High failure rate of ChAdOx1-nCoV19 immunization against asymptomatic infection in healthcare workers during a Delta variant surge

Rajat Ujjainiya, Akansha Tyagi, Viren Sardana, Salwa Naushin, Nitin Bhatheja, Kartik Kumar, Joydeb Barman, Satyartha Prakash, Rintu Kutum, Akash Kumar Bhaskar, Prateek Singh, Kumardeep Chaudhary, Menka Loomba, Yukti Khanna, Chestha Walecha, Rizwan Ahmed, Ashutosh Yadav, Archana Bajaj, Gaurav Malik, Sahar Qureshi, Swati Waghdhare, Samreen Siddiqui, Kamal Krishan Trehan, Manju Mani, Rajiv Dang, Poonam Das, Pankaj Dougall, Monica Mahajan, Sudipta Sonar, Kamini Jakhar, Reema Kumar, Mahima Tiwari, Shailendra Mani, Sankar Bhattacharyya, Sandeep Budhiraja, Anurag Agrawal, Debasis Dash (), Sujeet Jha () and Shantanu Sengupta ()
Additional contact information
Rajat Ujjainiya: CSIR-Institute of Genomics and Integrative Biology
Akansha Tyagi: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Viren Sardana: CSIR-Institute of Genomics and Integrative Biology
Salwa Naushin: CSIR-Institute of Genomics and Integrative Biology
Nitin Bhatheja: CSIR-Institute of Genomics and Integrative Biology
Kartik Kumar: CSIR-Institute of Genomics and Integrative Biology
Joydeb Barman: CSIR-Institute of Genomics and Integrative Biology
Satyartha Prakash: CSIR-Institute of Genomics and Integrative Biology
Rintu Kutum: CSIR-Institute of Genomics and Integrative Biology
Akash Kumar Bhaskar: CSIR-Institute of Genomics and Integrative Biology
Prateek Singh: CSIR-Institute of Genomics and Integrative Biology
Kumardeep Chaudhary: CSIR-Institute of Genomics and Integrative Biology
Menka Loomba: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Yukti Khanna: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Chestha Walecha: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Rizwan Ahmed: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Ashutosh Yadav: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Archana Bajaj: Max Hospital Shalimar Bagh
Gaurav Malik: Max Hospital Shalimar Bagh
Sahar Qureshi: Max Smart Super Speciality Hospital
Swati Waghdhare: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Samreen Siddiqui: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Kamal Krishan Trehan: Max Hospital Shalimar Bagh
Manju Mani: Max Smart Super Speciality Hospital
Rajiv Dang: Max Hospital
Poonam Das: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Pankaj Dougall: Saket, New Delhi (A Unit of Devki Devi Foundation)
Monica Mahajan: Max Hospital Panchsheel
Sudipta Sonar: Translational Health Science and Technology Institute
Kamini Jakhar: Translational Health Science and Technology Institute
Reema Kumar: Translational Health Science and Technology Institute
Mahima Tiwari: Translational Health Science and Technology Institute
Shailendra Mani: Translational Health Science and Technology Institute
Sankar Bhattacharyya: Translational Health Science and Technology Institute
Sandeep Budhiraja: Max Super Speciality Hospital, Saket
Anurag Agrawal: CSIR-Institute of Genomics and Integrative Biology
Debasis Dash: CSIR-Institute of Genomics and Integrative Biology
Sujeet Jha: Max Super Speciality Hospital, Saket, New Delhi (A Unit of Devki Devi Foundation)
Shantanu Sengupta: CSIR-Institute of Genomics and Integrative Biology

Nature Communications, 2022, vol. 13, issue 1, 1-6

Abstract: Abstract Immunization is expected to confer protection against infection and severe disease for vaccines while reducing risks to unimmunized populations by inhibiting transmission. Here, based on serial serological studies of an observational cohort of healthcare workers, we show that during a Severe Acute Respiratory Syndrome -Coronavirus 2 Delta-variant outbreak in Delhi, 25.3% (95% Confidence Interval 16.9-35.2) of previously uninfected, ChAdOx1-nCoV19 double vaccinated, healthcare workers were infected within less than two months, based on serology. Induction of anti-spike response was similar between groups with breakthrough infection (541 U/ml, Inter Quartile Range 374) and without (342 U/ml, Inter Quartile Range 497), as was the induction of neutralization activity to wildtype. This was not vaccine failure since vaccine effectiveness estimate based on infection rates in an unvaccinated cohort were about 70% and most infections were asymptomatic. We find that while ChAdOx1-nCoV19 vaccination remains effective in preventing severe infections, it is unlikely to be completely able to block transmission and provide herd immunity.

Date: 2022
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DOI: 10.1038/s41467-022-29404-3

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