Serial infection with SARS-CoV-2 Omicron BA.1 and BA.2 following three-dose COVID-19 vaccination

Lapointe, Hope R.; Mwimanzi, Francis; Cheung, Peter K.; Sang, Yurou; Yaseen, Fatima; Kalikawe, Rebecca; Datwani, Sneha; Waterworth, Rachel; Umviligihozo, Gisele; Ennis, Siobhan; Young, Landon; Dong, Winnie; Kirkby, Don; Burns, Laura; Leung, Victor; Holmes, Daniel T.; DeMarco, Mari L.; Simons, Janet; Matic, Nancy; Montaner, Julio S. G.; Brumme, Chanson J.; Prystajecky, Natalie; Niikura, Masahiro; Lowe, Christopher F.; Romney, Marc G.; Brockman, Mark A.; Brumme, Zabrina L.

doi:10.1101/2022.05.19.22275026

Cited by 4 publications

(2 citation statements)

References 47 publications

(52 reference statements)

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“…Rather, because of recent prior BA.1 infection among a wide swath of the NYC adult population, it may be that those re-infected with BA.2/BA.2.12.1 after a recent BA.1 infection had a lower mean peak viral load due to greater acquired T-cell mediated immunity from prior BA.1 infection. [35][36][37] This could effectively reduce the magnitude of peak SARS-CoV-2 concentration in wastewater, even for roughly the same number of individuals in the population with active SARS-CoV-2 infection. If this is true, it would suggest that wastewater surveillance may be less useful for surge detection soon after a recent widespread surge like BA.1, and requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April-May 2022

Qasmieh

Robertson

Teasdale

et al. 2022

Preprint

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ImportanceRoutine case surveillance data for SARS-CoV-2 are incomplete, biased, missing key variables of interest, and may be unreliable for both timely surge detection and understanding the burden of infection.ObjectiveTo determine the prevalence of SARS-CoV-2 infection during the Omicron BA.2/BA.2.12.1 surge in relation to official case counts, and to assess the epidemiology of infection and uptake of SARS-CoV-2 antivirals.DesignCross-sectional survey of a representative sample of New York City (NYC) adult residents, conducted May 7-8, 2022.SettingNYC, April 23-May 8, 2022, during which the official SARS-CoV-2 case count was 49,253 and BA.2.12.2 comprised 20% of reported cases.ParticipantsA representative sample of 1,030 NYC adult residents >18 years.Exposure(s)Vulnerability to severe COVID-19, including vaccination/booster status, prior COVID, age, and presence of comorbidities.Main Outcome(s) and Measure(s)Prevalence of SARS-CoV-2 infection during a 14-day period, weighted to represent the NYC adult population. Respondents self-reported on SARS-CoV-2 testing (including at-home rapid antigen tests), testing outcomes, COVID-like symptoms, and contact with confirmed/probable cases. Individuals with SARS-CoV-2 were asked about awareness/use of antiviral medications.ResultsAn estimated 22.1% (95%CI 17.9%-26.2%) of respondents had SARS-CoV-2 infection during the study period, corresponding to ∼1.5 million adults (95%CI 1.3-1.8 million). Prevalence was estimated at 34.9% (95%CI 26.9%-42.8%) among individuals with co-morbidities, 14.9% (95% CI 11.0%-18.8%) among those 65+ years, and 18.9% (95%CI 10.2%-27.5%) among unvaccinated persons. Hybrid protection against severe disease (i.e., from both vaccination and prior infection) was 66.2% (95%CI 55.7%-76.7%) among those with COVID and 46.3% (95%CI 40.2-52.2) among those without. Among individuals with COVID, 55.9% (95%CI 44.9%-67.0%) were not aware of the antiviral nirmatrelvir/ritonavir (Paxlovid™), and 15.1% (95%CI 7.1%-23.1%) reported receiving it.Conclusions and RelevanceThe true magnitude of NYC’s BA.2/BA.2.12.1 surge was vastly underestimated by routine SARS-CoV-2 surveillance. Until there is more certainty that the impact of future pandemic surges on severe population health outcomes will be diminished, representative surveys are needed for timely surge detection, and to estimate the true burden of infection, hybrid protection, and uptake of time-sensitive treatments.

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Section: Discussionmentioning

confidence: 99%

The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April-May 2022

Qasmieh

Robertson

Teasdale

et al. 2022

Preprint

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“…Only a few studies have analysed immune responses in PWH following three doses of COVID-19 vaccines, although initial reports on individuals with preserved CD4 + T cell count are optimistic (54). In our study of cART-treated PWH in the older age group, we showed that each COVID-19 vaccine dose, regardless of its type, induces binding IgG Abs for spike and RBD in plasma and spike IgG in saliva at levels similar in PWH and age-matched HIV-negative individuals.…”

Section: Longitudinal Modelling Of Cytokine Responses In T Cellsmentioning

confidence: 99%

Immunogenicity of COVID-19 vaccines and their effect on the HIV reservoir in older people with HIV

Matveev,

Mihelic,

Benko

et al. 2023

Preprint

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Older individuals and people with HIV (PWH) were prioritized for COVID-19 vaccination, yet comprehensive studies of the immunogenicity of these vaccines and their effects on HIV reservoirs are not available. We followed 68 PWH aged 55 and older and 23 age-matched HIV-negative individuals for 48 weeks from the first vaccine dose, after the total of three doses. All PWH were on antiretroviral therapy (cART) and had different immune status, including immune responders (IR), immune non-responders (INR), and PWH with low-level viremia (LLV). We measured total and neutralizing Ab responses to SARS-CoV-2 spike and RBD in sera, total anti-spike Abs in saliva, frequency of anti-RBD/NTD B cells, changes in frequency of anti-spike, HIV gag/nef-specific T cells, and HIV reservoirs in peripheral CD4+ T cells. The resulting datasets were used to create a mathematical model for within-host immunization. Various regimens of BNT162b2, mRNA-1273, and ChAdOx1 vaccines elicited equally strong anti-spike IgG responses in PWH and HIV-negative participants in serum and saliva at all timepoints. These responses had similar kinetics in both cohorts and peaked at 4 weeks post-booster (third dose), while half-lives of plasma IgG also dramatically increased post-booster in both groups. Salivary spike IgA responses were low, especially in INRs. PWH had diminished live virus neutralizing titers after two vaccine doses which were 'rescued' after a booster. Anti-spike T cell immunity was enhanced in IRs even in comparison to HIV-negative participants, suggesting Th1 imprinting from HIV, while in INRs it was the lowest. Increased frequency of viral 'blips' in PWH were seen post-vaccination, but vaccines did not affect the size of the intact HIV reservoir in CD4+ T cells in most PWH, except in LLVs. Thus, older PWH require three doses of COVID-19 vaccine to maximize neutralizing responses against SARS-CoV-2, although vaccines may increase HIV reservoirs in PWH with persistent viremia.

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The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April–May 2022

et al. 2023

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Background Routine case surveillance data for SARS-CoV-2 are incomplete, unrepresentative, missing key variables of interest, and may be increasingly unreliable for timely surge detection and understanding the true burden of infection. Methods We conducted a cross-sectional survey of a representative sample of 1030 New York City (NYC) adult residents ≥18 years on May 7-8, 2022. We estimated the prevalence of SARS-CoV-2 infection during the preceding 14-day period. Respondents were asked about SARS-CoV-2 testing, testing outcomes, COVID-like symptoms, and contact with SARS-CoV-2 cases. SARS-CoV-2 prevalence estimates were age- and sex-adjusted to the 2020 U.S. population. We triangulated survey-based prevalence estimates with contemporaneous official SARS-CoV-2 counts of cases, hospitalizations, and deaths, as well as SARS-CoV-2 wastewater concentrations. Results We show that 22.1% (95% CI 17.9–26.2%) of respondents had SARS-CoV-2 infection during the two-week study period, corresponding to ~1.5 million adults (95% CI 1.3-1.8 million). The official SARS-CoV-2 case count during the study period is 51,218. Prevalence is estimated at 36.6% (95% CI 28.3–45.8%) among individuals with co-morbidities, 13.7% (95% CI 10.4–17.9%) among those 65+ years, and 15.3% (95% CI 9.6–23.5%) among unvaccinated persons. Among individuals with a SARS-CoV-2 infection, hybrid immunity (history of both vaccination and infection) is 66.2% (95% CI 55.7–76.7%), 44.1% (95% CI 33.0–55.1%) were aware of the antiviral nirmatrelvir/ritonavir, and 15.1% (95% CI 7.1–23.1%) reported receiving it. Hospitalizations, deaths and SARS-CoV-2 virus concentrations in wastewater remained well below that during the BA.1 surge. Conclusions Our findings suggest that the true magnitude of NYC’s BA.2/BA.2.12.1 surge may have been vastly underestimated by routine case counts and wastewater surveillance. Hybrid immunity, bolstered by the recent BA.1 surge, likely limited the severity of the BA.2/BA.2.12.1 surge.

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Serial infection with SARS-CoV-2 Omicron BA.1 and BA.2 following three-dose COVID-19 vaccination

Cited by 4 publications

References 47 publications

The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April-May 2022

The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April-May 2022

Immunogenicity of COVID-19 vaccines and their effect on the HIV reservoir in older people with HIV

The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April–May 2022

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