Virological characteristics of SARS-CoV-2 vaccine breakthrough infections in health care workers

  1. Marc C. Shamier
  2. Alma Tostmann
  3. Susanne Bogers
  4. Janet de Wilde
  5. Jeroen IJpelaar
  6. Willemijn A. van der Kleij
  7. Herbert de Jager
  8. Bart L. Haagmans
  9. Richard Molenkamp
  10. Bas. B. Oude Munnink
  11. Carsten van Rossum
  12. Janette Rahamat-Langendoen
  13. Nannet van der Geest
  14. Chantal P. Bleeker-Rovers
  15. Heiman Wertheim
  16. Marion P.G. Koopmans
  17. Corine H. GeurtsvanKessel
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Abstract

Background

SARS-CoV-2 vaccines are highly effective at preventing COVID-19-related morbidity and mortality. As no vaccine is 100% effective, breakthrough infections are expected to occur.

Methods

We analyzed the virological characteristics of 161 vaccine breakthrough infections in a population of 24,706 vaccinated healthcare workers (HCWs), using RT-PCR and virus culture.

Results

The delta variant (B.1.617.2) was identified in the majority of cases. Despite similar Ct-values, we demonstrate lower probability of infectious virus detection in respiratory samples of vaccinated HCWs with breakthrough infections compared to unvaccinated HCWs with primary SARS-CoV-2 infections. Nevertheless, infectious virus was found in 68.6% of breakthrough infections and Ct-values decreased throughout the first 3 days of illness.

Conclusions

We conclude that rare vaccine breakthrough infections occur, but infectious virus shedding is reduced in these cases.

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