Association of Messenger RNA Coronavirus Disease 2019 (COVID-19) Vaccination and Reductions in Post COVID Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in a US Prospective Cohort of Essential Workers

J Infect Dis. 2025 Mar 17;231(3):665-676. doi: 10.1093/infdis/jiae556.

Abstract

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was messenger RNA (mRNA) COVID-19 vaccination (2 or 3 monovalent doses). Odds of PCCs among vaccinated and unvaccinated persons were compared with logistic regression.

Results: Of 936 participants, 23.6% reported PCCs and 83.2% were vaccinated. Participants who received 3 vaccine doses had lower odds of PCC-related gastrointestinal, neurological, and other symptoms compared to unvaccinated participants (adjusted odds ratio [95% confidence interval]: 0.37 [.16-.85], 0.56 [.32-.97], and 0.48 [.25-.91], respectively).

Conclusions: COVID-19 vaccination protected against development of PCCs among persons with mild infection during both Delta and Omicron variant predominance, supporting vaccination as an important PCCs prevention tool.

Keywords: COVID-19; COVID-19 vaccines; Long COVID; mRNA vaccines; post-COVID conditions.

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / immunology
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • COVID-19* / virology
  • Case-Control Studies
  • Female
  • Frontline Workers
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • SARS-CoV-2* / immunology
  • United States / epidemiology
  • Vaccination
  • Young Adult

Substances

  • COVID-19 Vaccines