Efficacy of the Covid-19 Vaccine after Recovery from COVID-19
The New England Journal of Medicine
TAKE-HOME MESSAGE
This retrospective study evaluated the effectiveness of the Pfizer (BNT162b2) COVID-19 vaccine in preventing reinfection in patients who had recovered from COVID-19.
A total of 149,039 patients who had recovered from COVID-19 were included, and, of these, 56% were subsequently vaccinated with the BNT162b2 vaccine. The reinfection rates were 2.46 cases per 100,000 persons per day and 10.21 cases per 100,000 persons per day in vaccinated and unvaccinated patients, respectively.
Among those who recovered from COVID-19, administration of the BNT162b2 vaccine was associated with a significantly decreased risk of reinfection.
COVID-19 vaccination following infection is an effective strategy to reduce reinfection risk.
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BACKGROUND
The risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) decreases substantially among patients who have recovered from coronavirus disease 2019 (Covid-19). However, it is unknown how long protective immunity lasts. Current guidelines recommend vaccination of recovered patients even though data regarding vaccine effectiveness in such cases are still limited.
METHODS
In this retrospective cohort study, authors reviewed electronic medical records from a large health care organization in Israel to assess reinfection rates in patients who had recovered from SARS-CoV-2 infection before any vaccination against Covid-19. Authors compared reinfection rates among patients who had subsequently received the BNT162b2 vaccine (Pfizer-BioNTech) and those who had not been vaccinated between March 1 and November 26, 2021. Authors used a Cox proportional-hazards regression model with time-dependent covariates to estimate the association between vaccination and reinfection after adjustment for demographic factors and coexisting illnesses. Vaccine effectiveness was estimated as 1 minus the hazard ratio. In a secondary analysis, Authors evaluated the vaccine effectiveness of one dose as compared with two doses.
RESULTS
A total of 149,032 patients who had recovered from SARS-CoV-2 infection met the eligibility criteria. Of these patients, 83,356 (56%) received subsequent vaccination during the 270-day study period. Reinfection occurred in 354 of the vaccinated patients (2.46 cases per 100,000 persons per day) and in 2168 of 65,676 unvaccinated patients (10.21 cases per 100,000 persons per day). Vaccine effectiveness was estimated at 82% among patients who were 16 to 64 years of age and 60% among those 65 years of age or older. No significant difference in vaccine effectiveness was found for one dose as compared with two doses.
CONCLUSIONS
Among patients who had recovered from Covid-19, the receipt of at least one dose of the BNT162b2 vaccine was associated with a significantly lower risk of recurrent infection.
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