One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients - Report - MDSpire

One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients

  • By

  • José Luis Piñana

  • Lourdes Vazquez

  • Marisa Calabuig

  • Lucia López-Corral

  • Gabriel Martin-Martin

  • Lucia Villalon

  • Gabriela Sanz-Linares

  • Venancio Conesa-Garcia

  • Andrés Sanchez-Salinas

  • Beatriz Gago

  • Ana Facal

  • Irene Risco-Gálvez

  • María T. Olave

  • Ildefonso Espigado

  • Javier Lopez-Jimenez

  • José Ángel Hernández-Rivas

  • Alejandro Avendaño-Pita

  • Ignacio Arroyo

  • Elena Ferrer

  • Irene García-Cadenas

  • Clara González-Santillana

  • Alicia Roldán-Pérez

  • Blanca Ferrer

  • Manuel Guerreiro

  • María Suarez-Lledó

  • Angela Camara

  • Diana Campos-Beltrán

  • David Navarro

  • Ángel Cedillo

  • Anna Sureda

  • Carlos Solano

  • Rodrigo Martino

  • January 5, 2023

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Incidence and Protective Factors of Breakthrough SARS-CoV-2 in Vaccinated Hematological Patients

Overview

This prospective study of 1551 fully vaccinated patients with hematological disorders (HD) monitored breakthrough SARS-CoV-2 infections over one year. It found a significant incidence of breakthrough infections despite vaccination, with serological response and booster doses influencing infection risk and severity.

Background

Patients with hematological disorders are at high risk for severe COVID-19, with early pandemic mortality rates exceeding 25%. Vaccination has reduced mortality to below 10%, but breakthrough infections remain common due to impaired humoral and cellular immunity in this population. The first-generation vaccines reduce severe disease but do not fully prevent infection, especially with Omicron variants. There is a lack of prospective data on breakthrough infection incidence, severity, and protective factors in vaccinated HD patients.

Data Highlights

Time Point After VaccinationPatients with Serological AssessmentPatients with Quantitative Antibody Data
3–6 weeks1398 (90.1%)1250 (89%)
3 months1174 (76%)1070 (91%)
6 months1023 (66%)900 (88%)
12 months849 (55%)820 (97%)

Key Findings

  • Among 1551 fully vaccinated HD patients, breakthrough SARS-CoV-2 infections occurred despite vaccination and boosters.
  • Serological response measured by SARS-CoV-2-reactive IgG antibodies was assessed at multiple time points up to 12 months post-vaccination.
  • Booster doses and higher antibody titers were associated with reduced risk of breakthrough infection.
  • Missing serological data were random and did not bias the analysis of infection risk.
  • None of the patients received pre-exposure monoclonal antibody prophylaxis during the study period.

Clinical Implications

Regular monitoring of SARS-CoV-2 antibody levels in hematological patients can help identify those at higher risk of breakthrough infection. Booster vaccinations remain important to enhance protection in this vulnerable population. Clinicians should remain vigilant for breakthrough infections even in fully vaccinated HD patients due to their impaired immune responses.

Conclusion

This large prospective registry demonstrates that breakthrough SARS-CoV-2 infections are common in fully vaccinated hematological patients, but serological response and booster doses provide protective effects. Continued surveillance and tailored preventive strategies are essential for this high-risk group.

References

  1. GETH-TC/SEHH/2022 -- Incidence of Breakthrough SARS-CoV-2 Infections After One Year in Hematological Patients

Original Source(s)

One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients

  • by José Luis Piñana, Lourdes Vazquez, Marisa Calabuig, Lucia López-Corral, Gabriel Martin-Martin, Lucia Villalon, Gabriela Sanz-Linares, Venancio Conesa-Garcia, Andrés Sanchez-Salinas, Beatriz Gago, Ana Facal, Irene Risco-Gálvez, María T. Olave, Ildefonso Espigado, Javier Lopez-Jimenez, José Ángel Hernández-Rivas, Alejandro Avendaño-Pita, Ignacio Arroyo, Elena Ferrer, Irene García-Cadenas, Clara González-Santillana, Alicia Roldán-Pérez, Blanca Ferrer, Manuel Guerreiro, María Suarez-Lledó, Angela Camara, Diana Campos-Beltrán, David Navarro, Ángel Cedillo, Anna Sureda, Carlos Solano, Rodrigo Martino

  • January 5, 2023

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