Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 20;228(12):1680-1689.
doi: 10.1093/infdis/jiad336.

SARS-CoV-2 Reinfection Cases in a Household-Based Prospective Cohort in Rio de Janeiro

Stephanie L S Penetra  1 , Heloisa F P Santos  1 , Paola Cristina Resende  2 , Leonardo Soares Bastos  3 , Michele F B da Silva  1 , Anielle Pina-Costa  1 , Renata Serrano Lopes  2 , Leonardo Saboia-Vahia  2 , Any Caroline Alves de Oliveira  2 , Elisa Cavalcante Pereira  2 , Fernando Medeiros Filho  1 , Mayumi D Wakimoto  1 , Guilherme A Calvet  1 , Trevon L Fuller  1   4 , Jimmy Whitworth  5 , Christopher Smith  5   6 , Karin Nielsen-Saines  4 , Marilia Sá Carvalho  3 , Otávio M Espíndola  1 , Lusiele Guaraldo  1 , Marilda M Siqueira  2 , Patricia Brasil  1
Affiliations

SARS-CoV-2 Reinfection Cases in a Household-Based Prospective Cohort in Rio de Janeiro

Stephanie L S Penetra et al. J Infect Dis. .

Abstract

This was a household-based prospective cohort study conducted in Rio de Janeiro, in which people with laboratory-confirmed coronavirus disease 2019 (COVID-19) and their household contacts were followed from April 2020 through June 2022. Ninety-eight reinfections were identified, with 71 (72.5%) confirmed by genomic analyses and lineage definition in both infections. During the pre-Omicron period, 1 dose of any COVID-19 vaccine was associated with a reduced risk of reinfection, but during the Omicron period not even booster vaccines had this effect. Most reinfections were asymptomatic or milder in comparison with primary infections, a justification for continuing active surveillance to detect infections in vaccinated individuals. Our findings demonstrated that vaccination may not prevent infection or reinfection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Therefore we highlight the need to continuously update the antigenic target of SARS CoV-2 vaccines and administer booster doses to the population regularly, a strategy well established in the development of vaccines for influenza immunization programs.

Keywords: COVID-19; Omicron; SARS-CoV-2 infection; reinfections; vaccine breakthrough; variants of concern.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Timing of infections for reinfected and nonreinfected individuals; virological results for each participant (n = 331). The follow-up period for each individual in the cohort is represented by a horizontal gray line, starting from the recruitment date. The lines are stacked on each other to form a sloping curve. The vertical dashed line separates the pre-Omicron and Omicron periods. The red dots represent each participant's positive reverse transcription polymerase chain reaction (RT-PCR) result and gray dots represent negative RT-PCR results.
Figure 2.
Figure 2.
Characterization of SARS-CoV-2 reinfection episodes. Reinfection was diagnosed by the identification of distinct SARS-CoV-2 lineages in naso/oropharyngeal swabs using whole-genome sequencing or genomic inference. When viral identification was not possible, reinfection was defined as 2 positive RT-PCR results occurring within an interval of at least 90 days, with negative RT-PCR results within this interval. Abbreviations: RT-PCR, reverse transcription polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Figure 3.
Figure 3.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineages responsible for the first SARS-CoV-2 infectious episode and corresponding SARS-CoV-2 lineages responsible for the second infection. Different lineages, identified by whole-genome sequencing, are represented by different tones; the width of the linkages is proportional to the number of people infected with each SARS-CoV-2 lineage.
See this image and copyright information in PMC

References

    1. Bont L, Versteegh J, Swelsen WT, et al. Natural reinfection with respiratory syncytial virus does not boost virus-specific T-cell immunity. Pediatr Res 2002; 52:363–7. - PubMed
    1. Patel MM, York IA, Monto AS, Thompson MG, Fry AM. Immune-mediated attenuation of influenza illness after infection: opportunities and challenges. Lancet Microbe 2021; 2:E715–25. - PubMed
    1. Ringlander J, Nilsson S, Westin J, Lindh M, Martner A, Hellstrand K. Low incidence of reinfection with endemic coronaviruses diagnosed by real-time PCR. J Infect Dis 2021; 223:2013–4. - PMC - PubMed
    1. Guo YF, Han JJ, Zhang Y, et al. SARS-CoV-2 Omicron variant: epidemiological features, biological characteristics, and clinical significance. Front Immunol 2022; 13:877101. - PMC - PubMed
    1. Naveca FG, Nascimento V, de Souza VC, et al. COVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergence. Nat Med 2021; 27:1230. - PubMed

Publication types

Substances