Health Analysis and Life Events Division, Office for National Statistics, Newport, UK
Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
BMJ. 2022 May 18;377:e069676. doi: 10.1136/bmj-2021-069676.
To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination.
Observational cohort study.
Community dwelling population, UK.
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.
Presence of long covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021.
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.
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.
在接种疫苗前，估计已感染 SARS-CoV-2 的成年人中，新冠疫苗接种与长新冠症状之间的关联。
观察性队列研究。
英国社区居住人群。
28356 名在 Office for National Statistics COVID-19 Infection Survey 中年龄在 18-69 岁之间的参与者，他们在感染 SARS-CoV-2 后至少接种了一剂腺病毒载体或 mRNA 新冠疫苗。
在 2021 年 2 月 3 日至 9 月 5 日的随访期间，感染后至少 12 周出现长新冠症状的情况。
参与者的平均年龄为 46 岁，55.6%（n=15760）为女性，88.7%（n=25141）为白种人。中位随访时间为首次接种后 141 天（所有参与者）和第二次接种后 67 天（83.8%的参与者）。6729 名参与者（23.7%）在随访期间至少报告过一次任何严重程度的长新冠症状。第一剂疫苗接种与长新冠的几率初始下降 12.8%（95%置信区间-18.6%至-6.6%，P<0.001），随后的数据显示轨迹上既有增加也有减少（每周增加 0.3%，95%置信区间每周-0.6%至 1.2%，P=0.51）。第二剂疫苗接种与长新冠的几率初始下降 8.8%（95%置信区间-14.1%至-3.1%，P=0.003），随后每周下降 0.8%（每周-1.2%至-0.4%，P<0.001）。根据社会人口特征、健康状况、因急性新冠感染住院、疫苗类型（腺病毒载体或 mRNA）或从 SARS-CoV-2 感染到接种疫苗的时间，未发现疫苗接种与长新冠之间的关联存在异质性。
接种新冠疫苗后，长新冠症状的发生几率观察到下降，且第二剂疫苗接种后证据表明持续改善，至少在中位随访 67 天内如此。疫苗接种可能有助于降低长新冠对人群健康的负担，尽管需要更长时间的随访。
