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Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: A population-based cohort study (COVIDENCE UK)

Giulia Vivaldi Orcid Logo, David A. Jolliffe, Hayley Holt, Florence Tydeman, Mohammad Talaei, Gwyneth Davies Orcid Logo, Ronan Lyons, Christopher J. Griffiths, Frank Kee, Aziz Sheikh, Seif O. Shaheen, Adrian R. Martineau

The Lancet Regional Health - Europe, Volume: 22, Start page: 100501

Swansea University Authors: Gwyneth Davies Orcid Logo, Ronan Lyons

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DOI (Published version): 10.1016/j.lanepe.2022.100501

Abstract

BackgroundLittle 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.MethodsThis prospective, population-based, UK study in adu...

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Published in: The Lancet Regional Health - Europe
ISSN: 2666-7762
Published: Elsevier BV 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa70390
Abstract: BackgroundLittle 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.MethodsThis 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.Findings1051 (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 (vs 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] vs 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 vs 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] vs none; post-booster: 1·29 [1·07–1·56]).
Keywords: SARS-CoV-2; Vaccination; Breakthrough infection; ChAdOx1; BNT162b2; mRNA-1273
College: Faculty of Medicine, Health and Life Sciences
Funders: OVIDENCE UK has received support from Barts Charity (MGU0459, MGU0466), Pharma Nord, the Fischer Family Foundation, DSM Nutritional Products, the Exilarch’s Foundation, the Karl R Pfleger Foundation, the AIM Foundation, Synergy Biologics, Cytoplan, the UK National Institute for Health and Care Research Clinical Research Network (52255; 52257), the Health Data Research UK BREATHE Hub, the UK Research and Innovation Industrial Strategy Challenge Fund (MC_PC_19004), Thornton & Ross, Warburtons, Matthew Isaacs (personal donation), Barbara Boucher (personal donation), and Hyphens Pharma. M.T. was supported by a grant from the Rosetrees Trust and The Bloom Foundation (M771) until May, 2021, and has been supported by Barts Charity since (MGU0570). D.A.J. is supported by a Barts Charity Lectureship (MGU045). The views expressed are those of the authors and not necessarily those of the funders. We thank all participants of COVIDENCE UK, and the following organisations who supported study recruitment: Asthma UK/British Lung Foundation, the British Heart Foundation, the British Obesity Society, Cancer Research UK, Diabetes UK, Future Publishing, Kidney Care UK, Kidney Wales, Mumsnet, the National Kidney Federation, the National Rheumatoid Arthritis Society, the North West London Health Research Register (DISCOVER), Primary Immunodeficiency UK, the Race Equality Foundation, SWM Health, the Terence Higgins Trust, and Vasculitis UK.
Start Page: 100501

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