Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: A population-based cohort study (COVIDENCE UK)

Giulia Vivaldi; David A. Jolliffe; Hayley Holt; Florence Tydeman; Mohammad Talaei; Gwyneth A. Davies; Ronan A. Lyons; Christopher J. Griffiths; Frank Kee; Aziz Sheikh; Seif O. Shaheen; Adrian R. Martineau

The Lancet Regional Health. Europe (Nov 2022)

Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: A population-based cohort study (COVIDENCE UK)

Giulia Vivaldi,
David A. Jolliffe,
Hayley Holt,
Florence Tydeman,
Mohammad Talaei,
Gwyneth A. Davies,
Ronan A. Lyons,
Christopher J. Griffiths,
Frank Kee,
Aziz Sheikh,
Seif O. Shaheen,
Adrian R. Martineau

Affiliations

Giulia Vivaldi: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Corresponding authors at: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark St, London E1 2AT, UK.
David A. Jolliffe: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Hayley Holt: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
Florence Tydeman: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Mohammad Talaei: Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Gwyneth A. Davies: Population Data Science, Swansea University Medical School, Singleton Park, Swansea, UK
Ronan A. Lyons: Population Data Science, Swansea University Medical School, Singleton Park, Swansea, UK
Christopher J. Griffiths: Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
Frank Kee: Centre for Public Health Research (NI), Queen's University Belfast, Belfast, UK
Aziz Sheikh: Usher Institute, University of Edinburgh, Edinburgh, UK
Seif O. Shaheen: Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Adrian R. Martineau: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK; Corresponding authors at: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark St, London E1 2AT, UK.

Journal volume & issue: Vol. 22
p. 100501

Abstract

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Summary: Background: Little is known about how demographic, behavioural, and vaccine-related factors affect risk of post-vaccination SARS-CoV-2 infection. We aimed to identify risk factors for SARS-CoV-2 infection after primary and booster vaccinations. Methods: This prospective, population-based, UK study in adults (≥16 years) vaccinated against SARS-CoV-2 assessed risk of breakthrough SARS-CoV-2 infection up to February, 2022, for participants who completed a primary vaccination course (ChAdOx1 nCoV-19 or BNT162b2) and those who received a booster dose (BNT162b2 or mRNA-1273). Cox regression models explored associations between sociodemographic, behavioural, clinical, pharmacological, and nutritional factors and test-positive breakthrough infection, adjusted for local weekly SARS-CoV-2 incidence. Findings: 1051 (7·1%) of 14 713 post-primary participants and 1009 (9·5%) of 10 665 post-booster participants reported breakthrough infection, over a median follow-up of 203 days (IQR 195–216) and 85 days (66–103), respectively. Primary vaccination with ChAdOx1 (vs BNT162b2) was associated with higher risk of infection in both post-primary analysis (adjusted hazard ratio 1·63, 95% CI 1·41–1·88) and after an mRNA-1273 booster (1·26 [1·00–1·57] vs BNT162b2 primary and booster). Lower risk of infection was associated with older age (post-primary: 0·97 [0·96–0·97] per year; post-booster: 0·97 [0·97–0·98]), whereas higher risk of infection was associated with lower educational attainment (post-primary: 1·78 [1·44–2·20] for primary/secondary vs postgraduate; post-booster: 1·46 [1·16–1·83]) and at least three weekly visits to indoor public places (post-primary: 1·36 [1·13–1·63] vs none; post-booster: 1·29 [1·07–1·56]). Interpretation: Vaccine type, socioeconomic status, age, and behaviours affect risk of breakthrough infection after primary and booster vaccinations. Funding: Barts Charity, UK Research and Innovation Industrial Strategy Challenge Fund.

Published in The Lancet Regional Health. Europe

ISSN: 2666-7762 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanepe/home

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