SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers
Author:
Porru Stefano, Monaco Maria Grazia LourdesORCID, Spiteri GianlucaORCID, Carta AngelaORCID, Pezzani Maria Diletta, Lippi GiuseppeORCID, Gibellini Davide, Tacconelli Evelina, Dalla Vecchia Ilaria, Sala EmmaORCID, Sansone EmanueleORCID, De Palma GiuseppeORCID, Bonfanti Carlo, Lombardo Massimo, Terlenghi Luigina, Pira EnricoORCID, Mansour IhabORCID, Coggiola Maurizio, Ciocan Catalina, Godono AlessandroORCID, Tardon AdoninaORCID, Rodriguez-Suarez Marta-Maria, Fernandez-Tardon GuillermoORCID, Jimeno-Demuth Francisco-Jose, Castro-Delgado Rafael-Vicente, Iglesias Cabo TaniaORCID, Scapellato Maria Luisa, Liviero Filippo, Moretto Angelo, Mason PaolaORCID, Pavanello SofiaORCID, Volpin Anna, Vimercati LuigiORCID, Tafuri SilvioORCID, De Maria LuigiORCID, Sponselli Stefania, Stefanizzi Pasquale, Caputi AntonioORCID, Gobba FabriziomariaORCID, Modenese AlbertoORCID, Casolari LorettaORCID, Garavini Denise, D’Elia Cristiana, Mariani Stefania, Filon Francesca LareseORCID, Cegolon Luca, Negro Corrado, Ronchese Federico, Rui Francesca, De Michieli Paola, Murgia Nicola, Dell’Omo Marco, Muzi Giacomo, Fiordi Tiziana, Gambelunghe Angela, Folletti Ilenia, Mates Dana, Calota Violeta Claudia, Neamtu Andra, Perseca Ovidiu, Staicu Catalin Alexandru, Voinoiu Angelica, Fabiánová Eleonóra, Bérešová Jana, Adamčáková Zora KľocováORCID, Nedela Roman, Lesňáková AnnaORCID, Holčíková Jana, Boffetta PaoloORCID, Abedini Mahsa, Ditano Giorgia, Asafo Shuffield SeyramORCID, Visci Giovanni, Violante Francesco SaverioORCID, Zunarelli Carlotta, Verlato GiuseppeORCID
Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
Funder
European Commission
Subject
Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology
Cited by
26 articles.
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