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. 2025 Dec;21(1):2474772.
doi: 10.1080/21645515.2025.2474772. Epub 2025 Mar 13.

Factors affecting the impact of COVID-19 vaccination on post COVID-19 conditions among adults: A systematic literature review

Abby E Rudolph  1 , Nadine Al Akoury  2 , Natalija Bogdanenko  3 , Kristen Markus  4 , Isabelle Whittle  4 , Olivia Wright  4 , Hammam Haridy  5 , Julia R Spinardi  6 , John M McLaughlin  1 , Moe H Kyaw  1
Affiliations

Factors affecting the impact of COVID-19 vaccination on post COVID-19 conditions among adults: A systematic literature review

Abby E Rudolph et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

This systematic literature review summarizes the evidence across 56 publications and pre-prints (January 2020-July 2023) with low-risk of bias based on JBI critical appraisal, that report adjusted estimates for the relationship between COVID-19 vaccination and Post-COVID-19 Condition (PCC) by timing of vaccination relative to infection or PCC-onset. Comparisons of adjusted vaccine effectiveness (aVE) against ≥1 PCC (vs. unvaccinated) across study characteristics known to impact PCC burden or VE against other COVID-19 endpoints were possible for 31 studies where vaccination preceded infection. Seventy-seven percent of pre-infection aVE estimates were statistically significant (range: 7%-95%). Statistically significant pre-infection aVE estimates were slightly higher for mRNA (range: 14%-84%) than non-mRNA vaccines (range: 16%-38%) and aVE ranges before and during Omicron overlapped. Our findings suggest that COVID-19 vaccination before SARS-CoV-2 infection reduces the risk of PCC regardless of vaccine type, number of doses received, PCC definition, predominant variant, and severity of acute infections included.

Keywords: COVID-19 vaccine; Post-COVID conditions; SARS-CoV-2; long COVID; post-acute sequelae of SARS-CoV-2 infection; vaccine effectiveness.

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Conflict of interest statement

Nadine Al Akoury, Moe H. Kyaw, Abby E. Rudolph, Julia Spinardi, John M. McLaughlin, and Hammam Haridy are employees of Pfizer Inc. and may hold stock or stock options. Kristen Markus, Isabelle Whittle, and Olivia Wright are employees of Adelphi Values PROVE™. Adelphi Values PROVE™ received funding from the study sponsor for the conduct of the review

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of included studies.
Figure 2.
Figure 2.
Adjusted pre-infection VE against ≥1 PCC (vs. Unvaccinated) for any or unspecified vaccine type or manufacturer, by vaccine type and number of doses (n = 16 estimates from 19 publications).
Figure 3.
Figure 3.
Adjusted pre-infection VE against ≥1 PCC (vs. Unvaccinated) for mRNA and non-mRNA vaccines, by vaccine type, manufacturer and dose (n = 31 estimates from 12 publications).
Figure 4.
Figure 4.
Adjusted pre-infection VE against ≥1 PCC (vs. Unvaccinated), by predominant variant circulating during acute infection.
Figure 5.
Figure 5.
Adjusted pre-infection VE against ≥1 PCC (vs. Unvaccinated), by PCC data source.
See this image and copyright information in PMC

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