Nature Communications (May 2023)

Protection against SARS-CoV-2 Omicron BA.4/5 variant following booster vaccination or breakthrough infection in the UK

  • Jia Wei,
  • Philippa C. Matthews,
  • Nicole Stoesser,
  • John N. Newton,
  • Ian Diamond,
  • Ruth Studley,
  • Nick Taylor,
  • John I. Bell,
  • Jeremy Farrar,
  • Jaison Kolenchery,
  • Brian D. Marsden,
  • Sarah Hoosdally,
  • E. Yvonne Jones,
  • David I. Stuart,
  • Derrick W. Crook,
  • Tim E. A. Peto,
  • A. Sarah Walker,
  • Koen B. Pouwels,
  • David W. Eyre,
  • the COVID-19 Infection Survey team

DOI
https://doi.org/10.1038/s41467-023-38275-1
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 15

Abstract

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Abstract Following primary SARS-CoV-2 vaccination, whether boosters or breakthrough infections provide greater protection against SARS-CoV-2 infection is incompletely understood. Here we investigated SARS-CoV-2 antibody correlates of protection against new Omicron BA.4/5 (re-)infections and anti-spike IgG antibody trajectories after a third/booster vaccination or breakthrough infection following second vaccination in 154,149 adults ≥18 y from the United Kingdom general population. Higher antibody levels were associated with increased protection against Omicron BA.4/5 infection and breakthrough infections were associated with higher levels of protection at any given antibody level than boosters. Breakthrough infections generated similar antibody levels to boosters, and the subsequent antibody declines were slightly slower than after boosters. Together our findings show breakthrough infection provides longer-lasting protection against further infections than booster vaccinations. Our findings, considered alongside the risks of severe infection and long-term consequences of infection, have important implications for vaccine policy.