COVID-19: risk factors linked to post vaccination breakthrough infections

Clinical microbiology and infection

https://www.clinicalmicrobiologyandin...

A minority of vaccinated individuals might get infected and suffer significant morbidity

Characteristics of vaccine breakthrough infections

Population (9 million) of Israeli patients, who were hospitalized with COVID-19 despite full vaccination.

Methods

Retrospective multicenter cohort study of 17 hospitals

Pfizer/BioNTech's BNT162b2 fully-vaccinated patients

Who developed COVID-19 and required hospitalization

(more than 7 days after the second vaccine)

(18% of admissions were before 21 days after second dose)

Alpha, B.1.1.7, 89% (UK)

Wildtype, 7%

Beta, B.1.351, 4% (SA)

Results

N = 152 patients

(half of hospitalized fully-vaccinated patients in Israel, 5.17million people)

Median age, 71.1 (range, 22-98) years

(half of hospitalized fully-vaccinated patients in Israel)

Poor outcomes in 38 patients

Mortality rate 22% (34/152)

Cohort characterized by a high rate of comorbidities

Hypertension 108, (71%)

Diabetes 73, (48%)

CHF 41, (27%)

Chronic kidney 37, (24%)

Chronic lung diseases 37, (24%)

Dementia 29, (19%)

Cancer 36, (24%)

No comorbidities, 9, (6 %)

Immunocompromised 60, (40%)

Higher SARS-CoV-2 viral-load was associated with a significant risk for poor outcome

Conclusions

Severe COVID-19 infection, with a high mortality rate, might develop in a minority of fully-vaccinated, with multiple comorbidities

(Higher rate of comorbidities and immunosuppression compared to non-vaccinated hospitalized patients)

Develop guidance to augment protection

Continued social-distancing

Additional vaccinations

(Israel, offering booster to immunocompramised)


WHO made errors

https://www.washingtonpost.com/world/...

Said it will fix several unintended errors

https://www.who.int/publications/i/it...

Will look into other possible discrepancies

Questions from The Washington Post

Changing the virus sequence IDs associated with three of the 13 early patients

Will clarify that the first family cluster was not linked to the Huanan wet market in Wuhan

First patient, fell ill Dec. 8, 2019

Lived on the other side of the Yaangtze river, in Wuchang district

(WIV is in Jiangxia district)

Tarik Jasarevic, a WHO spokesman

the question of where the first-known patient lived relative to the river was not relevant to the origin of the virus

the current first known patient is most probably not the first case

mistakes in the report were due to editing errors

they did not affect the data analysis process, nor the conclusions

Lawrence Gostin, professor of global health law, Georgetown University

We need more explanation about what the source of the error and the information was

There’s no clarity, and this does feed into public distrust of the integrity and rigor of the origins investigation