Longitudinal Analysis of SARS-CoV-2 Vaccine Breakthrough Infections Reveals Limited Infectious Virus Shedding and Restricted Tissue Distribution
Ruian Ke, Pamela P. Martinez, Rebecca L. Smith, Laura Gibson, Chad J. Achenbach, Sally M. McFall, Chao Qi, Joshua Jacob, Etienne Dembele, Camille Bundy, Lacy M. Simons, Egon A. Ozer, Judd F. Hultquist, Ramón Lorenzo-Redondo, Anita Opdycke, Claudia Hawkins, Robert L Murphy, Agha Zeeshan Mirza, Madison Conte, Nicholas Gallagher, Chun Huai Luo, Junko Jarrett, Abigail Conte, Ruifeng Zhou, Mireille Farjo, Gloria Rendon, Christopher J. Fields, Leyi Wang, Richard Fredrickson, Melinda E. Baughman, Karen Chiu, Hannah Choi, Kevin R. Scardina, Alyssa N. Owens, John Broach, Bruce Barton, Péter Lázár, Matthew L. Robinson, Heba H. Mostafa, Yukari C. Manabe, Andrew Pekosz, David D. McManus, Christopher B. Brooke
Abstract
Background: The global effort to vaccinate people against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an ongoing pandemic has raised questions about how vaccine breakthrough infections compare with infections in immunologically naive individuals and the potential for vaccinated individuals to transmit the virus. Methods: We examined viral dynamics and infectious virus shedding through daily longitudinal sampling in 23 adults infected with SARS-CoV-2 at varying stages of vaccination, including 6 fully vaccinated individuals. Results: The durations of both infectious virus shedding and symptoms were significantly reduced in vaccinated individuals compared with unvaccinated individuals. We also observed that breakthrough infections are associated with strong tissue compartmentalization and are only detectable in saliva in some cases. Conclusions: Vaccination shortens the duration of time of high transmission potential, minimizes symptom duration, and may restrict tissue dissemination.