Details

Autor(en) / Beteiligte

• Lumley, Sheila F
• Rodger, Gillian
• Constantinides, Bede
• Sanderson, Nicholas
• Chau, Kevin K
• Street, Teresa L
• O’Donnell, Denise
• Howarth, Alison
• Hatch, Stephanie B
• Marsden, Brian D
• Cox, Stuart
• James, Tim
• Warren, Fiona
• Peck, Liam J
• Ritter, Thomas G
• de Toledo, Zoe
• Warren, Laura
• Axten, David
• Cornall, Richard J
• Jones, E Yvonne
• Stuart, David I
• Screaton, Gavin
• Ebner, Daniel
• Hoosdally, Sarah
• Chand, Meera
• Crook, Derrick W
• O’Donnell, Anne-Marie
• Conlon, Christopher P
• Pouwels, Koen B
• Walker, A Sarah
• Peto, Tim E A
• Hopkins, Susan
• Walker, Timothy M
• Stoesser, Nicole E
• Matthews, Philippa C
• Jeffery, Katie
• Eyre, David W

Titel

An Observational Cohort Study on the Incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and B.1.1.7 Variant Infection in Healthcare Workers by Antibody and Vaccination Status

Ist Teil von

• Clinical infectious diseases, 2022-04, Vol.74 (7), p.1208-1219

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2022

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background Natural and vaccine-induced immunity will play a key role in controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. SARS-CoV-2 variants have the potential to evade natural and vaccine-induced immunity. Methods In a longitudinal cohort study of healthcare workers (HCWs) in Oxfordshire, United Kingdom, we investigated the protection from symptomatic and asymptomatic polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection conferred by vaccination (Pfizer-BioNTech BNT162b2, Oxford-AstraZeneca ChAdOx1 nCOV-19) and prior infection (determined using anti-spike antibody status), using Poisson regression adjusted for age, sex, temporal changes in incidence and role. We estimated protection conferred after 1 versus 2 vaccinations and from infections with the B.1.1.7 variant identified using whole genome sequencing. Results In total, 13 109 HCWs participated; 8285 received the Pfizer-BioNTech vaccine (1407 two doses), and 2738 the Oxford-AstraZeneca vaccine (49 two doses). Compared to unvaccinated seronegative HCWs, natural immunity and 2 vaccination doses provided similar protection against symptomatic infection: no HCW vaccinated twice had symptomatic infection, and incidence was 98% lower in seropositive HCWs (adjusted incidence rate ratio 0.02 [95% confidence interval {CI} < .01–.18]). Two vaccine doses or seropositivity reduced the incidence of any PCR-positive result with or without symptoms by 90% (0.10 [95% CI .02–.38]) and 85% (0.15 [95% CI .08–.26]), respectively. Single-dose vaccination reduced the incidence of symptomatic infection by 67% (0.33 [95% CI .21–.52]) and any PCR-positive result by 64% (0.36 [95% CI .26–.50]). There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7. Conclusions Natural infection resulting in detectable anti-spike antibodies and 2 vaccine doses both provide robust protection against SARS-CoV-2 infection, including against the B.1.1.7 variant. Natural infection resulting in detectable anti-spike antibodies and two vaccine doses both provided ≥85% protection against symptomatic and asymptomatic SARS-CoV-2 infection in healthcare workers, including against the B.1.1.7 variant. Single dose vaccination reduced symptomatic infection by 67%.