EBioMedicine (Oct 2023)

Risk of COVID-19 after natural infection or vaccinationResearch in context

  • Anne-Marie Rick,
  • Matthew B. Laurens,
  • Ying Huang,
  • Chenchen Yu,
  • Thomas C.S. Martin,
  • Carina A. Rodriguez,
  • Christina A. Rostad,
  • Rebone M. Maboa,
  • Lindsey R. Baden,
  • Hana M. El Sahly,
  • Beatriz Grinsztejn,
  • Glenda E. Gray,
  • Cynthia L. Gay,
  • Peter B. Gilbert,
  • Holly E. Janes,
  • James G. Kublin,
  • Yunda Huang,
  • Brett Leav,
  • Ian Hirsch,
  • Frank Struyf,
  • Lisa M. Dunkle,
  • Kathleen M. Neuzil,
  • Lawrence Corey,
  • Paul A. Goepfert,
  • Stephen R. Walsh,
  • Dean Follmann,
  • Karen L. Kotloff,
  • Atoya Adams,
  • Eric Miller,
  • Bruce G. Rankin,
  • Steven Shinn,
  • Marshall Nash,
  • Sinikka L. Green,
  • Colleen Jacobsen,
  • Jayasree Krishnankutty,
  • Sikhongi Phungwayo,
  • Richard M. Glover, II,
  • Stacy Slechta,
  • Troy Holdeman,
  • Robyn Hartvickson,
  • Amber Grant,
  • Terry L. Poling,
  • Terry D. Klein,
  • Thomas C. Klein,
  • Tracy R. Klein,
  • William B. Smith,
  • Richard L. Gibson,
  • Jennifer Winbigler,
  • Elizabeth Parker,
  • Priyantha N. Wijewardane,
  • Eric Bravo,
  • Jeffrey Thessing,
  • Michelle Maxwell,
  • Amanda Horn,
  • Catherine Mary Healy,
  • Christine Akamine,
  • Laurence Chu,
  • R. Michelle Chouteau,
  • Michael J. Cotugno,
  • George H. Bauer, Jr.,
  • Greg Hachigian,
  • Masaru Oshita,
  • Michael Cancilla,
  • Kristen Kiersey,
  • William Seger,
  • Mohammed Antwi,
  • Allison Green,
  • Anthony Kim,
  • Michael Desjardins,
  • Jennifer A. Johnson,
  • Amy Sherman,
  • Stephen R. Walsh,
  • Judith Borger,
  • Nafisa Saleem,
  • Joel Solis,
  • Martha Carmen Medina,
  • Westly Keating,
  • Edgar Garcia,
  • Cynthia Bueno,
  • Nathan Segall,
  • Douglas S. Denham,
  • Thomas Weiss,
  • Ayoade Avworo,
  • Parke Hedges,
  • Cynthia Becher Strout,
  • Rica Santiago,
  • Yvonne Davis,
  • Patty Howenstine,
  • Alison Bondell,
  • Kristin Marks,
  • Tina Wang,
  • Timothy Wilkin,
  • Mary Vogler,
  • Carrie Johnston,
  • Michele P. Andrasik,
  • Jessica G. Andriesen,
  • Gail Broder,
  • Niles Eaton,
  • Huub G. Gelderblom,
  • Rachael McClennen,
  • Nelson Michael,
  • Merlin Robb,
  • Carrie Sopher,
  • Vicki E. Miller,
  • Fredric Santiago,
  • Blanca Gomez,
  • Insiya Valika,
  • Amy Starr,
  • Valeria D. Cantos,
  • Sheetal Kandiah,
  • Carlos del Rio,
  • Nadine Rouphael,
  • Srilatha Edupuganti,
  • Evan J. Anderson,
  • Andres Camacho-Gonzalez,
  • Satoshi Kamidani,
  • Meghan Teherani,
  • David J. Diemert,
  • Elissa Malkin,
  • Marc Siegel,
  • Afsoon Roberts,
  • Gary Simon,
  • Bindu Balani,
  • Carolene Stephenson,
  • Steven Sperber,
  • Cristina Cicogna,
  • Marcus J. Zervos,
  • Paul Kilgore,
  • Mayur Ramesh,
  • Erica Herc,
  • Kate Zenlea,
  • Abram Burgher,
  • Ann M. Milliken,
  • Joseph D. Davis,
  • Brendan Levy,
  • Sandra Kelman,
  • Matthew W. Doust,
  • Denise Sample,
  • Sandra Erickson,
  • Shane G. Christensen,
  • Christopher Matich,
  • James Longe,
  • John Witbeck,
  • James T. Peterson,
  • Alexander Clark,
  • Gerald Kelty,
  • Issac Pena-Renteria,
  • Michael J. Koren,
  • Darlene Bartilucci,
  • Alpa Patel,
  • Carolyn Tran,
  • Christina Kennelly,
  • Robert Brownlee,
  • Jacob Coleman,
  • Hala Webster,
  • Carlos A. Fierro,
  • Natalia Leistner,
  • Amy Thompson,
  • Celia Gonzalez,
  • Lisa A. Jackson,
  • Janice Suyehira,
  • Milton Haber,
  • Maria M. Regalado,
  • Veronica Procasky,
  • Alisha Lutat,
  • Carl P. Griffin,
  • Ripley R. Hollister,
  • Jeremy Brown,
  • Melody Ronk,
  • Wayne L. Harper,
  • Lisa Cohen,
  • Lynn Eckert,
  • Matthew Hong,
  • Rambod Rouhbakhsh,
  • Elizabeth Danford,
  • John Johnson,
  • Richard Calderone,
  • Shishir K. Khetan,
  • Oyebisi Olanrewaju,
  • Nan Zhai,
  • Kimberly Nieves,
  • Allison O'Brien,
  • Paul S. Bradley,
  • Amanda Lilienthal,
  • Jim Callis,
  • Adam B. Brosz,
  • Andrea Clement,
  • Whitney West,
  • Luke Friesen,
  • Paul Cramer,
  • Frank S. Eder,
  • Ryan Little,
  • Victoria Engler,
  • Heather Rattenbury-Shaw,
  • David J. Ensz,
  • Allie Oplinger,
  • Brandon J. Essink,
  • Jay Meyer,
  • Frederick Raiser, III,
  • Kimberly Mueller,
  • Keith W. Vrbicky,
  • Charles Harper,
  • Chelsie Nutsch,
  • Wendell Lewis, III,
  • Cathy Laflan,
  • Jordan L. Whatley,
  • Nicole Harrell,
  • Amie Shannon,
  • Crystal Rowell,
  • Christopher Dedon,
  • Mamodikoe Makhene,
  • Gregory M. Gottschlich,
  • Kate Harden,
  • Melissa Gottschlich,
  • Mary Smith,
  • Richard Powell,
  • Murray A. Kimmel,
  • Simmy Pinto,
  • Timothy P. Vachris,
  • Mark Hutchens,
  • Stephen Daniels,
  • Margaret Wells,
  • Mimi Van Der Leden,
  • Peta-Gay Jackson-Booth,
  • Mira Baron,
  • Pamela Kane,
  • Shannen Seversen,
  • Mara Kryvicky,
  • Julia Lord,
  • Jamshid Saleh,
  • Matthew Miles,
  • Rafael Lupercio,
  • John W. McGettigan, Jr.,
  • Walter Patton,
  • Riemke Brakema,
  • Karin Choquette,
  • Jonlyn McGettigan,
  • Judith L. Kirstein,
  • Marcia Bernard,
  • Mary Beth Manning,
  • Joan Rothenberg,
  • Toby Briskin,
  • Denise Roadman,
  • Sharita Tedder-Edwards,
  • Howard I. Schwartz,
  • Surisday Mederos,
  • Shobha Swaminathan,
  • Amesika Nyaku,
  • Tilly Varughese,
  • Michelle DallaPiazza,
  • Sharon E. Frey,
  • Irene Graham,
  • Getahun Abate,
  • Daniel Hoft,
  • Leland N. Allen, III,
  • Leslie A. Edwards,
  • William S. Davis, Jr.,
  • Jessica M. Mena,
  • Mark E. Kutner,
  • Jorge Caso,
  • Maria Hernandez Moran,
  • Marianela Carvajal,
  • Janet Mendez,
  • Larkin T. Wadsworth, III,
  • Michael R. Adams,
  • Leslie Iverson,
  • Joseph L. Newberg,
  • Laura Pearlman,
  • Paul J. Nugent,
  • Michele D. Reynolds,
  • Jennifer Bashour,
  • Robert Schmidt,
  • Neil P. Sheth,
  • Kenneth Steil,
  • Ramy J. Toma,
  • William Kirby,
  • Pink Folmar,
  • Samantha Williams,
  • Paul Pickrell,
  • Stefanie Mott,
  • Carol Ann Linebarger,
  • Hussain Malbari,
  • David Pampe,
  • Veronica G. Fragoso,
  • Lisa Holloway,
  • Cecilia McKeown-Bragas,
  • Teresa Becker,
  • Barton G. Williams,
  • William H. Jones,
  • Jesse L. Clark,
  • Steven Shoptaw,
  • Michele Vertucci,
  • Will Hernandez,
  • Stephen A. Spector,
  • Amaran Moodley,
  • Jill Blumenthal,
  • Lisa Stangl,
  • Karen Deutsch,
  • Kathleen M. Mullane,
  • David Pitrak,
  • Cheryl Nuss,
  • Judy Pi,
  • Carl Fichtenbaum,
  • Margaret Powers-Fletcher,
  • Michelle Saemann,
  • Sharon Kohrs,
  • Thomas B. Campbell,
  • Andrew Lauria,
  • Jose C. Mancilla,
  • Hillary Dunlevy,
  • Richard M. Novak,
  • Andrea Wendrow,
  • Scott Borgetti,
  • Ben Ladner,
  • Lisa Chrisley,
  • Cheryl Young,
  • Susanne Doblecki-Lewis,
  • Maria L. Alcaide,
  • Jose Gonzales-Zamora,
  • Stephen Morris,
  • David Wohl,
  • Joseph Eron, Jr.,
  • Ian Frank,
  • Debora Dunbar,
  • David Metzger,
  • Florence Momplaisir,
  • Judith Martin,
  • Alejandro Hoberman,
  • Timothy Shope,
  • Gysella Muniz,
  • Richard Rupp,
  • Amber Stanford,
  • Megan Berman,
  • Laura Porterfield,
  • Michael Lewis,
  • Elham Ghadishah,
  • Joseph Yusin,
  • Mai Pham,
  • Clarence B. Creech, II,
  • Shannon Walker,
  • Stephanie Rolsma,
  • Robert Samuels,
  • Isaac Thomsen,
  • Spyros A. Kalams,
  • Greg Wilson,
  • Gregg H. Lucksinger,
  • Kevin Parks,
  • Ryan Israelsen,
  • Jaleh Ostovar,
  • Kary Kelly,
  • Jeffrey S. Overcash,
  • Hanh Chu,
  • Kia Lee,
  • Luis I. De La Cruz,
  • Steve Clemons,
  • Elizabeth Everette,
  • Suzanna Studdard,
  • Gowdhami Mohan,
  • Stefanie Tyson,
  • Alyssa-Kay Peay,
  • Danyel Johnson,
  • Gregory J. Feldman,
  • May-Yin Suen,
  • Jacqueline Muenzner,
  • Joseph Boscia,
  • Farhan Siddiqui,
  • John Sanders,
  • James Peacock,
  • Julio Nasim,
  • Michael L. Levin,
  • Julie Hussey,
  • Marcy Kulic,
  • Mark M. McKenzie,
  • Teresa Deese,
  • Erica Osmundsen,
  • Christy Sweet,
  • Valentine M. Ebuh,
  • Elwaleed Elnagar,
  • Georgette Ebuh,
  • Genevieve Iwuala,
  • Laurie J. Han-Conrad,
  • Todd Simmons,
  • Denis Tarakjian,
  • Jeremy Ackermann,
  • Mark S. Adams,
  • José O. Alemán,
  • Mohamed S. Al-Ibrahim,
  • David R. Andes,
  • Jeb Andrews,
  • Roberto C. Arduino,
  • Martín Bäcker,
  • Diana Badillo,
  • Emma Bainbridge,
  • Teresa A. Batteiger,
  • Jose A. Bazan,
  • Roger J. Bedimo,
  • Jorge A. Benitez,
  • Annette R. Bennett,
  • David I. Bernstein,
  • Kristin Bialobok,
  • Rebecca Boas,
  • Judith Brady,
  • Cynthia Brown,
  • Catherine A. Bunce,
  • Robert S. Call,
  • Wesley Campbell,
  • Ellie Carmody,
  • Christopher Carpenter,
  • Steven E. Carsons,
  • Marvin Castellon,
  • Mario Castro,
  • Hannah Catan,
  • Jennifer Chang,
  • Mouna G. Chebib,
  • Corey M. Chen,
  • Margaret Cheng,
  • Brian D.W. Chow,
  • Annie Ciambruschini,
  • Joseph P. Connor,
  • James H. Conway,
  • Maureen Cooney,
  • Marcel Curlin,
  • Claudia De La Matta Rodriguez,
  • Jon F. Dedon,
  • Emily Degan,
  • Michelle Dickey,
  • Craig Dietz,
  • Jennifer L. Dong,
  • Brenda Dorcely,
  • Michael P. Dube,
  • Carmel B. Dyer,
  • Benjamin Eckhardt,
  • Edward Ellerbeck,
  • Evan C. Ewers,
  • Amy Falk,
  • Brittany Feijoo,
  • Uriel R. Felsen,
  • Tom Fiel,
  • David Fitz-Patrick,
  • Charles M. Fogarty,
  • Stacy Ford,
  • Lina M. Forero,
  • Elizabeth Formentini,
  • Doris Franco-Vitteri,
  • Robert W. Frenck, Jr.,
  • Elie Gharib,
  • Suzanne Gharib,
  • Rola G. Rucker,
  • James N. Goldenberg,
  • Luis H. González,
  • Brett Gray,
  • Rusty Greene,
  • Robert M. Grossberg,
  • Juan V. Guanira-Carranza,
  • Alfredo Gilberto Guerreros Benavides,
  • Clint C. Guillory,
  • Shauna H. Gunaratne,
  • David Halpert,
  • Holli Hamilton,
  • William R. Hartman,
  • Sheryl L. Henderson,
  • Ramin Herati,
  • Laura Hernandez Guarin,
  • Robin Hilder,
  • Ken Ho,
  • Leila Hojat,
  • Sybil G. Hosek,
  • Jeffrey M. Jacobson,
  • Melanie Jay,
  • Diane H. Johnson,
  • Kathleen S. Jones,
  • Edward C. Jones-López,
  • Jessica E. Justman,
  • Scott Kahney,
  • Lois Katz,
  • Melinda Katz,
  • Daniel Kaul,
  • Michael C. Keefer,
  • Ashley Kennedy,
  • Jennifer Knishinsky,
  • Laura Kogelman,
  • Susan L. Koletar,
  • Angelica Kottkamp,
  • Maryrose Laguio-Vila,
  • Raphael J. Landovitz,
  • Jessica L. Lee,
  • Albert Liu,
  • Eneyda Giuvanela Llerena Zegarra,
  • Anna S. Lok,
  • James Lovell,
  • Ronald Lubelchek,
  • John Lucaj,
  • Gary Luckasen,
  • Annie Luetkemeyer,
  • Njira Lucia Lugogo,
  • Janine Maenza,
  • Carlos Malvestutto,
  • Monica Mauri,
  • Ryan C. Maves,
  • Kenneth H. Mayer,
  • Michael J. McCartney,
  • Margaret E. McCort,
  • M. Juliana McElrath,
  • Meredith McNairy,
  • Fernando L. Merino,
  • Eric A. Meyerowitz,
  • Carol L. Mitchell,
  • Cynthia L. Monaco,
  • Sauda Muhammad,
  • Sigridh Muñoz-Gómez,
  • Sonal Munsiff,
  • Paul Nee,
  • Nicole L. Nollen,
  • Asif Noor,
  • Claudio Nuñez Lagos,
  • Jason F. Okulicz,
  • Patrick A. Oliver,
  • Jessica Ortega,
  • Steven Palmer,
  • Lalitha Parameswaran,
  • Purvi Parikh,
  • Susan Parker,
  • Reza Parungao,
  • Juana R. Pavie,
  • Rebecca P. Madan,
  • Henry Peralta,
  • Jennifer Petts,
  • Kristen K. Pierce,
  • E. Javier Pretell Alva,
  • Lawrence J. Purpura,
  • Vanessa Raabe,
  • Sergio E. Recuenco,
  • Tamara Richards,
  • Sharon A. Riddler,
  • Barbara Rizzardi,
  • Rachel Rokser,
  • Charlotte-Paige Rolle,
  • Adam Rosen,
  • Jeffrey Rosen,
  • Lena R. Freese,
  • María E. Santolaya,
  • Linda M. Schipani,
  • Adam Schwartz,
  • Tiffany Schwasinger-Schmidt,
  • Hyman Scott,
  • Beverly E. Sha,
  • Shivanjali Shankaran,
  • Adrienne E. Shapiro,
  • Stephan C. Sharp,
  • Bo Shopsin,
  • Matthew D. Sims,
  • Stephanie Skipper,
  • Derek M. Smith,
  • Michael J. Smith,
  • M. Mahdee Sobhanie,
  • Brit Sovic,
  • Stephanie Sterling,
  • Robert Striker,
  • Karla Beatriz Tafur Bances,
  • Kawsar R. Talaat,
  • Edward M. Tavel, Jr.,
  • Hong V. Tieu,
  • Christian Tomaszewski,
  • Ryan Tomlinson,
  • Juan P. Torres,
  • Julian A. Torres,
  • John J. Treanor,
  • Sade Tukuru,
  • Robert J. Ulrich,
  • Gregory C. Utz,
  • Veronica Viar,
  • Roberto A. Viau Colindres,
  • Edward E. Walsh,
  • Mary C. Walsh,
  • Emmanuel B. Walter,
  • Jessica L. Weidler,
  • Yi H. Wu,
  • Kinara S. Yang,
  • Juan Luis Yrivarren Giorza,
  • Arthur L. Zemanek,
  • Kevin Zhang,
  • Barry S. Zingman,
  • Richard Gorman,
  • Carmen A. Paez,
  • Edith Swann,
  • Simbarashe G. Takuva,
  • Alex Greninger,
  • Pavitra Roychoudhury,
  • Robert W. Coombs,
  • Keith R. Jerome,
  • Flora Castellino,
  • Xiaomi Tong,
  • Corrina Pavetto,
  • Teletha Gipson,
  • Tina Tong,
  • Marina Lee,
  • James Zhou,
  • Michael Fay,
  • Kelly McQuarrie,
  • Chimeremma Nnadi,
  • Obiageli Sogbetun,
  • Nina Ahmad,
  • Ian De Proost,
  • Cyrus Hoseyni,
  • Paul Coplan,
  • Najat Khan,
  • Peter Ronco,
  • Dawn Furey,
  • Jodi Meck,
  • Johan Vingerhoets,
  • Boerries Brandenburg,
  • Jerome Custers,
  • Jenny Hendriks,
  • Jarek Juraszek,
  • Anne Marit de Groot,
  • Griet Van Roey,
  • Dirk Heerwegh,
  • Ilse Van Dromme,
  • Jorge F. Méndez Galván,
  • Monica B. Carrascal,
  • Adriana Sordo Duran,
  • Laura Ruy Sanchez Guerrero,
  • Martha Cecilia Gómora Madrid,
  • Alejandro Quintín Barrat Hernández,
  • Sharzhaad Molina Guizar,
  • Denisse Alejandra González Estrada,
  • Silvano Omar Martínez Pérez,
  • Zindy Yazmín Zárate Hinojosa,
  • Guillermo Miguel Ruiz-Palacios,
  • Aurelio Cruz-Valdez,
  • Janeth Pacheco-Flores,
  • Anyela Lara,
  • Secia Díaz-Miralrio,
  • María José Reyes Fentanes,
  • Jocelyn Zuleica Olmos Vega,
  • Daniela Pineda Méndez,
  • Karina Cano Martínez,
  • Winniberg Stephany Alvarez León,
  • Vida Veronica Ruiz Herrera,
  • Eduardo Gabriel Vázquez Saldaña,
  • Laura Julia Camacho Choza,
  • Karen Sofia Vega Orozco,
  • Sandra Janeth Ortega Domínguez,
  • Jorge A. Chacón,
  • Juan J. Rivera,
  • Erika A. Cutz,
  • Maricruz E. Ortegón,
  • María I. Rivera,
  • David Browder,
  • Cortney Burch,
  • Terri Moye,
  • Paul Bondy,
  • Lesley Browder,
  • Rickey D. Manning,
  • James W. Hurst,
  • Rodney E. Sturgeon,
  • Paul H. Wakefield,
  • John A. Kirby,
  • James Andersen,
  • Szheckera Fearon,
  • Rosa Negron,
  • Amy Medina,
  • John M. Hill,
  • Vivek Rajasekhar,
  • Hayes Williams,
  • LaShondra Cade,
  • Rhodna Fouts,
  • Connie Moya,
  • Corey G. Anderson,
  • Naomi Devine,
  • James Ramsey,
  • Ashley Perez,
  • David Tatelbaum,
  • Michael Jacobs,
  • Kathleen Menasche,
  • Vincent Mirkil,
  • Peter J. Winkle,
  • Amina Z. Haggag,
  • Michelle Haynes,
  • Marysol Villegas,
  • Sabina Raja,
  • Robert Riesenberg,
  • Stanford Plavin,
  • Mark Lerman,
  • Leana Woodside,
  • Maria Johnson,
  • C. Mary Healy,
  • Jennifer A. Whitaker,
  • Wendy A. Keitel,
  • Robert L. Atmar,
  • Gary Horwith,
  • Robin Mason,
  • Lisa Johnson,
  • Tambra Dora,
  • Deborah Murray,
  • Michael Cancilla,
  • Logan Ledbetter,
  • Beverly Ewing,
  • Kathryn E. Stephenson,
  • Chen S. Tan,
  • Rebecca Zash,
  • Jessica L. Ansel,
  • Kate Jaegle,
  • Caitlin J. Guiney,
  • Jeffrey A. Henderson,
  • Marcia O'Leary,
  • Kendra Enright,
  • Jill Kessler,
  • Pete Ducheneaux,
  • Asha Inniss,
  • Donald M. Brandon,
  • William B. Davis,
  • Daniel T. Lawler,
  • Yaa D. Oppong,
  • Ryan P. Starr,
  • Scott N. Syndergaard,
  • Rozeli Shelly,
  • Mashrur Islam Majumder,
  • Danny Sugimoto,
  • Jeffrey Dugas, Sr.,
  • Dolores Rijos,
  • Sandra Shelton,
  • Stephan Hong,
  • Howard Schwartz,
  • Nelia Sanchez-Crespo,
  • Jennifer Schwartz,
  • Terry Piedra,
  • Barbara Corral,
  • Carmen Medina,
  • Michael E. Dever,
  • Mitul Shah,
  • Michael Delgado,
  • Tameika Scott,
  • Lisa S. Usdan,
  • Lora J. McGill,
  • Valerie K. Arnold,
  • Carolyn Scatamacchia,
  • Codi M. Anthony,
  • Rajan Merchant,
  • Anelgine C. Yoon,
  • Janet Hill,
  • Lucy Ng-Price,
  • Teri Thompson-Seim,
  • Ronald Ackerman,
  • Jamie Ackerman,
  • Florida Aristy,
  • Nzeera Ketter,
  • Jon Finley,
  • Mildred Stull,
  • Monica Murray,
  • Zainab Rizvi,
  • Sonia Guerrero,
  • Yogesh K. Paliwal,
  • Amit Paliwal,
  • Sarah Gordon,
  • Bryan Gordon,
  • Cynthia Montano-Pereira,
  • Christopher Galloway,
  • Candice Montros,
  • Lily Aleman,
  • Samira Shairi,
  • Wesley Van Ever,
  • George H. Freeman,
  • Esther L. Harmon,
  • Marshall A. Cross,
  • Kacie Sales,
  • Catherine Q. Gular,
  • Matthew Hepburn,
  • Nathan Alderson,
  • Shana Harshell,
  • Siham Mahgoub,
  • Celia Maxwell,
  • Thomas Mellman,
  • Karl M. Thompson,
  • Glenn Wortman,
  • Jeff Kingsley,
  • April Pixler,
  • LaKondria Curry,
  • Sarah Afework,
  • Austin Swanson,
  • Jeffry Jacqmein,
  • Maggie Bowers,
  • Dawn Robison,
  • Victoria Mosteller,
  • Janet Garvey,
  • Mary Easley,
  • Rebecca J. Kurnat,
  • Raymond Cornelison,
  • Shanda Gower,
  • William Schnitz,
  • Destiny S. Heinzig-Cartwright,
  • Derek Lewis,
  • Fred E. Newton,
  • Aeiress Duhart,
  • Breanz Watkins,
  • Brandy Ball,
  • Jill York,
  • Shelby Pickle,
  • David B. Musante,
  • William P. Silver,
  • Linda R. Belhorn,
  • Nicholas A. Viens,
  • David Dellaero,
  • Matthew Hong,
  • Priti Patel,
  • Kendra Lisec,
  • Beth Safirstein,
  • Luz Zapata,
  • Lazaro Gonzalez,
  • Evelyn Quevedo,
  • Farah Irani,
  • Joseph Grillo,
  • Amy Potts,
  • Julie White,
  • Patrick Flume,
  • Gary Headden,
  • Brandie Taylor,
  • Ashley Warden,
  • Amy Chamberlain,
  • Robert Jeanfreau,
  • Susan Jeanfreau,
  • Paul G. Matherne,
  • Amy Caldwell,
  • Jessica Stahl,
  • Mandy Vowell,
  • Lauren Newhouse,
  • Vladimir Berthaud,
  • Zudi-Mwak Takizala,
  • Genevieve Beninati,
  • Kimberly Snell,
  • Sherrie Baker,
  • James Walker,
  • Tavane Harrison,
  • Meagan Miller,
  • Janet Otto,
  • Roni Gray,
  • Christine Wilson,
  • Tiffany Nemecek,
  • Hannah Harrington,
  • Chelsie Nutsch,
  • Sally Eppenbach,
  • Wendell Lewis,
  • Tana Bourgeois,
  • Lyndsea Folsom,
  • Gregory Holt,
  • Mehdi Mirsaeidi,
  • Rafael Calderon,
  • Paola Lichtenberger,
  • Jalima Quintero,
  • Becky Martinez,
  • Lilly Immergluck,
  • Erica Johnson,
  • Austin Chan,
  • Norberto Fas,
  • LaTeshia Thomas-Seaton,
  • Saadia Khizer,
  • Jonathan Staben,
  • Tatiana Beresnev,
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Journal volume & issue
Vol. 96
p. 104799

Abstract

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Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.

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