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. 2024 Nov 14;42(25):126114.
doi: 10.1016/j.vaccine.2024.07.015. Epub 2024 Jul 16.

Duration of vaccine protection against breakthrough infections during five COVID-19 waves among healthcare workers primarily vaccinated with CoronaVac

Alessandra Luna-Muschi  1 , Igor Carmo Borges  2 , Antonio Dos Santos Barboza  3 , Elizabeth de Faria  3 , Marina Farrel Cortês  4 , Roseli B Santos  3 , Bianca Costa Silva  5 , Camila Alves Maia da Silva  5 , Esmenia Coelho Rocha  5 , Valquíria Reis de Souza  5 , Raissa H de Araujo Eliodoro  5 , Franciane Mendes de Oliveira  5 , Ana Carolina Mamana  6 , Amanda Miyuki Hidifira  4 , Marli Nishikawara  3 , Victor Bertollo Gomes Porto  7 , Ana Paula B Barboza  4 , Vanderson Sampaio  8 , Mariângela Simão  8 , Carolina S Lazari  9 , Aluisio C Segurado  10 , Esper G Kallas  10 , Ana Marli C Sartori  10 , Anna S Levin  10 , Ester Cerdeira Sabino  5 , Silvia Figueiredo Costa  11 ; Covid Seq group  5
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Duration of vaccine protection against breakthrough infections during five COVID-19 waves among healthcare workers primarily vaccinated with CoronaVac

Alessandra Luna-Muschi et al. Vaccine. .

Abstract

We aimed to characterise vaccine-induced protection against COVID-19 during five waves caused by Variants of Concern (VOCs). This is a nested case-control study of 3,972 HCW primarily vaccinated with CoronaVac (98%) that evaluated symptomatic SARS-CoV-2 breakthrough infections (BI) in almost two-years follow-up until the 3rd Omicron wave. Predictors of protection against SARS-CoV-2 BI were analysed using conditional logistic regression models. We included 1,491 SARS-CoV-2 breakthrough cases, mostly mild, and 2,962 controls. Most participants (90%) had received at least one booster before the onset of the Omicron waves, mainly BNT162b2. A multivariate logistic regression showed that vaccine-induced protection against BI wanes after six months regardless of the number of monovalent booster doses. Additionally, booster dose with BNT162b2 showed a trend for higher protection compared to CoronaVac during the Omicron waves. In conclusion, immunity of monovalent booster doses against SARS-CoV-2 is short-lasting. Individuals previously vaccinated with an inactivated vaccine should receive a BNT162B2 booster dose.

Keywords: Booster dose; COVID-19; COVID-19 vaccine; Inactivated vaccine; SARS-CoV-2 breakthrough infections.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [AMCS received a grant from Instituto Butantan (2021-2022) as Principal Investigator of a study that evaluated the immunogenicity and safety of CoronaVac in immunocompromised patients].

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