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Virological characteristics of SARS-CoV-2 vaccine breakthrough infections in health care workers

Shamier, M. C.; Tostmann, A.; Bogers, S.; De Wilde, J.; IJpelaar, J.; Van Der Kleij, W.; De Jager, H.; Haagmans, B.; Molenkamp, R.; Oude Munnink, B.; van Rossum, C.; Rahamat-Langendoen, J.; Van Der Geest, N.; Bleeker-Rovers, C.; Wertheim, H.; Koopmans, M.; GeurtsvanKessel, C.

2021-08-21 infectious diseases Community evaluation
10.1101/2021.08.20.21262158 medRxiv
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BackgroundSARS-CoV-2 vaccines are highly effective at preventing COVID-19-related morbidity and mortality. As no vaccine is 100% effective, breakthrough infections are expected to occur. MethodsWe analyzed the virological characteristics of 161 vaccine breakthrough infections in a population of 24,706 vaccinated healthcare workers (HCWs), using RT-PCR and virus culture. ResultsThe delta variant (B.1.617.2) was identified in the majority of cases. Despite similar Ct-values, we demonstrate lower probability of infectious virus detection in respiratory samples of vaccinated HCWs with breakthrough infections compared to unvaccinated HCWs with primary SARS-CoV-2 infections. Nevertheless, infectious virus was found in 68.6% of breakthrough infections and Ct-values decreased throughout the first 3 days of illness. ConclusionsWe conclude that rare vaccine breakthrough infections occur, but infectious virus shedding is reduced in these cases.

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