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Incidence and Risk Factors of COVID-19 Vaccine Breakthrough Infections: A Prospective Cohort Study in Belgium.
Stouten, Veerle; Hubin, Pierre; Haarhuis, Freek; van Loenhout, Joris A F; Billuart, Matthieu; Brondeel, Ruben; Braeye, Toon; Van Oyen, Herman; Wyndham-Thomas, Chloé; Catteau, Lucy.
  • Stouten V; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Hubin P; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Haarhuis F; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • van Loenhout JAF; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Billuart M; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Brondeel R; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Braeye T; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Van Oyen H; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
  • Wyndham-Thomas C; Department of Public Health and Primary Care, Ugent, 9000 Gent, Belgium.
  • Catteau L; Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium.
Viruses ; 14(4)2022 04 13.
Article in English | MEDLINE | ID: covidwho-1786084
ABSTRACT
The objective of this study was to investigate the incidence and risk factors associated with COVID-19 vaccine breakthrough infections. We included all persons ≥18 years that had been fully vaccinated against COVID-19 for ≥14 days, between 1 February 2021 and 5 December 2021, in Belgium. The incidence of breakthrough infections (laboratory confirmed SARS-CoV-2-infections) was determined. Factors associated with breakthrough infections were analyzed using COX proportional hazard models. Among 8,062,600 fully vaccinated adults, we identified 373,070 breakthrough infections with an incidence of 11.2 (95%CI 11.2-11.3)/100 person years. Vaccination with Ad26.COV2.S (HR1.54, 95%CI 1.52-1.56) or ChAdOx1 (HR1.68, 95%CI 1.66-1.69) was associated with a higher risk of a breakthrough infection compared to BNT162b2, while mRNA-1273 was associated with a lower risk (HR0.68, 95%CI 0.67-0.69). A prior COVID-19-infection was protective against a breakthrough infection (HR0.23, 95%CI 0.23-0.24), as was an mRNA booster (HR0.44, 95%CI 0.43-0.45). During a breakthrough infection, those who had a prior COVID-19 infection were less likely to have COVID-19 symptoms of almost all types than naïve persons. We identified risk factors associated with breakthrough infections, such as vaccination with adenoviral-vector vaccines, which could help inform future decisions on booster vaccination strategies. A prior COVID-19 infection lowered the risk of breakthrough infections and of having symptoms, highlighting the protective effect of hybrid immunity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: V14040802

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: V14040802