Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: A systematic review and meta-regression

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dc.contributor.authorBobrovitz, Niklas
dc.contributor.authorWare, Harriet
dc.contributor.authorMa, Xiaomeng
dc.contributor.authorLi, Zihan
dc.contributor.authorHosseini, Reza
dc.contributor.authorCao, Christian
dc.contributor.authorSelemon, Anabel
dc.contributor.authorWhelan, Mairead
dc.contributor.authorPremji, Zahra
dc.contributor.authorIssa, Hanane
dc.contributor.authorCheng, Brianna
dc.contributor.authorAbu Raddad, Laith J
dc.contributor.authorBuckeridge, David L
dc.contributor.authorVan Kerkhove, Maria D
dc.contributor.authorPiechotta, Vanessa
dc.contributor.authorHigdon, Melissa M
dc.contributor.authorWilder-Smith, Annelies
dc.contributor.authorBergeri, Isabel
dc.contributor.authorFeikin, Daniel R
dc.contributor.authorArora, Rahul K
dc.contributor.authoret al.
dc.date.accessioned2023-11-08T17:46:22Z
dc.date.available2023-11-08T17:46:22Z
dc.date.copyright2023en_US
dc.date.issued2023
dc.description.abstractSummary Background The global surge in the omicron (B.1.1.529) variant has resulted in many individuals with hybrid immunity (immunity developed through a combination of SARS-CoV-2 infection and vaccination). We aimed to systematically review the magnitude and duration of the protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against infection and severe disease caused by the omicron variant. Methods For this systematic review and meta-regression, we searched for cohort, cross-sectional, and case–control studies in MEDLINE, Embase, Web of Science, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, the WHO COVID-19 database, and Europe PubMed Central from Jan 1, 2020, to June 1, 2022, using keywords related to SARS-CoV-2, reinfection, protective effectiveness, previous infection, presence of antibodies, and hybrid immunity. The main outcomes were the protective effectiveness against reinfection and against hospital admission or severe disease of hybrid immunity, hybrid immunity relative to previous infection alone, hybrid immunity relative to previous vaccination alone, and hybrid immunity relative to hybrid immunity with fewer vaccine doses. Risk of bias was assessed with the Risk of Bias In Non-Randomized Studies of Interventions Tool. We used log-odds random-effects meta-regression to estimate the magnitude of protection at 1-month intervals. This study was registered with PROSPERO (CRD42022318605). Findings 11 studies reporting the protective effectiveness of previous SARS-CoV-2 infection and 15 studies reporting the protective effectiveness of hybrid immunity were included. For previous infection, there were 97 estimates (27 with a moderate risk of bias and 70 with a serious risk of bias). The effectiveness of previous infection against hospital admission or severe disease was 74·6% (95% CI 63·1–83·5) at 12 months. The effectiveness of previous infection against reinfection waned to 24·7% (95% CI 16·4–35·5) at 12 months. For hybrid immunity, there were 153 estimates (78 with a moderate risk of bias and 75 with a serious risk of bias). The effectiveness of hybrid immunity against hospital admission or severe disease was 97·4% (95% CI 91·4–99·2) at 12 months with primary series vaccination and 95·3% (81·9–98·9) at 6 months with the first booster vaccination after the most recent infection or vaccination. Against reinfection, the effectiveness of hybrid immunity following primary series vaccination waned to 41·8% (95% CI 31·5–52·8) at 12 months, while the effectiveness of hybrid immunity following first booster vaccination waned to 46·5% (36·0–57·3) at 6 months. Interpretation All estimates of protection waned within months against reinfection but remained high and sustained for hospital admission or severe disease. Individuals with hybrid immunity had the highest magnitude and durability of protection, and as a result might be able to extend the period before booster vaccinations are needed compared to individuals who have never been infected.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipWHO COVID-19 Solidarity Response Fund and the Coalition for Epidemic Preparedness Innovations.en_US
dc.identifier.citationBobrovitz, N., Ware, H., Ma, X., Li, Z., Hosseini, R., Cao, C., ... Subissi, L. (2023). Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: A systematic review and meta-regression. The Lancet Infectious Diseases, 23(5), 556-567. https://doi.org/10.1016/S1473-3099(22)00801-5en_US
dc.identifier.urihttps://doi.org/10.1016/S1473-3099(22)00801-5
dc.identifier.urihttp://hdl.handle.net/1828/15606
dc.language.isoenen_US
dc.publisherThe Lancet Infectious Diseasesen_US
dc.titleProtective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: A systematic review and meta-regressionen_US
dc.typeArticleen_US

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