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. 2024 Feb 11;12(2):183.
doi: 10.3390/vaccines12020183.

Effectiveness of BNT162b2 BA.4/5 Bivalent COVID-19 Vaccine against Long COVID Symptoms: A US Nationwide Study

Manuela Di Fusco  1 , Xiaowu Sun  2 , Kristen E Allen  1 , Alon Yehoshua  1 , Alexandra Berk  2 , Mary B Alvarez  1 , Thomas M Porter  1 , Jinma Ren  1 , Laura Puzniak  1 , Santiago M C Lopez  1 , Joseph C Cappelleri  1
Affiliations

Effectiveness of BNT162b2 BA.4/5 Bivalent COVID-19 Vaccine against Long COVID Symptoms: A US Nationwide Study

Manuela Di Fusco et al. Vaccines (Basel). .

Abstract

Background: Long COVID has become a central public health concern. This study characterized the effectiveness of BNT162b2 BA.4/5 bivalent COVID-19 vaccine (bivalent) against long COVID symptoms.

Methods: Symptomatic US adult outpatients testing positive for SARS-CoV-2 were recruited between 2 March and 18 May 2023. Symptoms were assessed longitudinally using a CDC-based symptom questionnaire at Week 4, Month 3, and Month 6 following infection. The odds ratio (OR) of long COVID between vaccination groups was assessed by using mixed-effects logistic models, adjusting for multiple covariates.

Results: At Week 4, among 505 participants, 260 (51%) were vaccinated with bivalent and 245 (49%) were unvaccinated. Mean age was 46.3 years, 70.7% were female, 25.1% had ≥1 comorbidity, 43.0% prior infection, 23.0% reported Nirmatrelvir/Ritonavir use. At Month 6, the bivalent cohort had 41% lower risk of long COVID with ≥3 symptoms (OR: 0.59, 95% CI, 0.36-0.96, p = 0.034) and 37% lower risk of ≥2 symptoms (OR: 0.63, 95% CI, 0.41-0.96, p = 0.030). The bivalent cohort reported fewer and less durable symptoms throughout the six-month follow-up, driven by neurologic and general symptoms, especially fatigue.

Conclusions: Compared with unvaccinated participants, participants vaccinated with the bivalent were associated with approximately 40% lower risk of long COVID and less symptom burden over the six-month study duration.

Keywords: BA.4/5; BNT162b2; COVID-19; COVID-19 symptoms; PASC; SARS-CoV-2; bivalent; long COVID.

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Conflict of interest statement

M.D.F., A.Y., M.B.A., K.E.A., T.M.P., L.P., J.R., S.M.C.L. and J.C.C. are employees of Pfizer and may hold stock or stock options of Pfizer. X.S. and A.B. are employees of CVS Health and may hold stock of CVS Health.

Figures

Figure 1
Figure 1
Prevalence of long COVID symptoms by COVID-19 vaccination status and symptoms category across time points (Week 4, Month 3, Month 6). The category “Other” included: rash, joint or muscle pain, hair loss, changes in menstrual cycles.
Figure 2
Figure 2
Prevalence of long COVID symptoms by COVID-19 vaccination status.
Figure 2
Figure 2
Prevalence of long COVID symptoms by COVID-19 vaccination status.
Figure 3
Figure 3
Distribution of study participants across ordinal categories of number of symptoms and COVID-19 vaccination status, across time points (Week 4, Month 3, Month 6). For each vertical bar chart, the sum of the percentages equals 100% (allowing for rounding).
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