Transmission event of SARS-CoV-2 Delta variant reveals multiple vaccine breakthrough infections

IMPORTANCE: Vaccine breakthrough by an emergent SARS-CoV-2 variant poses a great risk to global public health. OBJECTIVE: To determine the SARS-CoV-2 variant responsible for 6 cases of vaccine breakthrough. DESIGN: Nasopharyngeal swabs from suspected vaccine breakthrough cases were tested for SARS-CoV-2 by qPCR for Wuhan-Hu1 and Alpha variant. Positive samples were then sequenced by Swift Normalase Amplicon Panels to determine the causal variant. SETTING: Transmission event occurred at events surrounding a wedding outside of Houston, TX. Two patients from India, likely transmitted the Delta variant to other guests. PARTICIPANTS: Following a positive SARS-CoV-2 qPCR test at a third-party site, six fully vaccinated patients were investigated. Three males and three females ranged from 53 to 69 years old. One patient suffered from diabetes while three others were classified as overweight. No significant other comorbidities were identified. None of the patients had a history of failed vaccination.