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COVID-19 breakthrough infection and post-vaccination neutralizing antibody among healthcare workers in a referral hospital in Tokyo: a case-control matching study
Clinical Infectious Diseases ( IF 11.8 ) Pub Date : 2021-12-22 , DOI: 10.1093/cid/ciab1048
Shohei Yamamoto 1 , Kenji Maeda 2 , Kouki Matsuda 2 , Akihito Tanaka 3 , Kumi Horii 4 , Kaori Okudera 5 , Junko S Takeuchi 6 , Tetsuya Mizoue 1 , Maki Konishi 1 , Mitsuru Ozeki 3 , Haruhito Sugiyama 7 , Nobuyoshi Aoyanagi 8 , Hiroaki Mitsuya 2 , Wataru Sugiura 9 , Norio Ohmagari 10
Affiliation  

Background While increasing coverage of effective vaccines against coronavirus disease 2019 (COVID-19), emergent variants raise concerns about breakthrough infection. Data are limited, however, whether breakthrough infection during the epidemic of the variant is ascribed to insufficient vaccine-induced immunogenicity. Methods We described incident COVID-19 in relation to the vaccination program among workers of a referral hospital in Tokyo. During the predominantly Delta epidemic, we followed 2,415 fully vaccinated staff (BNT162b2) for breakthrough infection and selected three matched controls. We measured post-vaccination neutralizing antibodies against the wild-type, Alpha (B.1.1.7), and Delta (B.1.617.2) strains using live viruses and anti-spike antibodies using quantitative assays, and compared them using the generalized estimating equation model between the two groups. Results No COVID-19 cases occurred 1–2 months after the vaccination program during the fourth epidemic wave in Japan, dominated by the Alpha variant, while 22 cases emerged 2–4 months after the vaccination program during the fifth wave, dominated by the Delta variant. In the vaccinated cohort, all 17 cases of breakthrough infection were mild or asymptomatic and had returned to work early. There was no measurable difference between cases and controls in post-vaccination neutralizing antibody titers against the wild-type, Alpha, and Delta, and anti-spike antibody titers, while neutralizing titers against the variants were considerably lower than those against the wild-type. Conclusions Post-vaccination neutralizing antibody titers were not decreased among patients with breakthrough infection relative to their controls under the Delta variant rampage. The result points to the importance of infection control measures in the post-vaccination era, irrespective of immunogenicity profile.

中文翻译:

东京一家转诊医院医护人员的 COVID-19 突破性感染和疫苗接种后中和抗体:病例对照匹配研究

背景 随着 2019 年冠状病毒病 (COVID-19) 有效疫苗的覆盖面不断扩大,新出现的变体引起了人们对突破性感染的担忧。然而,数据有限,变异流行期间的突破性感染是否归因于疫苗诱导的免疫原性不足。方法 我们描述了与东京一家转诊医院工作人员的疫苗接种计划相关的 COVID-19 事件。在 Delta 流行期间,我们跟踪了 2,415 名完全接种疫苗的工作人员 (BNT162b2) 的突破性感染,并选择了三个匹配的对照。我们使用活病毒测量了针对野生型、Alpha (B.1.1.7) 和 Delta (B.1.617.2) 菌株的疫苗接种后中和抗体,并使用定量测定法测量了抗尖峰抗体,并使用广义估计方程模型对两组进行比较。结果 在日本第四波流行病疫苗接种计划后 1-2 个月没有出现 COVID-19 病例,以 Alpha 变种为主,而在第五波流行病疫苗接种计划后 2-4 个月出现 22 例,以 Delta 为主变种。在接种队列中,17例突破性感染病例均为轻症或无症状,并已提前返回工作岗位。接种后针对野生型、Alpha 和 Delta 的中和抗体滴度以及抗尖峰抗体滴度在病例和对照之间没有可测量的差异,而针对变体的中和滴度明显低于针对野生型的中和抗体滴度. 结论 相对于 Delta 变异横冲直撞下的对照,突破性感染患者的疫苗接种后中和抗体滴度没有降低。结果表明,无论免疫原性如何,感染控制措施在后疫苗时代的重要性。
更新日期:2021-12-22
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