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Nicholas Morreale

Pronouns

He/Him/His

Job Title

Clinical Research Assistant

Academic Rank

Department

Medicine

Authors

Nicholas Morreale, Megan Powell, Julia Klopfer, John Almeida, Xiaofang Li, John Kupleian, Amy Sherman, M.D., Lindsey Baden, M.D.

Principal Investigator

Amy Sherman, MD

Research Category: COVID-19

Tags

Understanding COVID-19 breakthrough infection in vaccinated healthy adults

Scientific Abstract

Background: Despite highly effective SARS-CoV-2 mRNA vaccines, breakthrough infections persist among healthy individuals. Understanding breakthrough infections is necessary to inform public health strategies.

Methods: A prospective cohort study of healthy adults was conducted at Brigham and Women’s Hospital with longitudinal follow up through the recommended 3-dose or 4-dose (individuals >50 years old) mRNA COVID vaccine series. COVID-19 infection prevalence and time between vaccination and infection was followed in all patients.

Results: 68 participants were enrolled and followed from December 17,2020 to August 31, 2022. The cohort was composed of 39 (57%) females, with a median age 28.09 (IQR 24.05-53.47), and was predominately white (73%). Of the study cohort population, 58/68 (85%) received 3 doses of mRNA vaccines, and 6/68 (9%) received 4 doses. Infection prevalence among volunteers was 51%, with May 2022 having peak incidence of COVID-19. The average time between most recent vaccination to infection was 172 days (median 189, IQR 114.5 – 232.5).

Conclusion: Increased rates of SARS-COV-2 infections have been reported in the first half of 2022, suggesting antibody decay, decreased efficacy of vaccine immunity against variants of concern, and/or relaxation of social mitigation factors leading to increased infection rates.

Lay Abstract

Background: Despite well functioning COVID-19 vaccines people around the globe are still contracting and spreading the virus. Understanding how the virus is transmitted among a vaccinated population is necessary to help decide what public health strategies can help reduce rate of infection,

How We Operated: A group of healthy participants were followed over the course of the pandemic and typically dosing schedule. We asked them to report to us when they received COVID-19 vaccines and when they tested positive for the virus.

Results: Out of 68 participants that were followed throughout the study over half were white(73%), female(57%), and the middle age of the participants hovered around 28. 58 out of the 68 paticpants received 3 dose of the COVID vaccine, with 6 of those getting a fourth dose. 51% of the participants contracted COVID during the study. The month with the most cases was May 2022. The average time from most recent vaccine to COVID infection was 172 days.

Conclusion: Increased rates of COVID infections have been reported in the first half of 2022, suggesting the vaccines only protect people for a certain period of time, an evolving virus as a result of the vaccine protection and/or relaxation of social distancing leading to increased infection rates.

Clinical Implications

Despite highly effective SARS-CoV-2 mRNA vaccines, breakthrough infections persist among healthy individuals. Understanding breakthrough infections is necessary to inform public health strategies.