BNT162b2 vaccine fatal breakthroughs in Israel during the third (alpha) wave

According to the Israeli Ministry of Health registry, by 26 April 2021, 397 fully vaccinated patients were hospitalized in Israel with PCR-proven COVID-19 after their second vaccine dose, 234 of them had severe COVID-19 and 90 died. The distribution of variants of concern between the groups showed that both had a majority of B.1.1.7 (alpha), whereas the two B.1.351 variants (beta) were from patients that survived. Co-morbidities were more common in patients with vaccine breakthrough infections compared with unvaccinated hospitalized patients,

including diabetes (48% versus 27.9%–34.7%), hypertension (71% versus 43.5%–62%), heart failure (28% versus 5.8%–12.8%), chronic lung diseases (24% versus 7.4%–16.5%), chronic kidney disease (32% versus 12.7%–22.8%) and cancer (24% versus 4.8%–10.8%). Anti-Spike IgG (immunoglobulin G, antibodies involved in secondary response) were found in lower numbers in serum of patients with a poor outcome.

The mortality rate in the cohort was similar to that in unvaccinated hospitalized COVID-19 patients. 

Additional prospective longitudinal studies are urgently needed to identify predictors for severe vaccine breakthrough infection.


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REFERENCE

Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021;27(11):1652-1657. doi:10.1016/j.cmi.2021.06.036

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