Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021

Brown, Catherine; Vostok, Johanna; Johnson, Hillary; Burns, Meagan; Gharpure, Radhika; Sami, Samira; Sabo, Rebecca T; Hall, Noémi B.; Foreman, Anne; Schubert, Petra; Gallagher, Glen R.; Fink, Timelia; Madoff, Lawrence C.; Gabriel, Stacey; MacInnis, Bronwyn; Park, Daniel J.; Siddle, Katherine J.; Harik, Vaira; Arvidson, Deirdre; Brock-Fisher, Taylor; Dunn, Molly; Kearns, Amanda; Laney, A. Scott

doi:10.15585/mmwr.mm7031e2

Cited by 501 publications

(392 citation statements)

References 1 publication

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“…The rapid transmission and vaccine breakthrough infections in this outbreak might have resulted from the schoolchildren's vulnerability because of ineligibility for vaccination, coupled with the high transmissibility of the Delta variant. New evidence of the Delta variant's high transmissibility, even among fully vaccinated persons (6,7), supports recommendations for universal masking in schools § § (1). Further application of nonpharmaceutical prevention strategies, including routine testing, ventilation, and staying home while symptomatic, are also important for protecting the health of schoolchildren ineligible for vaccination because of their age (3).…”

Section: Discussionmentioning

confidence: 87%

Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021

Lam-Hine¹,

McCurdy²,

Santora³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

113

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MCPH) was notified by an elementary school that on May 23, an unvaccinated teacher had reported receiving a positive test result for SARS-CoV-2, the virus that causes COVID-19. The teacher reported becoming symptomatic on May 19, but continued to work for 2 days before receiving a test on May 21. On occasion during this time, the teacher read aloud unmasked to the class despite school requirements to mask while indoors. Beginning May 23, additional cases of COVID-19 were reported among other staff members, students, parents, and siblings connected to the school. To characterize the outbreak, on May 26, MCPH initiated case investigation and contact tracing that included whole genome sequencing (WGS) of available specimens. A total of 27 cases were identified, including that of the teacher. During May 23-26, among the teacher's 24 students, 22 students, all ineligible for vaccination because of age, received testing for SARS-CoV-2; 12 received positive test results. The attack rate in the two rows seated closest to the teacher's desk was 80% (eight of 10) and was 28% (four of 14) in the three back rows (Fisher's exact test; p = 0.036). During May 24-June 1, six of 18 students in a separate grade at the school, all also too young for vaccination, received positive SARS-CoV-2 test results. Eight additional cases were also identified, all in parents and siblings of students in these two grades. Among these additional cases, three were in persons fully vaccinated in accordance with CDC recommendations (1). Among the 27 total cases, 22 (81%) persons reported symptoms; the most frequently reported symptoms were fever (41%), cough (33%), headache (26%), and sore throat (26%). WGS of all 18 available specimens identified the B.1.617.2 (Delta) variant. Vaccines are effective against the Delta variant (2), but risk of transmission remains elevated among unvaccinated persons in schools without strict adherence to prevention strategies. In addition to vaccination for eligible persons, strict adherence to nonpharmaceutical prevention strategies, including masking, routine testing, facility ventilation, and staying home when symptomatic, are important to ensure safe in-person learning in schools (3).

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Section: Discussionmentioning

confidence: 87%

Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021

Lam-Hine¹,

McCurdy²,

Santora³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

113

View full text Add to dashboard Cite

show abstract

“…COVID-19 vaccine deployment has dramatically reduced the number of infections, hospitalizations, and deaths caused by SARS-CoV-2 [1,2]. However, there are reports of SARS-CoV-2 infections in fully vaccinated individuals [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. In the majority of individuals, these infections are presumed to be breakthrough infections associated with SARS-CoV-2 variants that escape vaccine-induced immunity.…”

Section: Introductionmentioning

confidence: 99%

Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients

Deng

Evdokimova

O’Brien

et al. 2021

Viruses

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The pandemic of COVID-19 caused by SARS-CoV-2 infection continues to spread around the world. Vaccines that elicit protective immunity have reduced infection and mortality, however new viral variants are arising that may evade vaccine-induced immunity or cause disease in individuals who are unable to develop robust vaccine-induced responses. Investigating the role of viral variants in causing severe disease, evading vaccine-elicited immunity, and infecting vulnerable individuals is important for developing strategies to control the pandemic. Here, we report fourteen breakthrough infections of SARS-CoV-2 in vaccinated individuals with symptoms ranging from asymptomatic/mild (6/14) to severe disease (8/14). High viral loads with a median Ct value of 19.6 were detected in the nasopharyngeal specimens from subjects regardless of disease severity. Sequence analysis revealed four distinct virus lineages, including alpha and gamma variants of concern. Immunosuppressed individuals were more likely to be hospitalized after infection (p = 0.047), however no specific variant was associated with severe disease. Our results highlight the high viral load that can occur in asymptomatic breakthrough infections and the vulnerability of immunosuppressed individuals to post-vaccination infections by diverse variants of SARS-CoV-2.

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“…For detailed information on COVID-19 vaccines in clinical development, refer to Table S1 which is adjusted from the WHO document [151]. Although a few claim vaccination is ineffective for limiting contagion, especially considering the vaccine breakthrough by the Delta variant (B.1.617.2) [175][176][177][178][179], vaccination is still recommended for everyone (≥12 years old) to prevent COVID-19 and particularly to avoid hospitalization and death [180].…”

Section: Vaccine Developmentmentioning

confidence: 99%

COVID-19: The Disease, the Immunological Challenges, the Treatment with Pharmaceuticals and Low-Dose Ionizing Radiation

Azzam

Jadhav

et al. 2021

Cells

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The year 2020 will be carved in the history books—with the proliferation of COVID-19 over the globe and with frontline health workers and basic scientists worldwide diligently fighting to alleviate life-threatening symptoms and curb the spread of the disease. Behind the shocking prevalence of death are countless families who lost loved ones. To these families and to humanity as a whole, the tallies are not irrelevant digits, but a motivation to develop effective strategies to save lives. However, at the onset of the pandemic, not many therapeutic choices were available besides supportive oxygen, anti-inflammatory dexamethasone, and antiviral remdesivir. Low-dose radiation (LDR), at a much lower dosage than applied in cancer treatment, re-emerged after a 75-year silence in its use in unresolved pneumonia, as a scientific interest with surprising effects in soothing the cytokine storm and other symptoms in severe COVID-19 patients. Here, we review the epidemiology, symptoms, immunological alterations, mutations, pharmaceuticals, and vaccine development of COVID-19, summarizing the history of X-ray irradiation in non-COVID diseases (especially pneumonia) and the currently registered clinical trials that apply LDR in treating COVID-19 patients. We discuss concerns, advantages, and disadvantages of LDR treatment and potential avenues that may provide empirical evidence supporting its potential use in defending against the pandemic.

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Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021

Cited by 501 publications

References 1 publication

Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021

Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021

Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients

COVID-19: The Disease, the Immunological Challenges, the Treatment with Pharmaceuticals and Low-Dose Ionizing Radiation

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