Vaccine Breakthrough Infections with SARS-CoV-2 Variants
Open accessAbstract
Emerging variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of clinical concern. In a cohort of 417 persons who had received the second dose of BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine at least 2 weeks previously, we identified 2 women with vaccine breakthrough infection. Despite evidence of vaccine efficacy in both women, symptoms of coronavirus disease 2019 developed, and they tested positive for SARS-CoV-2 by polymerase-chain-reaction testing. Viral sequencing revealed variants of likely clinical importance, including E484K in 1 woman and three mutations (T95I, del142-144, and D614G) in both. These observations indicate a potential risk of illness after successful vaccination and subsequent infection with variant virus, and they provide support for continued efforts to prevent and diagnose infection and to characterize variants in vaccinated persons. (Funded by the National Institutes of Health and others.).
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Breakthrough infections have emerged in a small percentage of vaccine recipients in other countries and health care institutions.
“However, breakthrough infections have emerged in a small percentage of vaccine recipients, a phenomenon that has been described in other countries and health care institutions.6-8”
From Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (2021) · cites this paper as [8]
Reports have been published in which certain variants of concern were more prevalent in breakthrough infections.
“In contrast, reports in which certain variants of concern were more prevalent in breakthrough infections have been published as well.8,16,26”
From Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (2021) · cites this paper as [8]
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- Authors
- Hacisuleyman, E., Hale, C., Saito, Y., Blachere, N. E., Bergh, M., Conlon, E. G., Schaefer-Babajew, D. J., DaSilva, J., Muecksch, F., Gaebler, C., Lifton, R., Nussenzweig, M. C., Hatziioannou, T., Bieniasz, P. D., & Darnell, R. B.
- Affiliations
- Howard Hughes Medical Institute (US)
- From the Laboratory of Molecular Neuro-oncology (E.H., C.H., Y.S., N.E.B., M.B., E.G.C., R.B.D.), the Laboratory of Molecular Immunology (D.J.S.-B., C.G., M.C.N.), the Laboratory of Human Genetics and Genomics (R.L.), the Laboratory of Retrovirology (J.D., F.M., T.H., P.D.B.), and the Howard Hughes Medical Institute (M.C.N., P.D.B., R.B.D.), Rockefeller University, New York.
- Corresponding author
- Darnell, Robert B.
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2021-06-10
- Volume
- 384
- Issue
- 23
- Pages
- 2212-2218
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC8117968
- OpenAlex
- W3153636933
- Cited by
- 716
- References
- 11
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 42 · 2023: 102 · 2022: 298 · 2021: 239 · 2020: 1
- FWCI
- 54.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Howard Hughes Medical Institute
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- SARS-CoV-2 variants, breakthrough infection, COVID-19 vaccination, BNT162b2, mRNA-1273, E484K mutation, D614G mutation, viral genome sequencing, vaccine efficacy
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, 2019-nCoV Vaccine mRNA-1273, Aged, Antibodies, Viral, Female, Humans, Middle Aged, Mutation, Neutralization Tests, Phylogeny, Polymerase Chain Reaction, Sequence Analysis, RNA, Viral Load, Antibodies, Neutralizing, Spike Glycoprotein, Coronavirus
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