Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals

Talia Kustin; Noam Harel; Uriah Finkel; Shay Perchik; Sheri Harari; Maayan Tahor; Itamar Caspi; Rachel Levy; Michael Leshchinsky; Shifra Ken Dror; Galit Bergerzon; Hala Gadban; Faten Gadban; Eti Eliassian; Orit Shimron; Loulou Saleh; Haim Ben-Zvi; Elena Keren Taraday; Doron Amichay; Anat Ben-Dor; Dana Sagas; Merav Strauss; Yonat Shemer Avni; Amit Huppert; Eldad Kepten; Ran D. Balicer; Doron Netzer; Shay Ben-Shachar; Adi Stern

doi:10.1038/s41591-021-01413-7

Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals

Talia Kustin, Noam Harel, Uriah Finkel, Shay Perchik, Sheri Harari, Maayan Tahor, Itamar Caspi, Rachel Levy, Michael Leshchinsky, Shifra Ken Dror, Galit Bergerzon, Hala Gadban, Faten Gadban, Eti Eliassian, Orit Shimron, Loulou Saleh, Haim Ben-Zvi, Elena Keren Taraday, Doron Amichay, Anat Ben-DorDana Sagas, Merav Strauss, Yonat Shemer Avni, Amit Huppert, Eldad Kepten, Ran D. Balicer, Doron Netzer, Shay Ben-Shachar^*, Adi Stern^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

228 Scopus citations

Abstract

The BNT162b2 mRNA vaccine is highly effective against SARS-CoV-2. However, apprehension exists that variants of concern (VOCs) may evade vaccine protection, due to evidence of reduced neutralization of the VOCs B.1.1.7 and B.1.351 by vaccine sera in laboratory assays. We performed a matched cohort study to examine the distribution of VOCs in infections of BNT162b2 mRNA vaccinees from Clalit Health Services (Israel) using viral genomic sequencing, and hypothesized that if vaccine effectiveness against a VOC is reduced, its proportion among breakthrough cases would be higher than in unvaccinated controls. Analyzing 813 viral genome sequences from nasopharyngeal swabs, we showed that vaccinees who tested positive at least 7 days after the second dose were disproportionally infected with B.1.351, compared with controls. Those who tested positive between 2 weeks after the first dose and 6 days after the second dose were disproportionally infected by B.1.1.7. These findings suggest reduced vaccine effectiveness against both VOCs within particular time windows. Our results emphasize the importance of rigorously tracking viral variants, and of increasing vaccination to prevent the spread of VOCs.

Original language	English
Pages (from-to)	1379-1384
Number of pages	6
Journal	Nature Medicine
Volume	27
Issue number	8
DOIs	https://doi.org/10.1038/s41591-021-01413-7
State	Published - Aug 2021

Funding

Funders	Funder number
AppsFlyer foundations
Edmond J. Safra Center for Bioinformatics
Horizon 2020 Framework Programme
H2020 European Research Council	852223
European Research Council
Israel Science Foundation	3963/19
Tel Aviv University

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41591-021-01413-7

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Kustin, T., Harel, N., Finkel, U., Perchik, S., Harari, S., Tahor, M., Caspi, I., Levy, R., Leshchinsky, M., Ken Dror, S., Bergerzon, G., Gadban, H., Gadban, F., Eliassian, E., Shimron, O., Saleh, L., Ben-Zvi, H., Keren Taraday, E., Amichay, D., ... Stern, A. (2021). Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals. Nature Medicine, 27(8), 1379-1384. https://doi.org/10.1038/s41591-021-01413-7

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title = "Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals",

abstract = "The BNT162b2 mRNA vaccine is highly effective against SARS-CoV-2. However, apprehension exists that variants of concern (VOCs) may evade vaccine protection, due to evidence of reduced neutralization of the VOCs B.1.1.7 and B.1.351 by vaccine sera in laboratory assays. We performed a matched cohort study to examine the distribution of VOCs in infections of BNT162b2 mRNA vaccinees from Clalit Health Services (Israel) using viral genomic sequencing, and hypothesized that if vaccine effectiveness against a VOC is reduced, its proportion among breakthrough cases would be higher than in unvaccinated controls. Analyzing 813 viral genome sequences from nasopharyngeal swabs, we showed that vaccinees who tested positive at least 7 days after the second dose were disproportionally infected with B.1.351, compared with controls. Those who tested positive between 2 weeks after the first dose and 6 days after the second dose were disproportionally infected by B.1.1.7. These findings suggest reduced vaccine effectiveness against both VOCs within particular time windows. Our results emphasize the importance of rigorously tracking viral variants, and of increasing vaccination to prevent the spread of VOCs.",

author = "Talia Kustin and Noam Harel and Uriah Finkel and Shay Perchik and Sheri Harari and Maayan Tahor and Itamar Caspi and Rachel Levy and Michael Leshchinsky and {Ken Dror}, Shifra and Galit Bergerzon and Hala Gadban and Faten Gadban and Eti Eliassian and Orit Shimron and Loulou Saleh and Haim Ben-Zvi and {Keren Taraday}, Elena and Doron Amichay and Anat Ben-Dor and Dana Sagas and Merav Strauss and {Shemer Avni}, Yonat and Amit Huppert and Eldad Kepten and Balicer, {Ran D.} and Doron Netzer and Shay Ben-Shachar and Adi Stern",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = aug,

doi = "10.1038/s41591-021-01413-7",

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Kustin, T, Harel, N, Finkel, U, Perchik, S, Harari, S, Tahor, M, Caspi, I, Levy, R, Leshchinsky, M, Ken Dror, S, Bergerzon, G, Gadban, H, Gadban, F, Eliassian, E, Shimron, O, Saleh, L, Ben-Zvi, H, Keren Taraday, E, Amichay, D, Ben-Dor, A, Sagas, D, Strauss, M, Shemer Avni, Y, Huppert, A, Kepten, E, Balicer, RD, Netzer, D, Ben-Shachar, S & Stern, A 2021, 'Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals', Nature Medicine, vol. 27, no. 8, pp. 1379-1384. https://doi.org/10.1038/s41591-021-01413-7

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AU - Kustin, Talia

AU - Harel, Noam

AU - Finkel, Uriah

AU - Perchik, Shay

AU - Harari, Sheri

AU - Tahor, Maayan

AU - Caspi, Itamar

AU - Levy, Rachel

AU - Leshchinsky, Michael

AU - Ken Dror, Shifra

AU - Bergerzon, Galit

AU - Gadban, Hala

AU - Gadban, Faten

AU - Eliassian, Eti

AU - Shimron, Orit

AU - Saleh, Loulou

AU - Ben-Zvi, Haim

AU - Keren Taraday, Elena

AU - Amichay, Doron

AU - Ben-Dor, Anat

AU - Sagas, Dana

AU - Strauss, Merav

AU - Shemer Avni, Yonat

AU - Huppert, Amit

AU - Kepten, Eldad

AU - Balicer, Ran D.

AU - Netzer, Doron

AU - Ben-Shachar, Shay

AU - Stern, Adi

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Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals

Abstract

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