Revealing COVID-19 breakthrough infection rates among vaccinated individuals at a tertiary care centre in South India
-
Vanathy Kandhasamy
,
Ramya Priyadarshini
,
Namrata Krishna Bhosale
,
Raji Ramachandran Pillai
,
Malarvizhi Ramalingam
,
Agiesh Kumar Balakrishna Pillai
,
Ezhumalai Govindasamy
,
Joshy Maducolil Easow
Abstract
Background and Objectives: The COVID-19 pandemic was mitigated by the rapid development and deployment of vaccines. While vaccines reduce infection severity, breakthrough infections (BTIs) still occur. The CDC defines BTI as a positive SARS-CoV-2 test ≥14 days post-vaccination. This study investigates the occurrence of COVID-19 BTIs at a tertiary care hospital in Puducherry, South India.
Materials and Methods: This retrospective study analysed hospital tested qRT-PCR data of individuals from the ICMR portal (March 2021–March 2022). Demographic and vaccination details were extracted.
Results: Among 8001 tested individuals, 1452 were vaccinated. The BTI rate decreased from 16.6% to 1.2% after the first dose and from 58% to 40% after the second one. Odds ratio indicated a 74% reduction in infection risk for vaccinated individuals compared to unvaccinated. Males had higher infection rates than females, regardless of vaccination status.
Conclusion: Our study demonstrates a higher BTI rate after one vaccine dose compared to two doses. The BTI rate also increased four months post-vaccination, even with two doses, potentially due to waning immunity and the emergence of new variants. Therefore, continued adherence to preventive measures in conjunction with vaccination is crucial for minimizing COVID-19 transmission.
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24. Balachandran S, Moni M, Sathyapalan DT, Varghese P, Jose MP, Murugan MR, et al. A comparison of clinical outcomes between vaccinated and vaccine-naive patients of COVID-19, in four tertiary care hospitals of Kerala, South India. Clin Epidemiol Glob Health 2022; 13: 100971.
25. Muthukrishnan J, Vardhan V, Mangalesh S, Koley M, Shankar S, Yadav AK, et al. Vaccination status and COVID-19 related mortality: A hospital based cross sectional study. Med J Armed Forces India 2021; 77(Suppl 2): S278-S282.
26. Butt AA, Nafady-Hego H, Chemaitelly H, Abou-Samra AB, Khal AA, Coyle PV, et al. Outcomes among patients with breakthrough SARS-CoV-2 infection after vaccination. Int J Infect Dis 2021; 110: 353-358.
27. Pijls BG, Jolani S, Atherley A, Dijkstra JIR, Franssen GHL, Hendriks S, et al. Temporal trends of sex differences for COVID-19 infection, hospitalisation, severe disease, intensive care unit (ICU) admission and death: a meta-analysis of 229 studies covering over 10M patients. F1000Res 2022; 11: 5.
28. Fernandez-de-Las-Penas C, Martin-Guerrero JD, Pellicer-Valero OJ, Navarro-Pardo E, Gómez-Mayordomo V, Cuadrado ML, et al. Female sex is a risk factor associated with long-term post-COVID related-symptoms but not with COVID-19 symptoms: The LONG-COVID-EXP-CM multicenter study. J Clin Med 2022; 11: 413.
2. Almaghaslah D, Kandasamy G, Almanasef M, Vasudevan R, Chandramohan S. Review on the coronavirus disease (COVID-19) pandemic: Its outbreak and current status. Int J Clin Pract 2020; 74(11): e13637.
3. Tang S, Mao Y, Jones RM, Tan Q, Ji JS, Li N, et al. Aerosol transmission of SARS-CoV-2? Evidence, prevention and control. Environ Int 2020; 144: 106039.
4. WHO (2023). Weekly epidemiological update on COVID-19 - 10 August 2023. Available from:
https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---10-august-2023
5. WHO (2022). Weekly epidemiological update on COVID-19 - 14 September 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---14-september-2022
6. Gupta S, Smith L, Diakiw A. Avoidance of COVID-19 for Children and Adolescents and Isolation Precautions. Pediatr Clin North Am 2021; 68: 1103-1118.
7. Kashte S, Gulbake A, El-Amin Iii SF, Gupta A. COVID-19 vaccines: rapid development, implications, challenges and future prospects. Hum Cell 2021; 34: 711-733.
8. Das S, Kar SS, Samanta S, Banerjee J, Giri B, Dash SK. Immunogenic and reactogenic efficacy of Covaxin and Covishield: a comparative review. Immunol Res 2022; 70: 289-315.
9. Vaishya R, Sibal A, Malani A, Kar S, Prasad K H, Sv K, et al. Symptomatic post-vaccination SARS-CoV-2 infections in healthcare workers- A multicenter cohort study. Diabetes Metab Syndr 2021; 15: 102306.
10. Tyagi K, Ghosh A, Nair D, Dutta K, Singh Bhandari P, Ahmed Ansari I, et al. Breakthrough COVID19 infections after vaccinations in healthcare and other workers in a chronic care medical facility in New Delhi, India. Diabetes Metab Syndr 2021; 15: 1007-1008.
11. Behera P, Singh AK, Subba SH, Mc A, Sahu DP, Chandanshive PD, et al. Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India. Hum Vaccin Immunother 2022; 18: 2034456.
12. Arora G, Taneja J, Bhardwaj P, Goyal S, Naidu K, Yadav SK, et al. Adverse events and breakthrough infections associated with COVID-19 vaccination in the Indian population. J Med Virol 2022; 94: 3147-3154.
13. Parameswaran A, Apsingi S, Eachempati KK, Dannana CS, Jagathkar G, Iyer M, et al. Incidence and severity of COVID-19 infection post-vaccination: a survey among Indian doctors. Infection 2022; 50: 889-895.
14. Kaur U, Bala S, Ojha B, Jaiswal S, Kansal S, Chakrabarti SS. Occurrence of COVID-19 in priority groups receiving ChAdOx1 nCoV-19 coronavirus vaccine (recombinant): A preliminary analysis from north India. J Med Virol 2022; 94: 407-412.
15. Malhotra V, Oberoi S, Khaira R, Balgir RS, Kaur B, Kaura S. A study to assess symptom profile and break through infections among health care workers post covid vaccination at tertiary care health facility. Indian J Community Med 2022; 47: 369-374.
16. Krishna B, Gupta A, Meena K, Gaba A, Krishna S, Jyoti R, et al. Prevalence, severity, and risk factor of breakthrough infection after vaccination with either the Covaxin or the Covishield among healthcare workers: A nationwide cross-sectional study. J Anaesthesiol Clin Pharmacol 2022; 38(Suppl 1): S66-S78.
17. Murugesan M, Mathews P, Paul H, Karthik R, Mammen JJ, Rupali P. Protective effect conferred by prior infection and vaccination on COVID-19 in a healthcare worker cohort in South India. PLoS One 2022; 17(5): e0268797.
18. Contractor A, Shivaprakash S, Tiwari A, Setia MS, Gianchandani T. Effectiveness of Covid-19 vaccines (CovishieldTM and Covaxin ®) in healthcare workers in Mumbai, India: A retrospective cohort analysis. PLoS One 2022; 17(10): e0276759.
19. Hacisuleyman E, Hale C, Saito Y, Blachere NE, Bergh M, Conlon EG, et al. Vaccine breakthrough infections with SARS-CoV-2 variants. N Engl J Med 2021; 384: 2212-2218.
20. Farinholt T, Doddapaneni H, Qin X, Menon V, Meng Q, Metcalf G, et al. Transmission event of SARS-CoV-2 delta variant reveals multiple vaccine breakthrough infections. BMC Med 2021; 19: 255.
21. Mishra M, Chaudhry R, Rana F, Rana F, Nag DS, Rai S. Serosurveillance of health care workers in a COVID hospital: immune response, and its longevity. Cureus 2021; 13(3): e14020.
22. Vitale J, Mumoli N, Clerici P, De Paschale M, Evangelista I, Cei M, et al. Assessment of SARS-CoV-2 reinfection 1 year after primary infection in a population in Lombardy, Italy. JAMA Intern Med 2021; 181: 1407-1408.
23. Mor V, Gutman R, Yang X, White EM, McConeghy KW, Feifer RA, et al. Short-Term impact of nursing home SARS-CoV -2 vaccinations on new infections, hospitalizations, and deaths. J Am Geriatr Soc 2021; 69: 2063-2069.
24. Balachandran S, Moni M, Sathyapalan DT, Varghese P, Jose MP, Murugan MR, et al. A comparison of clinical outcomes between vaccinated and vaccine-naive patients of COVID-19, in four tertiary care hospitals of Kerala, South India. Clin Epidemiol Glob Health 2022; 13: 100971.
25. Muthukrishnan J, Vardhan V, Mangalesh S, Koley M, Shankar S, Yadav AK, et al. Vaccination status and COVID-19 related mortality: A hospital based cross sectional study. Med J Armed Forces India 2021; 77(Suppl 2): S278-S282.
26. Butt AA, Nafady-Hego H, Chemaitelly H, Abou-Samra AB, Khal AA, Coyle PV, et al. Outcomes among patients with breakthrough SARS-CoV-2 infection after vaccination. Int J Infect Dis 2021; 110: 353-358.
27. Pijls BG, Jolani S, Atherley A, Dijkstra JIR, Franssen GHL, Hendriks S, et al. Temporal trends of sex differences for COVID-19 infection, hospitalisation, severe disease, intensive care unit (ICU) admission and death: a meta-analysis of 229 studies covering over 10M patients. F1000Res 2022; 11: 5.
28. Fernandez-de-Las-Penas C, Martin-Guerrero JD, Pellicer-Valero OJ, Navarro-Pardo E, Gómez-Mayordomo V, Cuadrado ML, et al. Female sex is a risk factor associated with long-term post-COVID related-symptoms but not with COVID-19 symptoms: The LONG-COVID-EXP-CM multicenter study. J Clin Med 2022; 11: 413.
| Files | ||
| Issue | Vol 17 No 2 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v17i2.18380 | |
| Keywords | ||
| Breakthrough infections; SARS-CoV-2 virus; COVID-19; Vaccination; Outbreak | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kandhasamy V, Priyadarshini R, Bhosale N, Pillai R, Ramalingam M, Balakrishna Pillai A, Govindasamy E, Maducolil Easow J. Revealing COVID-19 breakthrough infection rates among vaccinated individuals at a tertiary care centre in South India. Iran J Microbiol. 2025;17(2):194-203.
