Abstract
This study elucidated the clinical, humoral immune response and genomic analysis of vaccine breakthrough (VBT) infections after ChAdOx1 nCoV-19/Covishield vaccine in healthcare workers (HCWs). Amongst 1858 HCWs, 1639 had received either two doses (1346) or a single dose (293) of ChAdOx1 nCoV-19 vaccine. SARS-CoV-2 IgG antibodies and neutralizing antibodies were measured in the vaccinated group and the development of SARS-CoV-2 infection was monitored.Forty-six RT-PCR positive samples from the 203 positive samples were subjected to whole genome sequencing (WGS). Of the 203 (10.92%) infected HCWs, 21.46% (47/219) were non-vaccinated, which was significantly more than 9.52% (156/1639) who were vaccinated and infection was higher in doctors and nurses. Unvaccinated HCWs had 1.57 times higher risk compared to partially vaccinated HCWs and 2.49 times higher risk than those who were fully vaccinated.The partially vaccinated were at higher risk than the fully vaccinated (RR 1.58). Antibody non-response was seen in 3.44% (4/116), low antibody levels in 15.51% (18/116) and medium levels were found in 81.03% (94/116). Fully vaccinated HCWs had a higher antibody response at day 42 than those who were partially vaccinated (8.96 + 4.00 vs. 7.17 + 3.82). Whole genome sequencing of 46 samples revealed that the Delta variant (B.1.617.2) was predominant (69.5%). HCWs who had received two doses of vaccine showed better protection from mild, moderate, or severe infection, with a higher humoral immune response than those who had received a single dose. The genomic analysis revealed the predominance of the Delta variant (B.1.617.2) in the VBT infections.
Highlights
Vaccines have emerged as an effective countermeasure against the accelerating global increase in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causing coronavirus disease 2019 (COVID-19)
The CDC has defined a vaccine breakthrough infection (VBT) as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S Food and Drug Administration (FDA)-authorized COVID-19 vaccine [5]
We studied a large cohort of vaccinated healthcare workers (HCWs) who had VBT infections, their clinical characteristics, immune response and genomic analysis of the causative SARS-CoV-2 virus
Summary
Vaccines have emerged as an effective countermeasure against the accelerating global increase in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causing coronavirus disease 2019 (COVID-19). India has reported the rapid spread of the Alpha variant and witnessed the emergence of a variant of concern, Delta (B.1.617.2) and a variant of interest, Kappa (B.1.617.1) [4]. The CDC has defined a vaccine breakthrough infection (VBT) as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S Food and Drug Administration (FDA)-authorized COVID-19 vaccine [5]. We studied a large cohort of vaccinated HCWs who had VBT infections, their clinical characteristics, immune response and genomic analysis of the causative SARS-CoV-2 virus
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