Breakthrough COVID-19 Infections in the US: Implications for Prolonging the Pandemic

Alcendor, Donald J.; Matthews-Juarez, Patricia; Smoot, Duane T.; Hildreth, James E. K.; Lamar, Kimberly; Tabatabai, Mohammad; Wilus, Derek; Juárez, Paul D.

doi:10.3390/vaccines10050755

Cited by 17 publications

(13 citation statements)

References 105 publications

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“…Besides, a previous study revealed that clinical symptoms of the SARS-CoV-2 infection among partially or fully vaccinated cases was significantly lower (odds ratio = 0.26 [95% CI: 0.07-0.94]) than in unvaccinated cases [36]. Dysregulation of immune function like inflammaging and immunosenescence can increase the vulnerability of subjects to COVID-19 and result in inefficient protection after vaccination [37].…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for severe Covid-19 breakthrough infections: an observational longitudinal study

et al. 2022

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Background The drive to vaccinate large populations is nowadays the main instrument for combating the pandemic and preventing serious disease and death. However, breakthrough infection (post-vaccination infection) still happens after vaccination among fully vaccinated people. We aimed to assess the severity outcomes and to determine its associated factors among vaccinated COVID-19 cases in the governorate of Sousse, Tunisia. Methods We carried out a five-month observational longitudinal study including all the population of Sousse. Confirmed infections of SARS-CoV-2 and the vaccination status are recorded in the daily COVID- 19 database of the Regional Office of the Tunisian Ministry of Health. We included all post-vaccination COVID-19 cases for the analysis of the COVID-19 serious outcomes. Data were collected via 15-min telephonic call interviews conducted by trained interviewers. Descriptive analysis with calculating incidence rates of confirmed COVID-19 cases per 100,000 inhabitants was conducted. In binary logistic regression, adjusted odds ratios along with 95% intervals confidence were performed to determine factors related to severe or critical COVID-19. Results As of 31 July 2021, 107,545 persons over 19 years old have received at least one dose of COVID-19 vaccination. Among the vaccinated population, we traced and included 765 breakthrough infection cases, and the incidence rate was 711.3 per week. The majority were female (sex-ratio = 0.8), and the average age of the overall cases was 55.7 years. The prevalence of severe or critical cases in vaccinated COVID-19 patients occurs in 10.8% of cases. Patients with a medical history of cardiovascular diseases had more than two times increased odds to have a severe or critical disease. We also found the highest self-estimation of adherence to preventive measures was inversely correlated to serious cases and having an incomplete vaccination schema was strongly associated with complications. Conclusions We tried to provide evidence about the breakthrough infections to improve measures of prevention and control of COVID-19. Boosting immunity for vulnerable patients added to maintaining and promoting preventive measures are not only essential to prevent severe cases of breakthrough infections of COVID-19, but also other influenza-like diseases.

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Section: Discussionmentioning

confidence: 99%

“…Dysregulation of immune function like inflammaging and immunosenescence can increase the vulnerability of subjects to COVID-19 and result in inefficient protection after vaccination [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for severe Covid-19 breakthrough infections: an observational longitudinal study

et al. 2022

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“…However, vaccination rates in recruited Paxlovid-treated patients and controls were much lower (20% in cases vs. 27% in controls) than in the whole population (6-14 years, >90%). In addition, with the prevalence of the SARS-CoV-2 Omicron variant, vaccine breakthrough infection has become more common (11), and it has been well studied that patients with underlying diseases are at risk of severe COVID-19, even after vaccination (12,13). In addition, in immunocompromised patients, SARS-CoV-2 may persist and cause subsequent resurgence or repositivity (14,15).…”

Section: Discussionmentioning

confidence: 99%

The feasibility, safety, and efficacy of Paxlovid treatment in SARS-CoV-2-infected children aged 6–14 years: a cohort study

Yan¹,

Zhou²,

Zhu³

et al. 2022

Ann Transl Med

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Background: Paxlovid is recognized as an effective medication in preventing the progression of coronavirus disease of 2019 (COVID-19) to severe form in adults; however, its efficacy has remained unknown in pediatric cases. This study aimed to analyze the feasibility, safety, and efficacy of Paxlovid treatment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children aged 6-14 years. Methods: We conducted a cohort study based on prospectively collected clinical data. We recruited 5 pediatric cases with underlying diseases treated with Paxlovid from 7 April 2022 to 26 May 2022 and 30 age-matched patients with underlying diseases who were not treated with Paxlovid as controls. The safety and efficacy of Paxlovid were primarily assessed by inter-group comparisons. Results: Of the 5 Paxlovid-treated cases, including 1 male and 4 females, 3 and 2 cases were mildly and moderately ill, respectively. The underlying diseases included congenital heart defects, cerebral palsy, Down syndrome, and leukemia. Only 1 patient had received 1 dose of an inactivated SARS-CoV-2 vaccine. Paxlovid was initiated within 5 days after the onset of symptoms in all cases. Comedications were used in 2 cases. In the safety analyses, after Paxlovid initiation, 1 patient had transient diarrhea, and 1 patient had transiently elevated liver enzymes [alanine transaminase (ALT), 125 U/L; aspartate transaminase (AST), 83 U/L; normal range, <40 U/L]. In the efficacy analyses, all 5 Paxlovid-treated cases recovered, with the respective viral shedding times of 11, 4, 10, 9, and 9 days. Compared with age-matched controls, the viral shedding times were not significantly different between groups.Conclusions: Based on the current small sample size study, Paxlovid is a feasible option for treating SARS-CoV-2-infected children aged 6-14 years with underlying diseases. However, the safety and efficacy of Paxlovid warrant further large-scale studies.

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“… 113 Although influenza and SARS-CoV-2 vaccines reduce disease severity when vaccines fail to prevent infection, significant numbers of fatalities still occur, resulting in tens of thousands of annual influenza deaths in the United States. 114 , 115 , 116 With the imperfections of these vaccines, it seems a public health imperative to aggressively pursue better vaccines and vaccination strategies.…”

Section: Immune Correlates Of Protection Against Mucosal Respiratory ...mentioning

confidence: 99%

Rethinking next-generation vaccines for coronaviruses, influenzaviruses, and other respiratory viruses

Morens

Taubenberger

Fauci

2023

Cell Host & Microbe

112

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Breakthrough COVID-19 Infections in the US: Implications for Prolonging the Pandemic

Cited by 17 publications

References 105 publications

Risk factors for severe Covid-19 breakthrough infections: an observational longitudinal study

Risk factors for severe Covid-19 breakthrough infections: an observational longitudinal study

The feasibility, safety, and efficacy of Paxlovid treatment in SARS-CoV-2-infected children aged 6–14 years: a cohort study

Rethinking next-generation vaccines for coronaviruses, influenzaviruses, and other respiratory viruses

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