Risk of SARS-CoV-2 reinfection during multiple Omicron variant waves in the UK general population

Jia Wei (), Nicole Stoesser, Philippa C. Matthews, Tarnjit Khera, Owen Gethings, Ian Diamond, Ruth Studley, Nick Taylor, Tim E. A. Peto, A. Sarah Walker, Koen B. Pouwels and David W. Eyre
Additional contact information
Jia Wei: University of Oxford
Nicole Stoesser: University of Oxford
Philippa C. Matthews: University of Oxford
Tarnjit Khera: Office for National Statistics
Owen Gethings: Office for National Statistics
Ian Diamond: Office for National Statistics
Ruth Studley: Office for National Statistics
Nick Taylor: Office for National Statistics
Tim E. A. Peto: University of Oxford
A. Sarah Walker: University of Oxford
Koen B. Pouwels: The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford
David W. Eyre: University of Oxford

Nature Communications, 2024, vol. 15, issue 1, 1-14

Abstract: Abstract SARS-CoV-2 reinfections increased substantially after Omicron variants emerged. Large-scale community-based comparisons across multiple Omicron waves of reinfection characteristics, risk factors, and protection afforded by previous infection and vaccination, are limited. Here we studied ~45,000 reinfections from the UK’s national COVID-19 Infection Survey and quantified the risk of reinfection in multiple waves, including those driven by BA.1, BA.2, BA.4/5, and BQ.1/CH.1.1/XBB.1.5 variants. Reinfections were associated with lower viral load and lower percentages of self-reporting symptoms compared with first infections. Across multiple Omicron waves, estimated protection against reinfection was significantly higher in those previously infected with more recent than earlier variants, even at the same time from previous infection. Estimated protection against Omicron reinfections decreased over time from the most recent infection if this was the previous or penultimate variant (generally within the preceding year). Those 14–180 days after receiving their most recent vaccination had a lower risk of reinfection than those >180 days from their most recent vaccination. Reinfection risk was independently higher in those aged 30–45 years, and with either low or high viral load in their most recent previous infection. Overall, the risk of Omicron reinfection is high, but with lower severity than first infections; both viral evolution and waning immunity are independently associated with reinfection.

Date: 2024
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DOI: 10.1038/s41467-024-44973-1

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