As of 31 August 2021, there have
been 1,500,618 confirmed cases of COVID-19 in Bangladesh, reported to WHO, and
a total of 26,535,211 vaccine doses have been administered.
An important question emerges: if
infected, are we protected? There has been considerable discussion over the
past 4 months on COVID-19 vaccine effectiveness, but what is the effectiveness
and durability of prior infection?
To answer this question, researchers
in Denmark made use of a nationwide registry of PCR results from SARS-CoV-2
testing. Starting with individuals who were tested during Denmark’s first
COVID-19 wave (before June 1, 2020), the researchers then evaluated PCR results
from the same individuals during the second wave (September 1 through December
31, 2020).
Accordingly, they identified
11,068 positive cases and 514,271 negative cases in the first wave. During the
second wave, those who were previously positive had an infection rate of 5.4
cases per 100,000 person-days compared with 27.1/100,000 for the PCR-negative
group. This resulted in an estimated protection of 80.5% (95% CI, 75.4–84.5). A
similar result was obtained when only those individuals who had repeated
testing based on occupation were considered. There were no differences based on
sex or amount of time in follow-up. Of note, however, was a drop-off in
protection for those over age 65 years (down to 47.1% protection).
Observational studies are always a bit risky; but this one was done well and
utilized a number of alternative approaches to help validate the results. The
period of time between the first and second wave assessment periods was 92
days, so the results apply to a moderate time scale.
The take-home messages for
health-care clinicians are as follows:
We will need the
combined forces of immunity acquired by past infection and through active
vaccination to achieve the needed level of herd immunity. The potential
protection offered by both routes, however, is promising.
https://covid19.who.int/region/searo/country/bd
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