Objective To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination. Design Observational cohort study. Setting Community dwelling population, UK. Participants 28 356 participants in the Office for National Statistics COVID-19 Infection Survey aged 18-69 years who received at least one dose of an adenovirus vector or mRNA covid-19 vaccine after testing positive for SARS-CoV-2 infection. Main outcome measure Presence of long covid symptoms at least 12 weeks after infection over the follow-up period 3 February to 5 September 2021. Results Mean age of participants was 46 years, 55.6% (n=15 760) were women, and 88.7% (n=25 141) were of white ethnicity. Median follow-up was 141 days from first vaccination (among all participants) and 67 days from second vaccination (83.8% of participants). 6729 participants (23.7%) reported long covid symptoms of any severity at least once during follow-up. A first vaccine dose was associated with an initial 12.8% decrease (95% confidence interval −18.6% to −6.6%, P<0.001) in the odds of long covid, with subsequent data compatible with both increases and decreases in the trajectory (0.3% per week, 95% confidence interval −0.6% to 1.2% per week, P=0.51). A second dose was associated with an initial 8.8% decrease (95% confidence interval −14.1% to −3.1%, P=0.003) in the odds of long covid, with a subsequent decrease by 0.8% per week (−1.2% to −0.4% per week, P<0.001). Heterogeneity was not found in associations between vaccination and long covid by sociodemographic characteristics, health status, hospital admission with acute covid-19, vaccine type (adenovirus vector or mRNA), or duration from SARS-CoV-2 infection to vaccination. Conclusions The likelihood of long covid symptoms was observed to decrease after covid-19 vaccination and evidence suggested sustained improvement after a second dose, at least over the median follow-up of 67 days. Vaccination may contribute to a reduction in the population health burden of long covid, although longer follow-up is needed. Deidentified study data are available to accredited researchers in the ONS Secure Research Service under part 5, chapter 5 of the Digital Economy Act 2017. For further information about accreditation, contact research.support@ons.gov.uk or visit [ons.gov.uk/aboutus/whatwedo/statistics/requestingstatistics/approvedresearcherscheme][1]. [1]: http://ons.gov.uk/aboutus/whatwedo/statistics/requestingstatistics/approvedresearcherscheme

中文翻译：

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covid-19 疫苗接种后长期 covid 症状的轨迹：基于社区的队列研究

目的 评估接种前 SARS-CoV-2 感染成人的 covid-19 疫苗接种与长期新冠症状之间的关联。设计观察性队列研究。设置英国社区居住人口。参与者 国家统计局 COVID-19 感染调查的 28 356 名参与者，年龄为 18-69 岁，在 SARS-CoV-2 感染检测呈阳性后，至少接受了一剂腺病毒载体或 mRNA covid-19 疫苗。主要结局指标 2021 年 2 月 3 日至 9 月 5 日的随访期间，感染后至少 12 周内出现长期新冠症状。结果 参与者的平均年龄为 46 岁，其中 55.6%（n=15 760）为女性，88.7%为女性(n=25 141) 为白人。首次接种疫苗后的中位随访时间为 141 天（所有参与者），第二次疫苗接种后的中位随访时间为 67 天（83.8% 的参与者）。6729 名参与者 (23.7%) 在随访期间至少报告过一次任何严重程度的长期新冠症状。第一剂疫苗与长期感染的几率最初降低 12.8%（95% 置信区间 -18.6% 至 -6.6%，P<0.001）相关，随后的数据与轨迹的增加和减少相一致（0.3每周%，95%置信区间-0.6%至1.2%每周，P=0.51）。第二剂剂量与长期感染的几率最初下降 8.8%（95% 置信区间 -14.1% 至 -3.1%，P=0.003）相关，随后每周下降 0.8%（-1.2% 至 -每周 0.4%，P<0.001）。在社会人口学特征、健康状况、急性 covid-19 入院、疫苗类型（腺病毒载体或 mRNA）或从 SARS-CoV-2 感染到接种疫苗的持续时间方面，未发现疫苗接种与长期 covid 之间的关联存在异质性。结论 在接种 covid-19 疫苗后，观察到出现长期 covid 症状的可能性有所降低，并且有证据表明，至少在中位随访 67 天的情况下，第二剂疫苗后症状持续改善。尽管还需要更长时间的随访，但疫苗接种可能有助于减轻长期新冠病毒造成的人口健康负担。根据 2017 年《数字经济法案》第 5 部分第 5 章，经认可的研究人员可以在 ONS 安全研究服务中获得去识别化的研究数据。有关认证的更多信息，请联系 Research.support@ons.gov.uk 或访问 [ons.gov.英国/aboutus/whatwedo/statistics/requestingstatistics/approvedresearcherscheme][1]。[1]：http://ons.gov.uk/aboutus/whatwedo/statistics/requestingstatistics/approvedresearcherscheme