Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults

Prelog M, Jeske SD, Asam C, Fuchs A, Wieser A, Gall C, Wytopil M, Müller-Schmucker S, Beileke S, Goekkaya M, Kling E, Geldmacher C, Rubio-Acero R, Plank M, Christa C, Willmann A, Vu M, Einhauser S, Weps M, Lampl BM, Almanzar G, Kousha K, Schwägerl V, Liebl B, Weber B, Drescher J, Scheidt J, Gefeller O, Messmann H, Protzer U, Liese J, Hoelscher M, Wagner R, Überla K, Steininger P (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 170

Article Number: 105622

DOI: 10.1016/j.jcv.2023.105622

Abstract

Background: SARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs. Methods: In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity. Results: A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5–7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively). Conclusions: Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Augsburg Germany (DE) Universitätsklinikum Würzburg Germany (DE) Technische Universität München (TUM) Germany (DE) Universitätsklinikum Regensburg Germany (DE) Klinikum der Universität München Germany (DE) Universität Augsburg Germany (DE) Universität Regensburg Germany (DE) Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL) Germany (DE) Hochschule für Angewandte Wissenschaften Hof Germany (DE) smartlytic GmbH Germany (DE)

How to cite

APA:

Prelog, M., Jeske, S.D., Asam, C., Fuchs, A., Wieser, A., Gall, C.,... Steininger, P. (2024). Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults. Journal of Clinical Virology, 170. https://dx.doi.org/10.1016/j.jcv.2023.105622

MLA:

Prelog, Martina, et al. "Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults." Journal of Clinical Virology 170 (2024).

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