Association between inactivated COVID-19 vaccine and semen quality among males recovered from omicron infection: a retrospective cohort study

The protective effects of inactivated COVID-19 vaccines against SARS-CoV-2-associated semen impairment remain underexplored. We investigated associations between BBIBP-CorV vaccination and the semen quality in males recovering from SARS-CoV-2 infection. This single-center retrospective cohort study included 1,496 males recovering from SARS-CoV-2 infection at a tertiary hospital in Urumqi, China (February-May 2023). Participants were categorized into long-term and short-term effects groups based on the interval between semen collection and their most recent SARS-CoV-2 infection. The study assessed the association between the different doses of BBIBP-CorV vaccination and semen quality in both groups. A total of 1496 participants were recruited for the short-term (<i>n</i> = 307) and long-term effect groups (<i>n</i> = 1189). Participants had a median age of 32 (IQR: 30, 35). Compared to unvaccinated controls, 2-dose and 3-dose recipients showed reduced short-term semen quality impairment risks, with adjusted RR of 0.945 (95% CI 0.918, 0.973) and 0.965 (95% CI 0.937, 0.993), respectively. No significant results were found for long-term effect groups. Inactivated COVID-19 vaccination may protect against semen quality impairment among males recovering from SARS-CoV-2 Omicron infection within 90 days, especially in terms of semen volume and sperm progressive motility. Although preliminary evidence revealed a potential association between severe acute respiratory syndrome (SARS) and male sperm quality, deep insight into this scenario is scarce due to inadequate data. This study aimed to investigate the association between inactivated COVID-19 vaccine and short- and long-term semen quality. The study included 2,722 males grouped by the time interval between semen collection and the most recent infection with SARS-CoV-2 to explore the immediate and long-term effects of inactivated COVID-19 vaccine on semen quality. The results showed that in the near-term effect group, there was a significant reduction in semen quality impairment following vaccination. The incidence of reduced semen volume and decreased progressive motility of sperm was significantly reduced in unvaccinated subjects. Moreover, the long-term effects cannot be confirmed with certainty. This study demonstrated the short-term protective effect of COVID inactivated vaccine on semen quality.