TY - JOUR
T1 - Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections
T2 - A prospective cohort study in non-hospitalized adults
AU - CoVaKo Study Group
AU - Prelog, Martina
AU - Jeske, Samuel D.
AU - Asam, Claudia
AU - Fuchs, Andre
AU - Wieser, Andreas
AU - Gall, Christine
AU - Wytopil, Monika
AU - Mueller-Schmucker, Sandra M.
AU - Beileke, Stephanie
AU - Goekkaya, Mehmet
AU - Kling, Elisabeth
AU - Geldmacher, Christof
AU - Rubio-Acero, Raquel
AU - Plank, Michael
AU - Christa, Catharina
AU - Willmann, Annika
AU - Vu, Martin
AU - Einhauser, Sebastian
AU - Weps, Manuela
AU - Lampl, Benedikt M.J.
AU - Almanzar, Giovanni
AU - Kousha, Kimia
AU - Schwägerl, Valeria
AU - Liebl, Bernhard
AU - Weber, Beatrix
AU - Drescher, Johannes
AU - Scheidt, Jörg
AU - Gefeller, Olaf
AU - Messmann, Helmut
AU - Protzer, Ulrike
AU - Liese, Johannes
AU - Hoelscher, Michael
AU - Wagner, Ralf
AU - Überla, Klaus
AU - Steininger, Philipp
N1 - Publisher Copyright:
© 2023
PY - 2024/2
Y1 - 2024/2
N2 - Background: SARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs. Methods: In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity. Results: A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5–7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively). Conclusions: Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.
AB - Background: SARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs. Methods: In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity. Results: A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5–7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively). Conclusions: Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.
KW - Antibodies
KW - Breakthrough infection
KW - COVID-19 symptoms
KW - SARS-CoV-2
KW - Vaccine effectiveness
KW - Viral load
UR - http://www.scopus.com/inward/record.url?scp=85179995734&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2023.105622
DO - 10.1016/j.jcv.2023.105622
M3 - Article
C2 - 38091664
AN - SCOPUS:85179995734
SN - 1386-6532
VL - 170
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
M1 - 105622
ER -
