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J Infect Dis . Population-Level Relative Effectiveness of the COVID-19 Vaccines and the Contribution of Naturally Acquired Immunity

tetano

Editor, Senior Moderator
J Infect Dis


. 2022 Dec 7;jiac483.
doi: 10.1093/infdis/jiac483. Online ahead of print.
Population-Level Relative Effectiveness of the COVID-19 Vaccines and the Contribution of Naturally Acquired Immunity


Kayoko Shioda[SUP] 1 2 [/SUP], Yangping Chen[SUP] 1 [/SUP], Matthew H Collins[SUP] 3 [/SUP], Benjamin A Lopman[SUP] 1 [/SUP]



Affiliations

Abstract

Background: Immune protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be induced by natural infection or vaccination or both. Interaction between vaccine-induced immunity and naturally acquired immunity at the population level has been understudied.
Methods: We used regression models to evaluate whether the impact of coronavirus disease 2019 (COVID-19) vaccines differed across states with different levels of naturally acquired immunity from March 2021 to April 2022 in the United States. Analysis was conducted for 3 evaluation periods separately (Alpha, Delta, and Omicron waves). As a proxy for the proportion of the population with naturally acquired immunity, we used either the reported seroprevalence or the estimated proportion of the population ever infected in each state.
Results: COVID-19 mortality decreased as coverage of ≥1 dose increased among people ≥65 years of age, and this effect did not vary by seroprevalence or proportion of the total population ever infected. Seroprevalence and proportion ever infected were not associated with COVID-19 mortality, after controlling for vaccine coverage. These findings were consistent in all evaluation periods.
Conclusions: COVID-19 vaccination was associated with a sustained reduction in mortality at state level during the Alpha, Delta, and Omicron periods. The effect did not vary by naturally acquired immunity.

Keywords: COVID-19; SARS-CoV-2; booster; cumulative incidence; naturally acquired immunity; proportion of the population ever infected; seroprevalence; vaccine coverage; vaccine-induced immunity; waning antibodies.
 
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