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Post-COVID conditions following COVID-19 vaccination: a retrospective matched cohort study of patients with SARS-CoV-2 infection

Author

Listed:
  • Debbie E. Malden

    (Department of Research & Evaluation)

  • In-Lu Amy Liu

    (Department of Research & Evaluation)

  • Lei Qian

    (Department of Research & Evaluation)

  • Lina S. Sy

    (Department of Research & Evaluation)

  • Bruno J. Lewin

    (Department of Research & Evaluation
    Department of Clinical Science)

  • Dawn T. Asamura

    (Department of Research & Evaluation)

  • Denison S. Ryan

    (Department of Research & Evaluation)

  • Cassandra Bezi

    (Department of Research & Evaluation)

  • Joshua T. B. Williams

    (Ambulatory Care Services & Center for Health Systems Research)

  • Robyn Kaiser

    (HealthPartners Institute)

  • Matthew F. Daley

    (Institute for Health Research)

  • Jennifer C. Nelson

    (Kaiser Permanente Washington Health Research Institute (KPWHRI))

  • David L. McClure

    (Marshfield Clinic Research Institute)

  • Ousseny Zerbo

    (Vaccine Study Center)

  • Michelle L. Henninger

    (Center for Health Research)

  • Candace C. Fuller

    (Harvard Pilgrim Health Care Institute)

  • Eric S. Weintraub

    (Immunization Safety Office)

  • Sharon Saydah

    (Immunization Safety Office)

  • Sara Y. Tartof

    (Department of Research & Evaluation
    Department of Health Systems Science)

Abstract

COVID-19 vaccinations protect against severe illness and death, but associations with post-COVID conditions (PCC) are less clear. We aimed to evaluate the association between prior COVID-19 vaccination and new-onset PCC among individuals with SARS-CoV-2 infection across eight large healthcare systems in the United States. This retrospective matched cohort study used electronic health records (EHR) from patients with SARS-CoV-2 positive tests during March 2021-February 2022. Vaccinated and unvaccinated COVID-19 cases were matched on location, test date, severity of acute infection, age, and sex. Vaccination status was ascertained using EHR and integrated data on externally administered vaccines. Adjusted relative risks (RRs) were obtained from Poisson regression. PCC was defined as a new diagnosis in one of 13 PCC categories 30 days to 6 months following a positive SARS-CoV-2 test. The study included 161,531 vaccinated COVID-19 cases and 161,531 matched unvaccinated cases. Compared to unvaccinated cases, vaccinated cases had a similar or lower risk of all PCC categories except mental health disorders (RR: 1.06, 95% CI: 1.02–1.10). Vaccination was associated with ≥10% lower risk of sensory (RR: 0.90, 0.86–0.95), circulatory (RR: 0.88, 0.83–0.94), blood and hematologic (RR: 0.79, 0.71–0.89), skin and subcutaneous (RR: 0.69, 0.66–0.72), and non-specific COVID-19 related disorders (RR: 0.53, 0.51–0.56). In general, associations were stronger at younger ages but mostly persisted regardless of SARS-CoV-2 variant period, receipt of ≥3 vs. 1–2 vaccine doses, or time since vaccination. Pre-infection vaccination was associated with reduced risk of several PCC outcomes and hence may decrease the long-term consequences of COVID-19.

Suggested Citation

  • Debbie E. Malden & In-Lu Amy Liu & Lei Qian & Lina S. Sy & Bruno J. Lewin & Dawn T. Asamura & Denison S. Ryan & Cassandra Bezi & Joshua T. B. Williams & Robyn Kaiser & Matthew F. Daley & Jennifer C. N, 2024. "Post-COVID conditions following COVID-19 vaccination: a retrospective matched cohort study of patients with SARS-CoV-2 infection," Nature Communications, Nature, vol. 15(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-48022-9
    DOI: 10.1038/s41467-024-48022-9
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    References listed on IDEAS

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    1. M. Daniel Brannock & Robert F. Chew & Alexander J. Preiss & Emily C. Hadley & Signe Redfield & Julie A. McMurry & Peter J. Leese & Andrew T. Girvin & Miles Crosskey & Andrea G. Zhou & Richard A. Moffi, 2023. "Long COVID risk and pre-COVID vaccination in an EHR-based cohort study from the RECOVER program," Nature Communications, Nature, vol. 14(1), pages 1-12, December.
    2. Karin Magnusson & Doris Tove Kristoffersen & Andrea Dell’Isola & Ali Kiadaliri & Aleksandra Turkiewicz & Jos Runhaar & Sita Bierma-Zeinstra & Martin Englund & Per Minor Magnus & Jonas Minet Kinge, 2022. "Post-covid medical complaints following infection with SARS-CoV-2 Omicron vs Delta variants," Nature Communications, Nature, vol. 13(1), pages 1-9, December.
    3. Michael Marshall, 2021. "The four most urgent questions about long COVID," Nature, Nature, vol. 594(7862), pages 168-170, June.
    Full references (including those not matched with items on IDEAS)

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