1. COVID-19 Vaccination Breakthrough Infections in a Real-World Setting: Using Community Reporters to Evaluate Vaccine Effectiveness
- Author
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Reynolds MW, Xie Y, Knuth KB, Mack CD, Brinkley E, Toovey S, and Dreyer NA
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covid-19 ,vaccines ,breakthrough infections ,sars-cov-2 ,symptoms ,patient-reported outcomes ,Infectious and parasitic diseases ,RC109-216 - Abstract
Matthew W Reynolds,1 Yiqiong Xie,1 Kendall B Knuth,1 Christina D Mack,1 Emma Brinkley,1 Stephen Toovey,2 Nancy A Dreyer1 1Real World Solutions, IQVIA, Cambridge, MA, USA; 2Virology, Pegasus Research, London, UKCorrespondence: Matthew W Reynolds, Real-World Solutions, IQVIA, 201 Broadway, Cambridge, MA, 02139, USA, Email Matthew.Reynolds@IQVIA.comPurpose: Coronavirus disease 2019 (COVID-19) has highlighted the need for new methods of pharmacovigilance. Here, we use adult community volunteers to obtain systematic information on vaccine effectiveness and the nature and severity of breakthrough infections.Methods: Between December 15, 2020 and September 16, 2021, 11,826 unpaid community-based volunteers reported the following information to an on-line registry: COVID-19 test results, vaccination (Pfizer, Moderna, or Johnson & Johnson) and COVID-19 symptoms. COVID-19 infections were described based on vaccination status at the time of infection: 1) fully vaccinated, 2) partially vaccinated (received first of two-dose vaccines or were < 14 days post-final dose), or 3) unvaccinated.Results: Among 8554 participants who received any COVID-19 vaccine, COVID-19 infections were reported by 74 (1.0%) of those who were fully vaccinated and 198 (2.3%) of those who were partially vaccinated at the time of infection. Among the 74 participants who reported a breakthrough infection after full vaccination, the median time from vaccination to reported positive test result was 104.5 days (interquartile range: 77– 135 days), with no difference among vaccine manufacturers. One quarter (25.7%) of breakthrough infections in the fully vaccinated cases were asymptomatic and most (> 97%) fully vaccinated participants reported no symptoms or only mild symptoms compared to 89.3% of the unvaccinated cases. Only 1.4% of fully vaccinated participants reported experiencing at least 3 moderate-to-severe symptoms compared to 7.8% in the unvaccinated.Conclusion: Person-generated health data, also referred to as patient-reported outcomes, is a useful approach for quantifying breakthrough infections and their severity and for comparing vaccines.Trial Registration: Clinicaltrials.gov NCT04368065, EU PAS Register EUPAS36240.Keywords: COVID-19, vaccines, breakthrough infections, SARS-CoV-2, symptoms, patient-reported outcomes
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- 2022