Orui Masatsugu, Obara Taku, Ishikuro Mami, Noda Aoi, Shinoda Genki, Murakami Keiko, Nakamura Tomohiro, Metoki Hirohito, Ogishima Soichi, Izumi Yoko, Nakaya Naoki, Hozawa Atsushi, Ishii Tadashi, Nagami Fuji, Yamamoto Masayuki, Kuriyama Shinichi
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Graduate School of Medicine, Tohoku University, Sendai, Japan.
JMA J. 2024 Jul 16;7(3):353-363. doi: 10.31662/jmaj.2024-0043. Epub 2024 Jul 3.
To examine the interaction between lifestyle habits and the COVID-19 vaccinations for preventing SARS-CoV-2 infection, we analyzed 11,016 adult participants registered in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.
Lifestyle variables, including regular exercise, smoking and drinking habits, sleep status, body mass index, and daily breakfast consumption, were assessed from 2014 to 2019 using baseline questionnaires. Information on SARS-CoV-2 infection and the COVID-19 vaccination were also collected from March 2020 to May 2023. The study period was divided into two in the postvaccination phase: the first period (the beginning of the vaccination program) and the second period (the fourth shot onward).
In the Cox proportional-hazards model analysis, the five-time vaccinations group showed a significantly lower risk of SARS-CoV-2 infection adjusted age, sex, underlying health condition, and lifestyle variables (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.76-0.86). Logistic regression analysis revealed that a higher number of vaccinations was significantly associated with a low risk of SARS-CoV-2 infection regardless of lifestyle habits (three times in the first period: odds ratio [OR] 0.19, 95% CI 0.15-0.24; five times in the second period: OR 0.07, 95% CI 0.05-0.11 vs. none). Regarding lifestyle habits, the risk reduction in those who had sleep satisfaction (OR 0.12, 95% CI 0.08-0.18) was slightly larger than in those who had sleep dissatisfaction (OR 0.23, 95% CI 0.17-0.32) in the group with the highest number of vaccinations in the first period; however, this interaction was hardly confirmed in the second period when the number of infected cases significantly increased.
Our findings indicated that a higher number of COVID-19 vaccinations was associated with reduced risk of SARS-CoV-2 infection; otherwise, we may need to understand the advantages and limitations of a healthy lifestyle for preventing infection depending on the situation with vaccinations and infection spreading.
为了研究生活方式习惯与新冠疫苗接种在预防新冠病毒感染方面的相互作用，我们分析了参加东北医学大数据库项目出生及三代队列研究的11016名成年参与者。
2014年至2019年期间，通过基线调查问卷对包括规律运动、吸烟和饮酒习惯、睡眠状况、体重指数以及每日早餐摄入情况等生活方式变量进行评估。2020年3月至2023年5月期间还收集了新冠病毒感染和新冠疫苗接种的信息。在疫苗接种后阶段，研究期分为两个阶段：第一阶段（疫苗接种计划开始时）和第二阶段（第四针及以后）。
在Cox比例风险模型分析中，调整年龄、性别、基础健康状况和生活方式变量后，五次接种疫苗组的新冠病毒感染风险显著降低（风险比[HR]为0.81，95%置信区间[CI]为0.76 - 0.86）。逻辑回归分析显示，无论生活方式习惯如何，接种疫苗次数越多与新冠病毒感染低风险显著相关（第一阶段接种三次：优势比[OR]为0.19，95%CI为0.15 - 0.24；第二阶段接种五次：OR为0.07，95%CI为0.05 - 0.11，与未接种相比）。关于生活方式习惯，在第一阶段接种次数最多的组中，睡眠满意者（OR为0.12，95%CI为0.08 - 0.18）的风险降低幅度略大于睡眠不满意者（OR为0.23，95%CI为0.17 - 0.32）；然而，在第二阶段感染病例显著增加时，这种相互作用几乎未得到证实。
我们的研究结果表明，接种更多次数的新冠疫苗与降低新冠病毒感染风险相关；否则，我们可能需要根据疫苗接种和感染传播情况，了解健康生活方式在预防感染方面的优势和局限性。
