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Post-vaccination SARS-CoV-2 infections and incidence of presumptive B.1.427/B.1.429 variant among healthcare personnel at a northern California academic medical center.
Jacobson, Karen B; Pinsky, Benjamin A; Montez Rath, Maria E; Wang, Hannah; Miller, Jacob A; Skhiri, Mehdi; Shepard, John; Mathew, Roshni; Lee, Grace; Bohman, Bryan; Parsonnet, Julie; Holubar, Marisa.
  • Jacobson KB; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • Pinsky BA; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • Montez Rath ME; Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
  • Wang H; Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, CA, USA.
  • Miller JA; Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
  • Skhiri M; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
  • Shepard J; Department of Medicine, Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
  • Mathew R; Department of Quality, Patient Safety and Clinical Effectiveness, Stanford Health Care, Stanford, CA, USA.
  • Lee G; Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, USA.
  • Bohman B; Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, USA.
  • Parsonnet J; Workforce Health and Wellness, Stanford University School of Medicine, Stanford, CA, USA.
  • Holubar M; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Clin Infect Dis ; 2021 Jun 17.
Article in English | MEDLINE | ID: covidwho-1276158
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Health Personnel
Subject
COVID-19
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PROCESS_OF
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Health Personnel
2. Vaccines ADMINISTERED_TO Health Personnel
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ADMINISTERED_TO
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Health Personnel
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2019 novel coronavirus
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Health Personnel
5. Vaccines ADMINISTERED_TO Health Personnel
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Vaccines
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ADMINISTERED_TO
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Health Personnel
6. 2019 novel coronavirus PROCESS_OF Health Personnel
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2019 novel coronavirus
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PROCESS_OF
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Health Personnel
ABSTRACT

BACKGROUND:

Although mRNA-based SARS-CoV-2 vaccines report ≥90% efficacy, breakthrough infections occur. Little is known about the effectiveness of these vaccines against SARS-CoV-2 variants, including the highly-prevalent B.1.427/B.1.429 variant in California..

METHODS:

In this quality improvement project, we collected demographic and clinical information from post-vaccine SARS-CoV-2 cases (PVSCs), defined as health care personnel (HCP) with positive SARS-CoV-2 NAAT after receiving ≥1 vaccine dose. Available specimens were tested for L452R, N501Y and E484K mutations by RT-PCR. Mutation prevalence was compared among unvaccinated, early post-vaccinated (<=14 days after dose 1), partially vaccinated (positive test >14 days after dose 1 and ≤14 days after dose 2) and fully vaccinated (>14 days after dose 2) PVSCs.

RESULTS:

From December 2020-April 2021, >=23,090 HCPS received at least1 dose of an mRNA-based SARS-CoV-2 vaccine, and 660 HCP cases of SARS-CoV-2 occurred of which 189 were PVSCs. Among the PVSCs, 114 (60.3%), 49 (25.9%) and 26 (13.8%) were early post-vaccination, partially vaccinated, and fully vaccinated, respectively. Of 261 available samples from vaccinated and unvaccinated HCP, 103 (39.5%), including 42 PVSCs (36.5%), had L452R mutation presumed to be B.1.427/B.1.429,. When adjusted for community prevalence of B.1.427/B.1.429, PVSCs did not have significantly elevated risk for infection with B.1.427/B.1.429 compared with unvaccinated HCP.

CONCLUSIONS:

Most PVSCs occurred prior to expected onset of full, vaccine-derived immunity. Presumptive B.1.427/B.1.429 was not more prevalent in post-vaccine cases than in unvaccinated SARS-CoV-2 HCP. Continued infection control measures, particularly ≤14 days post-vaccination, and continued variant surveillance in PVSCs is imperative to control future SARS-CoV-2 surges.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Incidence study / Risk factors Language: English Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Incidence study / Risk factors Language: English Clinical aspect: Etiology Year: 2021
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