S37 Risk factors for breakthrough COVID-19 in 14, 713 UK adults after primary and booster doses of SARS-CoV-2 vaccines. (11th November 2022)

• Record Type: Journal Article
• Authors: Vivaldi, G; Jolliffe, DA; Holt, H; Talaei, M; Tydeman, F; Shaheen, SO; Martineau, AR
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A25
• Page End: A26
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.43
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction and Objectives: Little is known about how demographic, behavioural, and vaccine-related factors affect risk of post-vaccination SARS-CoV-2 infection. We aimed to identify risk factors for SARS-CoV-2 infection after primary and booster vaccinations. Methods: This prospective, population-based, UK study in adults (≥16 years) vaccinated against SARS-CoV-2 assessed risk of breakthrough SARS-CoV-2 infection up to February, 2022, for participants who completed a primary vaccination course (ChAdOx1 nCoV-19 or BNT1262b2) and those who received a booster dose (BNT1262b2 or mRNA-1273). Cox regression models explored associations between sociodemographic, behavioural, clinical, pharmacological, and nutritional factors and test-positive breakthrough infection, adjusted for local weekly SARS-CoV-2 incidence and testing behaviours. Results: 1051 (7.1%) of 14, 713 post-primary participants and 1009 (9.4%) of 10, 665 post-booster participants reported breakthrough infection, over a median follow-up of 203 days (IQR 195–216) and 85 days (66–103), respectively. Primary vaccination with ChAdOx1 ( vs BNT182b2) was associated with higher risk of infection in both post-primary analysis (adjusted hazard ratio 1.63, 95% CI 1.41–1.88) and after an mRNA-1273 booster (1.26 [1.00–1.57] vs BNT162b2 primary and booster). Lower risk of infection was associated with older age (post-primary: 0.97 [0.96–0.97] per year; post-booster: 0.97 [0.97–0.98]), whereas higher risk of infection was associated with lower educational attainment (post-primary: 1.78 [1.44–2.20] for primary or secondary vs postgraduate; post-booster: 1.46 [1.16–1.83]) and at least three weekly visits to indoor public places (post-primary: 1.36 [1.13–1.63] vs none; post-booster: 1.29 [1.07–1.56]). Conclusions: Vaccine type, socioeconomic status, age, and behaviours affect risk of breakthrough infection after primary and booster vaccinations. These findings can inform public health messaging and prioritisation for future vaccinations. Please refer to page A208 for declarations of interest related to this abstract.