Clinical and genomic characterization of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infections in mRNA vaccinated health care personnel in New York City Journal Article


Authors: Robilotti, E. V.; Whiting, K.; Lucca, A.; Poon, C.; Guest, R.; McMillen, T.; Jani, K.; Solovyov, A.; Kelson, S.; Browne, K.; Freeswick, S.; Hohl, T. M.; Korenstein, D.; Ruchnewitz, D.; Lässig, M.; Łuksza, M.; Greenbaum, B.; Seshan, V. E.; Babady, N. E.; Kamboj, M.
Article Title: Clinical and genomic characterization of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infections in mRNA vaccinated health care personnel in New York City
Abstract: Background Vaccine-induced clinical protection against severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) variants is an evolving target. There are limited genomic level data on SARS CoV-2 breakthrough infections and vaccine effectiveness (VE) since the global spread of the B.1.617.2 (Delta) variant. Methods In a retrospective study from 1 November 2020 to 31 August 2021, divided as pre-Delta and Delta-dominant periods, laboratory-confirmed SARS CoV-2 infections among healthcare personnel (HCP) at a large tertiary cancer center in New York City were examined to compare the weekly infection rate-ratio in vaccinated, partially vaccinated, and unvaccinated HCP. We describe the clinical and genomic epidemiologic features of post-vaccine infections to assess for selection of variants of concern (VOC)/variants of interest (VOI) in the early post-vaccine period and impact of B.1.617.2 (Delta) variant domination on VE. Results Among 13658 HCP in our cohort, 12379 received at least 1 dose of a messenger RNA (mRNA) vaccine. In the pre-Delta period overall VE was 94.5%. Whole genome sequencing (WGS) of 369 isolates in the pre-Delta period did not reveal a clade bias for VOC/VOI specific to post-vaccine infections. VE in the Delta dominant phase was 75.6%. No hospitalizations occurred among vaccinated HCP in the entire study period, compared to 17 hospitalizations and 1 death among unvaccinated HCP. Conclusions Findings show high VE among HCP in New York City in the pre-Delta phase, with moderate decline in VE post-Delta emergence. SARS CoV-2 clades were similarly distributed among vaccinated and unvaccinated infected HCP without apparent clustering during the pre-Delta period of diverse clade circulation. Strong vaccine protection against hospitalization was maintained through the entire study period.
Journal Title: Clinical Infectious Diseases
Volume: 75
Issue: 1
ISSN: 1058-4838
Publisher: Oxford University Press  
Date Published: 2022-07-01
Start Page: e774
End Page: e782
Language: English
DOI: 10.1093/cid/ciab886
PROVIDER: EBSCOhost
PROVIDER: cinahl
PUBMED: 34644393
PMCID: PMC9612794
DOI/URL:
Notes: Accession Number: 158756434 -- Entry Date: In Process -- Revision Date: 20220831 -- Publication Type: Article -- Journal Subset: Biomedical. -- Source: Cinahl
Altmetric
Citation Impact