SARS-CoV-2 vaccination, ABO blood group and risk of COVID-19: population-based cohort study

Abstract

ObjectiveTo compare outcomes between O and non-O blood groups, and by modified RNA (mRNA) and adenovirus-vectored (Ad-V) vaccines.DesignPopulation-based cohort study.SettingAll of Ontario, Canada. Linked data sets captured clinical encounters, vaccinations and laboratory testing for SARS-CoV-2.ParticipantsIndividuals aged 12+ years with known ABO blood group and free of SARS-CoV-2 before 15 January 2021.Main outcomes measuresThe main exposure, first SARS-CoV-2 vaccination, was modelled in a time-varying manner. O and non-O blood group was known prior to vaccination. SARS-CoV-2 infection, and severe COVID-19 (hospitalisation or death), were assessed starting 14 days after vaccination, up to 27 June 2021.Results2 472 261 individuals were included. 1 743 916 (70.5%) had at least one vaccination, of which 24.6% were fully vaccinated. Those vaccinated were more likely to be women, older in age, residing in a higher-income area and have higher rates of certain comorbid conditions, like cancer, diabetes and hypertension. Relative to unvaccinated, after receiving their first mRNA (adjusted HR (aHR) 0.46, 95% CI 0.44 to 0.47) or Ad-V (aHR 0.49, 95% CI 0.44 to 0.54) vaccine, the risk of SARS-CoV-2 infection was lower, as was severe COVID-19 (aHR 0.29, 95% CI 0.20 to 0.43 (mRNA); aHR 0.29, 95% CI 0.26 to 0.33 (Ad-V)). Stratifying by blood group produced similar results. For example, after first mRNA vaccination, the aHR of severe COVID-19 was 0.31 (95% CI 0.27 to 0.36) among non-O blood groups, and 0.27 (95% CI 0.22 to 0.32) among O blood groups, relative to unvaccinated. Fully vaccinated individuals had the lowest risk of SARS-CoV-2 and severe COVID-19.ConclusionsSARS-CoV-2 infection and severe COVID-19 are reduced by vaccination. This effect does not vary by vaccine type or blood group, but is more pronounced among fully, than partially, vaccinated individuals.

The impact of ABO blood types on humoral immunity responses and antibody persistency after different COVID‐19 vaccine regimens

“…Nevertheless, the analyzed data of the present study did not find any significant impact of blood types nor Rh factor on COVID‐19 severity or reinfection. In line with our findings, a Canadian study concluded that COVID‐19 infection and hospitalization were not affected by blood group 7 …”

“…Canadian study concluded that COVID-19 infection and hospitalization were not affected by blood group. 7 In the further step, we assessed the potential effect of blood types regarding vaccines immunogenicity. Five different vaccine groups were compared to find any correlation between ABO/Rh factor and Abs rise 21 days after the booster shots.…”

“…It is suggested that anti-A and anti-B antibodies (Abs), which are concomitantly generated in the respiratory and digestive tract by epithelial cells in the O-type group, may lead to immunoprotection as these tissues are the first target of injury in SARS-CoV-2 infection. 7,8 On the contrary, a higher rate of COVID-19 infection was observed among people with blood type A, 9 though this correlation was not a general finding in the related studies. 10 Rh type is the other important blood index, referring to the located proteins on the red blood cells' surface.…”

“…The data have shown that adults with blood group O had a lower risk of infection and also severe illness, compared with non‐O groups. It is suggested that anti‐A and anti‐B antibodies (Abs), which are concomitantly generated in the respiratory and digestive tract by epithelial cells in the O‐type group, may lead to immunoprotection as these tissues are the first target of injury in SARS‐CoV‐2 infection 7,8 . On the contrary, a higher rate of COVID‐19 infection was observed among people with blood type A, 9 though this correlation was not a general finding in the related studies 10 …”

Challenges in assessing the immunization status of adults in Germany – Lessons from a population-based VACCELERATE survey on polio vaccination

“…Highest sex related difference in vaccination rates was found in both, DEGS1 and our study, in the 50-59 years age group. Higher vaccination rates in women were also reported for other vaccine preventable diseases and geographic locations for example in uenza in the US and COVID-19 in Canada [31,32]. As these are not childhood vaccinations like PM, sex-speci c differences in health care adherence and decision-making that might have played a role there are less plausible causes regarding PM vaccination rates [31,33].…”