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Systematic Review

Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review

by
Shilpa Gopinath
1,*,
Angela Ishak
2,
Naveen Dhawan
3,4,5,
Sujan Poudel
2,
Prakriti Singh Shrestha
2,
Prabhjeet Singh
6,
Emily Xie
7,
Peggy Tahir
8,
Sima Marzaban
2,
Jack Michel
2 and
George Michel
9
1
Department of Internal Medicine, Division of Infectious Disease, Johns Hopkins University, Baltimore, MD 21205, USA
2
Division of Research and Academic Affairs, Larkin Community Hospital, South Miami, FL 33143, USA
3
Department of Bioengineering and Therapeutic Sciences, University of California San Francisco (UCSF), San Francisco, CA 94158, USA
4
Department of Bioengineering, University of California Berkeley, Berkeley, CA 94704, USA
5
Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, USA
6
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
7
Department of Plant and Microbial Biology, University of California, Berkeley, CA 94720, USA
8
University of California San Francisco (UCSF) Library, San Francisco, CA 94143, USA
9
Department of Internal Medicine, Larkin Community Hospital, South Miami, FL 33143, USA
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2022, 7(5), 81; https://doi.org/10.3390/tropicalmed7050081
Submission received: 17 April 2022 / Revised: 17 May 2022 / Accepted: 20 May 2022 / Published: 22 May 2022
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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Abstract

We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough infections (BTIs) in individuals who had completed a primary COVID-19 vaccination series. Thirty-three papers were included in the review. BTIs were more common among variants of concern (VOC) of which Delta accounted for the largest number of BTIs (96%), followed by Alpha (0.94%). In addition, 90% of patients with BTIs recovered, 11.6% were hospitalized with mechanical ventilation, and 0.6% resulted in mortality. BTIs were more common in healthcare workers (HCWs) and immunodeficient individuals with a small percentage found in fully vaccinated healthy individuals. VOC mutations were the primary cause of BTIs. Continued mitigation approaches (e.g., wearing masks and social distancing) are warranted even in fully vaccinated individuals to prevent transmission. Further studies utilizing genomic surveillance and heterologous vaccine regimens to boost the immune response are needed to better understand and control BTIs.
Keywords: COVID-19; SARS-CoV-2; variants; reinfections; breakthrough infections; vaccination COVID-19; SARS-CoV-2; variants; reinfections; breakthrough infections; vaccination

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MDPI and ACS Style

Gopinath, S.; Ishak, A.; Dhawan, N.; Poudel, S.; Shrestha, P.S.; Singh, P.; Xie, E.; Tahir, P.; Marzaban, S.; Michel, J.; et al. Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review. Trop. Med. Infect. Dis. 2022, 7, 81. https://doi.org/10.3390/tropicalmed7050081

AMA Style

Gopinath S, Ishak A, Dhawan N, Poudel S, Shrestha PS, Singh P, Xie E, Tahir P, Marzaban S, Michel J, et al. Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review. Tropical Medicine and Infectious Disease. 2022; 7(5):81. https://doi.org/10.3390/tropicalmed7050081

Chicago/Turabian Style

Gopinath, Shilpa, Angela Ishak, Naveen Dhawan, Sujan Poudel, Prakriti Singh Shrestha, Prabhjeet Singh, Emily Xie, Peggy Tahir, Sima Marzaban, Jack Michel, and et al. 2022. "Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review" Tropical Medicine and Infectious Disease 7, no. 5: 81. https://doi.org/10.3390/tropicalmed7050081

APA Style

Gopinath, S., Ishak, A., Dhawan, N., Poudel, S., Shrestha, P. S., Singh, P., Xie, E., Tahir, P., Marzaban, S., Michel, J., & Michel, G. (2022). Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review. Tropical Medicine and Infectious Disease, 7(5), 81. https://doi.org/10.3390/tropicalmed7050081

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