Evaluation of COVID-19 vaccine breakthrough infections among immunocompromised patients fully vaccinated with BNT162b2

COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies

“…In a US real-world study of nearly 1.2 million people fully vaccinated with the BNT162b2 mRNA vaccine, over 212,000 (18%) individuals were designated as having an IC condition [ 43 ]. This study utilized the broadest IC case algorithm of real-world studies to date, wherein 12 mutually exclusive IC conditions were identified (e.g.…”

“…This study utilized the broadest IC case algorithm of real-world studies to date, wherein 12 mutually exclusive IC conditions were identified (e.g. symptomatic HIV, solid/hematologic malignancy, organ transplant, rheumatologic/inflammatory condition, primary immunodeficiency, chronic kidney disease, usage of immunosuppressive/antimetabolite medication) [ 43 ]. Although this study did not directly measure VE, it reported the number of COVID-19 vaccine breakthrough infections following a second BNT162b2 dose between 10 December 2020 and 8 July 2021 [ 43 ].…”

“…symptomatic HIV, solid/hematologic malignancy, organ transplant, rheumatologic/inflammatory condition, primary immunodeficiency, chronic kidney disease, usage of immunosuppressive/antimetabolite medication) [ 43 ]. Although this study did not directly measure VE, it reported the number of COVID-19 vaccine breakthrough infections following a second BNT162b2 dose between 10 December 2020 and 8 July 2021 [ 43 ]. The total number of breakthrough infections was low (N = 978; 0.08%) but nearly 40% of cases occurred among the IC population, which only accounted for approximately 18% of the overall study population [ 43 ].…”

Unpacking the Implications of SARS-CoV-2 Breakthrough Infections on COVID-19 Vaccination Programs

“…They suggest a definition for breakthrough infection as a positive SARS-CoV-2 PCR test from the respiratory tract and documentation of lower respiratory tract disease in fully vaccinated people with mild to asymptomatic cases not classified as breakthroughs [11]. Studies have reported a higher risk of COVID-19 breakthrough infections with possibilities of severe symptoms in immunocompromised individuals with conditions like HIV, rheumatoid arthritis, and solid organ transplant [7,12], as well as those on biological therapies.…”

“…If every country could deliver the same vaccination rate, it would only take 68 days to have every person who needs a first dose vaccinated, translating to the attainment of global coverage by February 2022 [34]. With the evidence that breakthrough infections are more common in the elderly, those with comorbidities and the immunocompromised [7,9,12], it is critical to promote targeted interventions to enhance the protection of the vulnerable populations while availing resources to the yet to be fully vaccinated population. Despite the prediction by experts that everyone fully vaccinated will require a booster dose, it would have been reasonable to give these to targeted populations in whom the evidence shows they are probably needed.…”