Breakthrough SARS-CoV-2 Infections after Vaccination in North Carolina

Diane Uschner; Matthew Bott; William H Lagarde; Joseph Keating; Hazel Tapp; Andrea A Berry; Austin L Seals; Iqra Munawar; John Schieffelin; Joshua Yukich; Michele Santacatterina; Mihili Gunaratne; Lida M Fette; Brian Burke; Greg Strylewicz; Sharon L Edelstein; Amina Ahmed; Kristen Miller; John W Sanders; David Herrington; William S Weintraub; Michael S Runyon; On Behalf Of The Covid-Community Research Partnership

doi:10.3390/vaccines10111922

Breakthrough SARS-CoV-2 Infections after Vaccination in North Carolina

Vaccines (Basel). 2022 Nov 13;10(11):1922. doi: 10.3390/vaccines10111922.

Authors

Diane Uschner¹, Matthew Bott¹, William H Lagarde², Joseph Keating³, Hazel Tapp⁴, Andrea A Berry⁵, Austin L Seals⁶, Iqra Munawar⁷, John Schieffelin⁸, Joshua Yukich³, Michele Santacatterina¹, Mihili Gunaratne¹, Lida M Fette¹, Brian Burke¹, Greg Strylewicz¹, Sharon L Edelstein¹, Amina Ahmed⁹, Kristen Miller¹⁰, John W Sanders⁷, David Herrington⁶, William S Weintraub¹⁰, Michael S Runyon¹¹, On Behalf Of The Covid-Community Research Partnership

Affiliations

¹ The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
² Division of Pediatric Endocrinology, Department of Pediatrics, WakeMed Health and Hospitals, Raleigh, NC 27610, USA.
³ Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA.
⁴ Department of Family Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC 28262, USA.
⁵ Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
⁶ Division of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
⁷ Division of Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
⁸ Section of Infectious Disease, Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
⁹ Department of Pediatrics, Atrium Health Levine Children's Hospital, Charlotte, NC 28203, USA.
¹⁰ MedStar Health Research Institute, Georgetown University, Washington, DC 20007, USA.
¹¹ Department of Emergency Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC 28262, USA.

Abstract

We characterize the overall incidence and risk factors for breakthrough infection among fully vaccinated participants in the North Carolina COVID-19 Community Research Partnership cohort. Among 15,808 eligible participants, 638 reported a positive SARS-CoV-2 test after vaccination. Factors associated with a lower risk of breakthrough in the time-to-event analysis included older age, prior SARS-CovV-2 infection, higher rates of face mask use, and receipt of a booster vaccination. Higher rates of breakthrough were reported by participants vaccinated with BNT162b2 or Ad26.COV2.S compared to mRNA-1273, in suburban or rural counties compared to urban counties, and during circulation of the Delta and Omicron variants.

Keywords: Ad26.COV2.S; BNT162b2; Delta; Omicron; SARS-CoV-2 vaccination; age; booster vaccination; cumulative incidence; mRNA-1273; rural county.

Grants and funding

49927/NC Department of Health and Human Services