Scientists at the Cleveland Clinic, USA, recently evaluated the effectiveness of vaccination against coronavirus disease 2019 (COVID-19) in other people with or without a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
The study’s findings imply that Americans with prior SARS-CoV-2 infection do not reap the added benefits of vaccination, indicating that COVID-19 vaccines should be prioritized for Americans without prior infection. The study is recently available on the medRxiv* preprint server (not peer-reviewed).
In the United States, the U. S. Food and Drug Administration (FDA) granted emergency use authorization for two mRNA-based COVID-19 vaccines developed through Pfizer/BioNTech and Moderna, which have demonstrated superior efficacy against SARS-CoV-2 infection and COVID-19 diseases in clinical trials. However, the ability to vaccinate a large part of the world’s population is limited by the supply of vaccines.
To ensure equitable access to vaccines worldwide, the COVID-19 Vaccines Global Access (COVAX) initiative was launched. In many countries, especially those of low socioeconomic status, there is a severe shortage of vaccines. Therefore, to unload the maximum benefits of the vaccine, the maximum vulnerable population will have to be prioritized for vaccination.
Currently, most countries prioritize vaccination of fitness and other frontline personnel, the elderly, and others with comorbidities.
To further refine the prioritization criteria, scientists in the existing study assessed the need for COVID-19 vaccines for others who had already been infected with SARS-CoV-2.
The study was conducted on 52,238 Cleveland Clinic employees. It was thought that a positive RT-PCR test would indicate a SARS-CoV-2 infection. Participants won two doses of the Pfizer/BioNTech or Moderna COVID-19 vaccine 28 days apart. A player was thought to be vaccinated 14 days after receiving the 2nd dose of vaccine. Similarly, a player who tested positive for SARS-CoV-2 at least 42 days before the start of vaccination was previously considered infected.
Of all registered participants, 5% had previously become inflamed with SARS-CoV-2. Compared to 59% of non-inflamed participants, only 47% of previously inflamed participants had been vaccinated by the end of the study. Approximately 63% of all vaccinated participants won the Moderna vaccine.
Analysis of the cumulative occurrence of COVID-19 revealed that, in the study, SARS-CoV-2 infection occurred almost exclusively in participants who were not inflamed in the past and were not vaccinated.
Interestingly, no significant differences in COVID-19 occurrence were observed between previously inflamed and recently unvaccinated participants, inflamed and recently vaccinated past participants, and non-inflamed and recently vaccinated past participants.
Participants on those three teams had a particularly lower incidence of SARS-CoV-2 infection compared to previously uninfected and recently unvaccinated participants.
Specifically, of all infections during the study period, 99. 3% occurred in participants who were not inflamed in the past and were not vaccinated. In contrast, only 0. 7% of infections occurred in participants who were not inflamed in the past but were recently vaccinated.
It is vital to note that no case of SARS-CoV-2 infection was observed in the past in inflamed participants with or without vaccination.
With further statistical analysis, it was observed that COVID-19 vaccination especially reduced the risk of SARS-CoV-2 infection in participants who previously had no inflammation, but not in participants who previously had inflammation.
Although the study did not directly estimate the duration of coverage against herbal infection, it was noted that in the past inflamed participants remained against COVID-19 for at least 10 months after the onset of symptoms or a positive test result.
Vaccine shortages, coupled with the fact that vaccines are not offering greater coverage to those who have already been infected, is the most powerful argument for restricting vaccine handling to those who have not been infected.
In addition to occupation, age, and comorbid conditions, past infection can be a vital factor in deciding who to prioritize to get the vaccine.
A practical and helpful message would be that symptomatic COVID-19 is only as smart as having received a vaccine, and that other people whose COVID-19 has been proven through a reliable laboratory test do not need the vaccine.
The study concludes that “people who have a laboratory-confirmed symptomatic SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination, and vaccines can be safely prioritized over those who have not been infected in the past. “
Conversely, others without prior SARS-CoV-2 infection can reap the maximum benefits from vaccination. Therefore, based on the effects of the study, COVID-19 vaccines will be prioritized for other naïve people with no history of SARS-CoV-2 infection.
Written by
Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in each and every corner of the world. He holds a Bachelor of Science (B. Sc. ) and a Master of Science (M. Sc. ) in Human Biology and Physiology. After his master’s degree, Sanchari continued his doctoral studies in human physiology. She is the author of more than 10 original study articles, all of which have been published in world-renowned foreign journals.
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