COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)

Background and Methods: Vaccination is currently considered the most successful strategy for combating the SARS-CoV-2 virus. According to short-term clinical trials, protection against infection is estimated to reach up to 95% after complete vaccination (≥14 days after receipt of all recommended COV...

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Autores principales:	Lea Hsu, Barbara Grüne, Michael Buess, Christine Joisten, Jan Klobucnik, Johannes Nießen, David Patten, Anna Wolff, Gerhard A. Wiesmüller, Annelene Kossow, Julia Hurraß
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 vaccination breakthrough infections SARS-CoV-2 pandemic SARS-CoV-2 transmission Medicine R
Acceso en línea:	https://doaj.org/article/34c3577a757e461c856978ebcac0d7ed
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spelling	oai:doaj.org-article:34c3577a757e461c856978ebcac0d7ed2021-11-25T19:10:45ZCOVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)10.3390/vaccines91112672076-393Xhttps://doaj.org/article/34c3577a757e461c856978ebcac0d7ed2021-11-01T00:00:00Zhttps://www.mdpi.com/2076-393X/9/11/1267https://doaj.org/toc/2076-393XBackground and Methods: Vaccination is currently considered the most successful strategy for combating the SARS-CoV-2 virus. According to short-term clinical trials, protection against infection is estimated to reach up to 95% after complete vaccination (≥14 days after receipt of all recommended COVID-19 vaccine doses). Nevertheless, infections despite vaccination, so-called breakthrough infections, are documented. Even though they are more likely to have a milder or even asymptomatic course, the assessment of further transmission is highly relevant for successful containment. Therefore, we calculated the real-world transmission risk from fully vaccinated patients (vaccination group, VG) to their close contacts (CP) compared with the risk from unvaccinated reference persons matched according to age, sex, and virus type (control group = CG) utilizing data from Cologne’s health department. Results: A total of 357 breakthrough infections occurred among Cologne residents between 27 December 2020 (the date of the first vaccination in Cologne) and 6 August 2021. Of the 979 CPs in VG, 99 (10.1%) became infected. In CG, 303 of 802 CPs (37.8%) became infected. Factors promoting transmission included non-vaccinated status (<i>β</i> = 0.237; <i>p</i> < 0.001), male sex (<i>β</i> = 0.079; <i>p</i> = 0.049), the presence of symptoms (<i>β</i> = −0.125; <i>p</i> = 0.005), and lower cycle threshold value (<i>β</i> = −0.125; <i>p</i> = 0.032). This model explained 14.0% of the variance (corr. <i>R</i><sup>2</sup>). Conclusion: The number of transmissions from unvaccinated controls was three times higher than from fully vaccinated patients. These real-world data underscore the importance of vaccination in enabling the relaxation of stringent and restrictive general pandemic control measures.Lea HsuBarbara GrüneMichael BuessChristine JoistenJan KlobucnikJohannes NießenDavid PattenAnna WolffGerhard A. WiesmüllerAnnelene KossowJulia HurraßMDPI AGarticleCOVID-19vaccinationbreakthrough infectionsSARS-CoV-2 pandemicSARS-CoV-2 transmissionMedicineRENVaccines, Vol 9, Iss 1267, p 1267 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 vaccination breakthrough infections SARS-CoV-2 pandemic SARS-CoV-2 transmission Medicine R
spellingShingle	COVID-19 vaccination breakthrough infections SARS-CoV-2 pandemic SARS-CoV-2 transmission Medicine R Lea Hsu Barbara Grüne Michael Buess Christine Joisten Jan Klobucnik Johannes Nießen David Patten Anna Wolff Gerhard A. Wiesmüller Annelene Kossow Julia Hurraß COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
description	Background and Methods: Vaccination is currently considered the most successful strategy for combating the SARS-CoV-2 virus. According to short-term clinical trials, protection against infection is estimated to reach up to 95% after complete vaccination (≥14 days after receipt of all recommended COVID-19 vaccine doses). Nevertheless, infections despite vaccination, so-called breakthrough infections, are documented. Even though they are more likely to have a milder or even asymptomatic course, the assessment of further transmission is highly relevant for successful containment. Therefore, we calculated the real-world transmission risk from fully vaccinated patients (vaccination group, VG) to their close contacts (CP) compared with the risk from unvaccinated reference persons matched according to age, sex, and virus type (control group = CG) utilizing data from Cologne’s health department. Results: A total of 357 breakthrough infections occurred among Cologne residents between 27 December 2020 (the date of the first vaccination in Cologne) and 6 August 2021. Of the 979 CPs in VG, 99 (10.1%) became infected. In CG, 303 of 802 CPs (37.8%) became infected. Factors promoting transmission included non-vaccinated status (<i>β</i> = 0.237; <i>p</i> < 0.001), male sex (<i>β</i> = 0.079; <i>p</i> = 0.049), the presence of symptoms (<i>β</i> = −0.125; <i>p</i> = 0.005), and lower cycle threshold value (<i>β</i> = −0.125; <i>p</i> = 0.032). This model explained 14.0% of the variance (corr. <i>R</i><sup>2</sup>). Conclusion: The number of transmissions from unvaccinated controls was three times higher than from fully vaccinated patients. These real-world data underscore the importance of vaccination in enabling the relaxation of stringent and restrictive general pandemic control measures.
format	article
author	Lea Hsu Barbara Grüne Michael Buess Christine Joisten Jan Klobucnik Johannes Nießen David Patten Anna Wolff Gerhard A. Wiesmüller Annelene Kossow Julia Hurraß
author_facet	Lea Hsu Barbara Grüne Michael Buess Christine Joisten Jan Klobucnik Johannes Nießen David Patten Anna Wolff Gerhard A. Wiesmüller Annelene Kossow Julia Hurraß
author_sort	Lea Hsu
title	COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
title_short	COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
title_full	COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
title_fullStr	COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
title_full_unstemmed	COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)
title_sort	covid-19 breakthrough infections and transmission risk: real-world data analyses from germany’s largest public health department (cologne)
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/34c3577a757e461c856978ebcac0d7ed
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COVID-19 Breakthrough Infections and Transmission Risk: Real-World Data Analyses from Germany’s Largest Public Health Department (Cologne)

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