Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections

Laith J Abu-Raddad; Hiam Chemaitelly; Houssein H Ayoub; Patrick Tang; Peter Coyle; Mohammad R Hasan; Hadi M Yassine; Fatiha M Benslimane; Hebah A Al-Khatib; Zaina Al-Kanaani; Einas Al-Kuwari; Andrew Jeremijenko; Anvar Hassan Kaleeckal; Ali Nizar Latif; Riyazuddin Mohammad Shaik; Hanan F Abdul-Rahim; Gheyath K Nasrallah; Mohamed Ghaith Al-Kuwari; Adeel A Butt; Hamad Eid Al-Romaihi; Abdullatif Al-Khal; Mohametabd H Al-Thani; Roberto Bertollini

doi:10.1038/s41467-022-28199-7

Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections

Laith J Abu-Raddad, Hiam Chemaitelly, Houssein H Ayoub, Patrick Tang, Peter Coyle, Mohammad R Hasan, Hadi M Yassine, Fatiha M Benslimane, Hebah A Al-Khatib, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F Abdul-Rahim, Gheyath K Nasrallah, Mohamed Ghaith Al-Kuwari, Adeel A Butt, Hamad Eid Al-RomaihiAbdullatif Al-Khal, Mohametabd H Al-Thani, Roberto Bertollini

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar's national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9-1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9-4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5-4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.

Original language	English
Article number	532
Journal	Nature Communications
Volume	13
DOIs	https://doi.org/10.1038/s41467-022-28199-7
Publication status	Published - 27 Jan 2022

Keywords

Humans
Vaccination
Viral Load
Adolescent
Adult
Aged
Middle Aged
Child
Qatar
Female
Male
Young Adult
COVID-19
SARS-CoV-2
COVID-19 Vaccines
BNT162 Vaccine
2019-nCoV Vaccine mRNA-1273

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections
Copyright 2022 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 2.24 MBLicence: CC BY

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Abu-Raddad, L. J., Chemaitelly, H., Ayoub, H. H., Tang, P., Coyle, P., Hasan, M. R., Yassine, H. M., Benslimane, F. M., Al-Khatib, H. A., Al-Kanaani, Z., Al-Kuwari, E., Jeremijenko, A., Kaleeckal, A. H., Latif, A. N., Shaik, R. M., Abdul-Rahim, H. F., Nasrallah, G. K., Al-Kuwari, M. G., Butt, A. A., ... Bertollini, R. (2022). Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections. Nature Communications, 13, [532]. https://doi.org/10.1038/s41467-022-28199-7

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title = "Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections",

abstract = "SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar's national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9-1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9-4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5-4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.",

keywords = "Humans, Vaccination, Viral Load, Adolescent, Adult, Aged, Middle Aged, Child, Qatar, Female, Male, Young Adult, COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, 2019-nCoV Vaccine mRNA-1273",

author = "Abu-Raddad, {Laith J} and Hiam Chemaitelly and Ayoub, {Houssein H} and Patrick Tang and Peter Coyle and Hasan, {Mohammad R} and Yassine, {Hadi M} and Benslimane, {Fatiha M} and Al-Khatib, {Hebah A} and Zaina Al-Kanaani and Einas Al-Kuwari and Andrew Jeremijenko and Kaleeckal, {Anvar Hassan} and Latif, {Ali Nizar} and Shaik, {Riyazuddin Mohammad} and Abdul-Rahim, {Hanan F} and Nasrallah, {Gheyath K} and Al-Kuwari, {Mohamed Ghaith} and Butt, {Adeel A} and Al-Romaihi, {Hamad Eid} and Abdullatif Al-Khal and Al-Thani, {Mohametabd H} and Roberto Bertollini",

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doi = "10.1038/s41467-022-28199-7",

language = "English",

volume = "13",

journal = "Nature Communications",

issn = "2041-1723",

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Abu-Raddad, LJ, Chemaitelly, H, Ayoub, HH, Tang, P, Coyle, P, Hasan, MR, Yassine, HM, Benslimane, FM, Al-Khatib, HA, Al-Kanaani, Z, Al-Kuwari, E, Jeremijenko, A, Kaleeckal, AH, Latif, AN, Shaik, RM, Abdul-Rahim, HF, Nasrallah, GK, Al-Kuwari, MG, Butt, AA, Al-Romaihi, HE, Al-Khal, A, Al-Thani, MH & Bertollini, R 2022, 'Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections', Nature Communications, vol. 13, 532. https://doi.org/10.1038/s41467-022-28199-7

TY - JOUR

T1 - Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections

AU - Abu-Raddad, Laith J

AU - Chemaitelly, Hiam

AU - Ayoub, Houssein H

AU - Tang, Patrick

AU - Coyle, Peter

AU - Hasan, Mohammad R

AU - Yassine, Hadi M

AU - Benslimane, Fatiha M

AU - Al-Khatib, Hebah A

AU - Al-Kanaani, Zaina

AU - Al-Kuwari, Einas

AU - Jeremijenko, Andrew

AU - Kaleeckal, Anvar Hassan

AU - Latif, Ali Nizar

AU - Shaik, Riyazuddin Mohammad

AU - Abdul-Rahim, Hanan F

AU - Nasrallah, Gheyath K

AU - Al-Kuwari, Mohamed Ghaith

AU - Butt, Adeel A

AU - Al-Romaihi, Hamad Eid

AU - Al-Khal, Abdullatif

AU - Al-Thani, Mohametabd H

AU - Bertollini, Roberto

PY - 2022/1/27

Y1 - 2022/1/27

N2 - SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar's national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9-1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9-4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5-4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.

AB - SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar's national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9-1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9-4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5-4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.

KW - Humans

KW - Vaccination

KW - Viral Load

KW - Adolescent

KW - Adult

KW - Aged

KW - Middle Aged

KW - Child

KW - Qatar

KW - Female

KW - Male

KW - Young Adult

KW - COVID-19

KW - SARS-CoV-2

KW - COVID-19 Vaccines

KW - BNT162 Vaccine

KW - 2019-nCoV Vaccine mRNA-1273

U2 - 10.1038/s41467-022-28199-7

DO - 10.1038/s41467-022-28199-7

M3 - Article

VL - 13

JO - Nature Communications

JF - Nature Communications

SN - 2041-1723

M1 - 532

ER -

Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections

Abstract

Keywords

UN SDGs

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