Longitudinal Analysis of SARS-CoV-2 Vaccine Breakthrough Infections Reveals Limited Infectious Virus Shedding and Restricted Tissue Distribution

Ruian Ke; Pamela P Martinez; Rebecca L Smith; Laura L Gibson; Chad J Achenbach; Sally McFall; Chao Qi; Joshua Jacob; Etienne Dembele; Camille Bundy; Lacy M Simons; Egon A Ozer; Judd F Hultquist; Ramon Lorenzo-Redondo; Anita K Opdycke; Claudia Hawkins; Robert L Murphy; Agha Mirza; Madison Conte; Nicholas Gallagher; Chun Huai Luo; Junko Jarrett; Abigail Conte; Ruifeng Zhou; Mireille Farjo; Gloria Rendon; Christopher J Fields; Leyi Wang; Richard Fredrickson; Melinda E Baughman; Karen K Chiu; Hannah Choi; Kevin R Scardina; Alyssa N Owens; John Broach; Bruce Barton; Peter Lazar; Matthew L Robinson; Heba H Mostafa; Yukari C Manabe; Andrew Pekosz; David D McManus; Christopher B Brooke

doi:10.1093/ofid/ofac192

Longitudinal Analysis of SARS-CoV-2 Vaccine Breakthrough Infections Reveals Limited Infectious Virus Shedding and Restricted Tissue Distribution

Open Forum Infect Dis. 2022 Apr 13;9(7):ofac192. doi: 10.1093/ofid/ofac192. eCollection 2022 Jul.

Authors

Ruian Ke¹, Pamela P Martinez², Rebecca L Smith³, Laura L Gibson⁴, Chad J Achenbach⁴, Sally McFall⁵, Chao Qi⁶, Joshua Jacob⁷, Etienne Dembele⁷, Camille Bundy⁸, Lacy M Simons⁷, Egon A Ozer⁷, Judd F Hultquist⁷, Ramon Lorenzo-Redondo⁷, Anita K Opdycke⁹, Claudia Hawkins⁷, Robert L Murphy⁷, Agha Mirza¹⁰, Madison Conte¹⁰, Nicholas Gallagher¹¹, Chun Huai Luo¹¹, Junko Jarrett¹¹, Abigail Conte¹², Ruifeng Zhou¹², Mireille Farjo², Gloria Rendon¹³, Christopher J Fields¹³, Leyi Wang¹⁴, Richard Fredrickson¹⁴, Melinda E Baughman³, Karen K Chiu³, Hannah Choi³, Kevin R Scardina³, Alyssa N Owens¹⁵, John Broach⁴, Bruce Barton¹⁶, Peter Lazar¹⁶, Matthew L Robinson⁴, Heba H Mostafa¹¹, Yukari C Manabe⁴, Andrew Pekosz¹², David D McManus⁴, Christopher B Brooke²

Affiliations

¹ T-6, Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico, USA.
² Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
³ Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
⁴ Division of Infectious Diseases and Immunology, Departments of Medicine and Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
⁵ Center for Innovation in Point-of-Care Technologies for HIV/AIDS at Northwestern University, Evanston, Illinois, USA.
⁶ Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁷ Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁸ Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁹ Department of Health Service, Northwestern University, Evanston, Illinois, USA.
¹⁰ Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
¹¹ Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹² W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹³ High-Performance Biological Computing at the Roy J. Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
¹⁴ Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
¹⁵ Center for Clinical and Translational Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
¹⁶ Division of Biostatistics and Health Services Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Abstract

Background: The global effort to vaccinate people against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an ongoing pandemic has raised questions about how vaccine breakthrough infections compare with infections in immunologically naive individuals and the potential for vaccinated individuals to transmit the virus.

Methods: We examined viral dynamics and infectious virus shedding through daily longitudinal sampling in 23 adults infected with SARS-CoV-2 at varying stages of vaccination, including 6 fully vaccinated individuals.

Results: The durations of both infectious virus shedding and symptoms were significantly reduced in vaccinated individuals compared with unvaccinated individuals. We also observed that breakthrough infections are associated with strong tissue compartmentalization and are only detectable in saliva in some cases.

Conclusions: Vaccination shortens the duration of time of high transmission potential, minimizes symptom duration, and may restrict tissue dissemination.

Keywords: SARS-CoV-2; breakthrough infections; vaccines; viral dynamics.

Abstract

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