Yang Jingyan, Rai Kiran K, Alfred Tamuno, Massey Lucy, Massey Olivia, McGrath Leah, Andersen Kathleen M, Tritton Theo, Tsang Carmen, Butfield Rebecca, Reynard Charlie, Mendes Diana, Nguyen Jennifer L
Global Value and Access, Pfizer Inc, 66 Hudson Blvd E, New York, NY, 10001, USA.
Institute for Social and Economic Research and Policy, Columbia University, New York, NY, USA.
BMC Infect Dis. 2025 Feb 13;25(1):214. doi: 10.1186/s12879-024-10097-6.
Long COVID, a diverse set of symptoms that persist after a minimum of 4 weeks from the initial SARS-CoV-2 infection, has posed substantial burden to healthcare systems. There is some evidence that COVID-19 vaccination may be associated with lower risk of long COVID. However, little is known about the association between vaccination status and long COVID-associated healthcare resource utilisation (HCRU) and costs.
We conducted a cohort study using primary care electronic health record data in England from the Clinical Practice Research Datalink (CPRD) Aurum dataset linked to Hospital Episode Statistics where available. Adult (≥ 18 years) patients were indexed on a COVID-19 diagnosis between 1st March 2021 and 1st December 2021. Vaccination status was assessed at index: unvaccinated or completed primary series (two doses for immunocompetent and three doses for immunocompromised patients). Covariate balance was conducted using entropy balancing. Weighted multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) for incident long COVID, and separately long COVID primary care resource use, by vaccination status. Patients were followed up to a maximum of 9-months post index.
A total of 35,713 patients who had completed primary series vaccination, and 75,522 unvaccinated patients were included. The weighted and adjusted IRR for long COVID among patients vaccinated with the primary series compared to being unvaccinated was 0.81 (95% CI: 0.77-0.86) in the overall cohort, 0.83 (95% CI: 0.78-0.88) in the immunocompetent cohort and 0.28 (95% CI: 0.13-0.58) in the immunocompromised cohort. Among those with long COVID, there was no association between the rate of primary care consultations and vaccination status in the overall and immunocompetent cohorts. Cost of primary care consultations was greater in the unvaccinated group than for those who completed primary series.
Vaccination against COVID-19 may reduce the risk of long COVID in both immunocompetent and immunocompromised patients. However, no association was found between frequency of primary care visits and vaccination among patients diagnosed in 2021. Future studies with larger sample size, higher vaccine uptake, and longer study periods during the pandemic are needed to further quantify the impact of vaccination on long COVID.
长期新冠是指在首次感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）至少4周后持续出现的一系列多样症状，给医疗系统带来了沉重负担。有证据表明，接种新冠疫苗可能与降低长期新冠风险有关。然而，关于疫苗接种状况与长期新冠相关医疗资源利用（HCRU）及成本之间的关联，人们了解甚少。
我们利用来自英国临床实践研究数据链（CPRD）奥鲁姆数据集的基层医疗电子健康记录数据进行了一项队列研究，并在可用时与医院事件统计数据相链接。纳入2021年3月1日至2021年12月1日期间确诊为新冠的成年（≥18岁）患者。在索引时评估疫苗接种状况：未接种或完成初级系列接种（免疫功能正常者接种两剂，免疫功能低下者接种三剂）。使用熵平衡法进行协变量平衡。采用加权多变量泊松回归来估计按疫苗接种状况划分的新发长期新冠的发病率比（IRR），以及单独的长期新冠基层医疗资源使用情况。对患者进行最长9个月的索引后随访。
共纳入35713名完成初级系列接种的患者和75522名未接种患者。在整个队列中，接种初级系列疫苗的患者与未接种患者相比，长期新冠的加权调整后IRR为0.81（95%置信区间：0.77 - 0.86）；在免疫功能正常队列中为0.83（95%置信区间：0.78 - 0.88）；在免疫功能低下队列中为0.28（95%置信区间：0.13 - 0.58）。在患有长期新冠的患者中，整个队列和免疫功能正常队列的基层医疗咨询率与疫苗接种状况之间无关联。未接种组的基层医疗咨询成本高于完成初级系列接种的组。
接种新冠疫苗可能降低免疫功能正常和免疫功能低下患者患长期新冠的风险。然而，在2021年确诊的患者中，未发现基层医疗就诊频率与疫苗接种之间存在关联。需要在大流行期间进行样本量更大、疫苗接种率更高且研究期更长的未来研究，以进一步量化疫苗接种对长期新冠的影响。
