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Risk Factors Associated With SARS-CoV-2 Breakthrough Infections in Fully mRNA-Vaccinated Individuals: Retrospective

Cong Liu¹, Junghwan Lee¹, Casey Ta¹

¹Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States.

JMIR Public Health and Surveillance

|April 29, 2022

Summary

This summary is machine-generated.

Messenger RNA (mRNA) COVID-19 vaccines are effective, but breakthrough infections occur. Pfizer/BNT162b2 vaccine recipients, males, and immunocompromised individuals faced higher risks.

Keywords:

COVID-19 electronic health records medical informatics real-word evidence vaccination

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Published on: June 5, 2021

Area of Science:

Immunology
Vaccinology
Epidemiology

Background:

COVID-19 mRNA vaccines show high efficacy and safety in trials.
Breakthrough infections, though rare, have been documented post-vaccination.

Purpose of the Study:

To identify risk factors for COVID-19 breakthrough infections in individuals fully vaccinated with mRNA vaccines.
To analyze associations between vaccine type, demographics, and underlying conditions with breakthrough infection rates.

Main Methods:

Retrospective analysis of electronic health records from Columbia University Irving Medical Center/New York Presbyterian.
Inclusion criteria: NYC adult residents with at least one PCR test record.
Poisson regression used to assess risk factors, adjusting for calendar month, prior visits, and observational days.

Main Results:

The overall breakthrough infection rate was 0.16 (95% CI 0.14-0.18).
Higher risk observed for Pfizer/BNT162b2 recipients (IRR=1.66 vs. Moderna/mRNA-1273), males (IRR=1.47 vs. females), and immunocompromised individuals (IRR=1.48).
Specific high-risk conditions included primary immunodeficiency, organ transplant history, active tumors, immunosuppressant use, and Alzheimer disease.

Conclusions:

Both mRNA vaccines are effective, with Moderna/mRNA-1273 showing a lower breakthrough infection incidence.
Immunocompromised individuals and males are at higher risk for breakthrough infections.
Continuous monitoring and adaptable analysis are crucial for real-time vaccine effectiveness updates during the evolving pandemic.