Protection and Waning of Natural and Hybrid Immunity to SARS-CoV-2.
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
09 06 2022
09 06 2022
Historique:
pubmed:
26
5
2022
medline:
11
6
2022
entrez:
25
5
2022
Statut:
ppublish
Résumé
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides natural immunity against reinfection. Recent studies have shown waning of the immunity provided by the BNT162b2 vaccine. The time course of natural and hybrid immunity is unknown. Using the Israeli Ministry of Health database, we extracted data for August and September 2021, when the B.1.617.2 (delta) variant was predominant, on all persons who had been previously infected with SARS-CoV-2 or who had received coronavirus 2019 vaccine. We used Poisson regression with adjustment for confounding factors to compare the rates of infection as a function of time since the last immunity-conferring event. The number of cases of SARS-CoV-2 infection per 100,000 person-days at risk (adjusted rate) increased with the time that had elapsed since vaccination with BNT162b2 or since previous infection. Among unvaccinated persons who had recovered from infection, this rate increased from 10.5 among those who had been infected 4 to less than 6 months previously to 30.2 among those who had been infected 1 year or more previously. Among persons who had received a single dose of vaccine after previous infection, the adjusted rate was low (3.7) among those who had been vaccinated less than 2 months previously but increased to 11.6 among those who had been vaccinated at least 6 months previously. Among previously uninfected persons who had received two doses of vaccine, the adjusted rate increased from 21.1 among those who had been vaccinated less than 2 months previously to 88.9 among those who had been vaccinated at least 6 months previously. Among persons who had been previously infected with SARS-CoV-2 (regardless of whether they had received any dose of vaccine or whether they had received one dose before or after infection), protection against reinfection decreased as the time increased since the last immunity-conferring event; however, this protection was higher than that conferred after the same time had elapsed since receipt of a second dose of vaccine among previously uninfected persons. A single dose of vaccine after infection reinforced protection against reinfection.
Sections du résumé
BACKGROUND
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides natural immunity against reinfection. Recent studies have shown waning of the immunity provided by the BNT162b2 vaccine. The time course of natural and hybrid immunity is unknown.
METHODS
Using the Israeli Ministry of Health database, we extracted data for August and September 2021, when the B.1.617.2 (delta) variant was predominant, on all persons who had been previously infected with SARS-CoV-2 or who had received coronavirus 2019 vaccine. We used Poisson regression with adjustment for confounding factors to compare the rates of infection as a function of time since the last immunity-conferring event.
RESULTS
The number of cases of SARS-CoV-2 infection per 100,000 person-days at risk (adjusted rate) increased with the time that had elapsed since vaccination with BNT162b2 or since previous infection. Among unvaccinated persons who had recovered from infection, this rate increased from 10.5 among those who had been infected 4 to less than 6 months previously to 30.2 among those who had been infected 1 year or more previously. Among persons who had received a single dose of vaccine after previous infection, the adjusted rate was low (3.7) among those who had been vaccinated less than 2 months previously but increased to 11.6 among those who had been vaccinated at least 6 months previously. Among previously uninfected persons who had received two doses of vaccine, the adjusted rate increased from 21.1 among those who had been vaccinated less than 2 months previously to 88.9 among those who had been vaccinated at least 6 months previously.
CONCLUSIONS
Among persons who had been previously infected with SARS-CoV-2 (regardless of whether they had received any dose of vaccine or whether they had received one dose before or after infection), protection against reinfection decreased as the time increased since the last immunity-conferring event; however, this protection was higher than that conferred after the same time had elapsed since receipt of a second dose of vaccine among previously uninfected persons. A single dose of vaccine after infection reinforced protection against reinfection.
Identifiants
pubmed: 35613036
doi: 10.1056/NEJMoa2118946
pmc: PMC9165562
doi:
Substances chimiques
COVID-19 Vaccines
0
Viral Vaccines
0
BNT162 Vaccine
N38TVC63NU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2201-2212Informations de copyright
Copyright © 2022 Massachusetts Medical Society.
Références
Lancet. 2021 Oct 16;398(10309):1407-1416
pubmed: 34619098
N Engl J Med. 2021 Dec 23;385(26):2421-2430
pubmed: 34879188
JAMA. 2021 Nov 16;326(19):1930-1939
pubmed: 34724027
Am J Epidemiol. 2022 Mar 24;191(5):800-811
pubmed: 35081612
Nature. 2021 Mar;591(7851):639-644
pubmed: 33461210
J Infect Dis. 2021 Jul 2;224(1):49-59
pubmed: 33755731
N Engl J Med. 2021 Oct 7;385(15):1393-1400
pubmed: 34525275
MMWR Morb Mortal Wkly Rep. 2021 Nov 05;70(44):1539-1544
pubmed: 34735425
Lancet Microbe. 2021 Dec;2(12):e666-e675
pubmed: 34632431
N Engl J Med. 2021 Dec 9;385(24):e85
pubmed: 34706170
Eur J Clin Invest. 2021 Apr;51(4):e13520
pubmed: 33583018
Nat Med. 2020 Nov;26(11):1691-1693
pubmed: 32929268
N Engl J Med. 2021 Dec 9;385(24):e84
pubmed: 34614326
Am J Epidemiol. 2022 Jul 23;191(8):1420-1428
pubmed: 35355048
Nature. 2021 Oct;598(7881):393-394
pubmed: 34650244
Science. 2021 Mar 25;:
pubmed: 33766944
Nature. 2021 Jul;595(7867):426-431
pubmed: 34126625