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Persistent SARS-COV-2 infection in vaccinated individual with three doses of COVID-19 vaccine.

ABSTRACT: We describe a case of a 24-year-old Brazilian woman previously vaccinated with CoronaVac and a booster dose of Pfizer-BioNTech, with mild-to-moderate COVID-19, with persistent viral shedding. We evaluated viral load, antibody dynamics for SARS-CoV-2 and performed genomic analysis to identify the viral variant. The female remained positive for 40 days following symptom onset (cycle quantification mean: 32.54 ± 2.29). The humoral response was characterized by absence of IgM for the viral spike protein, increased IgG for the viral spike (1800.60 to 19558.60 AU/mL) and for the nucleocapsid (from 0.03 to 8.9 index value) proteins, and high titers of neutralizing antibodies (>488.00 IU/mL). The variant identified was the sublineage BA. 5.1. of Omicron (B.1.1.529). Our results suggest that even though the female produced an antibody response against SARS-CoV-2, the persistent infection can be explained by antibody decline and/or the immune evasion by the Omicron variant, illustrating the need to revaccinate or update vaccines.

SUBMITTER: Silva Vasconcelos G

PROVIDER: S-EPMC9910026 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Persistent SARS-COV-2 infection in vaccinated individual with three doses of COVID-19 vaccine.

Silva Vasconcelos Germana G da Conceição Rodrigues Fernandes Maria M Cardoso Matsui Tamires T Claudia Dos Santos Luciano Maria M Leite Costa Cecilia C Perdigão Mello Ferraz Clarissa C Braga Stehling Dias Fernando F Miyajima Fabio F Montenegro de Carvalho Araújo Fernanda F Helena Gambim Fonseca Marcela M

Vaccine 20230209 11

We describe a case of a 24-year-old Brazilian woman previously vaccinated with CoronaVac and a booster dose of Pfizer-BioNTech, with mild-to-moderate COVID-19, with persistent viral shedding. We evaluated viral load, antibody dynamics for SARS-CoV-2 and performed genomic analysis to identify the viral variant. The female remained positive for 40 days following symptom onset (cycle quantification mean: 32.54 ± 2.29). The humoral response was characterized by absence of IgM for the viral spike pro ...[more]

PMID: 36797096

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Project description:BackgroundMyocarditis is more common after severe acute respiratory syndrome coronavirus 2 infection than after COVID-19 vaccination, but the risks in younger people and after sequential vaccine doses are less certain.MethodsA self-controlled case series study of people ages 13 years or older vaccinated for COVID-19 in England between December 1, 2020, and December 15, 2021, evaluated the association between vaccination and myocarditis, stratified by age and sex. The incidence rate ratio and excess number of hospital admissions or deaths from myocarditis per million people were estimated for the 1 to 28 days after sequential doses of adenovirus (ChAdOx1) or mRNA-based (BNT162b2, mRNA-1273) vaccines, or after a positive SARS-CoV-2 test.ResultsIn 42 842 345 people receiving at least 1 dose of vaccine, 21 242 629 received 3 doses, and 5 934 153 had SARS-CoV-2 infection before or after vaccination. Myocarditis occurred in 2861 (0.007%) people, with 617 events 1 to 28 days after vaccination. Risk of myocarditis was increased in the 1 to 28 days after a first dose of ChAdOx1 (incidence rate ratio, 1.33 [95% CI, 1.09-1.62]) and a first, second, and booster dose of BNT162b2 (1.52 [95% CI, 1.24-1.85]; 1.57 [95% CI, 1.28-1.92], and 1.72 [95% CI, 1.33-2.22], respectively) but was lower than the risks after a positive SARS-CoV-2 test before or after vaccination (11.14 [95% CI, 8.64-14.36] and 5.97 [95% CI, 4.54-7.87], respectively). The risk of myocarditis was higher 1 to 28 days after a second dose of mRNA-1273 (11.76 [95% CI, 7.25-19.08]) and persisted after a booster dose (2.64 [95% CI, 1.25-5.58]). Associations were stronger in men younger than 40 years for all vaccines. In men younger than 40 years old, the number of excess myocarditis events per million people was higher after a second dose of mRNA-1273 than after a positive SARS-CoV-2 test (97 [95% CI, 91-99] versus 16 [95% CI, 12-18]). In women younger than 40 years, the number of excess events per million was similar after a second dose of mRNA-1273 and a positive test (7 [95% CI, 1-9] versus 8 [95% CI, 6-8]).ConclusionsOverall, the risk of myocarditis is greater after SARS-CoV-2 infection than after COVID-19 vaccination and remains modest after sequential doses including a booster dose of BNT162b2 mRNA vaccine. However, the risk of myocarditis after vaccination is higher in younger men, particularly after a second dose of the mRNA-1273 vaccine.

Dataset Information

Persistent SARS-COV-2 infection in vaccinated individual with three doses of COVID-19 vaccine.

Publications

Persistent SARS-COV-2 infection in vaccinated individual with three doses of COVID-19 vaccine.

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