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Introduction:While breakthrough SARS-CoV-2 infections were expected among vaccinated individuals, less is known about the incidence of post-acute SARS-CoV-2 sequelae (PASC) and mortality among vaccinated individuals.Methods:A retrospective analysis of Alabama Health System electronic health record (EHR) data was performed for 4,274 individuals with vaccination, clinical, medical, and mortality information between December 2020 and December 2021. The study population consisted of patients who had documented evidence of vaccination (e.g., two doses of Pfizer-BioNTech, two doses of Moderna, or a single dose of Janssen/Johnson & Johnson vaccines).Results:Out of 4,274 individuals with EHR data in our cohort, 2,177 were female (51%), with a mean age equal to 56 ± 16.2; 1,245 individuals had received one or more doses of a COVID-19 vaccine. There were 640 COVID-19 related deaths, of which were 265 women (41%), 487 (76%) had obesity/overweight, and 133 patients (21%) that had an organ transplant or had a history of cancer. A greater percentage of unvaccinated individuals had documented COVID-19 deaths compared to individuals who were vaccinated (N=57, 5% and 583, 19%, respectively). The odds of mortality were lower among those who were vaccinated, compared to those who were unvaccinated (OR = 0.2, 95% CI = 0.15, 0.27). Sensitivity analyses showed that mortality among vaccinated individuals comprised of 6% (13) of patients with 1 dose, 5% (42) of patients with 2 doses, and <1% (2) of patients with 3 doses. One hundred and eighteen individuals had a PASC diagnosis, with 57% (67) of patients having received at least 1 dose. PASC occurred in 6% (13) of patients with 1 dose, 10% (84) of patients with 2 doses, and 3% (6) of patients with 3 doses. The odds of having PASC were higher among those vaccinated, compared to those unvaccinated (OR = 3.32, 95% CI = 2.29, 4.81). Among those who were vaccinated and had PASC (N=67), a greater proportion were female than male (69% compared to 31%, respectively).Conclusions:At least 1 dose of a COVID-19 vaccine provided a lower odds of mortality in individuals with a breakthrough infection; however, in our population, vaccinated individuals had equal odds of post-acute SARS-CoV-2 sequelae (PASC) as unvaccinated individuals. |
