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In 417 patients who were considered fully vaccinated against COVID-19 (second dose of Moderna or Pfizer vaccine was at least 2 weeks prior and immunity noted with antibody testing), researchers found breakthrough infections in 2 women, both with variant strains.
Although these 2 women represent a small number of the total vaccinated persons in this study and their COVID-19 symptoms were mild, this raises concern on the potential for breakthrough infection despite vaccination and the risk for viral spread in a population as policies around COVID-19 relax.
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.
Vaccine Breakthrough Infections With SARS-CoV-2 Variants
N. Engl. J. Med 2021 Apr 21;[EPub Ahead of Print], E Hacisuleyman, C Hale, Y Saito, NE Blachere, M Bergh, EG Conlon, DJ Schaefer-Babajew, J DaSilva, F Muecksch, C Gaebler, R Lifton, MC Nussenzweig, T Hatziioannou, PD Bieniasz, RB Darnell