Short-term SARS-CoV-2 Re-infection Rate in Vaccinated Health Workers based on Received Vaccines: A Cross-sectional Study

Page: [309 - 313] Pages: 5

  • * (Excluding Mailing and Handling)

Abstract

Background: Vaccines during the Coronavirus disease 2019 (COVID-19) pandemic entered the market faster than a routine proportionate evaluation cycle. The highest number of deaths and morbidities, especially by the type of B.1.617.2 (Delta) variant, is one of the reasons for this inevitability. Accordingly, evaluation of the effects of vaccines is of great importance.

Methods: In this cross-sectional study, we investigated the effects of four current COVID-19 vaccines, such as AstraZeneca, Sputnik, Sinopharm, and Bharat, and the prevalence of COVID-19 occurrence among 600 vaccinated healthcare workers (HCWs) in the Southeast of Iran.

Results: The incidence of infection among vaccinated HCWs was 36.3%, without any age and gender difference, statistically. The infection rate with severe acute respiratory syndrome coronavirus- 2 (SARS-CoV-2) following immunization with AstraZeneca, Sputnik V, Bharat, and Sinopharm vaccines were 45.8%, 41.3%, 36.9%, and 18.6%, respectively (P.V=0.001). Those who had a history of previous SARS-CoV-2 infection were more affected again despite vaccination (P.V=0.001). However, out of 218 infected patients, only six patients (2.8%) were hospitalized, while 26 patients (11.9%) received remdesivir and two patients (0.9%) needed to additional target therapy with Iinterleukin-6 inhibitor of Tocilizumab due to cytokine storm.

Conclusion: During B.1.617.2 circulating variant, all vaccines after a complete vaccination schedule were relatively associated with protection against severe infection and hospitalization. We found that people who received the Sinopharm vaccine had the lowest incidence of COVID-19 (18.7%), followed by Bharat. The lowest incidence of protection occurred with viral vector-based vaccines, especially AstraZeneca.

Graphical Abstract

[1]
Sinaei R, Pezeshki S, Asadipour A, Shiari R, Sinaei R, Sinaei A. Anti-rheumatic drugs as potential anti-inflammatory, immunomodulatory agents against COVID-19: A systematic review. Ulum-i Daruyi 2021; 27(1): S13-28. [URL].
[http://dx.doi.org/10.34172/PS.2021.40]
[2]
World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Updated November 23, 2021. 2021. Available from: https://covid19.who.int/ [Accessed November 23, 2021].
[3]
Dhar MS, Marwal R, Vs R, et al. Genomic characterization and epidemiology of an emerging SARS-CoV-2 variant in Delhi, India. Science 2021; 374(6570): 995-9.
[http://dx.doi.org/10.1126/science.abj9932] [PMID: 34648303]
[4]
Nguyen LH, Drew DA, Graham MS, et al. COronavirus Pandemic Epidemiology Consortium. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health 2020; 5(9): e475-83.
[http://dx.doi.org/10.1016/S2468-2667(20)30164-X] [PMID: 32745512]
[5]
Stock AD, Bader ER, Cezayirli P, et al. COVID-19 infection among healthcare workers: serological findings supporting routine testing. Front Med 2020; 7: 471.
[http://dx.doi.org/10.3389/fmed.2020.00471] [PMID: 32974370]
[6]
Stamatatos L, Czartoski J, Wan YH, Homad LJ, Rubin V, Glantz H, et al. mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection. Science 2021; 372(6549): 1413-8.
[7]
Deng X, Garcia-Knight MA, Khalid MM, et al. Transmission, infectivity, and neutralization of a spike L452R SARS-CoV-2 variant. medRxiv 2021.
[8]
Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020; 383(27): 2603-15.
[http://dx.doi.org/10.1056/NEJMoa2034577]
[9]
Voysey M, Clemens SAC, Madhi SA, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 2021; 397(10269): 99-111.
[http://dx.doi.org/10.1016/S0140-6736(20)32661-1] [PMID: 33306989]
[10]
Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021; 384(5): 403-16.
[http://dx.doi.org/10.1056/NEJMoa2035389] [PMID: 33378609]
[11]
Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ 2021; 373: n1088.
[http://dx.doi.org/10.1136/bmj.n1088] [PMID: 33985964]
[12]
Hall VJ, Foulkes S, Saei A, et al. COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Lancet 2021; 397(10286): 1725-35.
[http://dx.doi.org/10.1016/S0140-6736(21)00790-X] [PMID: 33901423]
[13]
Thompson MG, Burgess JL, Naleway AL, et al. Interim estimates of vaccine effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines in preventing SARS-CoV-2 infection among health care personnel, first responders, and other essential and frontline workers—eight US locations, December 2020–March 2021. MMWR Morb Mortal Wkly Rep 2021; 70(13): 495-500.
[http://dx.doi.org/10.15585/mmwr.mm7013e3] [PMID: 33793460]
[14]
Dagan N, Barda N, Kepten E, et al. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. N Engl J Med 2021; 384(15): 1412-23.
[http://dx.doi.org/10.1056/NEJMoa2101765] [PMID: 33626250]
[15]
Abu-Raddad LJ, Chemaitelly H, Butt AA. Effectiveness of the BNT162b2 Covid-19 Vaccine against the B.1.1.7 and B.1.351 Variants. N Engl J Med 2021; 385(2): 187-9.
[16]
Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of Covid-19 vaccines against the B. 1.617. 2 (Delta) variant. N Engl J Med 2021; 385(7): 585-94.
[http://dx.doi.org/10.1056/NEJMoa2108891] [PMID: 34289274]
[17]
Pouwels KB, Pritchard E, Matthews PC, et al. Effect of Delta variant on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK. Nat Med 2021; 27(12): 2127-35.
[http://dx.doi.org/10.1038/s41591-021-01548-7] [PMID: 34650248]
[18]
Andrews N, Tessier E, Stowe J, Gower C, Kirsebom F, Simmons R, et al. Duration of protection against mild and severe disease by Covid-19 vaccines. N Engl J Med 2022; 386(4): 340-50.
[http://dx.doi.org/10.1056/NEJMoa2115481]
[19]
Israel A, Merzon E, Schäffer AA, Shenhar Y, Green I, Golan-Cohen A, et al. Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection in a large cohort. MedRxiv 2021.
[http://dx.doi.org/10.1101/2021.08.03.21261496]
[20]
Mizrahi B, Lotan R, Kalkstein N, et al. Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine. Nat Commun 2021; 12(1): 6379.
[http://dx.doi.org/10.1038/s41467-021-26672-3] [PMID: 34737312]
[21]
Andrews N, Stowe J, Kirsebom F, Gower C, Ramsay M, Bernal JL. Effectiveness of BNT162b2 (Comirnaty, Pfizer-BioNTech) COVID-19 booster vaccine against covid-19 related symptoms in England: test negative case-control study. Medrxiv 2021.
[http://dx.doi.org/10.1101/2021.11.15.21266341]
[22]
Bar-On YM, Goldberg Y, Mandel M, et al. Protection of BNT162b2 vaccine booster against Covid-19 in Israel. N Engl J Med 2021; 385(15): 1393-400.
[http://dx.doi.org/10.1056/NEJMoa2114255] [PMID: 34525275]
[23]
Centers for Disease Control and Prevention. Common investigation protocol for investigating suspected SARS CoV-2 reinfection. National Center for Immunization and Respiratory Diseases (U.S.). Division of Viral Diseases. 2020.
[24]
World Health Organization. COVID-19 therapeutic trial synopsis. 2020.
[25]
Mukherjee A, Anand T, Agarwal A, et al. SARS-CoV-2 re-infection: development of an epidemiological definition from India. Epidemiol Infect 2021; 149: e82.
[http://dx.doi.org/10.1017/S0950268821000662] [PMID: 33766185]
[26]
World Health Organization. Evaluation of COVID-19 vaccine effectiveness. 2021.
[27]
Hall VJ, Foulkes S, Charlett A, et al. SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN). Lancet 2021; 397(10283): 1459-69.
[http://dx.doi.org/10.1016/S0140-6736(21)00675-9] [PMID: 33844963]
[28]
Lumley SF, O’Donnell D, Stoesser NE, et al. Antibody status and incidence of SARS-CoV-2 infection in health care workers. N Engl J Med 2021; 384(6): 533-40.
[http://dx.doi.org/10.1056/NEJMoa2034545] [PMID: 33369366]
[29]
Pilz S, Chakeri A, Ioannidis JPA, et al. SARS-CoV-2 re-infection risk in Austria. Eur J Clin Invest 2021; 51(4): e13520.
[http://dx.doi.org/10.1111/eci.13520] [PMID: 33583018]
[30]
Letizia AG, Ge Y, Vangeti S, et al. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. Lancet Respir Med 2021; 9(7): 712-20.
[http://dx.doi.org/10.1016/S2213-2600(21)00158-2] [PMID: 33865504]
[31]
Hansen CH, Michlmayr D, Gubbels SM, Mølbak K, Ethelberg S. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. Lancet 2021; 397(10280): 1204-12.
[http://dx.doi.org/10.1016/S0140-6736(21)00575-4] [PMID: 33743221]
[32]
Krutikov M, Palmer T, Tut G, et al. Incidence of SARS-CoV-2 infection according to baseline antibody status in staff and residents of 100 long-term care facilities (VIVALDI): a prospective cohort study. Lancet Healthy Longev 2021; 2(6): e362-70.
[http://dx.doi.org/10.1016/S2666-7568(21)00093-3] [PMID: 34104901]
[33]
Desai D, Khan AR. Effectiveness of an inactivated virus-based SARS-CoV-2 vaccine, BBV152, in India: A test-negative, case-control study. Lancet Infect Dis 2021; S1473-3099(21): 00674-5.
[34]
Ella R, Reddy S, Blackwelder W, et al. Efficacy, safety, and lot to lot immunogencity of an inactivated SARS CoV-2 vaccine (BBV152): a double-blind, randomized, controlled phase 3 trial. MedRxiv 2021; 2021.06.30.21259439.
[35]
Sapkal GN, Yadav PD, Ella R, et al. Inactivated COVID-19 vaccine BBV152/COVAXIN effectively neutralizes recently emerged B.1.1.7 variant of SARS-CoV-2. J Travel Med 2021; 28(4): taab051.
[http://dx.doi.org/10.1093/jtm/taab051] [PMID: 33772577]
[36]
Kumar NP, Banurekha VV, C P GK, et al. Prime-boost vaccination with Covaxin/BBV152 induces heightened systemic cytokine and chemokine responses. Front Immunol 2021; 12: 752397.
[http://dx.doi.org/10.3389/fimmu.2021.752397] [PMID: 34721425]
[37]
Kant R, Dwivedi G, Zaman K, et al. Immunogenicity and safety of a heterologous prime-boost COVID-19 vaccine schedule: ChAdOx1 vaccine Covishield followed by BBV152 Covaxin. J Travel Med 2021; 28(8): taab166.
[http://dx.doi.org/10.1093/jtm/taab166] [PMID: 34652440]
[38]
McCauley L, Hayes R. Taking responsibility for front-line health-care workers. Lancet Public Health 2020; 5(9): e461-2.
[http://dx.doi.org/10.1016/S2468-2667(20)30179-1] [PMID: 32745513]
[39]
Qureshi AI, Baskett WI, Huang W, Lobanova I, Naqvi SH, Shyu CR. Re-infection with SARS-CoV-2 in patients undergoing serial laboratory testing. Clin Infect Dis 2021; ciab345.