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This correspondence reports the breakthrough incidence of COVID-19 infections among vaccinated healthcare workers at University of California San Diego Health (UCSDH). Coinciding with the lifting of mask mandates and the delta variant, the authors showed vaccine effectiveness exceeded 90% from March through June, but then fell to 65.5% in July.
These findings suggest the ongoing importance of social measures to manage the ongoing COVID-19 pandemic, including indoor masking, intensive testing, and ongoing vaccination outreach. The authors also consider the necessity of vaccine boosters.
In December 2020, the University of California San Diego Health (UCSDH) workforce experienced a dramatic increase in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Vaccination with mRNA vaccines began in mid-December 2020; by March, 76% of the workforce had been fully vaccinated, and by July, the percentage had risen to 87%. Infections had decreased dramatically by early February 2021.1 Between March and June, fewer than 30 health care workers tested positive each month. However, coincident with the end of California’s mask mandate on June 15 and the rapid dominance of the B.1.617.2 (delta) variant that first emerged in mid-April and accounted for over 95% of UCSDH isolates by the end of July (Fig. 1), infections increased rapidly, including cases among fully vaccinated persons. Institutional review board approval was obtained for use of administrative data on vaccinations and case-investigation data to examine mRNA SARS CoV-2 vaccine effectiveness.