History of primary-series and booster vaccination and protection against Omicron reinfection
Hiam Chemaitelly, Houssein H. Ayoub, Patrick Tang, Peter Coyle, Hadi M. Yassine, Asmaa A. Al Thani, Hebah A. Al-Khatib, Mohammad R. Hasan, Zaina Al Kanaani, Einas Al‐Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al‐Kuwari, Adeel A. Butt, Hamad Eid Al‐Romaihi, Mohamed H. Al-Thani, Abdullatif Al‐Khal, Roberto Bertollini, Laith J. Abu‐Raddad
Abstract
Laboratory evidence suggests a possibility of immune imprinting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the differences in the incidence of SARS-CoV-2 reinfection in a cohort of persons who had a primary Omicron infection, but different vaccination histories using matched, national, retrospective, cohort studies. Adjusted hazard ratio for reinfection incidence, factoring adjustment for differences in testing rate, was 0.43 [95% confidence interval (CI): 0.39 to 0.49] comparing history of two-dose vaccination to no vaccination, 1.47 (95% CI: 1.23 to 1.76) comparing history of three-dose vaccination to two-dose vaccination, and 0.57 (95% CI: 0.48 to 0.68) comparing history of three-dose vaccination to no vaccination. Divergence in cumulative incidence curves increased markedly when the incidence was dominated by BA.4/BA.5 and BA.2.75* Omicron subvariants. The history of primary-series vaccination enhanced immune protection against Omicron reinfection, but history of booster vaccination compromised protection against Omicron reinfection. These findings do not undermine the public health utility of booster vaccination.