Evidence of leaky protection following COVID-19 vaccination and SARS-CoV-2 infection in an incarcerated population

Margaret L. Lind (), Murilo Dorion, Amy J. Houde, Mary Lansing, Sarah Lapidus, Russell Thomas, Inci Yildirim, Saad B. Omer, Wade L. Schulz, Jason R. Andrews, Matt D. T. Hitchings, Byron S. Kennedy, Robert P. Richeson, Derek A. T. Cummings and Albert I. Ko ()
Additional contact information
Margaret L. Lind: Yale School of Public Health
Murilo Dorion: Yale School of Public Health
Amy J. Houde: Connecticut Department of Correction
Mary Lansing: Connecticut Department of Correction
Sarah Lapidus: Yale School of Public Health
Russell Thomas: Yale School of Public Health
Inci Yildirim: Yale School of Public Health
Saad B. Omer: Yale School of Public Health
Wade L. Schulz: Yale School of Medicine
Jason R. Andrews: Stanford University
Matt D. T. Hitchings: University of Florida
Byron S. Kennedy: Connecticut Department of Correction
Robert P. Richeson: Connecticut Department of Correction
Derek A. T. Cummings: University of Florida
Albert I. Ko: Yale School of Public Health

Nature Communications, 2023, vol. 14, issue 1, 1-13

Abstract: Abstract Whether SARS-CoV-2 infection and COVID-19 vaccines confer exposure-dependent (“leaky”) protection against infection remains unknown. We examined the effect of prior infection, vaccination, and hybrid immunity on infection risk among residents of Connecticut correctional facilities during periods of predominant Omicron and Delta transmission. Residents with cell, cellblock, and no documented exposure to SARS-CoV-2 infected residents were matched by facility and date. During the Omicron period, prior infection, vaccination, and hybrid immunity reduced the infection risk of residents without a documented exposure (HR: 0.36 [0.25–0.54]; 0.57 [0.42–0.78]; 0.24 [0.15–0.39]; respectively) and with cellblock exposures (0.61 [0.49–0.75]; 0.69 [0.58–0.83]; 0.41 [0.31–0.55]; respectively) but not with cell exposures (0.89 [0.58–1.35]; 0.96 [0.64–1.46]; 0.80 [0.46–1.39]; respectively). Associations were similar during the Delta period and when analyses were restricted to tested residents. Although associations may not have been thoroughly adjusted due to dataset limitations, the findings suggest that prior infection and vaccination may be leaky, highlighting the potential benefits of pairing vaccination with non-pharmaceutical interventions in crowded settings.

Date: 2023
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DOI: 10.1038/s41467-023-40750-8

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