The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel
Open accessAbstract
Objectives The mRNA coronavirus disease 2019 (COVID-19) vaccines have shown high effectiveness in the prevention of symptomatic COVID-19, hospitalization, severe disease and death. Nevertheless, a minority of vaccinated individuals might become infected and experience significant morbidity. Characteristics of vaccine breakthrough infections have not been studied. We sought to portray the population of Israeli patients, who were hospitalized with COVID-19 despite full vaccination. Methods A retrospective multicentre cohort study of 17 hospitals included patients fully vaccinated with Pfizer/BioNTech's BNT162b2 vaccine who developed COVID-19 more than 7 days after the second vaccine dose and required hospitalization. The risk for poor outcome, defined as a composite of mechanical ventilation or death, was assessed. Results A total of 152 patients were included, accounting for half of hospitalized fully vaccinated patients in Israel. Poor outcome was noted in 38 patients and mortality rate reached 22% (34/152). Notably, the cohort was characterized by a high rate of co-morbidities predisposing to severe COVID-19, including hypertension (108; 71%), diabetes (73; 48%), congestive heart failure (41; 27%), chronic kidney and lung diseases (37; 24% each), dementia (29; 19%) and cancer (36; 24%), and only six (4%) had no co-morbidities. Sixty (40%) of the patients were immunocompromised. Higher viral load was associated with a significant risk for poor outcome. Risk also appeared higher in patients receiving anti-CD20 treatment and in patients with low titres of anti-Spike IgG, but these differences did not reach statistical significance. Conclusions We found that severe COVID-19 infection, associated with a high mortality rate, might develop in a minority of fully vaccinated individuals with multiple co-morbidities. Our patients had a higher rate of co-morbidities and immunosuppression compared with previously reported non-vaccinated hospitalized individuals with COVID-19. Further characterization of this vulnerable population may help to develop guidance to augment their protection, either by continued social distancing, or by additional active or passive vaccinations.
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Cites
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
Polack, F. P., Thomas, S. J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J. L., Pérez Marc, G., Moreira, E. D., Zerbini, C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2034577 · Cited by 14,592 · cited 2×
“The mRNA coronavirus disease 2019 (COVID-19) vaccines, Pfizer/BioNTech's BNT162b2 and Moderna's mRNA-1273, were 94%e95% effective in preventing symptomatic COVID-19 in phase III studies, showing similar efficacy in different age groups, including persons older than 75 years, and persons with comorbidities [1,2].”
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine
Baden, L. R., El Sahly, H. M., Essink, B., Kotloff, K., Frey, S., Novak, R., Diemert, D., Spector, S. A., Rouphael, N., Creech, C. B., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2035389 · Cited by 10,119
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting
Dagan, N., Barda, N., Kepten, E., Miron, O., Perchik, S., Katz, M. A., Hernán, M. A., Lipsitch, M., Reis, B., & Balicer, R. D. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2101765 · Cited by 2,527 · cited 3×
“As effectiveness of BNT162b2was studied in patientsmore than 7 days after the second dose in most clinical studies [2,4,5], either symptom onset, the first positive PCR test or the date of admission, whichever happened first, had to be more than 7 days after the second dose.”
Haas, E. J., Angulo, F. J., McLaughlin, J. M., Anis, E., Singer, S. R., Khan, F., Brooks, N., Smaja, M., Mircus, G., Pan, K., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00947-8 · Cited by 1,564 · cited 3×
“As effectiveness of BNT162b2was studied in patientsmore than 7 days after the second dose in most clinical studies [2,4,5], either symptom onset, the first positive PCR test or the date of admission, whichever happened first, had to be more than 7 days after the second dose.”
Bernal, J. L., Andrews, N., Gower, C., Stowe, J., Robertson, C., Tessier, E., Simmons, R., Cottrell, S., Roberts, R., O’Doherty, M., et al. (2021) · doi:10.1101/2021.03.01.21252652 · Cited by 1,389 · cited 13×
“As effectiveness of BNT162b2was studied in patientsmore than 7 days after the second dose in most clinical studies [2,4,5], either symptom onset, the first positive PCR test or the date of admission, whichever happened first, had to be more than 7 days after the second dose.”
InfluentialSafety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting
Barda, N., Dagan, N., Ben-Shlomo, Y., Kepten, E., Waxman, J., Ohana, R., Hernán, M. A., Lipsitch, M., Kohane, I., Netzer, D., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2110475 · Cited by 1,027
Myers, L. C., Parodi, S. M., Escobar, G. J., & Liu, V. X. (2020) · JAMA · doi:10.1001/jama.2020.7202 · Cited by 467
Cited by
Diagnostics for COVID-19: moving from pandemic response to control
Peeling, R. W., Heymann, D. L., Teo, Y.-Y., & Garcia, P. J. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02346-1 · Cited by 486
Sun, J., Zheng, Q., Madhira, V., Olex, A. L., Anzalone, A. J., Vinson, A., Singh, J. A., French, E., Abraham, A. G., Mathew, J., et al. (2022) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2021.7024 · Cited by 265
Andrejko, K. L., Pry, J. M., Myers, J. F., Mehrotra, M., Lamba, K., Lim, E., Fukui, N., DeGuzman, J. L., Openshaw, J., Watt, J., et al. (2023) · American Journal of Epidemiology · doi:10.1093/aje/kwad017 · Cited by 28
Shooting at a Moving Target—Effectiveness and Emerging Challenges for SARS-CoV-2 Vaccine Development
Günl, F., Mecate-Zambrano, A., Rehländer, S., Hinse, S., Ludwig, S., & Brunotte, L. (2021) · Vaccines · doi:10.3390/vaccines9101052 · Cited by 27
“The other patients had been diagnosed with multiple co-morbidities, including hypertension, diabetes, congestive heart failure, chronic kidney and lung diseases, dementia and cancer [191].”
Background
Metadata
- Authors
- Brosh-Nissimov, T., Orenbuch-Harroch, E., Chowers, M., Elbaz, M., Nesher, L., Stein, M., Maor, Y., Cohen, R., Hussein, K., Weinberger, M., Zimhony, O., Chazan, B., Najjar, R., Zayyad, H., Rahav, G., & Wiener-Well, Y.
- Venue
- Clinical Microbiology and Infection
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 27
- Issue
- 11
- Pages
- 1652-1657
- ISSN
- 1198-743X (ISSN-L)
- OpenAlex
- W3179335016
- Cited by
- 327
- References
- 7
- FWCI
- 23.32
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Brosh-Nissimov, T., Orenbuch-Harroch, E., Chowers, M., Elbaz, M., Nesher, L., Stein, M., Maor, Y., Cohen, R., Hussein, K., Weinberger, M., Zimhony, O., Chazan, B., Najjar, R., Zayyad, H., Rahav, G., & Wiener-Well, Y. (2021). BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clinical Microbiology and Infection. https://doi.org/10.1016/j.cmi.2021.06.036
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