SARS-CoV-2 Breakthrough Infections in Fully Vaccinated Individuals

E, Ramirez; Wilkes, Rebecca P.; Carpi, Giovanna; Dorman, Jack; Bowen, Craig W.; Smith, Lisa A.

doi:10.1101/2021.06.21.21258990

Cited by 12 publications

(15 citation statements)

References 7 publications

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“…We found no signi cant difference in Ct values between vaccinated and unvaccinated groups infected with SARS-CoV-2. There were numerous studies with similar results, especially during the delta surge [31][32][33][34]. Given the substantial proportion of asymptomatic vaccine breakthrough cases with high viral loads, interventions, including masking and distancing, should be considered for all vaccinated persons especially in the settings with elevated COVID-19 transmission [35].…”

Section: Discussionmentioning

confidence: 92%

Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients who Were Vaccinated with Coronavac or Unvaccinated: An Analytical, Cross Sectional Study

Yavuz

Tuncer

Aydın

et al. 2022

Preprint

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PurposeCOVID-19 vaccines have been shown to be highly effective; however, vaccine breakthrough infections resulting from hospitalization may still occur in a small percentage of vaccinated individuals. We investigated whether the clinical and microbiological features and outcomes were different between hospitalized COVID-19 vaccinated and unvaccinated COVID-19 patients.MethodsThis multicentre, prospective, cross-sectional study was performed between April and June 2021. All hospitalized COVID-19 patients who previously had at least one dose of Coronavac were included in the study, along with some unvaccinated patients. All epidemiologic, clinical and laboratory data of the patients were recorded and compared between the vaccinated and unvaccinated individuals.ResultsThere were 69 fully Coronavac vaccinated and 175 unvaccinated patients. All breakthrough infections occurred in the first 3 months of vaccination. Fully vaccinated patients were older and had more comorbidities than unvaccinated patients (p<0.05). There were minor differences between the groups in the symptoms, physical and laboratory findings, anti-spike IgG positivity rate, mean anti-SARS-CoV-2 S antibody level, and severity of COVID-19. The mortality rate of fully vaccinated patients was higher than the mortality rate in unvaccinated patients; however, vaccination was not an independent risk factor for mortality.ConclusionsHospitalized patients with breakthrough COVID-19 after Coronavac vaccination were usually older with comorbidities. The severity and clinical outcomes of these cases were similar to those of unvaccinated patients. Our findings suggest that the immune response elicited by Coronovac could be insufficient to prevent COVID-19-related severe disease and death within 3 months of vaccination among elderly people with comorbidities.

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Section: Discussionmentioning

confidence: 92%

Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients who Were Vaccinated with Coronavac or Unvaccinated: An Analytical, Cross Sectional Study

Yavuz

Tuncer

Aydın

et al. 2022

Preprint

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“…Subsequently, with the pandemic of Alpha, Delta, Omicron and other variants, more and more countries have reported different types of vaccine breakthrough cases. 14 In China, despite strict prevention and control measures and high vaccination coverage rates, occasional breakthrough infections were detected. Our study summarized the genomic, immunological and clinical features of COVID‐19 vaccine breakthrough infections in Beijing, China from June 1 to August 22, 2021, and achieved some beneficial results.…”

Section: Discussionmentioning

confidence: 99%

Genomic, immunological, and clinical analysis of COVID‐19 vaccine breakthrough infections in Beijing, China

Tian

Song

Zhang

et al. 2022

Journal of Medical Virology

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As the coronavirus disease 2019 (COVID‐19) pandemic is still ongoing and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants are circulating worldwide, an increasing number of breakthrough infections are being detected despite the good efficacy of COVID‐19 vaccines. Data on 88 COVID‐19 breakthrough cases (breakthrough infections group) and 41 unvaccinated cases (unvaccinated group) from June 1 to August 22, 2021, were extracted from a cloud database established at Beijing Ditan Hospital to evaluate the clinical, immunological, and genomic characteristics of COVID‐19 breakthrough infections. Among these 129 COVID‐19 cases, 33 whole genomes were successfully sequenced, of which 23 were Delta variants, including 15 from the breakthrough infections group. Asymptomatic and mild cases predominated in both groups, but two patients developed severe disease in the unvaccinated group. The median time of viral shedding in the breakthrough infections group was significantly lower than that in the unvaccinated group (p = 0.003). In the breakthrough infections group, the IgG titers showed a significantly increasing trend (p = 0.007), and the CD4 + T lymphocyte count was significantly elevated (p = 0.018). For people infected with the Delta variant in the two groups, no significant difference was observed in either the quantitative reverse‐transcription polymerase chain reaction results or viral shedding time. In conclusion, among vaccinated patients, the cases of COVID‐19 vaccine breakthrough infections were mainly asymptomatic and mild, IgG titers were significantly increased and rose rapidly, and the viral shedding time was shorter.

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“…We analyzed a large sample that represents the general population of the U.S. west coast. Previous published studies in the U.S. (9,(23)(24)(25)(26)(27) are limited to a cohort with specific characteristics, such as health-care workers (6,15,23,27), patients with specific comorbidities (28)(29)(30), veterans (9,24,29,31), patients of academic hospitals (32,33). PSJH is a community-served hospital that covers five states of the west coast in both rural and urban areas.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Time to reinfection and vaccine breakthrough SARS-CoV-2 infections: a retrospective cohort study

Molani

Baumgartner

Hwang

et al. 2022

Preprint

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Background: It is important to understand how BNT162b2, mRNA-1273, and JNJ-78436735 COVID-19 vaccines, as well as prior infection, protect against breakthrough cases and reinfections. Real world evidence on acquired immunity from vaccines, and from SARS-CoV-2 infection, can help public health decision-makers understand disease dynamics and viral escape to inform resource allocation for curbing the spread of pandemic. Methods: This retrospective cohort study presents demographic information, survival functions, and probability distributions for 2,627,914 patients who received recommended doses of COVID-19 vaccines, and 63,691 patients who had a prior COVID-19 infection. In addition, patients receiving different vaccines were matched by age, sex, ethnic group, state of residency, and the quarter of the year in 2021 the COVID-19 vaccine was completed, to support survival analysis on pairwise matched cohorts. Findings: Each of the three vaccines and infection-induced immunity all showed a high probability of survival against breakthrough or reinfection cases (mRNA-1273: 0.997, BNT162b2: 0.997, JNJ-78436735: 0.992, previous infection: 0.965 at 180 days). The incidence rate of reinfection among those unvaccinated and previously infected was higher than that of breakthrough among the vaccinated population (reinfection: 0.9%; breakthrough:0.4%). In addition, 280 vaccinated patients died (0.01% all-cause mortality) within 21 days of the last vaccine dose, and 5898 (3.1 %) died within 21 days of a positive COVID-19 test. Conclusions: Despite a gradual decline in vaccine-induced and infection-induced immunity, both acquired immunities were highly effective in preventing breakthrough and reinfection. In addition, for unvaccinated patients with COVID-19, those who did not die within 90 days of their initial infection (9565 deaths, 5.0% all-cause mortality rate), had a comparable asymptotic pattern of breakthrough infection as those who acquired immunity from a vaccine. Overall, the risks associated with COVID-19 infection are far greater than the marginal advantages of immunity acquired by prior infection.

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SARS-CoV-2 Breakthrough Infections in Fully Vaccinated Individuals

Cited by 12 publications

References 7 publications

Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients who Were Vaccinated with Coronavac or Unvaccinated: An Analytical, Cross Sectional Study

Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients who Were Vaccinated with Coronavac or Unvaccinated: An Analytical, Cross Sectional Study

Genomic, immunological, and clinical analysis of COVID‐19 vaccine breakthrough infections in Beijing, China

Time to reinfection and vaccine breakthrough SARS-CoV-2 infections: a retrospective cohort study

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