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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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“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]
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“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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A broad neutralizing nanobody against SARS-CoV-2 engineered from an approved drug
Liu, Q., Cai, C., 黄燕燕, Zhou, L., Guan, Y., Fu, S., Lin, Y., Yang, T., Yan, H., Zhang, Z., et al. (2024) · Cell Death and Disease · doi:10.1038/s41419-024-06802-7 · Cited by 14
Mutational Landscape and Interaction of SARS-CoV-2 with Host Cellular Components
Srivastava, M., Hall, D., Omoru, O. B., Gill, H. M., Smith, S., & Janga, S. C. (2021) · Microorganisms · doi:10.3390/microorganisms9091794 · Cited by 13
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Computation of Antigenicity Predicts SARS-CoV-2 Vaccine Breakthrough Variants
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Genomic surveillance of SARS-CoV-2 in COVID-19 vaccinated healthcare workers in Lebanon
Alkalamouni, H., Hassan, F. F. A., Hamdan, M. B., Page, A. J., Lott, M. C., Matthews, M., Ghosn, N., Rady, A., Mahfouz, R. A., Araj, G. F., et al. (2023) · BMC Medical Genomics · doi:10.1186/s12920-023-01443-9 · Cited by 16
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The Immunopathobiology of SARS-CoV-2 Infection
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Therapeutic prevention of COVID-19 in elderly: a case–control study
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Determining the Reliability of Rapid SARS-CoV-2 Antigen Detection in Fully Vaccinated Individuals
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Immunology and Technology of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccines
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Variant-specific antibody response following repeated SARS-CoV-2 vaccination and infection
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Immunopathogenesis of Different Emerging Viral Infections: Evasion, Fatal Mechanism, and Prevention
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Clinical Outcomes of Adult Patients Hospitalized with COVID-19 after Vaccination
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Human neutralizing antibodies for SARS-CoV-2 prevention and immunotherapy
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Metadata
- 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
- 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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