Vaccine Breakthrough Infections with SARS-CoV-2 Variants

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Title

Vaccine Breakthrough Infections with SARS-CoV-2 Variants

Subject

Description

Emerging variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of clinical concern. In a cohort of 417 persons who had received the second dose of BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna) vaccine at least 2 weeks previously, we identified 2 women with vaccine breakthrough infection.

Date Last Updated (Year-Month-Day)

2021-04-21

Citation

Hacisuleyman, Ezgi, Caryn Hale, Yuhki Saito, Nathalie E. Blachere, Marissa Bergh, Erin G. Conlon, Dennis J. Schaefer-Babajew, Justin DaSilva, Frauke Muecksch, Christian Gaebler, Richard Lifton, Michel C. Nussenzweig, Theodora Hatziioannou, Paul D. Bieniasz, and Robert B. Darnell. 2021. "Vaccine Breakthrough Infections with SARS-CoV-2 Variants." New England Journal of Medicine.

Abstract

Emerging variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of clinical concern. In a cohort of 417 persons who had received the second dose of BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna) vaccine at least 2 weeks previously, we identified 2 women with vaccine breakthrough infection. Despite evidence of vaccine efficacy in both women, symptoms of coronavirus disease 2019 developed, and they tested positive for SARS-CoV-2 by polymerase-chain-reaction testing. Viral sequencing revealed variants of likely clinical importance, including E484K in 1 woman and three mutations (T95I, del142–144, and D614G) in both. These observations indicate a potential risk of illness after successful vaccination and subsequent infection with variant virus, and they provide support for continued efforts to prevent and diagnose infection and to characterize variants in vaccinated persons. (Funded by the National Institutes of Health and others.)

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Free online on NEJM.