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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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SARS-CoV-2 immunity and an overview of the COVID-19 vaccines
Marković, M. (2021) · Medicinski podmladak · doi:10.5937/mp72-33315 · Cited by 3
Hogan, J. I., & Kotton, C. N. (2021) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofab557 · Cited by 3
Update to COVID-19 serologic testing : FAQs and caveats
Kadkhoda, K. (2022) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.87a.20054-up · Cited by 3
Determinants of the willingness to get the third COVID-19 vaccine dose among health care workers
Paris, C., Saade, A., Tadié, É., Van, R. N., Turmel, V., Garlantézec, R., & Tattevin, P. (2022) · Infectious Diseases Now · doi:10.1016/j.idnow.2022.04.007 · Cited by 3
Zhu, Y., Lü, Y., Zhou, C., Tong, G., Gao, M., Zhan, Y., Wang, Y., Liang, R., Li, Y., Gao, T., et al. (2022) · Med · doi:10.1016/j.medj.2022.05.003 · Cited by 3
Sequence similarity of SARS-CoV-2 and humans: Implications for SARS-CoV-2 detection
Li, H., Hong, X., Ding, L., Meng, S., Liao, R., Jiang, Z., & Liu, D. J. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.946359 · Cited by 5
Campos, G. S., Giovanetti, M., de Moraes, L. E. P., da Hora, H. S., Bandeira, A. C., Alcantara, K. V. O. M. D., & Sardi, S. I. (2023) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.20220955 · Cited by 4
Sabet, F., Gauthier, B., Siddiqui, M., Wilmer, A., Prystajecky, N., Rydings, P., Andrews, M., & Pollock, S. (2021) · Canada Communicable Disease Report · doi:10.14745/ccdr.v47i12a05 · Cited by 2
Broadly neutralizing antibodies against SARS-CoV-2 variants
Zhang, L. (2022) · National Science Open · doi:10.1360/nso/20220005 · Cited by 3
Wachinger, J., McMahon, S. A., Lohmann, J., Allegri, M. D., & Denkinger, C. M. (2022) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2022.100140 · Cited by 3
Kasuga, I., Gamo, S., Yokoe, Y., SUGIYAMA, T., TOKURA, M., NOGUCHI, M., Okayama, M., TAKEDA, Y., SATO, T. A., Mori, M., et al. (2022) · Health Evaluation and Promotion · doi:10.7143/jhep.49.462 · Cited by 3
Scheuermann, S. E., Goff, K. A., Rowe, L. A., Beddingfield, B. J., & Maness, N. J. (2023) · Viruses · doi:10.3390/v15091937 · Cited by 3
Post vaccination COVID-19 infection among health care workers in secondary medical care centre
Pandurangaiah, R., Leela, G. R., Jose, D. T., & Mathew, D. R. (2021) · International Journal of Clinical Obstetrics and Gynaecology · doi:10.33545/gynae.2021.v5.i3c.920 · Cited by 3
Translating known drivers of COVID-19 disease severity to design better SARS-CoV-2 vaccines
Pelletier, A. N., Sékaly, R., & Tomalka, J. A. (2021) · Current Opinion in Virology · doi:10.1016/j.coviro.2021.11.012 · Cited by 3
A simple stochastic theory of extinction shows rapid elimination of a Sars-like pandemicPreprint
Khatri, B. S. (2020) · medRxiv · doi:10.1101/2020.08.10.20171454 · Cited by 3
COVID-19 Vaccine Intentions in the United States—December 2020 to March 2021Preprint
Czeisler, M. É., Rajaratnam, S. M. W., Howard, M. E., & Czeisler, C. A. (2021) · medRxiv · doi:10.1101/2021.05.16.21257290 · Cited by 3
Kumar, R., Kodan, P., Aggarwal, R., Deepak, G. P., & Trikha, A. (2021) · QJM · doi:10.1093/qjmed/hcab205 · Cited by 3
Verdurme, L., Danesh, G., Trombert‐Paolantoni, S., Sofonea, M. T., Noel, V., Foulongne, V., Montès, B., Tuaillon, É., Haïm‐Boukobza, S., Roquebert, B., et al. (2021) · medRxiv · doi:10.1101/2021.09.13.21263371 · Cited by 3
Predicting COVID-19 Vaccine Efficacy from Neutralizing Antibody LevelsPreprint
Abedi, M. R., Dixon, S. L., Guyon, T., Hsu, S., Jacobs, A. R., Nair, L. J., & Terbrueggen, R. H. (2021) · medRxiv · doi:10.1101/2021.10.13.21264921 · Cited by 3
Waning immune responses against SARS-CoV-2 among vaccinees in Hong KongPreprint
Peng, Q., Zhou, R., Wang, Y., Zhao, M., Liu, N., Li, S., Huang, H., Yang, D., Au, K., Wang, H., et al. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.12.22.473934 · Cited by 3
Coulon, P.-G. A., Prakash, S., Dhanushkodi, N. R., Srivastava, R., Zayou, L., Tifrea, D. F., Edwards, R. A., Cesar, J. F., Schubl, S. D., Hsieh, L. L., et al. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.01.30.478343 · Cited by 4
Torii, S., Kim, K. S., Koseki, J., Suzuki, R., Iwanami, S., Fujita, Y., Jeong, Y. D., Matsuura, Y., Shimamura, T., Iwami, S., et al. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.02.22.481436 · Cited by 3
Genomic Surveillance of SARS CoV2 in COVID-19 vaccinated healthcare workers in LebanonPreprint
Alkalamouni, H., Hassan, F. F. A., Hamdan, M. B., Page, A. J., Lott, M. C., Ghosn, N., Rady, A., Mahfouz, R. A., Araj, G. F., Dbaibo, G. S., et al. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.06.06.494965 · Cited by 3
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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