Vaccination has proven effective against infection with SARS-CoV-2, as well as death and hospitalisation following COVID-19 illness. However, little is known about the effect of vaccination on other acute and post-acute outcomes of COVID-19. Data were obtained from the TriNetX electronic health records network (over 81 million patients mostly in the USA). Using a retrospective cohort study and time-to-event analysis, we compared the incidences of COVID-19 outcomes between individuals who received a COVID-19 vaccine (approved for use in the USA) at least 2 weeks before SARS-CoV-2 infection and propensity score-matched individuals unvaccinated for COVID-19 but who had received an influenza vaccine. Outcomes were ICD-10 codes representing documented COVID-19 sequelae in the 6 months after a confirmed SARS-CoV-2 infection (recorded between January 1 and August 31, 2021, i.e. before the emergence of the Omicron variant). Associations with the number of vaccine doses (1 vs. 2) and age (<60 vs. ≥ 60 years-old) were assessed. Among 10,024 vaccinated individuals with SARS-CoV-2 infection, 9479 were matched to unvaccinated controls. Receiving at least one COVID-19 vaccine dose was associated with a significantly lower risk of respiratory failure, ICU admission, intubation/ventilation, hypoxaemia, oxygen requirement, hypercoagulopathy/venous thromboembolism, seizures, psychotic disorder, and hair loss (each as composite endpoints with death to account for competing risks; HR 0.70–0.83, Bonferroni-corrected p < 0.05), but not other outcomes, including long-COVID features, renal disease, mood, anxiety, and sleep disorders. Receiving 2 vaccine doses was associated with lower risks for most outcomes. Associations between prior vaccination and outcomes of SARS-CoV-2 infection were marked in those <60 years-old, whereas no robust associations were observed in those ≥60 years-old. In summary, COVID-19 vaccination is associated with lower risk of several, but not all, COVID-19 sequelae in those with breakthrough SARS-CoV-2 infection. The findings may inform service planning, contribute to forecasting public health impacts of vaccination programmes, and highlight the need to identify additional interventions for COVID-19 sequelae.

事实证明，疫苗接种可有效预防 SARS-CoV-2 感染以及 COVID-19 疾病后的死亡和住院治疗。然而，关于疫苗接种对 COVID-19 的其他急性和急性后结果的影响知之甚少。数据来自 TriNetX 电子健康记录网络（超过 8100 万患者，大部分在美国）。使用回顾性队列研究和事件发生时间分析，我们比较了在 SARS-CoV-2 感染前至少 2 周接种 COVID-19 疫苗（获准在美国使用）的个体之间 COVID-19 结果的发生率和倾向得分匹配的未接种 COVID-19 但已接种流感疫苗的个体。结果是 ICD-10 代码，代表在确诊 SARS-CoV-2 感染后 6 个月内记录的 COVID-19 后遗症（记录于 2021 年 1 月 1 日至 8 月 31 日之间，即在 Omicron 变体出现之前）。评估了与疫苗剂量（1 对 2）和年龄（<60 对 ≥ 60 岁）的关联。在 10,024 名感染 SARS-CoV-2 的已接种疫苗的个体中，有 9479 名与未接种疫苗的对照组相匹配。接受至少一剂 COVID-19 疫苗可显着降低呼吸衰竭、入住 ICU、插管/通气、低氧血症、需氧量、高凝血病/静脉血栓栓塞、癫痫发作、精神障碍和脱发的风险（每项均作为复合终点用死亡来解释竞争风险；HR 0.70–0.83，Bonferroni 校正的 p < 0.05），但不是其他结果，包括长期 COVID 特征、肾脏疾病、情绪、焦虑和睡眠障碍。接受 2 剂疫苗与大多数结果的较低风险相关。在 60 岁以下的人群中，既往接种疫苗与 SARS-CoV-2 感染的结果之间存在显着关联，而在 60 岁以上的人群中未观察到强有力的关联。总之，在突破性 SARS-CoV-2 感染者中，接种 COVID-19 疫苗可降低几种（但不是全部）COVID-19 后遗症的风险。这些发现可能为服务规划提供信息，有助于预测疫苗接种计划对公共卫生的影响，并强调需要确定针对 COVID-19 后遗症的额外干预措施。在 60 岁以下的人群中，既往接种疫苗与 SARS-CoV-2 感染的结果之间存在显着关联，而在 60 岁以上的人群中未观察到强有力的关联。总之，在突破性 SARS-CoV-2 感染者中，接种 COVID-19 疫苗可降低几种（但不是全部）COVID-19 后遗症的风险。这些发现可能为服务规划提供信息，有助于预测疫苗接种计划对公共卫生的影响，并强调需要确定针对 COVID-19 后遗症的额外干预措施。在 60 岁以下的人群中，既往接种疫苗与 SARS-CoV-2 感染的结果之间存在显着关联，而在 60 岁以上的人群中未观察到强有力的关联。总之，在突破性 SARS-CoV-2 感染者中，接种 COVID-19 疫苗可降低几种（但不是全部）COVID-19 后遗症的风险。这些发现可能为服务规划提供信息，有助于预测疫苗接种计划对公共卫生的影响，并强调需要确定针对 COVID-19 后遗症的额外干预措施。突破性 SARS-CoV-2 感染者的 COVID-19 后遗症。这些发现可能为服务规划提供信息，有助于预测疫苗接种计划对公共卫生的影响，并强调需要确定针对 COVID-19 后遗症的额外干预措施。突破性 SARS-CoV-2 感染者的 COVID-19 后遗症。这些发现可能为服务规划提供信息，有助于预测疫苗接种计划对公共卫生的影响，并强调需要确定针对 COVID-19 后遗症的额外干预措施。