Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults.
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Prelog Martina, Jeske Samuel D, Asam Claudia, Fuchs Andre, Wieser Andreas, Gall Christine, Wytopil Monika, Mueller-Schmucker Sandra M, Beileke Stephanie, Goekkaya Mehmet, Kling Elisabeth, Geldmacher Christof, Rubio-Acero Raquel, Plank Michael, Christa Catharina, Willmann Annika, Vu Martin, Einhauser Sebastian, Weps Manuela, Lampl Benedikt M J, Almanzar Giovanni, Kousha Kimia, Schwägerl Valeria, Liebl Bernhard, Weber Beatrix, Drescher Johannes, Scheidt Jörg, Gefeller Olaf, Messmann Helmut, Protzer Ulrike, Liese Johannes, Hoelscher Michael, Wagner Ralf, Überla Klaus, Steininger Philipp, CoVaKo Study Group
Аннотация
METHODS: In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity.
RESULTS: A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5-7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively).
CONCLUSIONS: Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.