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AuthorAbu-Raddad, Laith J
AuthorChemaitelly, Hiam
AuthorAyoub, Houssein H
AuthorYassine, Hadi M
AuthorBenslimane, Fatiha M
AuthorAl Khatib, Hebah A
AuthorTang, Patrick
AuthorHasan, Mohammad R
AuthorCoyle, Peter
AuthorAl Kanaani, Zaina
AuthorAl Kuwari, Einas
AuthorJeremijenko, Andrew
AuthorKaleeckal, Anvar Hassan
AuthorLatif, Ali Nizar
AuthorShaik, Riyazuddin Mohammad
AuthorAbdul Rahim, Hanan F
AuthorNasrallah, Gheyath K
AuthorAl Kuwari, Mohamed Ghaith
AuthorButt, Adeel A
AuthorAl Romaihi, Hamad Eid
AuthorAl-Thani, Mohamed H
AuthorAl Khal, Abdullatif
AuthorBertollini, Roberto
Available date2021-11-07T07:45:22Z
Publication Date2021-11-01
Publication NameJournal of the American Medical Association (JAMA)
Identifierhttp://dx.doi.org/10.1001/jama.2021.19623
CitationAbu-Raddad LJ, Chemaitelly H, Ayoub HH, et al. Association of Prior SARS-CoV-2 Infection With Risk of Breakthrough Infection Following mRNA Vaccination in Qatar. JAMA. Published online November 01, 2021. doi:10.1001/jama.2021.19623
ISSN0098-7484
URIhttp://hdl.handle.net/10576/24855
AbstractThe effect of prior SARS-CoV-2 infection on vaccine protection remains poorly understood. To assess protection from SARS-CoV-2 breakthrough infection after mRNA vaccination among persons with vs without prior SARS-CoV-2 infection. Matched-cohort studies in Qatar for the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines. A total of 1 531 736 individuals vaccinated with either vaccine between December 21, 2020, and September 19, 2021, were followed up beginning 14 days after receiving the second dose until September 19, 2021. Prior SARS-CoV-2 infection and COVID-19 vaccination. Incident SARS-CoV-2 infection, defined as a polymerase chain reaction (PCR)-positive nasopharyngeal swab regardless of reason for PCR testing or presence of symptoms. Cumulative incidence was calculated using the Kaplan-Meier estimator method. The BNT162b2-vaccinated cohort comprised 99 226 individuals with and 290 432 matched individuals without prior PCR-confirmed infection (median age, 37 years; 68% male). The mRNA-1273-vaccinated cohort comprised 58 096 individuals with and 169 514 matched individuals without prior PCR-confirmed infection (median age, 36 years; 73% male). Among BNT162b2-vaccinated persons, 159 reinfections occurred in those with and 2509 in those without prior infection 14 days or more after dose 2. Among mRNA-1273-vaccinated persons, 43 reinfections occurred in those with and 368 infections in those without prior infection. Cumulative infection incidence among BNT162b2-vaccinated individuals was an estimated 0.15% (95% CI, 0.12%-0.18%) in those with and 0.83% (95% CI, 0.79%-0.87%) in those without prior infection at 120 days of follow-up (adjusted hazard ratio for breakthrough infection with prior infection, 0.18 [95% CI, 0.15-0.21]; P < .001). Cumulative infection incidence among mRNA-1273-vaccinated individuals was an estimated 0.11% (95% CI, 0.08%-0.15%) in those with and 0.35% (95% CI, 0.32%-0.40%) in those without prior infection at 120 days of follow-up (adjusted hazard ratio, 0.35 [95% CI, 0.25-0.48]; P < .001). Vaccinated individuals with prior infection 6 months or more before dose 1 had statistically significantly lower risk for breakthrough infection than those vaccinated less than 6 months before dose 1 (adjusted hazard ratio, 0.62 [95% CI, 0.42-0.92]; P = .02 for BNT162b2 and 0.40 [95% CI, 0.18-0.91]; P = .03 for mRNA-1273 vaccination). Prior SARS-CoV-2 infection was associated with a statistically significantly lower risk for breakthrough infection among individuals receiving the BNT162b2 or mRNA-1273 vaccines in Qatar between December 21, 2020, and September 19, 2021. The observational study design precludes direct comparisons of infection risk between the 2 vaccines.
SponsorQatar Genome Programme provided funding for the viral genome sequencing. Support was provided by the Biomedical Research Program; the Biostatistics, Epidemiology, and Biomathematics Research Core; and the Genomics Core, all at Weill Cornell Medicine–Qatar, as well as from the Ministry of Public Health and Hamad Medical Corporation to facilitate the conduct of this study.
Languageen
PublisherAmerican Medical Association
SubjectSARS-CoV-2
Vaccination
TitleAssociation of Prior SARS-CoV-2 Infection With Risk of Breakthrough Infection Following mRNA Vaccination in Qatar.
TypeArticle
ESSN1538-3598
dc.accessType Open Access


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