SECONDARY INFECTIONS IN THE FAMILY FROM PRIMARY CASES OF COVID-19 BREAKTHROUGH INFECTIONS IN FULLY VACCINATED OR NOT FULLY VACCINATED PEOPLE. TWO DOSES MODESTLY REDUCE FAMILY TRANSMISSION BUT DOES NOT ELIMINATE IT
Keywords:
COVID-19, SARS-CoV-2, Epidemiological characteristic, Household contact, Secondary attack rate
Abstract
Background It is unclear whether vaccination of individuals against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) protects members of their households.
Objective Epidemiological evaluation of SARS-CoV-2 transmissibility from fully and incompletely vaccinated index cases with COVID-19 breakthrough infection to initially uninfected family members (secondary attack rate)
Methodology An observational, longitudinal, and prospective study of all families with a primary case of COVID-19 breakthrough infection in fully vaccinated or not fully vaccinated people and at least one COVID-19 secondary case in family members was conducted from February to November 2021 in a general medicine office in Toledo, Spain. Clinical and epidemiological variables were compared between secondary cases of primary cases of COVID-19 breakthrough infection in fully vaccinated people versus secondary cases of primary cases of COVID-19 breakthrough infection in not fully vaccinated people.
Results Twenty-five index cases (25 families; 84 people) were included, 13 fully vaccinated, which gave rise to 20 secondary cases, and 12 not fully vaccinated, which gave rise to 21 secondary cases. The secondary attack rate of exposed family members to fully vaccinated primary cases were 61% (20/33), and the secondary attack rate of exposed family members to not fully vaccinated primaries was 81% (21/33).
Conclusions In the context of general medicine in Toledo (Spain), from February to November 2021 (before omicron), two doses of COVID-19 vaccine vs. only one modestly reduce family transmission but do not eliminate it.
References
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12. Eyre DW, Taylor D, Purver M, et al. (2021) The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission. MedRxiv; 2021.09.28.21264260. https://doi.org/10.1101/2021.09.28.21264260
13. Turabian JL (1995) [Notebooks of Family and Community Medicine. An introduction to the principles of Family Medicine]. Madrid: Díaz de Santos.
http://www.amazon.co.uk/Cuadernos-medicina-familia-y-comunitaria/dp/8479781920
14.Nandí-Lozano E, Espinosa LE, Viñas-Flores L, Avila-Figueroa C (2002) [Acute respiratory infection in children who go to a child development center]. Salud Publica Mex; 44:201-6. https://www.scielosp.org/article/spm/2002.v44n3/201-206/es/
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18. Mao S, Huang T, Yuan H, et al. (2020) Epidemiological analysis of 67 local COVID-19 clusters in Sichuan Province, China. BMC Public Health; 20: 1525. https://doi.org/10.1186/s12889-020-09606-4
19. Strauss AL (1984) Chronic illness and the quality of life. St Louis: The C.V. Mosby Company.
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21. Royal College of General Practitioners (1986) The Classification and Analisis of General Practice Data. Ocasional Paper 26.
22. Donaldson RJ, Donaldson LJ (1983) Essential Comunity Medicine. Lancaster: MTP Press.
23. Turabian JL (2017) Family Genogram in General Medicine: A Soft Technology that can be Strong. An Update. Res Med Eng Sci; 3(1). http://crimsonpublishers.com/rmes/pdf/RMES.000551.pdf
24. Russell LT (2020) Capturing Family Complexity in Family Nursing Research and Practice. J Fam Nurs; 26(4):287-93. https://journals.sagepub.com/doi/10.1177/1074840720965396
25.-Watts C, Shrader E (1998) How to do (or not to do)… The genogram: a new research tool to document patterns of decision-making, conflict and vulnerability within households. Health Policy Plan; 13: 459-64. https://academic.oup.com/heapol/article/13/4/459/596227
26. McIlvain H, Crabtree B, Medder J, et al. (1998) Using practice genograms to understand and describe practice configurations. Fam Med; 30: 490-6. https://pubmed.ncbi.nlm.nih.gov/9669161/
27. Consejería de Sanidad Castilla La Mancha (2021) https://sanidad.castillalamancha.es/ciudadanos/enfermedades-infecciosas/coronavirus/preguntas-frecuentes-sobre-el-coronavirus-covid-19/campa%C3%B1a-vacunacion
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30. Shamier MC, Tostmann A, Bogers S, et al. (2021) Virological characteristics of SARS-CoV-2 vaccine breakthrough infections in health care workers. MedRxiv2021.08.20.21262158. https://doi.org/10.1101/2021.08.20.21262158
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32. Ramirez E, Wilkes RP, Carpi G, Dorman J, Bowen C, Smith L (2021) SARS-CoV-2 Breakthrough Infections in Fully Vaccinated Individuals. MedRxiv2021.06.21.21258990. https://doi.org/10.1101/2021.06.21.21258990
33. Smriti Mallapaty (2021) COVID vaccines slash viral spread – but Delta is an unknown. Studies show that vaccines reduce the spread of SARS-CoV-2 by more than 80%, but the Delta variant is creating fresh uncertainty. Nature; 27 July. https://doi.org/10.1038/d41586-021-02054-z
34. Cuppini L (2021) [What happens when you get Covid being vaccinated? In vaccinated people, the coronavirus stays in the nose and for a few days]. El Mundo; Martes, 3 agosto. https://www.elmundo.es/ciencia-y-salud/salud/2021/08/03/6108cf92fc6c83ee208b459b.html
35. Burioni R, Topol EJ (2021) Has SARS-CoV-2 reached peak fitness?. Nat Med;27: 1323–4. https://doi.org/10.1038/s41591-021-01421-7
36. Lopez Bernal J, Andrews N, Gower C, et al. (2021) Effectiveness of Covid-19 vaccines against the B.1.617.2 (delta) variant. N Engl J Med; 385:585-94. https://europepmc.org/article/MED/34289274#free-full-text
37.Gorvett Z (2021) How effective is a single vaccine dose against. BEST OF BBC FUTURE | COVID-19 Covid-19? BBC; 15th January 2021. https://www.bbc.com/future/article/20210114-covid-19-how-effective-is-a-single-vaccine-dose
38.Chodick G, Tene L, Patalon T, et al. (2021) Assessment of Effectiveness of 1 Dose of BNT162b2 Vaccine for SARS-CoV-2 Infection 13 to 24 Days After Immunization. JAMA Netw Open; 4(6): e2115985. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780700
39. Polack FP, Thomas SJ, Kitchin N, et al. (2020) Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med; 383: 2603-15. https://pubmed.ncbi.nlm.nih.gov/33301246/
40. Turabian JL (2022) Transmissibility of primary cases not completely vaccinated and effectiveness of incomplete vaccination against SARS-Cov-2 in secondary cases in the household. study of 12 families from February 1 to November, 30, 2021 (before omicron), in a general medicine office in Toledo, Spain: it is a very bad idea not to complete vaccination. Annals of Public Health & Epidemiology. In Press. https://irispublishers.com/aphe/article-in-press.php
41. Roa R (2021) [Vaccines decrease contagion?]. La biblioteca de Springfield;19 de noviembre. https://rubenroa.blogspot.com/2021/11/las-vacunas-disminuyen-el-contagio.html
42. Bosetti P, Tran Kiem C, Andronico A, et al. (2022) Epidemiology and control of SARS-CoV-2 epidemics in partially vaccinated populations: a modeling study applied to France. BMC Med; 20: 33. https://doi.org/10.1186/s12916-022-02235-1
43. Butt AA, Nafady-Hego H, Chemaitelly H, et al. Hiam Chemaitelly,(2921) Outcomes Among Patients with Breakthrough SARS-CoV-2 Infection After Vaccination. Int J Infect Dis; 110: 353-8. https://www.ijidonline.com/article/S1201-9712(21)00639-1/fulltext
44. Thompson MG, Burgess JL, Naleway AL, et al. (2021) Prevention and attenuation of Covid-19 with the BNT162b2 and mRNA-1273 vaccines. N Engl J Med; 385:320-9. https://doi.org/10.1056/NEJMoa2107058
45. Shrotri M, Navaratnam AMD, Nguyen V, et al. (2021) Spike-antibody waning after second dose of BNT162b2 or ChAdOx1. Lancet. https://doi.org/10.1016/S0140-6736(21)01642-1
46. Mahase E (2021) Covid-19: Most people admitted to hospital after vaccination were infected before immunity could develop, research shows. BMJ; 373: n1127. https://www.bmj.com/content/373/bmj.n1127?utm_source=etoc&utm_medium=email&utm_campaign=tbmj&utm_content=weekly&utm_term=20210507
47. White EM, Yang X, Feifer RA, Gravenstein S, Mor V (2021) Incident SARS-CoV-2 Infection among mRNA-Vaccinated and Unvaccinated Nursing Home Residents. N Engl J Med. https://www.nejm.org/doi/full/10.1056/NEJMc2104849?query=WB
49. Dean NE, Hogan JW, Schnitzer ME (2021) Covid-19 Vaccine Effectiveness and the Test-Negative Design. N Engl J Med. https://www.nejm.org/doi/full/10.1056/NEJMe2113151?query=TOC&cid=NEJM%20eToc,%20September%209,%202021%20DM277747_NEJM_Non_Subscriber&bid=607481677
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Published
2022-03-20
How to Cite
Turabian, J. L. (2022). SECONDARY INFECTIONS IN THE FAMILY FROM PRIMARY CASES OF COVID-19 BREAKTHROUGH INFECTIONS IN FULLY VACCINATED OR NOT FULLY VACCINATED PEOPLE. TWO DOSES MODESTLY REDUCE FAMILY TRANSMISSION BUT DOES NOT ELIMINATE IT. Journal of SARS-CoV-2 Research, 2, 12 - 24. https://doi.org/10.36013/sarc-cov-2.v2i.85
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