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. 2022 Mar 23;74(6):1089-1092.
doi: 10.1093/cid/ciab581.

Variants of Concern Are Overrepresented Among Postvaccination Breakthrough Infections of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Washington State

Abbye E McEwen  1 , Seth Cohen  2 , Chloe Bryson-Cahn  2 , Catherine Liu  3 , Steven A Pergam  3 , John Lynch  2 , Adrienne Schippers  4 , Kathy Strand  4 , Estella Whimbey  2 , Nandita S Mani  2 , Allison J Zelikoff  5 , Vanessa A Makarewicz  5 , Elizabeth R Brown  3 , Shah A Mohamed Bakhash  1 , Noah R Baker  1 , Jared Castor  1 , Robert J Livingston  1 , Meei-Li Huang  1 , Keith R Jerome  1   3 , Alexander L Greninger  1   3 , Pavitra Roychoudhury  1   3
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Variants of Concern Are Overrepresented Among Postvaccination Breakthrough Infections of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Washington State

Abbye E McEwen et al. Clin Infect Dis. .

Abstract

Across 20 vaccine breakthrough cases detected at our institution, all 20 (100%) infections were due to variants of concern (VOCs) and had a median Ct of 20.2 (IQR, 17.1-23.3). When compared with 5174 contemporaneous samples sequenced in our laboratory, VOCs were significantly enriched among breakthrough infections (P < .05).

Keywords: SARS-CoV-2; sequencing; vaccine breakthrough; variants of concern.

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Figures

Figure 1.
Figure 1.
Variants of concern are overrepresented in vaccine breakthrough SARS-CoV-2 genomes. A, Cumulative number of breakthrough cases and their Pangolin lineages. B, Proportions of lineages for UWVL sequences collected during the same time period. Relative risk of vaccine escape for each VOC (C) and spike amino acid change (D). Error bars represent 95% confidence intervals. *P < .05, **P < .01 (Fisher’s exact test). Abbreviations: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; UWVL, University of Washington Virology Lab; VOC, variant of concern (total); VOC-R, variant of concern with reduced neutralization; VOC-WT, variant of concern without reduced neutralization; VOI, variant of interest.
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