Sujarwoto Sujarwoto, Holipah Holipah, Andarini Sri, Aknuranda Ismiarta, Sahputri Rindi A M, Sarwono Achwan, Kusharyanto Paulus Gatot, Kusumo Budiarto Eko, Maharani Asri
Department of Public Administration, University of Brawijaya, Malang, Indonesia.
Politeknik Manufaktur Bangka Belitung, Bangka Belitung, Indonesia.
Front Public Health. 2025 Jul 28;13:1598246. doi: 10.3389/fpubh.2025.1598246. eCollection 2025.
Long COVID affects a significant proportion of individuals after SARS-CoV-2 infection. While vaccines reduce severe disease, their effect on long COVID remains unclear, especially in rural, resource-limited settings. This study investigates the association between vaccination status, vaccine type, and long COVID in Malang Regency, East Java.
We analysed cross-sectional data from 5,735 adults who tested positive for COVID-19 between June 2022 and June 2023. Long COVID was defined as persistent symptoms ≥12 weeks post-infection. Data on vaccination status, vaccine type, comorbidities, and sociodemographic characteristics were collected through surveys and linked to immunisation records. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) for long COVID, including stratified analyses by vaccine platform and dose.
Long COVID was reported by 56.2% of participants. Compared to unvaccinated individuals, those who received mRNA vaccines had significantly lower odds of long COVID, Moderna (OR = 0.341, 95% CI: 0.067-0.887) and Pfizer (OR = 0.220, 95% CI: 0.057-0.771), while recipients of non-mRNA vaccines, such as Sinovac (OR = 1.205, 95% CI: 1.038-1.331), had increased odds. A dose-response relationship was observed for mRNA vaccines, with two doses (OR = 0.420, 95% CI: 0.402-0.511) and three or more doses (OR = 0.743, 95% CI: 0.601-0.712) both reducing risk compared to no mRNA vaccination. Older age, hypertension, higher education, and higher income were also associated with increased long COVID risk.
mRNA COVID-19 vaccines and full vaccination schedules are strongly protective against long COVID in rural Indonesia. These findings highlight the need to improve access to mRNA vaccines and booster doses to reduce long-term COVID-19 impacts in underserved populations.
新冠长期症状在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染后的很大一部分个体中出现。虽然疫苗可降低重症风险，但其对新冠长期症状的影响仍不明确，尤其是在农村、资源有限的地区。本研究调查了东爪哇省玛琅摄政区的疫苗接种状况、疫苗类型与新冠长期症状之间的关联。
我们分析了2022年6月至2023年6月期间新冠病毒检测呈阳性的5735名成年人的横断面数据。新冠长期症状定义为感染后持续症状≥12周。通过调查收集了疫苗接种状况、疫苗类型、合并症和社会人口学特征的数据，并与免疫记录相关联。使用多变量逻辑回归来估计新冠长期症状的调整优势比（aOR），包括按疫苗平台和剂量进行分层分析。
56.2%的参与者报告有新冠长期症状。与未接种疫苗的个体相比，接种信使核糖核酸（mRNA）疫苗的个体出现新冠长期症状的几率显著较低，如莫德纳疫苗（优势比[OR]=0.341，95%置信区间[CI]：0.067-0.887）和辉瑞疫苗（OR=0.220，95%CI：0.057-0.771），而接种非mRNA疫苗（如科兴疫苗，OR=1.205，95%CI：1.038-1.331）的个体几率增加。观察到mRNA疫苗存在剂量反应关系，与未接种mRNA疫苗相比，两剂（OR=0.420，95%CI：0.402-0.511）和三剂或更多剂（OR=0.743，95%CI：0.601-0.712）均可降低风险。年龄较大、患有高血压、受教育程度较高和收入较高也与新冠长期症状风险增加有关。
mRNA新冠疫苗和完整的疫苗接种方案对印度尼西亚农村地区的新冠长期症状具有很强的保护作用。这些发现凸显了改善mRNA疫苗和加强针的可及性以减少新冠疫情对服务不足人群长期影响的必要性。
