Longitudinal Analysis of SARS-CoV-2 Vaccine Breakthrough Infections Reveals Limited Infectious Virus Shedding and Restricted Tissue Distribution

Author:

Ke Ruian1ORCID,Martinez Pamela P234ORCID,Smith Rebecca L456,Gibson Laura L7,Achenbach Chad J789,McFall Sally1011,Qi Chao12,Jacob Joshua8,Dembele Etienne8,Bundy Camille13,Simons Lacy M89,Ozer Egon A89,Hultquist Judd F89,Lorenzo-Redondo Ramon89,Opdycke Anita K14,Hawkins Claudia89,Murphy Robert L89,Mirza Agha15,Conte Madison15,Gallagher Nicholas16,Luo Chun Huai16,Jarrett Junko16,Conte Abigail17,Zhou Ruifeng17,Farjo Mireille2,Rendon Gloria18,Fields Christopher J18ORCID,Wang Leyi19,Fredrickson Richard19,Baughman Melinda E4,Chiu Karen K4,Choi Hannah4,Scardina Kevin R4,Owens Alyssa N20,Broach John72122,Barton Bruce2324ORCID,Lazar Peter23,Robinson Matthew L715,Mostafa Heba H16,Manabe Yukari C71517,Pekosz Andrew17ORCID,McManus David D725,Brooke Christopher B24ORCID

Affiliation:

1. T-6, Theoretical Biology and Biophysics, Los Alamos National Laboratory , Los Alamos, New Mexico , USA

2. Department of Microbiology, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

3. Department of Statistics, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

4. Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

5. Department of Pathobiology, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

6. Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

7. Division of Infectious Diseases and Immunology, Departments of Medicine and Pediatrics, University of Massachusetts Medical School , Worcester, Massachusetts , USA

8. Institute for Global Health, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA

9. Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA

10. Center for Innovation in Point-of-Care Technologies for HIV/AIDS at Northwestern University , Evanston, Illinois , USA

11. Department of Biomedical Engineering, Northwestern University , Evanston, Illinois , USA

12. Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA

13. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA

14. Department of Health Service, Northwestern University , Evanston, Illinois , USA

15. Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine , Baltimore, Maryland , USA

16. Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA

17. W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA

18. High-Performance Biological Computing at the Roy J. Carver Biotechnology Center, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

19. Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign , Urbana, Illinois , USA

20. Center for Clinical and Translational Research, University of Massachusetts Medical School , Worcester, Massachusetts , USA

21. UMass Memorial Medical Center , Worcester, Massachusetts , USA

22. Department of Emergency Medicine, University of Massachusetts Medical School , Worcester, Massachusetts , USA

23. Division of Biostatistics and Health Services Research, University of Massachusetts Medical School , Worcester, Massachusetts , USA

24. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, Massachusetts , USA

25. Division of Cardiology, University of Massachusetts Medical School , Worcester, Massachusetts , USA

Abstract

Abstract Background The global effort to vaccinate people against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an ongoing pandemic has raised questions about how vaccine breakthrough infections compare with infections in immunologically naive individuals and the potential for vaccinated individuals to transmit the virus. Methods We examined viral dynamics and infectious virus shedding through daily longitudinal sampling in 23 adults infected with SARS-CoV-2 at varying stages of vaccination, including 6 fully vaccinated individuals. Results The durations of both infectious virus shedding and symptoms were significantly reduced in vaccinated individuals compared with unvaccinated individuals. We also observed that breakthrough infections are associated with strong tissue compartmentalization and are only detectable in saliva in some cases. Conclusions Vaccination shortens the duration of time of high transmission potential, minimizes symptom duration, and may restrict tissue dissemination.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Reference20 articles.

1. Individuals cannot rely on COVID-19 herd immunity: durable immunity to viral disease is limited to viruses with obligate viremic spread;Yewdell;PLoS Pathog,2021

2. Vaccination with BNT162b2 reduces transmission of SARS-CoV-2 to household contacts in Israel;Prunas;Science,2022

3. Shedding of infectious SARS-CoV-2 despite vaccination. medRxiv 2021 [Preprint]. 15 October 2021;Riemersma

4. Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine-breakthrough infections: a multi-center cohort study;Chia;Clin Microbiol Infect,2022

5. Infection with the SARS-CoV-2 Delta variant is associated with higher recovery of infectious virus compared to the Alpha variant in both unvaccinated and vaccinated individuals;Luo,2021

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