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. 2022 Jul 1;5(7):e2223917.
doi: 10.1001/jamanetworkopen.2022.23917.

Effectiveness Associated With Vaccination After COVID-19 Recovery in Preventing Reinfection

Nickolas Lewis  1 , Laura C Chambers  1   2 , Huong T Chu  2 , Taylor Fortnam  1 , Roberta De Vito  1 , Lisa M Gargano  2 , Philip A Chan  1   2   3 , James McDonald  2 , Joseph W Hogan  1
Affiliations

Effectiveness Associated With Vaccination After COVID-19 Recovery in Preventing Reinfection

Nickolas Lewis et al. JAMA Netw Open. .

Abstract

Importance: The benefit of vaccination for preventing reinfection among individuals who have been previously infected with SARS-CoV-2 is largely unknown.

Objective: To obtain population-based estimates of the probability of SARS-CoV-2 reinfection and the effectiveness associated with vaccination after recovery from COVID-19.

Design, setting, and participants: This cohort study used Rhode Island statewide surveillance data from March 1, 2020, to December 9, 2021, on COVID-19 vaccinations, laboratory-confirmed cases, hospitalizations, and fatalities to conduct a population-based, retrospective study during periods when wild type, Alpha, and Delta strains of SARS-CoV-2 were predominant. Participants included Rhode Island residents aged 12 years and older who were previously diagnosed with COVID-19 and unvaccinated at the time of first infection, stratified into 3 subpopulations: long-term congregate care (LTCC) residents, LTCC employees, and the general population (ie, individuals not associated with congregate settings). Data were analyzed from October 2021 to January 2022.

Exposures: Completion of the primary vaccination series, defined as 14 days after the second dose of an mRNA vaccine or 1 dose of vector virus vaccine.

Main outcomes and measures: The main outcome was SARS-CoV-2 reinfection, defined as a laboratory-confirmed positive result on a polymerase chain reaction (PCR) or antigen test at least 90 days after the first laboratory-confirmed positive result on a PCR or antigen test.

Results: Overall, 3124 LTCC residents (median [IQR] age, 81 [71-89]; 1675 [53.6%] females), 2877 LTCC employees (median [IQR] age, 41 [30-53]; 2186 [76.0%] females), and 94 516 members of the general population (median [IQR] age, 35 [24-52] years; 45 030 [47.6%] females) met eligibility criteria. Probability of reinfection at 9 months for those who remained unvaccinated after recovery from prior COVID-19 was 13.0% (95% CI, 12.0%-14.0%) among LTCC residents, 10.0% (95% CI, 8.8%-11.5%) among LTCC employees, and 1.9% (95% CI, 1.8%-2.0%) among the general population. Completion of the primary vaccination series after infection was associated with 49% (95% CI, 27%-65%) protection among LTCC residents, 47% (95% CI, 19%-65%) protection among LTCC employees, and 62% (95% CI, 56%-68%) protection in the general population against reinfection, adjusting for potential sociodemographic and clinical confounders and temporal variation in infection rates.

Conclusions and relevance: These findings suggest that risk of SARS-CoV-2 reinfection after recovery from COVID-19 was relatively high among individuals who remained unvaccinated. Vaccination after recovery from COVID-19 was associated with reducing risk of reinfection by approximately half.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Sample of Observation Patterns
CPVS indicates completion of primary vaccination series.
Figure 2.
Figure 2.. Flowchart for the Analysis Cohort
LTCC indicates long-term congregate care.
Figure 3.
Figure 3.. Kaplan-Meier Curves by Vaccination Status
CPVS indicates completion of primary vaccination series; LTCC, long-term congregate care.
See this image and copyright information in PMC

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