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. 2023 Nov 17;23(1):2281.
doi: 10.1186/s12889-023-17121-5.

Association of known SARS-CoV-2 serostatus and adherence to personal protection measures and the impact of personal protective measures on seropositivity in a population-based cross-sectional study (MuSPAD) in Germany

R Kettlitz #  1 , M Harries #  2   3 , J Ortmann  4 , G Krause  4   5   6 ; MuSPAD Team; A Aigner #  7 , B Lange #  4   5   6
Collaborators, Affiliations

Association of known SARS-CoV-2 serostatus and adherence to personal protection measures and the impact of personal protective measures on seropositivity in a population-based cross-sectional study (MuSPAD) in Germany

R Kettlitz et al. BMC Public Health. .

Erratum in

Abstract

Background: In 2020/2021 in Germany, several non-pharmacological interventions were introduced to lower the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated to what extent knowledge of prior infection with SARS-CoV-2 or vaccination status influenced the use of personal protection measures (PPM). Further, we were interested in the effect of compliance with PPM on SARS-CoV-2 serostatus.

Methods: Data was based on a sequential, multilocal seroprevalence study (MuSPAD), carried out in eight locations from July 2020 to August 2021. We estimated the association between a known SARS-CoV-2 serostatus (reported positive PCR test or vaccination) and self-reported PPM behavior (hand hygiene, physical distancing, wearing face mask), just as the association of PPM compliance with seropositivity against nucleocapsid (NC), receptor-binding domain (RBD), and spike protein (S) antigens. We identified relevant variables and deduced adjustment sets with directed acyclic graphs (DAG), and applied mixed logistic regression.

Results: Out of the 22,297 participants (median age: 54 years, 43% male), 781 were classified as SARS-CoV-2-infected and 3,877 had a vaccinated immune response. Vaccinated individuals were less likely to keep 1.5 m distance [OR = 0.74 (95% CI: 0.57-0.97)] and only partly physically distanced [OR = 0.71 (95% CI: 0.58-0.87)]. Participants with self-reported positive PCR test had a lower chance of adhering partly to physical distancing [OR = 0.70 (95% CI: 0.50-0.99)] in comparison to the reference group. Higher odds of additionally wearing a face mask was observed in vaccinated [OR = 1.28 (95% CI: 1.08-1.51)] even if it was not obligatory. Overall, among unvaccinated participants, we found little evidence of lower odds of seropositivity given mask wearing [OR: 0.91 (95% CI: 0.71-1.16)], physical distancing [OR: 0.84 (95% CI: 0.59-1.20)] and no evidence for completely adhering to hand cleaning [OR: 0.97 (95% CI: 0.29-3.22)].

Conclusions: A known confirmed prior infection and vaccination may have the potential to influence adherence to PPM.

Keywords: Germany; Non-pharmacological interventions; Personal protection measures; SARS-CoV-2; Seroepidemiologic studies; Serostatus.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Adjusted odds ratio (OR) estimates and confidence intervals (CI) for the association of the exposures vaccination and known prior SARS-CoV-2 infection with compliance to personal protection measures
Fig. 2
Fig. 2
Adjusted odds ratio (OR) estimates and confidence intervals (CI) of the primary exposures compliance with personal protection measures on SARS-CoV-2 serostatus
See this image and copyright information in PMC

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