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SARS-CoV-2 Reinfection Cases in a Household-Based Prospective Cohort in Rio de Janeiro

Stephanie L S Penetra1, Heloisa F P Santos1, Paola Cristina Resende2

  • 1Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.

The Journal of Infectious Diseases
|August 12, 2023
PubMed

Insights

COVID-19 reinfection risk was reduced by one vaccine dose pre-Omicron, but not during the Omicron variant surge, even with boosters. Most reinfections were mild, underscoring the need for updated vaccines.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Vaccinology

Background:

  • The emergence of SARS-CoV-2 variants, including Omicron, has raised concerns about vaccine effectiveness against infection and reinfection.
  • Understanding the dynamics of COVID-19 reinfection in a vaccinated population is crucial for public health strategies.

Purpose of the Study:

  • To investigate the incidence and characteristics of COVID-19 reinfections in a household cohort.
  • To evaluate the impact of vaccination status, including booster doses, on the risk of reinfection during different SARS-CoV-2 variant periods.

Main Methods:

  • Prospective household cohort study in Rio de Janeiro (April 2020 - June 2022).
  • Identification and confirmation of reinfections using laboratory testing and genomic analyses.
  • Analysis of vaccination status and its association with reinfection risk across pre-Omicron and Omicron periods.

Main Results:

  • Ninety-eight COVID-19 reinfections were identified; 71% confirmed by genomic sequencing.
  • Pre-Omicron: One vaccine dose reduced reinfection risk.
  • Omicron period: Neither primary vaccination nor booster doses significantly reduced reinfection risk.
  • Most reinfections were asymptomatic or milder than primary infections.

Conclusions:

  • Vaccination may not fully prevent SARS-CoV-2 infection or reinfection, particularly with newer variants.
  • Continuous surveillance of infections in vaccinated individuals is warranted.
  • Regular updates to vaccine antigenic targets and booster administration are recommended, similar to influenza vaccination strategies.

Keywords:
COVID-19OmicronSARS-CoV-2 infectionreinfectionsvaccine breakthroughvariants of concern

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