Preprint: Long COVID Risk and Pre-COVID Vaccination: An EHR-Based Cohort Study from the RECOVER Program 2022 Brannock et al

Abstract

Importance
Characterizing the effect of vaccination on long COVID allows for better healthcare recommendations.

Objective
To determine if, and to what degree, vaccination prior to COVID-19 is associated with eventual long COVID onset, among those a documented COVID-19 infection.

Design,
Settings, and Participants Retrospective cohort study of adults with evidence of COVID-19 between August 1, 2021 and January 31, 2022 based on electronic health records from eleven healthcare institutions taking part in the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, a project of the National Covid Cohort Collaborative (N3C).

Exposures
Pre-COVID-19 receipt of a complete vaccine series versus no pre-COVID-19 vaccination.

Main
Outcomes and Measures Two approaches to the identification of long COVID were used. In the clinical diagnosis cohort (n=47,752), ICD-10 diagnosis codes or evidence of a healthcare encounter at a long COVID clinic were used. In the model-based cohort (n=199,498), a computable phenotype was used. The association between pre-COVID vaccination and long COVID was estimated using IPTW-adjusted logistic regression and Cox proportional hazards.

Results
In both cohorts, when adjusting for demographics and medical history, pre-COVID vaccination was associated with a reduced risk of long COVID (clinic-based cohort: HR, 0.66; 95% CI, 0.55-0.80; OR, 0.69; 95% CI, 0.59-0.82; model-based cohort: HR, 0.62; 95% CI, 0.56-0.69; OR, 0.70; 95% CI, 0.65-0.75).

Conclusions and Relevance
Long COVID has become a central concern for public health experts. Prior studies have considered the effect of vaccination on the prevalence of future long COVID symptoms, but ours is the first to thoroughly characterize the association between vaccination and clinically diagnosed or computationally derived long COVID. Our results bolster the growing consensus that vaccines retain protective effects against long COVID even in breakthrough infections.

Question
Does vaccination prior to COVID-19 onset change the risk of long COVID diagnosis?

Findings
Four observational analyses of EHRs showed a statistically significant reduction in long COVID risk associated with pre-COVID vaccination (first cohort: HR, 0.66; 95% CI, 0.55-0.80; OR, 0.69; 95% CI, 0.59-0.82; second cohort: HR, 0.62; 95% CI, 0.56-0.69; OR, 0.70; 95% CI, 0.65-0.75).

Meaning V
accination prior to COVID onset has a protective association with long COVID even in the case of breakthrough infections.

https://www.medrxiv.org/content/10.1101/2022.10.06.22280795v1

 

The language of "breakthrough infection" really shouldn't be used. It has no meaning, the vaccines don't prevent infection, this is as meaningless as "post-treatment Lyme disease", which assumes things that aren't true, no treatment is 100% effective, especially those ones, and many patients never get treated anyway. So much marketing in the language of medicine.

The findings are basically in an unreadable format so here goes:





And all this tells us is a number of recorded diagnoses, which is a different number than the actual number of patients. Not very helpful, frankly.