SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact.
SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact.
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DOI：
10.1038/s41577-021-00662-4
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Balicer RD
中科院分区：
文献类型：
--
作者：
Lipsitch M;Krammer F;Regev-Yochay G;Lustig Y;Balicer RD
在完全接种疫苗的个体中发生严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）的突破性感染正受到严格审查，因为它们在确定在高度接种疫苗的人群中控制病毒传播的限制需要保持多长时间以及确定是否需要额外的疫苗剂量或改变疫苗配方和/或给药间隔方面具有重要意义。突破性感染的测量在随机、安慰剂对照、双盲田间试验之外具有挑战性。然而，有必要进行实验室和观察性研究，以了解免疫力下降、病毒变异和其他决定疫苗有效性变化的因素对不同严重程度的2019冠状病毒病（COVID-19）的影响。在这里，我们描述了用于衡量疫苗有效性的方法，并提供了一个合成的新兴文献的疫苗有效性和突破率的决定因素。我们认为，与其试图将年龄、病毒变异和接种疫苗后的时间等因素的影响分开，不如将突破性感染的发生率最好地视为个体在任何时候的免疫水平、个体暴露的变异和疾病的严重程度的结果。我们还解决了有关向地方性转变的关键开放问题，改变疫苗配方以跟踪病毒变异的潜在需求，识别保护免疫相关性的需求，以及使用各种工具对抗突破性感染的公共卫生挑战，包括全球疫苗短缺时代的助推器。在这里，Lipsitch及其同事评估了在接种COVID-19疫苗的个体中发生的突破性SARS-CoV-2感染的影响。作者解释了如何测量突破性感染率，这些感染的原因是什么，并讨论了根据这些感染需要考虑的其他关键问题。
Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fully vaccinated individuals are receiving intense scrutiny because of their importance in determining how long restrictions to control virus transmission will need to remain in place in highly vaccinated populations as well as in determining the need for additional vaccine doses or changes to the vaccine formulations and/or dosing intervals. Measurement of breakthrough infections is challenging outside of randomized, placebo-controlled, double-blind field trials. However, laboratory and observational studies are necessary to understand the impact of waning immunity, viral variants and other determinants of changing vaccine effectiveness against various levels of coronavirus disease 2019 (COVID-19) severity. Here, we describe the approaches being used to measure vaccine effectiveness and provide a synthesis of the burgeoning literature on the determinants of vaccine effectiveness and breakthrough rates. We argue that, rather than trying to tease apart the contributions of factors such as age, viral variants and time since vaccination, the rates of breakthrough infection are best seen as a consequence of the level of immunity at any moment in an individual, the variant to which that individual is exposed and the severity of disease being considered. We also address key open questions concerning the transition to endemicity, the potential need for altered vaccine formulations to track viral variants, the need to identify immune correlates of protection, and the public health challenges of using various tools to counter breakthrough infections, including boosters in an era of global vaccine shortages. Here, Lipsitch and colleagues assess the impact of breakthrough SARS-CoV-2 infections that occur in individuals who have been vaccinated against COVID-19. The authors explain how the rate of breakthrough infections can be measured, what the causes of these infections are and discuss other key questions that need to be considered in light of these infections.
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DOI：
10.1056/nejmoa2113017
发表时间：
2021-11-04
期刊：
The New England journal of medicine
影响因子：
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COVE Study Group
DOI：
10.1126/science.abm0620
发表时间：
2022-01-21
期刊：
Science (New York, N.Y.)
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影响因子：
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DOI：
10.1016/s1473-3099(21)00460-6
发表时间：
2022-01
期刊：
The Lancet. Infectious diseases
影响因子：
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Antonelli M;Penfold RS;Merino J;Sudre CH;Molteni E;Berry S;Canas LS;Graham MS;Klaser K;Modat M;Murray B;Kerfoot E;Chen L;Deng J;Österdahl MF;Cheetham NJ;Drew DA;Nguyen LH;Pujol JC;Hu C;Selvachandran S;Polidori L;May A;Wolf J;Chan AT;Hammers A;Duncan EL;Spector TD;Ourselin S;Steves CJ
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Steves CJ
DOI：
10.1101/2020.06.15.153387
发表时间：
2021-01-01
期刊：
JACC. Basic to translational science
影响因子：
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作者：
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通讯作者：
Bix, Gregory J