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Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine

Constant efforts to prevent infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are actively carried out around the world. Several vaccines are currently approved for emergency use in the population, while ongoing studies continue to provide information on their safety and eff...

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Autores principales: Duarte, Luisa F., Gálvez, Nicolás M. S., Iturriaga, Carolina, Melo-González, Felipe, Soto, Jorge A., Schultz, Bárbara M., Urzúa, Marcela, González, Liliana A., Vázquez, Yaneisi, Ríos, Mariana, Berríos-Rojas, Roslye V., Rivera-Pérez, Daniela, Moreno-Tapia, Daniela, Pacheco, Gaspar A., Vallejos, Omar P., Hoppe-Elsholz, Guillermo, Navarrete, María S., Rojas, Álvaro, Fasce, Rodrigo A., Fernández, Jorge, Mora, Judith, Ramírez, Eugenio, Zeng, Gang, Meng, Weining, González-Aramundiz, José V., González, Pablo A., Abarca, Katia, Bueno, Susan M., Kalergis, Alexis M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511644/
https://www.ncbi.nlm.nih.gov/pubmed/34659237
http://dx.doi.org/10.3389/fimmu.2021.742914
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author Duarte, Luisa F.
Gálvez, Nicolás M. S.
Iturriaga, Carolina
Melo-González, Felipe
Soto, Jorge A.
Schultz, Bárbara M.
Urzúa, Marcela
González, Liliana A.
Vázquez, Yaneisi
Ríos, Mariana
Berríos-Rojas, Roslye V.
Rivera-Pérez, Daniela
Moreno-Tapia, Daniela
Pacheco, Gaspar A.
Vallejos, Omar P.
Hoppe-Elsholz, Guillermo
Navarrete, María S.
Rojas, Álvaro
Fasce, Rodrigo A.
Fernández, Jorge
Mora, Judith
Ramírez, Eugenio
Zeng, Gang
Meng, Weining
González-Aramundiz, José V.
González, Pablo A.
Abarca, Katia
Bueno, Susan M.
Kalergis, Alexis M.
author_facet Duarte, Luisa F.
Gálvez, Nicolás M. S.
Iturriaga, Carolina
Melo-González, Felipe
Soto, Jorge A.
Schultz, Bárbara M.
Urzúa, Marcela
González, Liliana A.
Vázquez, Yaneisi
Ríos, Mariana
Berríos-Rojas, Roslye V.
Rivera-Pérez, Daniela
Moreno-Tapia, Daniela
Pacheco, Gaspar A.
Vallejos, Omar P.
Hoppe-Elsholz, Guillermo
Navarrete, María S.
Rojas, Álvaro
Fasce, Rodrigo A.
Fernández, Jorge
Mora, Judith
Ramírez, Eugenio
Zeng, Gang
Meng, Weining
González-Aramundiz, José V.
González, Pablo A.
Abarca, Katia
Bueno, Susan M.
Kalergis, Alexis M.
author_sort Duarte, Luisa F.
collection PubMed
description Constant efforts to prevent infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are actively carried out around the world. Several vaccines are currently approved for emergency use in the population, while ongoing studies continue to provide information on their safety and effectiveness. CoronaVac is an inactivated SARS-CoV-2 vaccine with a good safety and immunogenicity profile as seen in phase 1, 2, and 3 clinical trials around the world, with an effectiveness of 65.9% for symptomatic cases. Although vaccination reduces the risk of disease, infections can still occur during or after completion of the vaccination schedule (breakthrough cases). This report describes the clinical and immunological profile of vaccine breakthrough cases reported in a clinical trial in progress in Chile that is evaluating the safety, immunogenicity, and efficacy of two vaccination schedules of CoronaVac (clinicaltrials.gov NCT04651790). Out of the 2,263 fully vaccinated subjects, at end of June 2021, 45 have reported symptomatic SARS-CoV-2 infection 14 or more days after the second dose (1.99% of fully vaccinated subjects). Of the 45 breakthrough cases, 96% developed mild disease; one case developed a moderate disease; and one developed a severe disease and required mechanical ventilation. Both cases that developed moderate and severe disease were adults over 60 years old and presented comorbidities. The immune response before and after SARS-CoV-2 infection was analyzed in nine vaccine breakthrough cases, revealing that six of them exhibited circulating anti-S1-RBD IgG antibodies with neutralizing capacities after immunization, which showed a significant increase 2 and 4 weeks after symptoms onset. Two cases exhibited low circulating anti-S1-RBD IgG and almost non-existing neutralizing capacity after either vaccination or infection, although they developed a mild disease. An increase in the number of interferon-γ-secreting T cells specific for SARS-CoV-2 was detected 2 weeks after the second dose in seven cases and after symptoms onset. In conclusion, breakthrough cases were mostly mild and did not necessarily correlate with a lack of vaccine-induced immunity, suggesting that other factors, to be defined in future studies, could lead to symptomatic infection after vaccination with CoronaVac.
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spelling pubmed-85116442021-10-14 Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine Duarte, Luisa F. Gálvez, Nicolás M. S. Iturriaga, Carolina Melo-González, Felipe Soto, Jorge A. Schultz, Bárbara M. Urzúa, Marcela González, Liliana A. Vázquez, Yaneisi Ríos, Mariana Berríos-Rojas, Roslye V. Rivera-Pérez, Daniela Moreno-Tapia, Daniela Pacheco, Gaspar A. Vallejos, Omar P. Hoppe-Elsholz, Guillermo Navarrete, María S. Rojas, Álvaro Fasce, Rodrigo A. Fernández, Jorge Mora, Judith Ramírez, Eugenio Zeng, Gang Meng, Weining González-Aramundiz, José V. González, Pablo A. Abarca, Katia Bueno, Susan M. Kalergis, Alexis M. Front Immunol Immunology Constant efforts to prevent infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are actively carried out around the world. Several vaccines are currently approved for emergency use in the population, while ongoing studies continue to provide information on their safety and effectiveness. CoronaVac is an inactivated SARS-CoV-2 vaccine with a good safety and immunogenicity profile as seen in phase 1, 2, and 3 clinical trials around the world, with an effectiveness of 65.9% for symptomatic cases. Although vaccination reduces the risk of disease, infections can still occur during or after completion of the vaccination schedule (breakthrough cases). This report describes the clinical and immunological profile of vaccine breakthrough cases reported in a clinical trial in progress in Chile that is evaluating the safety, immunogenicity, and efficacy of two vaccination schedules of CoronaVac (clinicaltrials.gov NCT04651790). Out of the 2,263 fully vaccinated subjects, at end of June 2021, 45 have reported symptomatic SARS-CoV-2 infection 14 or more days after the second dose (1.99% of fully vaccinated subjects). Of the 45 breakthrough cases, 96% developed mild disease; one case developed a moderate disease; and one developed a severe disease and required mechanical ventilation. Both cases that developed moderate and severe disease were adults over 60 years old and presented comorbidities. The immune response before and after SARS-CoV-2 infection was analyzed in nine vaccine breakthrough cases, revealing that six of them exhibited circulating anti-S1-RBD IgG antibodies with neutralizing capacities after immunization, which showed a significant increase 2 and 4 weeks after symptoms onset. Two cases exhibited low circulating anti-S1-RBD IgG and almost non-existing neutralizing capacity after either vaccination or infection, although they developed a mild disease. An increase in the number of interferon-γ-secreting T cells specific for SARS-CoV-2 was detected 2 weeks after the second dose in seven cases and after symptoms onset. In conclusion, breakthrough cases were mostly mild and did not necessarily correlate with a lack of vaccine-induced immunity, suggesting that other factors, to be defined in future studies, could lead to symptomatic infection after vaccination with CoronaVac. Frontiers Media S.A. 2021-09-29 /pmc/articles/PMC8511644/ /pubmed/34659237 http://dx.doi.org/10.3389/fimmu.2021.742914 Text en Copyright © 2021 Duarte, Gálvez, Iturriaga, Melo-González, Soto, Schultz, Urzúa, González, Vázquez, Ríos, Berríos-Rojas, Rivera-Pérez, Moreno-Tapia, Pacheco, Vallejos, Hoppe-Elsholz, Navarrete, Rojas, Fasce, Fernández, Mora, Ramírez, Zeng, Meng, González-Aramundiz, González, Abarca, Bueno and Kalergis https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Duarte, Luisa F.
Gálvez, Nicolás M. S.
Iturriaga, Carolina
Melo-González, Felipe
Soto, Jorge A.
Schultz, Bárbara M.
Urzúa, Marcela
González, Liliana A.
Vázquez, Yaneisi
Ríos, Mariana
Berríos-Rojas, Roslye V.
Rivera-Pérez, Daniela
Moreno-Tapia, Daniela
Pacheco, Gaspar A.
Vallejos, Omar P.
Hoppe-Elsholz, Guillermo
Navarrete, María S.
Rojas, Álvaro
Fasce, Rodrigo A.
Fernández, Jorge
Mora, Judith
Ramírez, Eugenio
Zeng, Gang
Meng, Weining
González-Aramundiz, José V.
González, Pablo A.
Abarca, Katia
Bueno, Susan M.
Kalergis, Alexis M.
Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title_full Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title_fullStr Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title_full_unstemmed Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title_short Immune Profile and Clinical Outcome of Breakthrough Cases After Vaccination With an Inactivated SARS-CoV-2 Vaccine
title_sort immune profile and clinical outcome of breakthrough cases after vaccination with an inactivated sars-cov-2 vaccine
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511644/
https://www.ncbi.nlm.nih.gov/pubmed/34659237
http://dx.doi.org/10.3389/fimmu.2021.742914
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