Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections

Laith J. Abu-Raddad (), Hiam Chemaitelly, Houssein H. Ayoub, Patrick Tang, Peter Coyle, Mohammad R. Hasan, Hadi M. Yassine, Fatiha M. Benslimane, Hebah A. Al-Khatib, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul-Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al-Kuwari, Adeel A. Butt, Hamad Eid Al-Romaihi, Abdullatif Al-Khal, Mohametabd H. Al-Thani and Roberto Bertollini
Additional contact information
Laith J. Abu-Raddad: Weill Cornell Medicine-Qatar, Cornell University
Hiam Chemaitelly: Weill Cornell Medicine-Qatar, Cornell University
Houssein H. Ayoub: Qatar University
Patrick Tang: Sidra Medicine
Peter Coyle: Hamad Medical Corporation
Mohammad R. Hasan: Sidra Medicine
Hadi M. Yassine: Qatar University
Fatiha M. Benslimane: Qatar University
Hebah A. Al-Khatib: Qatar University
Zaina Al-Kanaani: Hamad Medical Corporation
Einas Al-Kuwari: Hamad Medical Corporation
Andrew Jeremijenko: Hamad Medical Corporation
Anvar Hassan Kaleeckal: Hamad Medical Corporation
Ali Nizar Latif: Hamad Medical Corporation
Riyazuddin Mohammad Shaik: Hamad Medical Corporation
Hanan F. Abdul-Rahim: Qatar University
Gheyath K. Nasrallah: Qatar University
Mohamed Ghaith Al-Kuwari: Primary Health Care Corporation
Adeel A. Butt: Cornell University
Hamad Eid Al-Romaihi: Ministry of Public Health
Abdullatif Al-Khal: Hamad Medical Corporation
Mohametabd H. Al-Thani: Ministry of Public Health
Roberto Bertollini: Ministry of Public Health

Nature Communications, 2022, vol. 13, issue 1, 1-11

Abstract: Abstract SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar’s national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9–1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9–4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5–4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.

Date: 2022
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DOI: 10.1038/s41467-022-28199-7

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