Breakthrough infections with SARS-CoV-2 omicron despite mRNA vaccine booster dose

• Published in: The Lancet (British edition) 2022-02, Vol.399 (10325), p.625-626
• Main Authors: Kuhlmann, Constanze, Mayer, Carla Konstanze, Claassen, Mathilda, Maponga, Tongai, Burgers, Wendy A, Keeton, Roanne, Riou, Catherine, Sutherland, Andrew D, Suliman, Tasnim, Shaw, Megan L, Preiser, Wolfgang
• Format: Article
• Language: English
• Subjects: 2019-nCoV Vaccine mRNA-1273 - administration & dosage; 2019-nCoV Vaccine mRNA-1273 - immunology; Adult; Antibodies; BNT162 Vaccine - administration & dosage; BNT162 Vaccine - immunology; ChAdOx1 nCoV-19 - administration & dosage; ChAdOx1 nCoV-19 - immunology; Coronaviruses; Correspondence; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 - prevention & control; COVID-19 - virology; COVID-19 vaccines; COVID-19 Vaccines - immunology; Dashboards; Disease transmission; Female; Humans; Immunization, Secondary; Immunogenicity, Vaccine; Infections; Male; mRNA; mRNA vaccines; SARS-CoV-2 - immunology; SARS-CoV-2 - isolation & purification; SARS-CoV-2 - pathogenicity; Severe acute respiratory syndrome coronavirus 2; Spike protein; Vaccines; Viral diseases; Viral Load
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(22)00090-3

The most recent SARS-CoV-2 variant of concern to emerge has been named omicron.1 Its immune evasion potential was predicted by genomic data and has been preliminarily confirmed by observations of an increased incidence of reinfections and breakthrough infections.2 This has triggered calls to intensify vaccination programmes including provision of vaccine booster doses.3 A group of German visitors who had received three doses of SARS-CoV-2 vaccines, including at least two doses of an mRNA vaccine, experienced breakthrough infections with omicron between late November and early December, 2021, while in Cape Town, South Africa. At the onset of their breakthrough infections, all individuals had high levels of viral spike protein binding antibodies, similar to levels reported 4 weeks following second vaccine doses6 and as expected after receipt of booster vaccine doses.7 Viral RNA loads in omicron variant infections have yet to be reported. Encouragingly, early data from South Africa suggest maintained if reduced effectiveness of the BNT162b2 vaccine against hospital admission.14 Dwayne Senior/Bloomberg/Getty Images For National Institutes of Health COVID-19 Treatment Guidelines see https://www.covid19treatmentguidelines.nih.gov For SARS-CoV-2 infections in the Western Cape province see https://coronavirus.westerncape.gov.za/covid-19-dashboard CK and CKM contributed equally.