Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave

Uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcar...

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Main Authors: Yu-Ching Dai, Yen-Chia Lin, Lauren L. Ching, Alanna C. Tseng, Yujia Qin, Vivek R. Nerurkar, Wei-Kung Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-11-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2022.1019490/full
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author Yu-Ching Dai
Yen-Chia Lin
Lauren L. Ching
Lauren L. Ching
Alanna C. Tseng
Alanna C. Tseng
Yujia Qin
Vivek R. Nerurkar
Vivek R. Nerurkar
Wei-Kung Wang
Wei-Kung Wang
author_facet Yu-Ching Dai
Yen-Chia Lin
Lauren L. Ching
Lauren L. Ching
Alanna C. Tseng
Alanna C. Tseng
Yujia Qin
Vivek R. Nerurkar
Vivek R. Nerurkar
Wei-Kung Wang
Wei-Kung Wang
author_sort Yu-Ching Dai
collection DOAJ
description Uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcare workers or in long-term care facilities. Most BTIs were identified by reverse transcription-polymerase chain reaction (RT-PCR) or antigen test for individuals experiencing symptoms, known as symptomatic BTIs. In this study, we detected seroconversion of anti-nucleocapsid (N) antibody to identify both symptomatic and asymptomatic BTIs in a cohort of COVID-19-naive university employees and students following two or three doses of mRNA vaccines. We reported 4 BTIs among 85 (4.7%) participants caused by the Omicron and Delta VOC during the transition from the Delta to Omicron wave of the pandemic; three were symptomatic and confirmed by RT-PCR test and one asymptomatic. A symptomatic reinfection two and half months after a BTI was found in one participant. Two of three symptomatic BTIs and the reinfection were confirmed by whole genome sequencing. All were supported by a >4-fold increase in neutralizing antibodies against the Delta or Omicron variant. Moreover, we found both symptomatic and asymptomatic BTIs can boost neutralizing antibodies against VOC with variable degrees ranging from 2.5- to 77.4-fold increase in neutralizing antibody titers. As BTIs continue, our findings highlight the application of anti-N antibody test to ongoing studies of immunity induced by spike-based vaccine, and provide new insights into the establishment of herd immunity in the community during the post-vaccination era.
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spelling doaj.art-8e3901801ad840c08d21ee0be27080792022-12-22T02:44:27ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.10194901019490Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron waveYu-Ching Dai0Yen-Chia Lin1Lauren L. Ching2Lauren L. Ching3Alanna C. Tseng4Alanna C. Tseng5Yujia Qin6Vivek R. Nerurkar7Vivek R. Nerurkar8Wei-Kung Wang9Wei-Kung Wang10Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesPacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesPacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesPacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesPacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United StatesUncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcare workers or in long-term care facilities. Most BTIs were identified by reverse transcription-polymerase chain reaction (RT-PCR) or antigen test for individuals experiencing symptoms, known as symptomatic BTIs. In this study, we detected seroconversion of anti-nucleocapsid (N) antibody to identify both symptomatic and asymptomatic BTIs in a cohort of COVID-19-naive university employees and students following two or three doses of mRNA vaccines. We reported 4 BTIs among 85 (4.7%) participants caused by the Omicron and Delta VOC during the transition from the Delta to Omicron wave of the pandemic; three were symptomatic and confirmed by RT-PCR test and one asymptomatic. A symptomatic reinfection two and half months after a BTI was found in one participant. Two of three symptomatic BTIs and the reinfection were confirmed by whole genome sequencing. All were supported by a >4-fold increase in neutralizing antibodies against the Delta or Omicron variant. Moreover, we found both symptomatic and asymptomatic BTIs can boost neutralizing antibodies against VOC with variable degrees ranging from 2.5- to 77.4-fold increase in neutralizing antibody titers. As BTIs continue, our findings highlight the application of anti-N antibody test to ongoing studies of immunity induced by spike-based vaccine, and provide new insights into the establishment of herd immunity in the community during the post-vaccination era.https://www.frontiersin.org/articles/10.3389/fmed.2022.1019490/fullsevere acute respiratory syndrome coronavirus 2variants of concernbreakthrough infectionneutralizing antibodiesanti-nucleocapsid antibodywhole genome sequencing
spellingShingle Yu-Ching Dai
Yen-Chia Lin
Lauren L. Ching
Lauren L. Ching
Alanna C. Tseng
Alanna C. Tseng
Yujia Qin
Vivek R. Nerurkar
Vivek R. Nerurkar
Wei-Kung Wang
Wei-Kung Wang
Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
Frontiers in Medicine
severe acute respiratory syndrome coronavirus 2
variants of concern
breakthrough infection
neutralizing antibodies
anti-nucleocapsid antibody
whole genome sequencing
title Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
title_full Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
title_fullStr Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
title_full_unstemmed Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
title_short Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
title_sort identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti nucleocapsid antibody among fully vaccinated non healthcare workers during the transition from the delta to omicron wave
topic severe acute respiratory syndrome coronavirus 2
variants of concern
breakthrough infection
neutralizing antibodies
anti-nucleocapsid antibody
whole genome sequencing
url https://www.frontiersin.org/articles/10.3389/fmed.2022.1019490/full
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