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. Author manuscript; available in PMC: 2026 Feb 1.
Published in final edited form as: Am J Med. 2023 Sep 9;138(2):287–297.e21. doi: 10.1016/j.amjmed.2023.08.009

Table 2.

Effect of vaccination status prior to COVID-19 illness on disability*

Vaccination Status prior to illness** Mobility Disability IADL Disability Mental Fatigue




Odds Ratio 95% CI Odds Ratio 95 % CI Odds Ratio 95% CI

Model 1: adjusted for date of infection, age, gender, race, BMI, prior exercise, education, income, and prior comorbidity
Unvaccinated or 1 dose mRNA 1 1 1
2 doses mRNA or 1 dose adenovirus 0.57 0.42, 0.77 0.67 0.51, 0.87 0.72 0.52, 0.96
3+ doses mRNA or 2 doses adenovirus 0.38 0.24, 0.63 0.51 0.33, 0.79 0.44 0.25, 0.67

Model 2: adjusted for date of infection, age, gender, race, BMI, prior exercise, education, income, prior comorbidity and hospitalization
Unvaccinated or 1 dose mRNA 1 1 1
2 doses mRNA or 1 dose adenovirus 0.67 0.50, 0.91 0.77 0.59, 1.02 0.75 0.55, 1.00
3+ doses mRNA or 2 doses adenovirus 0.48 0.29, 0.78 0.62 0.40, 0.96 0.46 0.27, 0.71

Model 3: Instrumental variable analysis **
Unvaccinated 1 1 1
2+ doses mRNA or 1+ dose adenovirus 0.22 0.06, 0.81 0.53 0.20, 1.38 1.12 0.38, 2.90
*

Sample is weighted to represent the COVID-19 Symptom Survey with survey weights to generalize to the US. Unweighted results are in Tables S.5.1 and S.5.4. Sensitivity analyses of the needed strength of non-causal pathways are shown in Tables S.5.2 and S5.5. Directed acyclic graph that guided analyses is shown in Figure S.5.1. Analysis restricted to those whose COVID-19 illness occurred after vaccines were available in the US. This resulted in a reduced sample size of 2,540 persons with evidence of long-COVID in models 1 and models 2. There were 2,464 persons in the instrumental variable analysis as 76 persons were missing length of time between vaccination and infection. Sample size was too small to separate 2 doses mRNA or 1 dose adenovirus and 3+ doses mRNA or 2 doses adenovirus for the instrumental variable analysis.

**

Age, gender, co-morbidity, education, income, ethnicity, race, and date of infection were included in both the first and second stage of the instrumental variable analyses. Strength of state as an instrumental variable is provided in Table S.5.