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Abstract

Background

COVID-19 remains a major infectious disease with substantial implications for individual and public health including the risk of a post-infection syndrome, long COVID. The continuous changes in dominant variants of SARS-CoV-2 necessitate a careful study of the effect of preventative strategies.

Aim

We aimed to estimate the effectiveness of post-vaccination, post-infection and hybrid immunity against severe cases requiring oxygen support caused by infections with SARS-CoV-2 variants BA1/2 and BA4/5+, and against long COVID in the infected population and their changes over time.

Methods

We used a Cox regression analysis with time-varying covariates and calendar time and logistic regression applied to national-level data from Czechia from December 2021 until August 2023.

Results

Recently boosted vaccination, post-infection and hybrid immunity provide significant protection against a severe course of COVID-19, while unboosted vaccination more than 10 months ago has a negligible protective effect. The post-vaccination immunity against the BA1/2 or BA4/5+ variants, especially based on the original vaccine types, appears to wane rapidly compared with post-infection and hybrid immunity. Once infected, however, previous immunity plays only a small protective role against long COVID.

Conclusion

Vaccination remains an effective preventative measure against a severe course of COVID-19 but its effectiveness wanes over time thus highlighting the importance of booster doses. Once infected, vaccines may have a small protective effect against the development of long COVID.

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2024-08-29
2024-09-01
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.35.2300690
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Post-vaccination, post-infection and hybrid immunity against severe cases of COVID-19 and long COVID after infection with SARS-CoV-2 Omicron subvariants, Czechia, December 2021 to August 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Martin+%C5%A0m%C3%ADd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Šmíd Martin</a>, <a href="/search?value1=Tamara+Barusov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Barusová Tamara</a>, <a href="/search?value1=Ji%C5%99%C3%AD+Jarkovsk%C3%BD&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jarkovský Jiří</a>, <a href="/search?value1=Ond%C5%99ej+M%C3%A1jek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Májek Ondřej</a>, <a href="/search?value1=Tom%C3%A1%C5%A1+Pavl%C3%ADk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pavlík Tomáš</a>, <a href="/search?value1=Lenka+P%C5%99ibylov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Přibylová Lenka</a>, <a href="/search?value1=Josef%C3%ADna+Weinerov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Weinerová Josefína</a>, <a href="/search?value1=Milan+Zaj%C3%AD%C4%8Dek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zajíček Milan</a>, <a href="/search?value1=Jan+Trnka&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Trnka Jan</a></span>. Post-vaccination, post-infection and hybrid immunity against severe cases of COVID-19 and long COVID after infection with SARS-CoV-2 Omicron subvariants, Czechia, December 2021 to August 2023. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(35):pii=2300690. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.35.2300690" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.35.2300690</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 01 Dec 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 31 May 2024 </span> </p>
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