The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022
Abstract Background Long COVID, a diverse set of symptoms that persist after a minimum of 4 weeks from the initial SARS-CoV-2 infection, has posed substantial burden to healthcare systems. There is some evidence that COVID-19 vaccination may be associated with lower risk of long COVID. However, litt...
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BMC
2025-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10097-6 |
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| author | Jingyan Yang Kiran K. Rai Tamuno Alfred Lucy Massey Olivia Massey Leah McGrath Kathleen M. Andersen Theo Tritton Carmen Tsang Rebecca Butfield Charlie Reynard Diana Mendes Jennifer L Nguyen |
| author_facet | Jingyan Yang Kiran K. Rai Tamuno Alfred Lucy Massey Olivia Massey Leah McGrath Kathleen M. Andersen Theo Tritton Carmen Tsang Rebecca Butfield Charlie Reynard Diana Mendes Jennifer L Nguyen |
| author_sort | Jingyan Yang |
| collection | DOAJ |
| description | Abstract Background Long COVID, a diverse set of symptoms that persist after a minimum of 4 weeks from the initial SARS-CoV-2 infection, has posed substantial burden to healthcare systems. There is some evidence that COVID-19 vaccination may be associated with lower risk of long COVID. However, little is known about the association between vaccination status and long COVID-associated healthcare resource utilisation (HCRU) and costs. Methods We conducted a cohort study using primary care electronic health record data in England from the Clinical Practice Research Datalink (CPRD) Aurum dataset linked to Hospital Episode Statistics where available. Adult (≥ 18 years) patients were indexed on a COVID-19 diagnosis between 1st March 2021 and 1st December 2021. Vaccination status was assessed at index: unvaccinated or completed primary series (two doses for immunocompetent and three doses for immunocompromised patients). Covariate balance was conducted using entropy balancing. Weighted multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) for incident long COVID, and separately long COVID primary care resource use, by vaccination status. Patients were followed up to a maximum of 9-months post index. Results A total of 35,713 patients who had completed primary series vaccination, and 75,522 unvaccinated patients were included. The weighted and adjusted IRR for long COVID among patients vaccinated with the primary series compared to being unvaccinated was 0.81 (95% CI: 0.77–0.86) in the overall cohort, 0.83 (95% CI: 0.78–0.88) in the immunocompetent cohort and 0.28 (95% CI: 0.13–0.58) in the immunocompromised cohort. Among those with long COVID, there was no association between the rate of primary care consultations and vaccination status in the overall and immunocompetent cohorts. Cost of primary care consultations was greater in the unvaccinated group than for those who completed primary series. Conclusion Vaccination against COVID-19 may reduce the risk of long COVID in both immunocompetent and immunocompromised patients. However, no association was found between frequency of primary care visits and vaccination among patients diagnosed in 2021. Future studies with larger sample size, higher vaccine uptake, and longer study periods during the pandemic are needed to further quantify the impact of vaccination on long COVID. |
| format | Article |
| id | doaj-art-d8282fc4e2f44658af9d66488cc0df8c |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-d8282fc4e2f44658af9d66488cc0df8c2025-08-20T02:43:15ZengBMCBMC Infectious Diseases1471-23342025-02-0125111010.1186/s12879-024-10097-6The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022Jingyan Yang0Kiran K. Rai1Tamuno Alfred2Lucy Massey3Olivia Massey4Leah McGrath5Kathleen M. Andersen6Theo Tritton7Carmen Tsang8Rebecca Butfield9Charlie Reynard10Diana Mendes11Jennifer L Nguyen12Global Value and Access, Pfizer IncAdelphi Real WorldGlobal Value and Access, Pfizer IncAdelphi Real WorldAdelphi Real WorldGlobal Value and Access, Pfizer IncGlobal Value and Access, Pfizer IncAdelphi Real WorldPfizer LtdPfizer LtdPfizer LtdPfizer LtdGlobal Value and Access, Pfizer IncAbstract Background Long COVID, a diverse set of symptoms that persist after a minimum of 4 weeks from the initial SARS-CoV-2 infection, has posed substantial burden to healthcare systems. There is some evidence that COVID-19 vaccination may be associated with lower risk of long COVID. However, little is known about the association between vaccination status and long COVID-associated healthcare resource utilisation (HCRU) and costs. Methods We conducted a cohort study using primary care electronic health record data in England from the Clinical Practice Research Datalink (CPRD) Aurum dataset linked to Hospital Episode Statistics where available. Adult (≥ 18 years) patients were indexed on a COVID-19 diagnosis between 1st March 2021 and 1st December 2021. Vaccination status was assessed at index: unvaccinated or completed primary series (two doses for immunocompetent and three doses for immunocompromised patients). Covariate balance was conducted using entropy balancing. Weighted multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) for incident long COVID, and separately long COVID primary care resource use, by vaccination status. Patients were followed up to a maximum of 9-months post index. Results A total of 35,713 patients who had completed primary series vaccination, and 75,522 unvaccinated patients were included. The weighted and adjusted IRR for long COVID among patients vaccinated with the primary series compared to being unvaccinated was 0.81 (95% CI: 0.77–0.86) in the overall cohort, 0.83 (95% CI: 0.78–0.88) in the immunocompetent cohort and 0.28 (95% CI: 0.13–0.58) in the immunocompromised cohort. Among those with long COVID, there was no association between the rate of primary care consultations and vaccination status in the overall and immunocompetent cohorts. Cost of primary care consultations was greater in the unvaccinated group than for those who completed primary series. Conclusion Vaccination against COVID-19 may reduce the risk of long COVID in both immunocompetent and immunocompromised patients. However, no association was found between frequency of primary care visits and vaccination among patients diagnosed in 2021. Future studies with larger sample size, higher vaccine uptake, and longer study periods during the pandemic are needed to further quantify the impact of vaccination on long COVID.https://doi.org/10.1186/s12879-024-10097-6COVID-19Long COVIDVaccinationPrimary careImmunocompromisedImmunocompetent |
| spellingShingle | Jingyan Yang Kiran K. Rai Tamuno Alfred Lucy Massey Olivia Massey Leah McGrath Kathleen M. Andersen Theo Tritton Carmen Tsang Rebecca Butfield Charlie Reynard Diana Mendes Jennifer L Nguyen The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 BMC Infectious Diseases COVID-19 Long COVID Vaccination Primary care Immunocompromised Immunocompetent |
| title | The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 |
| title_full | The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 |
| title_fullStr | The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 |
| title_full_unstemmed | The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 |
| title_short | The impact of COVID vaccination on incidence of long COVID and healthcare resource utilisation in a primary care cohort in England, 2021–2022 |
| title_sort | impact of covid vaccination on incidence of long covid and healthcare resource utilisation in a primary care cohort in england 2021 2022 |
| topic | COVID-19 Long COVID Vaccination Primary care Immunocompromised Immunocompetent |
| url | https://doi.org/10.1186/s12879-024-10097-6 |
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