DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214284

COVID-19 vaccination and breakthrough infections among healthcare workers: an online survey

Ramesh Masthi, Gowri Hebbar

Abstract


Background: COVID-19 vaccinations were started in India among health care workers in January, 2021. These vaccinations provide protective immunity against the infection but may not completely exclude the possibility of contracting the infection. The objective was to assess the risk of contracting COVID-19 disease following vaccination; to describe the adherence to COVID appropriate behavior by vaccinated individuals.

Methods: A cross-sectional study was conducted using an online questionnaire. The subjects selected were health care workers, medical students and other frontline workers. The sample size was 393. The risk of COVID-19 following vaccination was assessed against various factors like age, type of vaccination, status of vaccination, pre-existing comorbidities etc.

Results: Out of the 393 vaccinated subjects, 57 (14.5%) acquired COVID-19 breakthrough infection. Majority of these individuals (75.4%) experienced mild symptoms. All vaccinated individuals were protected from severe COVID-19 disease. Most vaccinated individuals continued to strictly adhere to COVID appropriate behavior i.e., masks (97.0% and 98.0%), sanitized hands (93.0% and 98.0%) and maintain social distanced (91.6% and 86%) in both fully and partially vaccinated groups following vaccination.

Conclusions: One tenth of the subjects were infected with COVID-19 following vaccination. Most experienced mild symptoms and risk of severe disease was significantly reduced.  There was no significant association between the type of vaccine administered and risk of infection.


Keywords


Breakthrough infection, COVID appropriate behaviour, COVID-19 vaccine

Full Text:

PDF

References


Corona virus disease (COVID-19). World Health Organization. Available at: https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19. Accessed on 1 July 2021.

Timeline: WHO’s COVID-19 response. Available at: https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/interactive-timeline?gclid=Cj0KCQjwu7OIBhCsARIsALxCUaOcIkbgQ0mrvE4jdxj5bRyjLw9ZFNkqIO5KP7NggichUxMHu3Iin1UaAhM8EALw_wcB#!. Accessed on 1 July 2021.

Weekly epidemiological update on COVID-19- 29 June 2021. World Health Organization. Available at: https://www.who.int/publications/m/item/ weekly-epidemiological-update-on-covid-19---29-june-2021. Accessed on 1 July 2021.

Tregoning JS, Brown ES, Cheeseman HM, Flight KE, Higham SL, Lemm NM, et al. Vaccines for COVID‐19. Clin Exp Immunol. 2020;202(2):162-92.

COVID-19 vaccine tracker and landscape. World Health Organization. Available at: https://www. who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines. Accessed on 6 May 2021.

Oliver S, Gargano J, Marin M, Wallace M, Curran KG, Chamberland M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Moderna COVID-19 Vaccine — United States, December 2020. MMWR Morb Mortal Wkly Rep. 2021;69:1653-6.

Pfizer and Biontech conclude phase 3 study of covid-19 vaccine candidate, meeting all primary efficacy endpoints. Available at:

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-conclude-phase-3-study-covid-19-vaccine. Accessed on 1 July 2021.

Sputnik V COVID-19 vaccine candidate appears safe and effective. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00191-4/fulltext. Accessed on 30 June 2021

Oysey, Merryn Aban, Marites, et al. Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials -United Kingdom, The Lancet. 2021;397(10277):881-91.

Phase 3 Clinical Trial of Covaxin, developed by ICMR and Bharat Biotech, shows 81% efficacy. Available at: https://pib.gov.in/Pressreleaseshare. aspx?PRID=1702293. Accessed on 18 May 2021.

Covid vaccination drive in India to begin from January 16, healthcare workers to get priority. India Today. Available at: https://www.indiatoday.in/ coronavirus-outbreak/story/coronavirus-vaccination-drive-india-begin-from-january-16-healthcare-workers-priority-1757458-2021-01-09. Accessed on 18 May 2021.

Bagcchi S. The world’s largest COVID-19 vaccination campaign. Lancet Infect Dis. 2021;21(3):323.

Revised guidelines for implementation of national COVID vaccination program. Available at: https://www.mohfw.gov.in/pdf/RevisedVaccinationGuidelines.pdf. Accessed on 8 August 2021.

Bergwerk M, Gonen T, Lustig Y, Amit S, Lipsitch M, Cohen C, et al. Covid-19 breakthrough infections in vaccinated health care workers. N Engl J Med. 2021;385:1474-84.

Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, et al. Post-vaccination SARS-CoV-2 infection: risk factors and illness profile in a prospective, observational community-based case-control study. MedRxiv. 2021.

Tyagi K, Ghosh A, Nair D, Dutta K, Bhandari PS, Ansari IA, et al. Breakthrough COVID-19 infections after vaccinations in healthcare and other workers in a chronic care medical facility in New Delhi, India. Diabetes Metab Syndr Clin Res Rev. 2021;15(3):1007-8.

Teran RA, Walblay KA, Shane EL, Xydis S, Gretsch S, Gagner A, et al. Postvaccination SARS‐CoV‐2 infections among skilled nursing facility residents and staff members-Chicago, Illinois, December 2020–March 2021. Am J Transpl. 2021;21(6):2290-7.

Second wave: Over 1,000 fully vaccinated Bengaluru cops tested Covid positive. Available at: https://timesofindia.indiatimes.com/city/ bengaluru/second-wave-over-1000-fully-vaccinated-bengaluru-cops-tested-covid-positive/articleshow/83681781.cms. Accessed on 30 June 2021.

Only 10% of Covid vaccine breakthroughs in Odisha needed hospitalisation: Study. Hindustan Times. Available at: https://www.hindustan-times.com/india-news/study-in-odisha-reports-75-breakthrough-infections-101624593473203.html. Accessed on 30 June 2021.

Two doses of COVID-19 vaccine offer 77% protection against hospitalisation, CMC Vellore study finds. Available at: https://www.thehindu.com/sci-tech/health/two-doses-of-covid-19-vaccine-offer-77-protection-against-hospitalisation-cmc-vellore-study-finds/article34788059.ece. Accessed on 1 July 2021.

Definition of vaccine breakthrough infection. Available at: https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html.Accessed on 26 October 2021.

Birhane M, Bressler S, Chang G, Clark T, Dorough L, Fischer M, et al. COVID-19 Vaccine Breakthrough Infections Reported to CDC- United States, January 1-April 30, 2021. Morb Mortal Week Rep. 2021;70(21):792-3.

Clinical guidance for management of adult Covid19 patients. Available at: https://covid.aiims.edu/clinical-guidance-for-management-of-adult-covid-19-patients/. Accessed on 30 June 2021.

Ramesh M, Sowmyashree U. Awareness of COVID 19 vaccine in a Rural Area near Bangalore, Karnataka. Nat J Community Med. 2021;12(3):72-5.

Qunaibi EA, Helmy M, Basheti I, Sultan I. A high rate of COVID-19 vaccine hesitancy in a large-scale survey on Arabs. Elife. 2021;10:e68038.

How much vaccines can India make? And the catch Businesstoday.in. Available at: https://www. businesstoday.in/coronavirus/story/after-launching-how-much-vaccine-can-india-make-and-the-catch-293353-2021-04-13. Accessed on 04 June 2021.

Coronavirus: AIIMS Study Claims Delta Variant Is Highly Infectious Even For Those Who Are Vaccinated. Etimes. Available at: https://time sofindia.indiatimes.com/life-style/health-fitness/health-news/coronavirus-aiims-study-claims-delta-variant-is-highly-infectious-even-for-those-who-are-vaccinated/photostory/83395457.cms? picid=83395462. Accessed on 30 June 2021.

Koh D. Occupational risks for COVID-19 infection. Occup Med. 2020;70(1):3-5.