Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases.
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Stalman Eileen W, Wieske Luuk, van Dam Koos P J, Kummer Laura Y, van Kempen Zoé L E, Killestein Joep, Volkers Adriaan G, Tas Sander W, Boekel Laura, Wolbink Gertjan J, Van der Kooi Anneke J, Raaphorst Joost, Löwenberg Mark, Takkenberg R Bart, D'Haens Geert R A M, Spuls Phyllis I, Bekkenk Marcel W, Musters Annelie H, Post Nicoline F, Bosma Angela L, Hilhorst Marc L, Vegting Yosta, Bemelman Frederique J, Voskuyl Alexandre E, Broens Bo, Parra Sanchez Agner, van Els Cécile A C M, Wit Jelle De, Rutgers Abraham, de Leeuw Karina, Horváth Barbara, Verschuuren Jan J G M, Ruiter Annabel M, van Ouwerkerk Lotte, van der Woude Diane, Allaart C F, Teng Onno Y K, van Paassen Pieter, Busch Matthias H, Jallah Papay B P, Brusse Esther, van Doorn Pieter A, Baars Adája Elisabeth, Hijnen Dirk Jan, Schreurs Corine R G, Van der Pol W Ludo, Goedee H Stephan, Steenhuis Maurice, Keijzer Sofie, Keijser Jim B D, Boogaard Arend, Cristianawati Olvi, Ten Brinke Anja, Verstegen Niels J M, Zwinderman Koos A H, Rispens Theo, van Ham S Marieke, Kuijpers Taco W, Eftimov Filip, T2B! immunity against SARS-CoV-2 study group
Аннотация
METHODS: Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants.
RESULTS: 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection.
CONCLUSIONS: The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.