Vivaldi Giulia, Jolliffe David A, Holt Hayley, Tydeman Florence, Talaei Mohammad, Davies Gwyneth A, Lyons Ronan A, Griffiths Christopher J, Kee Frank, Sheikh Aziz, Shaheen Seif O, Martineau Adrian R
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.
Lancet Reg Health Eur. 2022 Sep 23;22:100501. doi: 10.1016/j.lanepe.2022.100501. eCollection 2022 Nov.
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.
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.
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 ( 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] 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 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] none; post-booster: 1·29 [1·07-1·56]).
Vaccine type, socioeconomic status, age, and behaviours affect risk of breakthrough infection after primary and booster vaccinations.
Barts Charity, UK Research and Innovation Industrial Strategy Challenge Fund.
关于人口统计学、行为学和疫苗相关因素如何影响接种疫苗后感染新冠病毒的风险，人们了解甚少。我们旨在确定初次接种和加强接种后感染新冠病毒的风险因素。
这项基于人群的前瞻性英国研究纳入了接种新冠疫苗的成年人（≥16岁），评估了截至2022年2月完成初次疫苗接种疗程（ChAdOx1 nCoV-19或BNT162b2）的参与者以及接受加强剂量（BNT162b2或mRNA-1273）的参与者出现突破性新冠病毒感染的风险。Cox回归模型探讨了社会人口统计学、行为学、临床、药理学和营养因素与检测呈阳性的突破性感染之间的关联，并根据当地每周新冠病毒发病率进行了调整。
在初次接种后的14713名参与者中，有1051人（7.1%）报告了突破性感染，在加强接种后的10665名参与者中，有1009人（9.5%）报告了突破性感染，初次接种后的参与者中位随访时间为203天（四分位间距195-216天），加强接种后的参与者中位随访时间为85天（66-103天）。在初次接种后的分析中，接种ChAdOx1（对比BNT162b2）与感染风险较高相关（调整后的风险比为1.63，95%置信区间为1.41-1.88），在接种mRNA-1273加强针后也是如此（1.26 [1.00-1.57]，对比BNT162b2初次接种和加强接种）。感染风险较低与年龄较大相关（初次接种后：每年0.97 [0.96-0.97]；加强接种后：0.97 [0.97-0.98]），而感染风险较高与教育程度较低相关（初次接种后：小学/中学学历对比研究生学历为1.78 [1.44-2.20]；加强接种后：1.46 [1.16-1.83]），以及每周至少三次前往室内公共场所（初次接种后：1.36 [1.13-1.63]，对比从不前往；加强接种后：1.29 [1.07-1.56]）。
疫苗类型、社会经济地位、年龄和行为会影响初次接种和加强接种后突破性感染的风险。
英国巴茨慈善机构、英国研究与创新产业战略挑战基金。
