design better research. Nat Rev Immunol 2022;22:201-2. doi:10. 1038/ s41577-022-00692-6 · DOI
- Alwan NA. The teachings of Long COVID. Commun Med 2021;1:15. doi:10. 1038/s43856-021-00016-0. · DOI
- Massey D, Berrent D, Akrami A, et al. Change in Symptoms and Immune Response in People with Post-Acute Sequelae of SARS-Cov-2 Infection (PASC) After SARS-Cov-2 Vaccination. medRxiv 2021. www.medrxiv.org/content/10.1101/2021.07.21.21260391v2. doi:10.1101/2021.07.21.21260391 · DOI
- Ryan FJ, Hope CM, Masavuli MG, et al. Long-term perturbation of the peripheral immune system months after SARS-CoV-2 infection. BMC Med 2022;20:26. doi:10. 1186/s12916-021-02228-6 · DOI
- Drosos AA, Pelechas E, Voulgari PV. Long COVID from rheumatology perspective: a simple mimicker or promoter of autoimmunity?Clin Rheumatol 2022;41:957-8. doi:10. 1007/s10067-022-06092-4 · DOI
- Gaebler C, Wang Z, Lorenzi JCC, et al. Evolution of antibody immunity to SARS-CoV-2. Nature 2021;591:639-44. doi:10. 1038/s41586- 021-03207-w · DOI · Paper page
- García-Abellán J, Padilla S, Fernández-González M, et al. Antibody Response to SARS-CoV-2 is Associated with Long-term Clinical Outcome in Patients with COVID-19: a Longitudinal Study. J Clin Immunol 2021;41:1490-501. doi:10. 1007/s10875-021-01083-7 · DOI
- Walker AJ, MacKenna B, Inglesby P, et al, The OpenSAFELY Collaborative). Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY. Br J Gen Pract 2021;71:e806-14. doi:10. 3399/BJGP.2021.0301 · DOI
Cited by
Sorted by citations
The Lancet Commission on lessons for the future from the COVID-19 pandemic
Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbøl, K., Colombo, F., Barron, G. C., Espinosa, M. F., Gaspar, V., Gaviria, A., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01585-9 · Cited by 842 · see citing works
Notarte, K. I., Catahay, J. A., Velasco, J. V., Pastrana, A., Ver, A. T., Pangilinan, F. C., Peligro, P. J., Casimiro, M., Guerrero, J. J., Gellaco, M. M. L., et al. (2022) · eClinicalMedicine · doi:10.1016/j.eclinm.2022.101624 · Cited by 480 · see citing works
Watanabe, A., Iwagami, M., Yasuhara, J., Takagi, H., & Kuno, T. (2023) · Vaccine · doi:10.1016/j.vaccine.2023.02.008 · Cited by 304 · see citing works
Chudzik, M., Babicki, M., Kapusta, J., Kałuzińska-Kołat, Ż., Kołat, D., Jankowski, P., & Mastalerz-Migas, A. (2022) · Viruses · doi:10.3390/v14081755 · Cited by 65 · see citing works
Are vaccines a potential treatment for long COVID?
Sivan, M., Greenhalgh, T., Milne, R., & Delaney, B. (2022) · BMJ · doi:10.1136/bmj.o988 · Cited by 27 · see citing works
- Authors
- Ayoubkhani, D., Bermingham, C., Pouwels, K. B., Glickman, M., Nafilyan, V., Zaccardi, F., Khunti, K., Alwan, N. A., & Walker, A. S.
- Affiliations
- Office for National Statistics (GB)
- National Institute for Health and Care Research (GB)
- University of Leicester (GB)
- University Hospital Southampton NHS Foundation Trust (GB)
- Corresponding author
- Ayoubkhani, Daniel
- ORCID
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2022-05-18
- Volume
- 377
- Pages
- e069676
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC9115603
- OpenAlex
- W4280606735
- Cited by
- 414
- References
- 6
- Citations by year
- 2026: 25 · 2025: 49 · 2024: 101 · 2023: 161 · 2022: 78
- FWCI
- 51.18
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- BMJ (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Department of Health and Social Care
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- long COVID, COVID-19 vaccination, COVID-19 pandemic, vaccine efficacy, second vaccine dose, adenovirus vector vaccine, mRNA vaccines, symptom trajectories, community-dwelling adults, socio-demographic heterogeneity, health status
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, Post-Acute COVID-19 Syndrome, Adult, Female, Humans, Male, Middle Aged, RNA, Messenger, Vaccination, Cohort Studies
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