Sporadic clusters of healthcare-associated COVID-19 infection occurred in a highly vaccinated HCW and patient population, over a 3-month period during ongoing community transmission of the B.1.617.2 variant. Enhanced infection-prevention measures and robust surveillance systems, including routine-rostered-testing of all inpatients and staff and usage of N95-respirators in all clinical areas, were insufficient in achieving zero healthcare-associated transmission. The unvaccinated and immunocompromised remain at-risk and should be prioritized for enhanced surveillance.