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Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study

Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study
Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study

Objective: To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination. Design: Observational cohort study. Setting: Community dwelling population, UK. Participants: 28 356 participants in the Office for National Statistics COVID-19 Infection Survey aged 18-69 years who received at least one dose of an adenovirus vector or mRNA covid-19 vaccine after testing positive for SARS-CoV-2 infection. Main outcome measure: Presence of long covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021. Results: Mean age of participants was 46 years, 55.6% (n=15 760) were women, and 88.7% (n=25 141) were of white ethnicity. Median follow-up was 141 days from first vaccination (among all participants) and 67 days from second vaccination (83.8% of participants). 6729 participants (23.7%) reported long covid symptoms of any severity at least once during follow-up. A first vaccine dose was associated with an initial 12.8% decrease (95% confidence interval -18.6% to -6.6%, P<0.001) in the odds of long covid, with subsequent data compatible with both increases and decreases in the trajectory (0.3% per week, 95% confidence interval -0.6% to 1.2% per week, P=0.51). A second dose was associated with an initial 8.8% decrease (95% confidence interval -14.1% to -3.1%, P=0.003) in the odds of long covid, with a subsequent decrease by 0.8% per week (-1.2% to -0.4% per week, P<0.001). Heterogeneity was not found in associations between vaccination and long covid by sociodemographic characteristics, health status, hospital admission with acute covid-19, vaccine type (adenovirus vector or mRNA), or duration from SARS-CoV-2 infection to vaccination. Conclusions: The likelihood of long covid symptoms was observed to decrease after covid-19 vaccination and evidence suggested sustained improvement after a second dose, at least over the median follow-up of 67 days. Vaccination may contribute to a reduction in the population health burden of long covid, although longer follow-up is needed.

0959-8138
e069676
Ayoubkhani, Daniel
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Bermingham, Charlotte
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Pouwels, Koen B
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Glickman, Myer
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Nafilyan, Vahé
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Zaccardi, Francesco
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Khunti, Kamlesh
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Alwan, Nisreen A.
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Walker, A. Sarah
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Ayoubkhani, Daniel
cfd1b0e2-6685-4edb-a53f-299582b89280
Bermingham, Charlotte
097f6236-9ec0-41c4-afc0-3cb8881640f1
Pouwels, Koen B
0f98f313-4c0b-42d9-9a50-183d32005db3
Glickman, Myer
61b66cbc-a403-4cd6-b7b5-eb18fccae968
Nafilyan, Vahé
bae04e8d-af87-4def-965c-3d59e2017a9b
Zaccardi, Francesco
8d31a980-3db1-4477-9514-c18087cf886a
Khunti, Kamlesh
9c8c31f1-6a5c-41d6-b683-9d7d804656b6
Alwan, Nisreen A.
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Walker, A. Sarah
e07841ba-91e9-4b85-971b-b95c299afa3a

Ayoubkhani, Daniel, Bermingham, Charlotte, Pouwels, Koen B, Glickman, Myer, Nafilyan, Vahé, Zaccardi, Francesco, Khunti, Kamlesh, Alwan, Nisreen A. and Walker, A. Sarah (2022) Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study. The BMJ, e069676, [e069676]. (doi:10.1136/bmj-2021-069676).

Record type: Article

Abstract

Objective: To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination. Design: Observational cohort study. Setting: Community dwelling population, UK. Participants: 28 356 participants in the Office for National Statistics COVID-19 Infection Survey aged 18-69 years who received at least one dose of an adenovirus vector or mRNA covid-19 vaccine after testing positive for SARS-CoV-2 infection. Main outcome measure: Presence of long covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021. Results: Mean age of participants was 46 years, 55.6% (n=15 760) were women, and 88.7% (n=25 141) were of white ethnicity. Median follow-up was 141 days from first vaccination (among all participants) and 67 days from second vaccination (83.8% of participants). 6729 participants (23.7%) reported long covid symptoms of any severity at least once during follow-up. A first vaccine dose was associated with an initial 12.8% decrease (95% confidence interval -18.6% to -6.6%, P<0.001) in the odds of long covid, with subsequent data compatible with both increases and decreases in the trajectory (0.3% per week, 95% confidence interval -0.6% to 1.2% per week, P=0.51). A second dose was associated with an initial 8.8% decrease (95% confidence interval -14.1% to -3.1%, P=0.003) in the odds of long covid, with a subsequent decrease by 0.8% per week (-1.2% to -0.4% per week, P<0.001). Heterogeneity was not found in associations between vaccination and long covid by sociodemographic characteristics, health status, hospital admission with acute covid-19, vaccine type (adenovirus vector or mRNA), or duration from SARS-CoV-2 infection to vaccination. Conclusions: The likelihood of long covid symptoms was observed to decrease after covid-19 vaccination and evidence suggested sustained improvement after a second dose, at least over the median follow-up of 67 days. Vaccination may contribute to a reduction in the population health burden of long covid, although longer follow-up is needed.

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Accepted/In Press date: 12 April 2022
Published date: 18 May 2022
Additional Information: Publisher Copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

Identifiers

Local EPrints ID: 457163
URI: http://eprints.soton.ac.uk/id/eprint/457163
ISSN: 0959-8138
PURE UUID: 4290429c-d29d-447d-9f17-f028ba8adf56
ORCID for Nisreen A. Alwan: ORCID iD orcid.org/0000-0002-4134-8463

Catalogue record

Date deposited: 25 May 2022 16:51
Last modified: 05 Oct 2022 01:48

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Contributors

Author: Daniel Ayoubkhani
Author: Charlotte Bermingham
Author: Koen B Pouwels
Author: Myer Glickman
Author: Vahé Nafilyan
Author: Francesco Zaccardi
Author: Kamlesh Khunti
Author: A. Sarah Walker

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