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Protection against SARS-CoV-2 Omicron BA.4/5 variant following booster vaccination or breakthrough infection in the UK

Author

Listed:
  • Jia Wei

    (University of Oxford
    University of Oxford)

  • Philippa C. Matthews

    (University of Oxford
    The Francis Crick Institute
    University College London)

  • Nicole Stoesser

    (University of Oxford
    Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital
    The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford)

  • John N. Newton

    (University of Exeter)

  • Ian Diamond

    (Office for National Statistics)

  • Ruth Studley

    (Office for National Statistics)

  • Nick Taylor

    (Office for National Statistics)

  • John I. Bell

    (University of Oxford)

  • Jeremy Farrar

    (Wellcome Trust)

  • Jaison Kolenchery

    (University of Oxford
    Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital)

  • Brian D. Marsden

    (University of Oxford
    University of Oxford)

  • Sarah Hoosdally

    (University of Oxford)

  • E. Yvonne Jones

    (University of Oxford)

  • David I. Stuart

    (University of Oxford)

  • Derrick W. Crook

    (University of Oxford
    Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital
    The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford)

  • Tim E. A. Peto

    (University of Oxford
    Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital
    The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford)

  • A. Sarah Walker

    (University of Oxford
    University of Oxford
    The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    MRC Clinical Trials Unit at UCL, UCL)

  • Koen B. Pouwels

    (The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    University of Oxford)

  • David W. Eyre

    (University of Oxford
    Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital
    The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
    The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford)

Abstract

Following primary SARS-CoV-2 vaccination, whether boosters or breakthrough infections provide greater protection against SARS-CoV-2 infection is incompletely understood. Here we investigated SARS-CoV-2 antibody correlates of protection against new Omicron BA.4/5 (re-)infections and anti-spike IgG antibody trajectories after a third/booster vaccination or breakthrough infection following second vaccination in 154,149 adults ≥18 y from the United Kingdom general population. Higher antibody levels were associated with increased protection against Omicron BA.4/5 infection and breakthrough infections were associated with higher levels of protection at any given antibody level than boosters. Breakthrough infections generated similar antibody levels to boosters, and the subsequent antibody declines were slightly slower than after boosters. Together our findings show breakthrough infection provides longer-lasting protection against further infections than booster vaccinations. Our findings, considered alongside the risks of severe infection and long-term consequences of infection, have important implications for vaccine policy.

Suggested Citation

  • Jia Wei & Philippa C. Matthews & Nicole Stoesser & John N. Newton & Ian Diamond & Ruth Studley & Nick Taylor & John I. Bell & Jeremy Farrar & Jaison Kolenchery & Brian D. Marsden & Sarah Hoosdally & E, 2023. "Protection against SARS-CoV-2 Omicron BA.4/5 variant following booster vaccination or breakthrough infection in the UK," Nature Communications, Nature, vol. 14(1), pages 1-15, December.
  • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-38275-1
    DOI: 10.1038/s41467-023-38275-1
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    References listed on IDEAS

    as
    1. Ellen J. Thompson & Dylan M. Williams & Alex J. Walker & Ruth E. Mitchell & Claire L. Niedzwiedz & Tiffany C. Yang & Charlotte F. Huggins & Alex S. F. Kwong & Richard J. Silverwood & Giorgio Di Gessa , 2022. "Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records," Nature Communications, Nature, vol. 13(1), pages 1-11, December.
    2. Jia Wei & Philippa C. Matthews & Nicole Stoesser & Thomas Maddox & Luke Lorenzi & Ruth Studley & John I. Bell & John N. Newton & Jeremy Farrar & Ian Diamond & Emma Rourke & Alison Howarth & Brian D. M, 2021. "Anti-spike antibody response to natural SARS-CoV-2 infection in the general population," Nature Communications, Nature, vol. 12(1), pages 1-12, December.
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