Breakthrough infection after COVID-19 vaccination: A threat for Nepal due to SARS-CoV-2 variants circulating in 2nd wave ravaging India

Abstract

After a year of the COVID-19 pandemic, the meta-analysis in Dec 2020 did not support its reinfections. Now it’s clear that not only reinfection following earlier exposure is a reality, but also breakthrough infections after vaccinations have been increasingly reported. A breakthrough infection means that the infection has broken through the protection provided by the vaccine. The course of the disease, strict observation for preventive measures, together with safe vaccines is necessary long-term solutions. The effectiveness of the vaccine, durability of immunity, the role of the virus variants, the incidence and severity of breakthrough infections are the challenges in real life. A breakthrough infection is the detection of SARS-CoV-2 RNA or antigen in the respiratory specimen ≥14 days after inoculation of a vaccine. A breakthrough infection of 0.04 to 13% has been reported in the literature. Nepal began vaccine rollout in late Jan 2021. Nearly 3 million population has been vaccinated by two vaccines, the Covishield (AstraZeneca, from India) and Vero Cell (Sinopharm, China). Only minor ‘Adverse Event Following Immunization’ after the initial vaccine rollout has been reported. There is a lack of reports on the breakthrough infection for these vaccines in the local population. Analysis of the data on breakthrough infection from the vaccine rollouts in Nepal is awaited.

Comparative Analysis of RT-PCR, RT-LAMP, and Antigen Testing Strategies for Effective COVID-19 Outbreak Control: A Modeling Study

“…In response to this unprecedented challenge, many countries implemented nonpharmaceutical interventions (NPIs) such as physical distancing, remote work, face mask-wearing, and school and workplace closures while awaiting the widespread distribution of effective vaccines [9][10][11][12][13] . However, despite the availability of vaccines, the emergence of new variants and waning immunity has led to ongoing breakthrough infections and reinfections, contributing to a persistently challenging situation [14][15][16][17][18] .…”

Clinico-epidemiological profile and outcome of infected health care workers during the three consecutive waves of COVID-19 pandemic: a longitudinal cohort study

“…9 According to the WHO Program for International Drug Monitoring (PIDM) database, till date a total of 335,052 re-infection cases and 6470 vaccine breakthrough cases have been reported 10 while Indian studies alone account for a high rate of re-infection (incidence range of 4.5-34.8%) and breakthrough infections (incidence range of 0.4−13%) among HCWs. [11][12][13][14] On the 6th of November 2020, the Centers for Disease Control defined 'prolonged contact' as the cumulative period of exposure of 15 min or more to an infected person(s) within a period of 24 h. 15 This ensures the safety concerns of HCWs, who daily work in a highly infectious environment (including many subclinical and undiagnosed cases).…”

A sentinel surveillance of adverse events and breakthrough infections following COVID-19 precautionary dose among south Indian healthcare workers

“…Vaccine breakthrough COVID-19 infections are defined as an individual testing positive for SARS-CoV-2 by RRT-PCR or rapid antigen test (RAT) any time after 14 days of receiving one dose of any of the licensed COVID-19 vaccines [8] . Initially very low rate of breakthrough cases was reported but many studies conducted in different parts of the world showed an incidence range of 0.04% to 13% [9] . According to the World Health Organization (WHO) Programme for International Drug Monitoring (PIDM) database; a total of 5130 vaccine breakthrough cases have been reported to date [10] .…”