Comparing Hybrid and Regular COVID-19 Vaccine-induced Immunity Against the Omicron Epidemic

Overview

Journal NPJ Vaccines

Date 2022 Dec 15

PMID 36522341

Authors

Lei Huang

Francisco Tsz Tsun Lai

Vincent Ka Chun Yan

Franco Wing Tak Cheng

Ching Lung Cheung

Celine Sze Ling Chui

Xue Li

Eric Yuk Fai Wan

Carlos King Ho Wong

Ivan Fan Ngai Hung

Chak Sing Lau

Ian Chi Kei Wong

Esther Wai Yin Chan

Affiliations

Soon will be listed here.

Abstract

Evidence on the effectiveness of COVID-19 vaccines among people who recovered from a previous SARS-CoV-2 infection is warranted to inform vaccination recommendations. Using the territory-wide public healthcare and vaccination records of over 2.5 million individuals in Hong Kong, we examined the potentially differential risk of SARS-CoV-2 infection, hospitalization, and mortality between those receiving two homologous doses of BNT162b2 or CoronaVac versus those with a previous infection receiving only one dose amid the Omicron epidemic. Results show a single dose after a SARS-CoV-2 infection is associated with a lower risk of infection (BNT162b2: adjusted incidence rate ratio [IRR] = 0.475, 95% CI: 0.410-0.550; CoronaVac: adjusted IRR = 0.397, 95% CI: 0.309-0.511) and no significant difference was detected in the risk of COVID-19-related hospitalization or mortality compared with a two-dose vaccination regimen. Findings support clinical recommendations that those with a previous infection could receive a single dose to gain at least similar protection as those who received two doses without a previous infection.

Citing Articles

Post-acute sequelae of hospitalised COVID-19 re-infection compared with hospitalised first-time infection: a population-based retrospective cohort study in Hong Kong.

Yan V, Zhang Y, Yang D, Li X, Mak L, Lai F BMJ Public Health. 2025; 3(1):e000833.

PMID: 40017919 PMC: 11816715. DOI: 10.1136/bmjph-2023-000833.

Comparing the protection of heterologous booster of inhaled Ad5-nCoV vaccine and hybrid immunity against Omicron BA.5 infection: a cohort study of hospital staff in China.

Wang K, Zeng T, Guo Z, Liang J, Sun S, Ni Y BMC Infect Dis. 2024; 24(1):1401.

PMID: 39695978 PMC: 11654266. DOI: 10.1186/s12879-024-10250-1.

Protection from prior natural infection vs. vaccination against SARS-CoV-2-a statistical note to avoid biased interpretation.

Weber S, Hedberg P, Naucler P, Wolkewitz M Front Med (Lausanne). 2024; 11:1376275.

PMID: 38933111 PMC: 11199770. DOI: 10.3389/fmed.2024.1376275.

Prior infections and effectiveness of SARS-CoV-2 vaccine in test-negative studies: a systematic review and meta-analysis.

Tsang T, Sullivan S, Huang X, Wang C, Wang Y, Nealon J Am J Epidemiol. 2024; 193(12):1868-1881.

PMID: 38904437 PMC: 11637527. DOI: 10.1093/aje/kwae142.

Population Behavior Changes Underlying Phasic Shifts of SARS-CoV-2 Exposure Settings Across 3 Omicron Epidemic Waves in Hong Kong: Prospective Cohort Study.

Chan C, Lee S, Kwan T, Wong S, Yeoh E, Wong N JMIR Public Health Surveill. 2024; 10:e51498.

PMID: 38896447 PMC: 11222765. DOI: 10.2196/51498.

References

Sette A, Crotty S . Adaptive immunity to SARS-CoV-2 and COVID-19. Cell. 2021; 184(4):861-880. PMC: 7803150. DOI: 10.1016/j.cell.2021.01.007. View

Chen J, Wang R, Gilby N, Wei G . Omicron Variant (B.1.1.529): Infectivity, Vaccine Breakthrough, and Antibody Resistance. J Chem Inf Model. 2022; 62(2):412-422. PMC: 8751645. DOI: 10.1021/acs.jcim.1c01451. View

Berec L, Smid M, Pribylova L, Majek O, Pavlik T, Jarkovsky J . Protection provided by vaccination, booster doses and previous infection against covid-19 infection, hospitalisation or death over time in Czechia. PLoS One. 2022; 17(7):e0270801. PMC: 9269461. DOI: 10.1371/journal.pone.0270801. View

Shenai M, Rahme R, Noorchashm H . Equivalency of Protection From Natural Immunity in COVID-19 Recovered Versus Fully Vaccinated Persons: A Systematic Review and Pooled Analysis. Cureus. 2021; 13(10):e19102. PMC: 8627252. DOI: 10.7759/cureus.19102. View

Cowling B, Ali S, Ng T, Tsang T, Li J, Fong M . Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020; 5(5):e279-e288. PMC: 7164922. DOI: 10.1016/S2468-2667(20)30090-6. View

Melenotte C, Silvin A, Goubet A, Lahmar I, Dubuisson A, Zumla A . Immune responses during COVID-19 infection. Oncoimmunology. 2020; 9(1):1807836. PMC: 7480812. DOI: 10.1080/2162402X.2020.1807836. View

Xu Z, Liu K, Gao G . Omicron variant of SARS-CoV-2 imposes a new challenge for the global public health. Biosaf Health. 2022; 4(3):147-149. PMC: 8767758. DOI: 10.1016/j.bsheal.2022.01.002. View

Maier H, Balmaseda A, Saborio S, Ojeda S, Barilla C, Sanchez N . Protection Associated with Previous SARS-CoV-2 Infection in Nicaragua. N Engl J Med. 2022; 387(6):568-570. PMC: 9342422. DOI: 10.1056/NEJMc2203985. View

Lai F, Li X, Peng K, Huang L, Ip P, Tong X . Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine : A Case-Control Study. Ann Intern Med. 2022; 175(3):362-370. PMC: 8814917. DOI: 10.7326/M21-3700. View

10.

Nonaka C, Franco M, Graf T, Barcia C, de Avila Mendonca R, de Sousa K . Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil. Emerg Infect Dis. 2021; 27(5):1522-1524. PMC: 8084516. DOI: 10.3201/eid2705.210191. View

11.

Petras M . Highly Effective Naturally Acquired Protection Against COVID-19 Persists for at Least 1 Year: A Meta-Analysis. J Am Med Dir Assoc. 2021; 22(11):2263-2265. PMC: 8443339. DOI: 10.1016/j.jamda.2021.08.042. View

12.

Glatman-Freedman A, Bromberg M, Dichtiar R, Hershkovitz Y, Keinan-Boker L . The BNT162b2 vaccine effectiveness against new COVID-19 cases and complications of breakthrough cases: A nation-wide retrospective longitudinal multiple cohort analysis using individualised data. EBioMedicine. 2021; 72:103574. PMC: 8445746. DOI: 10.1016/j.ebiom.2021.103574. View

13.

Krammer F, Srivastava K, Alshammary H, Amoako A, Awawda M, Beach K . Antibody Responses in Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine. N Engl J Med. 2021; 384(14):1372-1374. PMC: 8008743. DOI: 10.1056/NEJMc2101667. View

14.

Ferrara P, Ponticelli D, Magliuolo R, Borrelli M, Schiavone B, Mantovani L . Time-Varying Effect of Hybrid Immunity on the Risk of Breakthrough Infection after Booster Dose of mRNA COVID-19 Vaccine: The MOSAICO Study. Vaccines (Basel). 2022; 10(8). PMC: 9413553. DOI: 10.3390/vaccines10081353. View

15.

Lopez Bernal J, Andrews N, Gower C, Robertson C, Stowe J, Tessier E . Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ. 2021; 373:n1088. PMC: 8116636. DOI: 10.1136/bmj.n1088. View

16.

Dolgin E . Is one vaccine dose enough if you've had COVID? What the science says. Nature. 2021; 595(7866):161-162. DOI: 10.1038/d41586-021-01609-4. View

17.

McMenamin M, Nealon J, Lin Y, Wong J, Cheung J, Lau E . Vaccine effectiveness of one, two, and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong: a population-based observational study. Lancet Infect Dis. 2022; 22(10):1435-1443. PMC: 9286709. DOI: 10.1016/S1473-3099(22)00345-0. View

18.

Anderson M, Stec M, Rewane A, Landay A, Cloherty G, Moy J . SARS-CoV-2 Antibody Responses in Infection-Naive or Previously Infected Individuals After 1 and 2 Doses of the BNT162b2 Vaccine. JAMA Netw Open. 2021; 4(8):e2119741. PMC: 8346938. DOI: 10.1001/jamanetworkopen.2021.19741. View

19.

Block J . Vaccinating people who have had covid-19: why doesn't natural immunity count in the US?. BMJ. 2021; 374:n2101. DOI: 10.1136/bmj.n2101. View

20.

Altarawneh H, Chemaitelly H, Hasan M, Ayoub H, Qassim S, Almukdad S . Protection against the Omicron Variant from Previous SARS-CoV-2 Infection. N Engl J Med. 2022; 386(13):1288-1290. PMC: 8849180. DOI: 10.1056/NEJMc2200133. View