Viral loads of Delta-variant SARS-CoV-2 breakthrough infections after vaccination and booster with BNT162b2

Levine-Tiefenbrun, Matan; Yelin, Idan; Alapi, Hillel; Katz, Rachel; Herzel, Esma; Kuint, Jacob; Chodick, Gabriel; Gazit, Sivan; Patalon, Tal; Kishony, Roy

doi:10.1038/s41591-021-01575-4

Cited by 214 publications

(183 citation statements)

References 19 publications

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“…The CDC continues to collaborate with health departments to monitor these trends. 16,28 Findings from this study are consistent with what has been reported elsewhere [1][2][3][4][5][6]9 and underscore the likely value of boosters for certain high-risk groups 17,[23][24][25] and continued use of nonpharmaceutical interventions, including among vaccinated persons.…”

Section: Discussionsupporting

confidence: 85%

“…A similar analytical approach from Israel suggested waning immunity among BNT162b2 vaccine recipients, 5,6 whereas a study from New York State showed small differences in VE associated with waning. 1,17 These apparently contradictory results when evaluating rates among vaccinated individuals versus vaccine efficacy provide complementary perspectives on the data. The former perspective emphasizes rates that differ over time since vaccination, focusing on the relative differences among vaccination cohorts; the latter perspective shows that these differences are relatively small when compared with the unvaccinated population.…”

Section: Discussionmentioning

confidence: 99%

“…22 It seems reasonable to believe that booster doses could reduce the risk of severe disease in elderly persons and potentially help reduce transmission of SARS-CoV-2 among other age groups. 17,[23][24][25] However, vaccinating the unvaccinated continues to be a public health priority. A recent modeling study suggests that increasing vaccine coverage from current levels to 84% could reduce the reproductive number, which quantifies the average number of cases that each case goes on to infect by 37%.…”

Section: Discussionmentioning

confidence: 99%

“…Michigan Department of Health and Human Services, Lansing7 Arkansas Department of Health, Little Rock8 Georgia Department of Health, Atlanta9 Florida Department of Health, Tallahassee10 Arizona Department of Health Services, Phoenix11 Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta12 Nebraska Department of Health and Human Services, Lincoln13 Wisconsin Department of Health Services, Madison14 Idaho Department of Health and Welfare, Boise15 Data Analytics and Visualization Task Force, COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta16 New Mexico Department of Health, Santa Fe17 Indiana Department of Health, Indianapolis18 Tennessee Department of Health, Nashville…”

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confidence: 99%

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Covid-19 Rates by Time since Vaccination during Delta Variant Predominance

et al. 2022

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This article examines Covid-19 case and death rates among recipients of one of three FDA-approved vaccines. The data show that protection from infection attributable to the BNT162b2 and mRNA-1273 vaccine recipients and from death among older BNT162b2 recipients wanes over 6 months, whereas case and death rates among recipients of the Ad26.COV2.S vaccine are higher overall without a consistent pattern of waning immunity.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Covid-19 Rates by Time since Vaccination during Delta Variant Predominance

et al. 2022

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“…For example, the mRNA BNT162b2 COVID-19 vaccine (Pfizer-BioNTech, Comirnaty) has been estimated to reduce the risk of infection with the Delta variant by approximatively four-fold in adults and 10-fold in adolescents ( 13 , 168 ). Although breakthrough infections can occur in vaccinated individuals ( 169 ), emerging evidence suggests that their infectiousness even with the Delta variant might be reduced ( 170 ). However, this effect declines with time and so a third (booster) vaccine dose may be needed.…”

Section: Synergistic Risk Mitigation In Schoolsmentioning

confidence: 99%

Considerations for the Safe Operation of Schools During the Coronavirus Pandemic

Lordan

Prior

Hennessy

et al. 2021

Front. Public Health

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During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, providing safe in-person schooling has been a dynamic process balancing evolving community disease burden, scientific information, and local regulatory requirements with the mandate for education. Considerations include the health risks of SARS-CoV-2 infection and its post-acute sequelae, the impact of remote learning or periods of quarantine on education and well-being of children, and the contribution of schools to viral circulation in the community. The risk for infections that may occur within schools is related to the incidence of SARS-CoV-2 infections within the local community. Thus, persistent suppression of viral circulation in the community through effective public health measures including vaccination is critical to in-person schooling. Evidence suggests that the likelihood of transmission of SARS-CoV-2 within schools can be minimized if mitigation strategies are rationally combined. This article reviews evidence-based approaches and practices for the continual operation of in-person schooling.

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Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

Wald

2022

JAMA

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The vaccines to prevent COVID-19 are remarkable for their safety, efficacy, and pace of development. Initial enthusiasm that followed the release of the preliminary results that formed the basis for distribution of the vaccines under Emergency Use Authorization (EUA) has been dampened by the inequity in access to the vaccines across the globe, vaccine hesitancy, and emergence of variants that partly evade vaccine-induced antibodies. These factors are related, and all 3 contribute to ongoing morbidity, mortality, and societal disruption related to SARS-CoV-2 in much of the world. Incomplete coverage with the vaccine leads to infection of immunocompromised persons who are likely to harbor the virus for prolonged periods (or chronically), allowing for mutations that are then selected for immune evasion and better fitness to the human host. 1 The new variants are sufficiently altered structurally such that neither prior SARS-CoV-2 infection or even much higher levels of vaccine-induced antibodies are protective.In this issue of JAMA, Spitzer and colleagues assess the effect of a booster dose of the mRNA vaccine BNT162b2 (Pfizer-BioNTech) on acquisition of SARS-CoV-2 infection among health care workers in a tertiary medical center in Tel Aviv, Israel. 2 Israel achieved high vaccination coverage of most health care workers, who were prioritized for immunization receiving both doses of the BNT162b2 vaccine by the end of January 2021. As such, when the Delta variant arose in June 2021, most health care workers had received their second dose of vaccine about 6 months earlier, and emerging data showed that the antibody titers in response to vaccination had waned.Although Spitzer et al initially aimed to provide a booster vaccine dose only for persons with antibody titers less than the median, universal boosting was recommended by health authorities. The investigators enrolled a cohort of health care workers who had completed a 2-dose vaccination series of BNT162b2 and subsequently received a booster dose of the vaccine. Infections in the cohort were monitored by SARS-CoV-2 polymerase chain reaction (PCR) tests every 2 weeks regardless of symptoms. Anti-SARS-CoV-2 spike protein receptorbinding domain (anti-S1-RBD) was measured at baseline and 1 month after the booster.The study cohort included 1928 health workers, and 1650 (85.6%) received a booster dose during the study. The median overall follow-up was 39 days, and the median follow-up of boosted persons, beginning 7 or more days after the receipt of the booster vaccination, was 26 days. Overall, 3552 PCR tests were obtained with 51% before and 49% after boosting. A total of 44 persons tested positive for SARS-CoV-2 during

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Viral loads of Delta-variant SARS-CoV-2 breakthrough infections after vaccination and booster with BNT162b2

Cited by 214 publications

References 19 publications

Covid-19 Rates by Time since Vaccination during Delta Variant Predominance

Covid-19 Rates by Time since Vaccination during Delta Variant Predominance

Considerations for the Safe Operation of Schools During the Coronavirus Pandemic

Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

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