Breakthrough SARS-CoV-2 Infections after Vaccination in North Carolina

Diane Uschner, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Matthew Bott, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
William H. Lagarde, Division of Pediatric Endocrinology, Department of Pediatrics, WakeMed Health and Hospitals, Raleigh, NC 27610, USA.
Joseph Keating, Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA.
Hazel Tapp, Department of Family Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC 28262, USA.
Andrea A. Berry, Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Austin L. Seals, Division of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
Iqra Munawar, Division of Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
John Schieffelin, Section of Infectious Disease, Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Joshua Yukich, Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA.
Michele Santacatterina, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Mihili Gunaratne, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Lida M. Fette, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Brian Burke, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Greg Strylewicz, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Sharon L. Edelstein, The Biostatistics Center, George Washington University, Rockville, MD 20852, USA.
Amina Ahmed, Department of Pediatrics, Atrium Health Levine Children's Hospital, Charlotte, NC 28203, USA.
Kristen Miller, MedStar Health Research Institute, Georgetown University, Washington, DC 20007, USA.
John W. Sanders, Division of Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
David Herrington, Division of Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA.
William S. Weintraub, MedStar Health Research Institute, Georgetown University, Washington, DC 20007, USA.
Michael S. Runyon, Department of Emergency Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC 28262, USA.
On Behalf Of The Covid-Community Research Partnership

Document Type

Journal Article

Publication Date

11-13-2022

Journal

Vaccines

Volume

10

Issue

11

DOI

10.3390/vaccines10111922

Keywords

Ad26.COV2.S; BNT162b2; Delta; Omicron; SARS-CoV-2 vaccination; age; booster vaccination; cumulative incidence; mRNA-1273; rural county

Abstract

We characterize the overall incidence and risk factors for breakthrough infection among fully vaccinated participants in the North Carolina COVID-19 Community Research Partnership cohort. Among 15,808 eligible participants, 638 reported a positive SARS-CoV-2 test after vaccination. Factors associated with a lower risk of breakthrough in the time-to-event analysis included older age, prior SARS-CovV-2 infection, higher rates of face mask use, and receipt of a booster vaccination. Higher rates of breakthrough were reported by participants vaccinated with BNT162b2 or Ad26.COV2.S compared to mRNA-1273, in suburban or rural counties compared to urban counties, and during circulation of the Delta and Omicron variants.

Department

Biostatistics and Bioinformatics

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