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. 2023 Feb;28(7):2200724.
doi: 10.2807/1560-7917.ES.2023.28.7.2200724.

Higher risk of SARS-CoV-2 Omicron BA.4/5 infection than of BA.2 infection after previous BA.1 infection, the Netherlands, 2 May to 24 July 2022

Stijn P Andeweg  1 , Brechje de Gier  1 , Harry Vennema  1 , Ivo van Walle  1 , Noortje van Maarseveen  2   3 , Nina E Kusters  2 , Hester E de Melker  1 , Susan Jm Hahné  1 , Susan van den Hof  1 , Dirk Eggink  1 , Mirjam J Knol  1
Affiliations

Higher risk of SARS-CoV-2 Omicron BA.4/5 infection than of BA.2 infection after previous BA.1 infection, the Netherlands, 2 May to 24 July 2022

Stijn P Andeweg et al. Euro Surveill. 2023 Feb.

Abstract

BackgroundIn summer 2022, SARS-CoV-2 Omicron BA.5 became dominant in Europe. In vitro studies have shown a large reduction of antibody neutralisation for this variant.AimWe aimed to investigate differences in protection from previous infection and/or vaccination against infection with Omicron BA.4/5 vs BA.2.MethodsWe employed a case-only approach including positive PCR tests from community testing between 2 May and 24 July 2022 that were tested for S gene target failure (SGTF), which distinguishes BA.4/5 from BA.2 infection. Previous infections were categorised by variant using whole genome sequencing or SGTF. We estimated by logistic regression the association of SGTF with vaccination and/or previous infection, and of SGTF of the current infection with the variant of the previous infection, adjusting for testing week, age group and sex.ResultsThe percentage of registered previous SARS-CoV-2 infections was higher among 19,836 persons infected with Omicron BA.4/5 than among 7,052 persons infected with BA.2 (31.3% vs 20.0%). Adjusting for testing week, age group and sex, the adjusted odds ratio (aOR) was 1.4 (95% CI: 1.3-1.5). The distribution of vaccination status did not differ for BA.4/5 vs BA.2 infections (aOR = 1.1 for primary and booster vaccination). Among persons with a previous infection, those currently infected with BA4/5 had a shorter interval between infections, and the previous infection was more often caused by BA.1, compared with those currently infected with BA.2 (aOR = 1.9; 95% CI: 1.5-2.6).ConclusionOur results suggest immunity induced by BA.1 is less effective against BA.4/5 infection than against BA.2 infection.

Keywords: Omicron BA.2; Omicron BA.4; Omicron BA.5; SARS-CoV-2; Vaccination; previous infection.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Proportion of cases infected with SARS-CoV-2 BA.2 (non-SGTF) and BA.4/5 (SGTF) who had previous infections (n = 26,888) and different vaccination histories (n = 17,391), per week, the Netherlands, 2 May–24 July 2022
Figure 2
Figure 2
Interval of testing dates between previous and current infections with SARS-CoV-2 BA.2 (non-SGTF) and BA.4/5 (SGTF), in days, the Netherlands, 2 May–24 July 2022 (n = 7,625)
See this image and copyright information in PMC

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