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Dominance of Alpha and Iota variants in SARS-CoV-2 vaccine breakthrough infections in New York City
- Source :
- J Clin Invest
- Publication Year :
- 2021
-
Abstract
- The efficacy of COVID-19 mRNA vaccines is high, but breakthrough infections still occur. We compared the SARS-CoV-2 genomes of 76 breakthrough cases after full vaccination with BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), or JNJ-78436735 (Janssen) to unvaccinated controls (February-April 2021) in metropolitan New York, including their phylogenetic relationship, distribution of variants, and full spike mutation profiles. Their median age was 48 years; seven required hospitalization and one died. Most breakthrough infections (57/76) occurred with B.1.1.7 (Alpha) or B.1.526 (Iota). Among the 7 hospitalized cases, 4 were infected with B.1.1.7, including 1 death. Both unmatched and matched statistical analyses considering age, sex, vaccine type, and study month as covariates supported the null hypothesis of equal variant distributions between vaccinated and unvaccinated in chi-squared and McNemar tests (p>0.1) highlighting a high vaccine efficacy against B.1.1.7 and B.1.526. There was no clear association among breakthroughs between type of vaccine received and variant. In the vaccinated group, spike mutations in the N-terminal domain and receptor-binding domain that have been associated with immune evasion were overrepresented. The evolving dynamic of SARS-CoV-2 variants requires broad genomic analyses of breakthrough infections to provide real-life information on immune escape mediated by circulating variants and their spike mutations.
- Subjects :
- Adult
Male
medicine.medical_specialty
COVID-19 Vaccines
Alpha (ethology)
medicine.disease_cause
Iota
Evolution, Molecular
Immune system
McNemar's test
Protein Domains
Epidemiology
medicine
Humans
BNT162 Vaccine
Dominance (genetics)
Aged
Immune Evasion
Aged, 80 and over
Mutation
Ad26COVS1
business.industry
SARS-CoV-2
COVID-19
General Medicine
Middle Aged
Vaccine efficacy
Virology
Vaccination
Spike Glycoprotein, Coronavirus
Female
New York City
business
2019-nCoV Vaccine mRNA-1273
Research Article
Subjects
Details
- ISSN :
- 15588238
- Volume :
- 131
- Issue :
- 18
- Database :
- OpenAIRE
- Journal :
- The Journal of clinical investigation
- Accession number :
- edsair.doi.dedup.....9dab3f4c53af53d41351aef3e6702bbb