Thread by @zalaly

The latest from our team in @NatureMedicine

Does vaccination protect from #LongCovid?

Vaccines modestly reduce but do not eliminate risk of Long Covid

@VAResearch @vahsrd @WUSTLmed @WUSTLnews @VREFSTL

@Biostayan @BCBowe

nature.com/articles/s4159…

A thread 🧵

In this study of more than 13 million people

Long Covid after breakthrough infection (vaccinated people who subsequently got SARS-CoV-2 infection) is indistinguishable in terms of clinical features from Long Covid in unvaccinated people

nature.com/articles/s4159…

In comparisons vs several uninfected controls
(contemporary, historical, and vaccinated controls)

people with breakthrough infection consistently had higher risk of death and Long Covid sequelae in nearly every organ system

nature.com/articles/s4159…

To understand the effect of vaccine on Long Covid, we evaluated vaccinated people with breakthrough SARS-CoV-2 infection vs unvaccinated people with SARS-CoV-2 infection

People with breakthrough had
34% less risk of death
15% less risk of Long Covid

nature.com/articles/s4159…

The risk reduction was most evident for blood clots (56% reduction) and pulmonary sequelae (49% reduction) (risk reduction on the relative scale)

Risk reduction was modest in other organ systems

nature.com/articles/s4159…

Among people with breakthrough infection, immunocompromised people have a higher risk of Long Covid than those with no immune dysfunction — highlighting the need to pay extra attention to this vulnerable group

nature.com/articles/s4159…

To place this in a broader context of the post-viral illness, we evaluated people who were hospitalized for breakthrough SARS-CoV-2 vs seasonal influenza.

Breakthrough SARS-CoV-2 was associated with higher risk of death and post-acute sequelae than flu

nature.com/articles/s4159…

Not only COVID-19 is riskier than the flu.
Even breakthrough COVID-19 is riskier than the flu

nature.com/articles/s4159…

Overall, the burden of death and disease experienced by people with breakthrough SARS-CoV-2 infection is not trivial.

nature.com/articles/s4159…

Vaccines reduce (modestly) but do not eliminate risk of #LongCovid.

nature.com/articles/s4159…

Knowing that infection seems almost unavoidable in the current environment and knowing that the risk of Long Covid in vaccinated people is not small means that many will be left with chronic and potentially disabling disease that has no treatment

nature.com/articles/s4159…

Now that we know that vaccines are not sufficient as a sole line of defense, we need to urgently develop and deploy additional layers of protection to reduce risk of Long Covid

nature.com/articles/s4159…

These may include vaccines specifically designed to reduce risk of Long Covid, and therapeutics that could be taken in the acute phase to reduce risk of Long covid

Paxlovid and other antivirals must be urgently tested in trials for Long Covid

nature.com/articles/s4159…

We need to urgently trial (test) as many therapeutics/treatments as possible to understand which ones work.

This must be a national priority.

nature.com/articles/s4159…

Thanks to our funders @VAResearch @vahsrd our Editors and Reviewers.

nature.com/articles/s4159…

Thanks to the #LongCovid community!

nature.com/articles/s4159…