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Meta-Analysis
. 2023 Mar 10;41(11):1783-1790.
doi: 10.1016/j.vaccine.2023.02.008. Epub 2023 Feb 8.

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis

Atsuyuki Watanabe  1 , Masao Iwagami  2 , Jun Yasuhara  3 , Hisato Takagi  4 , Toshiki Kuno  5
Affiliations
Meta-Analysis

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis

Atsuyuki Watanabe et al. Vaccine. .

Abstract

Background: The relationship between coronavirus disease 2019 (COVID-19) vaccination and long COVID has not been firmly established. We conducted a systematic review and meta-analysis to evaluate the association between COVID-19 vaccination and long COVID.

Methods: PubMed and EMBASE databases were searched on September 2022 without language restrictions (CRD42022360399) to identify prospective trials and observational studies comparing patients with and without vaccination before severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We also included studies reporting symptomatic changes of ongoing long COVID following vaccination among those with a history of SARS-CoV-2 infection. Odds ratios (ORs) for each outcome were synthesized using a random-effects model. Symptomatic changes after vaccination were synthesized by a one-group meta-analysis.

Results: Six observational studies involving 536,291 unvaccinated and 84,603 vaccinated (before SARS-CoV-2 infection) patients (mean age, 41.2-66.6; female, 9.0-67.3%) and six observational studies involving 8,199 long COVID patients (mean age, 40.0 to 53.5; female, 22.2-85.9%) who received vaccination after SARS-CoV-2 infection were included. Two-dose vaccination was associated with a lower risk of long COVID compared to no vaccination (OR, 0.64; 95% confidence interval [CI], 0.45-0.92) and one-dose vaccination (OR, 0.60; 95% CI, 0.43-0.83). Two-dose vaccination compared to no vaccination was associated with a lower risk of persistent fatigue (OR, 0.62; 95% CI, 0.41-0.93) and pulmonary disorder (OR, 0.50; 95% CI, 0.47-0.52). Among those with ongoing long COVID symptoms, 54.4% (95% CI, 34.3-73.1%) did not report symptomatic changes following vaccination, while 20.3% (95% CI, 8.1-42.4%) experienced symptomatic improvement after two weeks to six months of COVID-19 vaccination.

Conclusions: COVID-19 vaccination before SARS-CoV-2 infection was associated with a lower risk of long COVID, while most of those with ongoing long COVID did not experience symptomatic changes following vaccination.

Keywords: COVID-19; Long COVID; Post-acute sequelae of COVID-19; SARS-CoV-2; Vaccine.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of study selection.
Fig. 2
Fig. 2
Forest plots showing the odds ratio of long COVID (a: two-dose vaccination vs no vaccination, b: two-dose vaccination vs one-dose vaccination, c: one-dose vaccination vs no vaccination).
Fig. 3
Fig. 3
Forest plots showing the symptomatic change of long COVID after vaccination (a: improved, b: worsened, c: unchanged).
See this image and copyright information in PMC

References

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