Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project
Abstract Background SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. Methods Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulativ...
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| Format: | Article |
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Springer
2023-07-01
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| Series: | Journal of Epidemiology and Global Health |
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| Online Access: | https://doi.org/10.1007/s44197-023-00139-8 |
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| author | Stefano Porru Maria Grazia Lourdes Monaco Gianluca Spiteri Angela Carta Gulser Caliskan Concepción Violán Pere Torán-Monserrat Luigi Vimercati Silvio Tafuri Paolo Boffetta Francesco Saverio Violante Emma Sala Emanuele Sansone Fabriziomaria Gobba Loretta Casolari Andreas Wieser Christian Janke Adonina Tardon Marta Maria Rodriguez-Suarez Filippo Liviero Maria Luisa Scapellato Marco dell’Omo Nicola Murgia Dana Mates Violeta Claudia Calota Jozef Strhársky Mariana Mrázová Enrico Pira Alessandro Godono Greta Camilla Magnano Corrado Negro Giuseppe Verlato Orchestra WP5 Working Group |
| author_facet | Stefano Porru Maria Grazia Lourdes Monaco Gianluca Spiteri Angela Carta Gulser Caliskan Concepción Violán Pere Torán-Monserrat Luigi Vimercati Silvio Tafuri Paolo Boffetta Francesco Saverio Violante Emma Sala Emanuele Sansone Fabriziomaria Gobba Loretta Casolari Andreas Wieser Christian Janke Adonina Tardon Marta Maria Rodriguez-Suarez Filippo Liviero Maria Luisa Scapellato Marco dell’Omo Nicola Murgia Dana Mates Violeta Claudia Calota Jozef Strhársky Mariana Mrázová Enrico Pira Alessandro Godono Greta Camilla Magnano Corrado Negro Giuseppe Verlato Orchestra WP5 Working Group |
| author_sort | Stefano Porru |
| collection | DOAJ |
| description | Abstract Background SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. Methods Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. Results 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63–0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23–1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05–0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. Conclusions The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics. |
| first_indexed | 2024-03-12T04:10:49Z |
| format | Article |
| id | doaj.art-589839e139ed4fd0b612b4fef8269032 |
| institution | Directory Open Access Journal |
| issn | 2210-6014 |
| language | English |
| last_indexed | 2024-03-12T04:10:49Z |
| publishDate | 2023-07-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Epidemiology and Global Health |
| spelling | doaj.art-589839e139ed4fd0b612b4fef82690322023-09-03T11:04:57ZengSpringerJournal of Epidemiology and Global Health2210-60142023-07-0113357758810.1007/s44197-023-00139-8Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA ProjectStefano Porru0Maria Grazia Lourdes Monaco1Gianluca Spiteri2Angela Carta3Gulser Caliskan4Concepción Violán5Pere Torán-Monserrat6Luigi Vimercati7Silvio Tafuri8Paolo Boffetta9Francesco Saverio Violante10Emma Sala11Emanuele Sansone12Fabriziomaria Gobba13Loretta Casolari14Andreas Wieser15Christian Janke16Adonina Tardon17Marta Maria Rodriguez-Suarez18Filippo Liviero19Maria Luisa Scapellato20Marco dell’Omo21Nicola Murgia22Dana Mates23Violeta Claudia Calota24Jozef Strhársky25Mariana Mrázová26Enrico Pira27Alessandro Godono28Greta Camilla Magnano29Corrado Negro30Giuseppe Verlato31Orchestra WP5 Working GroupSection of Occupational Medicine, Department of Diagnostics and Public Health, University of VeronaOccupational Medicine Unit, University Hospital of VeronaOccupational Medicine Unit, University Hospital of VeronaSection of Occupational Medicine, Department of Diagnostics and Public Health, University of VeronaUnit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of VeronaInstitut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana NordInstitut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana NordInterdisciplinary Department of Medicine, University of BariInterdisciplinary Department of Medicine, University of BariDepartment of Medical and Surgical Sciences, University of BolognaDepartment of Medical and Surgical Sciences, University of BolognaUnit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali CiviliDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of BresciaDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio EmiliaHealth Surveillance Service, University Hospital of ModenaDivision of Infectious Diseases and Tropical Medicine, University Hospital, LMU MunichDivision of Infectious Diseases and Tropical Medicine, University Hospital, LMU MunichUniversity of Oviedo, Health Research Institute of Asturias (ISPA) and CIBERESPHUCA (SESPA), University of Oviedo, and Health Research Institute of Asturias (ISPA)Department of Cardiac Thoracic Vascular Sciences and Public Health, University of PadovaDepartment of Cardiac Thoracic Vascular Sciences and Public Health, University of PadovaSection of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of PerugiaDepartment of Environmental and Prevention Sciences, University of FerraraNational Institute of Public HealthNational Institute of Public HealthMedical Microbiology Department, Regional Authority of Public HealthPublic Health Institute, St. Elizabeth University of Health and Social WorkDepartment of Public Health and Pediatrics, University of TorinoDepartment of Public Health and Pediatrics, University of TorinoDepartment of Medical Sciences, Unit of Occupational Medicine, University of TriesteDepartment of Medical Sciences, Unit of Occupational Medicine, University of TriesteUnit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of VeronaAbstract Background SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. Methods Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. Results 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63–0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23–1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05–0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. Conclusions The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.https://doi.org/10.1007/s44197-023-00139-8SARS-CoV-2COVID-19 breakthrough infectionsCOVID-19 vaccineBooster vaccinationBooster doseVaccine effectiveness |
| spellingShingle | Stefano Porru Maria Grazia Lourdes Monaco Gianluca Spiteri Angela Carta Gulser Caliskan Concepción Violán Pere Torán-Monserrat Luigi Vimercati Silvio Tafuri Paolo Boffetta Francesco Saverio Violante Emma Sala Emanuele Sansone Fabriziomaria Gobba Loretta Casolari Andreas Wieser Christian Janke Adonina Tardon Marta Maria Rodriguez-Suarez Filippo Liviero Maria Luisa Scapellato Marco dell’Omo Nicola Murgia Dana Mates Violeta Claudia Calota Jozef Strhársky Mariana Mrázová Enrico Pira Alessandro Godono Greta Camilla Magnano Corrado Negro Giuseppe Verlato Orchestra WP5 Working Group Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project Journal of Epidemiology and Global Health SARS-CoV-2 COVID-19 breakthrough infections COVID-19 vaccine Booster vaccination Booster dose Vaccine effectiveness |
| title | Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project |
| title_full | Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project |
| title_fullStr | Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project |
| title_full_unstemmed | Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project |
| title_short | Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project |
| title_sort | incidence and determinants of symptomatic and asymptomatic sars cov 2 breakthrough infections after booster dose in a large european multicentric cohort of health workers orchestra project |
| topic | SARS-CoV-2 COVID-19 breakthrough infections COVID-19 vaccine Booster vaccination Booster dose Vaccine effectiveness |
| url | https://doi.org/10.1007/s44197-023-00139-8 |
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