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Investigating SARS-CoV-2 breakthrough infections per variant and vaccine type
Jozef Dingemans1, Brian M J W van der Veer1, Koen M F Gorgels2
1Department of Medical Microbiology, Infectious diseases and Infection prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands.
Frontiers in Microbiology
|December 12, 2022
Summary
The emergence of SARS-CoV-2 Delta and Omicron variants increased breakthrough infections, particularly with non-mRNA vaccines. Elderly individuals are at higher risk for severe illness from these breakthrough infections.
Area of Science:
- Virology and Immunology
- Vaccinology
- Epidemiology
Background:
- Breakthrough SARS-CoV-2 infections occur despite high vaccine efficacy.
- Variants of Concern (VOC) may contribute to breakthrough infections.
- Understanding the impact of VOCs on vaccine effectiveness is crucial.
Purpose of the Study:
- To investigate SARS-CoV-2 genotypes in breakthrough infections.
- To compare infection rates across different vaccine types and variants.
- To assess factors influencing disease severity in vaccinated individuals.
Main Methods:
- Analysis of 378 breakthrough infections (January-July 2021).
- Week-by-week comparison of SARS-CoV-2 genotypes in vaccinated individuals versus community lineages.
- Genomic surveillance of Delta and Omicron variants during a transition period.
Main Results:
- Delta variant emergence significantly increased breakthrough infections, especially with non-mRNA vaccines (Vaxzevria, Jcovden).
- Symptomatic individuals had higher viral loads; Delta variant infections showed increased viral loads compared to Alpha.
- Omicron variant proportion was higher in boosted individuals compared to unvaccinated or fully vaccinated individuals.
Conclusions:
- Delta and Omicron variants reduce the effectiveness of certain vaccine types against SARS-CoV-2 infection.
- Elderly individuals are at increased risk of severe breakthrough infections.
- Spike protein N-terminal domain mutations play a role in immune evasion.
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