
59 Studies Showing the COVID-19 ‘Vaccines’ Wane Rapidly, Ultimately Don’t Mitigate Disease Spread
Here are the top 59 studies showing that, after several months, the COVID-19 “vaccines” don’t work to stop people from catching or spreading the disease. Furthermore, these studies demonstrate the COVID “vaccines” ultimately result in negative efficacy.
Along with the myriad studies from the literature, this post also includes: population-scale data, anecdotal examples of “breakthrough cases” from celebrities and politicians, letters from scientists and doctors to peer-reviewed journals, and news headlines all evincing the COVID-19 “vaccines'” inefficacy.
While it’s become patently obvious the COVID-19 “vaccines” from the likes of Pfizer, Moderna, and Johnson & Johnson are utterly incapable of mitigating contraction or transmission of the disease, it’s still critical to track the phenomenon in the literature—for the record, and, hopefully, coming lawsuits. To that end, below are 59 studies—most of which have been published in peer-reviewed journals—evincing the undeniable fact the COVID-19 “vaccines” ultimately do nothing to stop transmission of the disease. And, worse yet, contribute to the spread of infection thanks to a decline into negative efficacy after the four month mark.
Study after study shows a significant decline in efficacy for the “vaccinations,” a commonsense claim for anybody who can put two and two together and realize that’s why authorities have been pushing for one booster after another. There isn’t only stark evidence of the COVID-19 vaccines’ failure in the peer-reviewed literature however; there are also endless anecdotal examples of famous people coming down with COVID-19 after being “vaccinated.” Everybody from Barack Obama to Gavin Newsom to Bill Gates has tested positive for SARS-CoV-2 infection following “vaccination,” often times after a booster dose.
Along with the studies in the literature, as well as the countless anecdotal examples of “breakthrough infections” from politicians and celebrities, there’s also the fact that the most highly “vaccinated” countries have seen massive increases in infection on the population-level. In Australia, for example, as of June 25, 2022, 95% of the country was “vaccinated” against COVID-19; incredibly, this increase in “vaccination” caused COVID-19 deaths to be much higher than they were prior to the rollout of the injections.
There have also been numerous letters written by scientists and doctors to major medical journals regarding the inefficacy of the COVID-19 “vaccines” on disease transmission. A communication in Nature Medicine authored by Tel Aviv University’s Matan Levine-Tiefenbrun, et al., for example, notes that “The effectiveness of the coronavirus disease 2019 (COVID-19) BNT162b2 vaccine in preventing disease and reducing viral loads of breakthrough infections (BTIs) has been decreasing, concomitantly with the rise of the Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).” The authors add in their communication that the “vaccines'” ability to lessen the amount of viral load in recipients “starts to decline 2 months after vaccination and ultimately vanishes 6 months or longer after vaccination.”
In addition, immediately below is CDC Director Rochelle Walensky noting unequivocally that “what [the ‘vaccines’] can’t do anymore is prevent transmission.” Albert Bourla, the CEO of Pfizer, notes in a separate interview—just below Walensky’s—that “we know that the two dose[s] of the vaccine offers very limited protection if any.”
Incredibly, even Governor Gavin Newsom admitted on December 15, 2021 that “Omicron in particular is of concern because we know the transmissibility is much higher [versus other strains]…[and] the vast majority [of cases]—overwhelming majority—have been fully vaccinated… .”

“What the vaccines can't do anymore is prevent transmission."
— DrScott (@drscott_atlanta) January 9, 2022
CDC Director Walenskypic.twitter.com/s3BjMVBOub
Today, @GavinNewsom explained the recent mask mandate (that won't be enforced) is because, of the 48 Omicron cases identified in CA, "the overwhelming majority have been fully vaccinated. That's why masking becomes even more important in this environment." pic.twitter.com/UOZhcvlsZA
— Jonathan Zachreson (@JZachreson) December 16, 2021
Former White House Covid Response Coordinator Dr. Deborah Birx to Neil: "50% of the people who died from the omicron surge were older, vaccinated. So that's why I'm saying even if you're vaccinated and boosted, if you're unvaccinated right now, the key is testing and paxolovid." pic.twitter.com/1oB62gFdCJ
— Neil Cavuto (@TeamCavuto) July 22, 2022
STUDIES SHOWING THE COVID-19 ‘VACCINES’ DO NOTHING TO STOP DISEASE TRANSMISSION
Immediately below are 59 studies (and counting) showing the COVID-19 “vaccines” do not mitigate transmission of the disease. Note that most of the studies have been published in peer-reviewed journals.
1. Medical Archive (Posted July 31, 2021)
TITLE: Correlation of SARS-CoV-2 Breakthrough Infections to Time-from-vaccine;
Preliminary Study
METHODS: “Data regarding the duration of protection are essential for effective resource allocation and
vaccine administration, such as the need and urgency of a third dose.15,16 Israel’s rapid rollout
of the mass vaccination campaign allows us to investigate the correlation between time-from vaccine and vaccine effectiveness against the Delta variant.”
“To this end, we conducted a retrospective cohort study comparing the incidence rates of
breakthrough infections between early and late vaccinees, using data from Maccabi
Healthcare Services (MHS), Israel’s second largest Health Maintenance Organization, which
covers 2.5 million members (25% of the population) and provides a representative sample of
the Israeli population.”
CONCLUSION: “In this cohort of MHS members, all of whom are vaccinated with the BioNTech/Pfizer
mRNA BNT162b2 vaccine in a two-dose regimen, we identified a significant correlation between time-from-vaccine and afforded protection against SARS-CoV-2 infection. The risk for breakthrough infection was significantly higher for early vaccinees compared to those vaccinated later”
“Taken together, the study suggests a possible relative decrease in the long-term protection of
the BNT162b2 vaccine against the Delta variant of SARS-CoV-2. This preliminary finding
should be evaluated in future studies, including a comparison to long-term protection against
different strains, and prospective clinical trials to examine the effect of a booster vaccine
against breakthrough infection.”
2. Centers for Disease Control and Prevention (Posted August 6, 2021)
TITLE: Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021
METHODS: “During July 2021, 469 cases of COVID-19 associated with multiple summer events and large public gatherings in a town in Barnstable County, Massachusetts, were identified among Massachusetts residents; vaccination coverage among eligible Massachusetts residents was 69%. Approximately three quarters (346; 74%) of cases occurred in fully vaccinated persons (those who had completed a 2-dose course of mRNA vaccine [Pfizer-BioNTech or Moderna] or had received a single dose of Janssen [Johnson & Johnson] vaccine ≥14 days before exposure). Genomic sequencing of specimens from 133 patients identified the B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, in 119 (89%) and the Delta AY.3 sublineage in one (1%). Overall, 274 (79%) vaccinated patients with breakthrough infection were symptomatic. Among five COVID-19 patients who were hospitalized, four were fully vaccinated; no deaths were reported. Real-time reverse transcription–polymerase chain reaction (RT-PCR) cycle threshold (Ct) values in specimens from 127 vaccinated persons with breakthrough cases were similar to those from 84 persons who were unvaccinated, not fully vaccinated, or whose vaccination status was unknown (median = 22.77 and 21.54, respectively).”
CONCLUSION: “As population-level vaccination coverage increases, vaccinated persons are likely to represent a larger proportion of COVID-19 cases. Second, asymptomatic breakthrough infections might be underrepresented because of detection bias. Third, demographics of cases likely reflect those of attendees at the public gatherings, as events were marketed to adult male participants; further study is underway to identify other population characteristics among cases, such as additional demographic characteristics and underlying health conditions including immunocompromising conditions. MA DPH, CDC, and affected jurisdictions are collaborating in this response; MA DPH is conducting additional case investigations, obtaining samples for genomic sequencing, and linking case information with laboratory data and vaccination history. Finally, Ct values obtained with SARS-CoV-2 qualitative RT-PCR diagnostic tests might provide a crude correlation to the amount of virus present in a sample and can also be affected by factors other than viral load. Although the assay used in this investigation was not validated to provide quantitative results, there was no significant difference between the Ct values of samples collected from breakthrough cases and the other cases. This might mean that the viral load of vaccinated and unvaccinated persons infected with SARS-CoV-2 is also similar. However, microbiological studies are required to confirm these findings.”
“Event organizers and local health jurisdictions should continually assess the need for additional measures, including limiting capacity at gatherings or event postponement, based on current rates of COVID-19 transmission, population vaccination coverage, and other factors. On July 27, CDC released recommendations that all persons, including those who are fully vaccinated, should wear masks in indoor public settings in areas where COVID-19 transmission is high or substantial. Findings from this investigation suggest that even jurisdictions without substantial or high COVID-19 transmission might consider expanding prevention strategies, including masking in indoor public settings regardless of vaccination status, given the potential risk of infection during attendance at large public gatherings that include travelers from many areas with differing levels of transmission.”
3. Vaccines (Published August 4, 2021)
TITLE: An Outbreak of COVID-19 among mRNA-Vaccinated Nursing Home Residents
METHODS: “In Italy a progressive reduction in COVID-19 cases, isolations, hospitalizations and deaths was observed in LTCFs during February-April 2021. This was presumably related to the start of the vaccination campaign. Despite these encouraging data, several outbreaks of COVID 19 among vaccinated subjects have been described, both in Italy and worldwide, and it is important to describe and analyze these cases to better understand whether predisposing conditions for vaccine failure may be present. The purpose of this paper is to report an unexpected outbreak of COVID-19 infections among vaccinated guests and staff of a nursing home in the province of Vercelli, Italy.”
CONCLUSION/DISCUSSION: “The effectiveness of vaccination in elderly and often immunocompromised individuals is a matter of discussion in the scientific community, and several studies are underway to estimate it in LTCFs. Even if a recent study showed that a single-dose SARS-CoV-2 vaccination in older adults living in LTCFs provides substantial protection against infection from 4–7 weeks after vaccination and might reduce SARS-CoV-2 transmission, this observation has to be treated with caution, especially in case of new virus variants. Overall, the results of our investigation showing a SARS-CoV-2 infection rate of 45% percent in a BNT162b2-vaccinated population is a totally unexpected finding, that deserves further scrutiny, especially considering the high percentage of symptomatic cases (67%) and deaths (33%) reported herein. Considering also a recent report by White et al., the effectiveness of vaccination of nursing home guests should be much higher than that observed in our study.”
4. Infectious Diseases (Published September 13, 2021)
TITLE: Investigation of an Outbreak of COVID-19 in a French Nursing Home With Most Residents Vaccinated
METHODS: “This cohort study was conducted according to the principle of the Declaration of Helsinki. The president of the Comité de Protection des Personnes Ile-de-France VI determined that this study was exempt from ethics committee review and oral or written participant consent according to the French law (décret No. 2016-1537, November 17, 2016). Residents of the facility and their families were informed that a report about the outbreak would be published using deidentified data. This report follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cohort studies.”
CONCLUSION: “This cohort study’s findings suggest that an outbreak of COVID-19 can occur among fully vaccinated NH residents. The study found evidence of transmission among vaccinated residents, but few individuals who were infected developed severe disease and 1 patient, who was unvaccinated, died. Moreover, these outcomes occurred in a setting in which approximately 30% of staff members were vaccinated.”
5. Clinical Microbiology and Infection (Published November 2021)
TITLE: BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel
METHODS: A retrospective multicentre cohort study of 17 hospitals included patients fully vaccinated with Pfizer/BioNTech’s BNT162b2 vaccine who developed COVID-19 more than 7 days after the second vaccine dose and required hospitalization. The risk for poor outcome, defined as a composite of mechanical ventilation or death, was assessed.
CONCLUSION: “A total of 152 patients were included, accounting for half of hospitalized fully vaccinated patients in Israel. Poor outcome was noted in 38 patients and mortality rate reached 22% (34/152). Notably, the cohort was characterized by a high rate of co-morbidities predisposing to severe COVID-19, including hypertension (108; 71%), diabetes (73; 48%), congestive heart failure (41; 27%), chronic kidney and lung diseases (37; 24% each), dementia (29; 19%) and cancer (36; 24%), and only six (4%) had no co-morbidities. Sixty (40%) of the patients were immunocompromised. Higher viral load was associated with a significant risk for poor outcome. Risk also appeared higher in patients receiving anti-CD20 treatment and in patients with low titres of anti-Spike IgG, but these differences did not reach statistical significance.”
“We found that severe COVID-19 infection, associated with a high mortality rate, might develop in a minority of fully vaccinated individuals with multiple co-morbidities. Our patients had a higher rate of co-morbidities and immunosuppression compared with previously reported non-vaccinated hospitalized individuals with COVID-19. Further characterization of this vulnerable population may help to develop guidance to augment their protection, either by continued social distancing, or by additional active or passive vaccinations. “
6. Centers for Disease Control and Prevention (Volume 27, Number 10—October 2021)
TITLE: Breakthrough Infections of SARS-CoV-2 Gamma Variant in Fully Vaccinated Gold Miners, French Guiana, 2021
METHODS: “We collected data by completing standardized forms with data gathered through interviews and medical examination of all gold miners and by reviewing the health center records. All employees of the mine were examined by a physician and screened by nasopharyngeal Panbio COVID-19 Ag Rapid Test device… if they were symptomatic.”
CONCLUSION: “An outbreak of severe acute respiratory syndrome coronavirus 2 caused by the Gamma variant of concern infected 24/44 (55%) employees of a gold mine in French Guiana (87% symptomatic, no severe forms). The attack rate was 60% (15/25) among fully vaccinated miners and 75% (3/4) among unvaccinated miners without a history of infection.“
“We describe a COVID-19 Gamma variant cluster with a high attack rate even in fully vaccinated persons. The Gamma variant is the predominant variant in French Guiana which, as of July 2021, caused a third epidemic wave, threatening to overwhelm the hospital capacity. Such a low vaccine efficiency against infection by the Gamma variant was not expected because in vitro studies have shown a similar reduction of neutralization for Beta or Gamma variants by BNT162b2-elicited antibodies and a conserved CD4+ T-cell response against spike proteins from the Beta variant. Of the 10,262 COVID-19 vaccine breakthrough infections identified in the United States during January–April 2021, for which 555 had available sequencing, only 28 were caused by the Gamma variant.”
7. Journal of Travel Medicine (Published July 6, 2021)
TITLE: COVID-19 in fully vaccinated Everest trekkers in Nepal
METHODS: “Mount Everest (8848.46 m) attracts trekkers and mountaineers who may be immunized with different COVID-19 vaccines. Among fourteen COVID-19 positive Everest travellers presenting to CIWEC in 2021, five had double doses vaccination with ChAdOx1 nCoV-19 (n = 2), Sinopharm (n = 1), Sputnik V (n = 1) and mRNA-1273 (n = 1), and one had single dose of ChAdOx1 nCoV-19. Among these, three required hospital admission, while three were treated as outpatients and no mortality was reported. We present two COVID-19 cases, one with severe pneumonia and another with sequenced Delta variant, despite two doses of vaccination.”
DISCUSSION: “Trekking exposes travellers to tight indoor quarters where social distancing cannot be maintained, and respiratory infections can spread rapidly. Cold temperatures drive people indoors into the one heated space in a lodge. Immunization should be prioritized for guides, porters, lodge owners who are the potential source and reservoir of infections. When pandemic is overwhelming the health care system, care may not always be sufficient for sick travellers to remote regions. These two cases highlight that travellers and mountaineers, even if fully vaccinated, may need to avoid countries or areas where the pandemic is at its peak or where there is a high infection risk or where new variants of concerns are circulating which may be immune escaping and associated with lower vaccine effectiveness.”
8. Medical Archive (Posted November 19, 2021)
TITLE: Transmission potential of vaccinated and unvaccinated persons infected with the SARS-CoV-2 Delta variant in a federal prison, July—August 2021
METHODS: “Consenting incarcerated persons with confirmed SARS-CoV-2 infection provided mid-turbinate nasal specimens daily for 10 consecutive days and reported symptom data via questionnaire. Real-time reverse transcription-polymerase chain reaction (RT-PCR), viral whole genome sequencing, and viral culture was performed on these nasal specimens. Duration of RT-PCR positivity and viral culture positivity was assessed using survival analysis.”
CONCLUSION: “A total of 978 specimens were provided by 95 participants, of whom 78 (82%) were fully vaccinated and 17 (18%) were not fully vaccinated. No significant differences were detected in duration of RT-PCR positivity among fully vaccinated participants (median: 13 days) versus those not fully vaccinated (median: 13 days; p=0.50), or in duration of culture positivity (medians: 5 days and 5 days; p=0.29). Among fully vaccinated participants, overall duration of culture positivity was shorter among Moderna vaccine recipients versus Pfizer (p=0.048) or Janssen (p=0.003) vaccine recipients.”
“As this field continues to develop, clinicians and public health practitioners should consider vaccinated persons who become infected with SARS-CoV-2 to be no less infectious than unvaccinated persons. These findings are critically important, especially in congregate settings where viral transmission can lead to large outbreaks.”
9. Vaccine (Published November 26, 2021)
TITLE: COVID-19 vaccine – Long term immune decline and breakthrough infections
METHODS: “We conducted a 5-month longitudinal prospective study involving vaccinated healthcare personnel, who were tested monthly for antibody titer, and sampled biweekly and on clinical indication for SARS-COV-2 polymerase chain reaction (PCR), to determine antibody decline and breakthrough infection.”
CONCLUSION: “100 participants were recruited to the study. Antibody titer reached the climate after one month of the second dose of the vaccine, and declined rapidly thereafter: the median antibody levels were 895; 22,266; 9,682; 2,554 and 1,401 AU/ml in the day of the second dose, and in one month interval thereafter, respectively. In other words, four months after vaccination, the mean antibody level was 6% of the peak levels. During the study period, 4 breakthrough infections were diagnosed, 2 of which were asymptomatic, and the remaining two were mild cases; sharp elevation of antibody titer was seen after infection.
“Antibody titer drops rapidly one month after the second dose of the vaccine. All infections within the study period were mild or asymptomatic, after which titer elevations were seen.”
10. Nature Medicine (Published October 14, 2021)
TITLE: Effect of Delta variant on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK
METHODS: “We, therefore, assessed the effectiveness of the BNT162b2, ChAdOx1 and mRNA-1273 vaccines against new SARS-CoV-2 PCR-positive cases using the Office for National Statistics (ONS) COVID-19 Infection Survey (CIS), a large, community-based survey of individuals living in randomly selected private households across the UK, where RT–PCR tests were performed after a pre-determined schedule, irrespective of symptoms, vaccination and prior infection. Besides avoiding bias from test-seeking behavior changing after receipt of particular vaccines, other advantages over existing studies include the ability to adjust for prior infection status and a wider range of potential confounders, including working in patient-facing healthcare, care homes or social care, household characteristics and (in)direct contact with hospitals or care homes.”
CONCLUSION: “In addition to reduced VE, we found a substantial shift in viral burden in individuals who were infected despite two vaccinations with BNT162b2 or ChAdOx1 in the B.1.617.2-dominant period, with similar average Ct values to individuals infected without vaccination, and much more similar percentages reporting symptoms, driven by Ct. Although, with B.1.1.7, we and others found that vaccinated individuals had lower viral burden (higher Ct values) than unvaccinated individuals, the greater number of new PCR-positive cases (1,736 ≥14d after second vaccination) allowed us to show that there are two different types of such infections: a low-viral-burden group that dominated early in 2021 and a high-viral-burden group that increased in frequency with B.1.617.2. Individuals receiving ChAdOx1 were more likely to fall into the latter group after their second vaccination, as were an increasing percentage of new PCR-positive individuals with increasing time from second BNT162b2 vaccination, mirroring changes in protection against new PCR positivity. Peak viral load, therefore, now appears similar in infected vaccinated and unvaccinated individuals, with potential implications for onward transmission risk, given the strong association between peak Ct and infectivity. However, the degree to which this might translate into new infections is unclear; a greater percentage of virus might be non-viable in individuals who are vaccinated, and/or their viral loads might also decline faster, as suggested by a recent study of patients hospitalized with B.1.617.2…(supported by associations between higher Ct and higher antibody levels here and in ref.), leading to shorter periods ‘at risk’ for onwards transmission. Nevertheless, there might be implications for any policies that assume a low risk of onward transmission from vaccinated individuals (for example, relating to self-isolation and travel), despite vaccines both still protecting against infection, thereby still reducing transmission overall. This might be particularly important when vaccinated individuals are not aware of their infection status or perceive that their risk of transmission is low. Notably, individuals infected after second vaccination appeared to gain an antibody boost, and higher prior antibody levels were independently associated with lower viral burden.”
11. Nature Communications (Published November 4, 2021)
TITLE: Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine
METHODS: “The study population consisted of all MHS members aged 16 and above who received the second dose of the vaccine between January and April 2021. Individuals were considered fully vaccinated if they received two doses of the BNT162b2, the second one administered within the 21-to-28-day interval set by national guidelines. The minority who did not follow the guidelines included those infected after the first dose or those suffering an intercurrent illness that delayed the administration of the second dose.”
CONCLUSION: “In this cohort of MHS members, all of whom are vaccinated with the BioNTech/Pfizer mRNA BNT162b2 vaccine in a two-dose regimen, we identified a significant correlation between time-from-vaccine and afforded protection against SARS-CoV-2 infection. The risk for breakthrough infection was significantly higher for Early Vaccinees compared with those vaccinated later with an additional trend for higher risk for hospitalization among the Early Vaccinees group. Our results correspond to recent publications that demonstrate a significant decline in antibody levels and immune systems compounds over time following the second dose of vaccination.”

12. The American Journal of Pathology (Published February 7, 2022)
TITLE: Delta Variants of SARS-CoV-2 Cause Significantly Increased Vaccine Breakthrough COVID-19 Cases in Houston, Texas
METHODS: “Specimens were obtained from registered patients at Houston Methodist hospitals, associated facilities (eg, urgent care centers), and institutions in the Houston metropolitan region that use our laboratory services. The great majority of individuals had signs or symptoms consistent with COVID-19. For analyses focusing on the Delta family variants, a comprehensive sample of genomes obtained from March 15, 2021, through September 20, 2021, was used.”
CONCLUSION/DISCUSSION: “Delta was significantly more likely to cause vaccine breakthrough cases. However, importantly, 19.7% of all the 16,965 COVID-19 cases with genome sequence data occurred in fully vaccinated individuals. Importantly, only a small number [n = 896 (5.3%)] of these patients required hospitalization. Vaccine breakthrough cases have emerged as an area of great interest, especially so with the increasing percentage of COVID-19 cases caused by Delta variants and the recognition that they are important causes of breakthroughs. Although the current analysis did not identify a simple relationship between the time elapsed since administration of the second booster vaccination and the date of vaccination breakthrough, this is an important area for continued study. Although the potential relationship between vaccination breakthrough and waning immunity were not studied, studies of this topic are ongoing.”
13. Medical Archive (Posted January 19, 2022)
TITLE: Signals of significantly increased vaccine breakthrough, decreased hospitalization rates, and less severe disease in patients with COVID-19 caused by the Omicron variant of SARS-CoV-2 in Houston, Texas
METHODS: “Specimens were obtained from patients registered at Houston Methodist facilities (e.g., hospitals and urgent care centers), and institutions in the Houston metropolitan region that use our laboratory services. The great majority of individuals had signs or symptoms consistent with COVID-19 disease. For analyses focusing on patients with COVID-19 caused by the Omicron variant, samples obtained from November 27, 2021 through January 5, 2022 were used.”
DISCUSSION/CONCLUSION: “We…analyzed Omicron vaccine breakthrough cases. We found 2,497 of the 4,468 total Omicron patients (55.9%) for whom we have whole genome sequence data met the CDC definition of vaccine breakthrough cases. There was no simple relationship between the time elapsed since administration of the second vaccination dose and the date of vaccination breakthrough. These 2,497 patients received either two doses of the Pfizer-BioNTech BNT162b2 (n = 1828, 73%) or Moderna mRNA-1273 (n = 553, 22%), or one dose of J&J/Janssen JNJ273 78436735 (n = 115, 5%) vaccine; vaccine type was not specified for one individual. This distribution reflects the majority use of BNT162b2 vaccination doses in our health system. Compared to either Alpha or Delta patients, a significantly greater percentage of patients with breakthrough cases was caused by the Omicron VOC (55.9% compared to 3.2% and 24.3% for Alpha and Delta VOCs, respectively). We next analyzed individuals with breakthrough cases after receiving a third (booster) dose of either the Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine. We found that 711 (15.9%) of the 4,468 Omicron patients met this criteria. Consistent with Omicron causing a significantly increased number of vaccine breakthrough cases, many studies have reported that this variant has reduced sensitivity to antibody neutralization in vitro, likely in large part due to the extensive number of amino acid and other
structural changes occurring in Omicron spike protein.”
14. Clinical Microbiology and Infection (Published April 2022)
TITLE: Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
METHODS: “We conducted a multicentre retrospective cohort study of patients in Singapore who had received a licensed mRNA vaccine and been admitted to hospital with B.1.617.2 SARS-CoV-2 infection. We compared clinical features, virological and serological kinetics (anti-nucleocapsid, anti-spike and surrogate virus neutralization titres) between fully vaccinated and unvaccinated individuals.”
CONCLUSION: “Out of 218 individuals with B.1.617.2 infection, 84 received an mRNA vaccine of which 71 were fully vaccinated, 130 were unvaccinated and four received a non-mRNA vaccine. Despite significantly older age in the vaccine breakthrough group, only 2.8% (2/71) developed severe COVID-19 requiring oxygen supplementation compared with 53.1% (69/130) in the unvaccinated group (p < 0.001). Odds of severe COVID-19 following vaccination were significantly lower (adjusted odds ratio 0.07 95% CI 0.015–0.335, p 0.001). PCR cycle threshold values were similar between vaccinated and unvaccinated groups at diagnosis, but viral loads decreased faster in vaccinated individuals. Early, robust boosting of anti-spike protein antibodies was observed in vaccinated patients; however, these titres were significantly lower against B.1.617.2 than the wildtype vaccine strain.”
15. Viruses (Published April 13, 2022)
TITLE: Incidence and Risk Factors of COVID-19 Vaccine Breakthrough Infections: A Prospective Cohort Study in Belgium
METHODS: “We used data from the LINK-VACC project: a prospective, real-time cohort with national-level coverage in Belgium. The population of interest comprised all individuals aged 18 years and above, living in Belgium, who had been fully vaccinated with a primary vaccination scheme for at least 14 days with a COVID-19 vaccine approved by the European Medicine Agency, between 1 February 2021 and 5 December 2021. We chose a 14-day interval to allow time for an immune response to develop. Two mRNA vaccines (BNT162b2: 2 doses of 30 µg/dose and mRNA-1273: 2 doses of 100 µg/dose) and two viral vector vaccines (ChAdOx1: 2 doses of >2.5 × 108 infectious units and Ad26.COV2.S: 1 dose of >8.92 log10 infectious units) were used.”
CONCLUSION: “Of all fully vaccinated persons, 373,070 (4.6%) developed a breakthrough infection during follow up. Overall, the incidence of breakthrough infections was 11.2 per 100 person years (95%CI 11.2–11.3). The median time to infection was 121 days (IQR 97–156). We observed a comparable incidence by sex, and higher incidences for younger age groups than for older age groups (18.4 versus 4.6 per 100 person years, for age groups 35–44 and ≥85, respectively). The incidence of breakthrough infections was higher within individuals vaccinated with viral-vector-based vaccines (12.7 and 16.5 per 100 person years for ChAdOx1 and Ad26.COV2.S, respectively), compared to those vaccinated with mRNA-based vaccines (11.0 and 7.6 per 100 person years for BNT162b2 and mRNA-1273, respectively). Among persons who had a prior COVID-19 infection before vaccination, a lower incidence of breakthrough infections was observed compared to COVID-19 naïve persons (3.2 versus 12.0 per 100 person years).When analyzing the daily incidence of breakthrough infection by calendar date, the highest incidences were observed during the fourth COVID-19 wave that started on 4 October 2021, coinciding with a high positivity rate in the general population. The majority of breakthrough cases occurred 4 months after full vaccination. When comparing the incidence of breakthrough infections between different VOC dominance periods, a higher incidence was observed in the delta period than in the alpha period (14.2 versus 1.8 per 100 person years).”
“Of the 373,070 persons with a breakthrough infection, 216,814 (58.1%) had available information on symptoms. Of these persons 70.1% (151,888/216,814) had symptoms compatible with COVID-19, with an overall incidence rate of symptomatic breakthrough infections of 4.6 per 100 person years. Persons with a symptomatic breakthrough infection had a comparable distribution of demographic and clinical characteristics as all persons with a breakthrough infection and as persons with asymptomatic breakthrough infections.”
“The unadjusted cumulative incidence of a breakthrough infection at 300 days after primary vaccination was 15.8% and for a reported symptomatic breakthrough infection it was 5.6%. The younger age group of 18–64 year olds had a higher cumulative incidence of a breakthrough infection than persons aged 65–79 or ≥80 years. The cumulative incidences by brand of the primary vaccination scheme were higher for persons vaccinated with the Ad26.COV2.S vaccine or ChAdOx1 compared to persons vaccinated with BNT162b2 or mRNA-1273. Notably, persons with a prior COVID-19 infection had lower cumulative incidences of a breakthrough infection than naïve persons. Comparable observations were made for symptomatic breakthrough infections.”
16. The Lancet Infectious Diseases (October 29, 2021)
TITLE: Community Transmission and Viral Load Kinetics of the SARS-CoV-2 delta (B.1.167.2) Variant in Vaccinated and Unvaccinated Individuals in the UK: a prospective, longitudinal, cohort study
METHODS: “Between Sept 13, 2020, and Sept 15, 2021, 602 community contacts (identified via the UK contract-tracing system) of 471 UK COVID-19 index cases were recruited to the Assessment of Transmission and Contagiousness of COVID-19 in Contacts cohort study and contributed 8145 upper respiratory tract samples from daily sampling for up to 20 days. Household and non-household exposed contacts aged 5 years or older were eligible for recruitment if they could provide informed consent and agree to self-swabbing of the upper respiratory tract. We analysed transmission risk by vaccination status for 231 contacts exposed to 162 epidemiologically linked delta variant-infected index cases. We compared viral load trajectories from fully vaccinated individuals with delta infection (n=29) with unvaccinated individuals with delta (n=16), alpha (B.1.1.7; n=39), and pre-alpha (n=49) infections. Primary outcomes for the epidemiological analysis were to assess the secondary attack rate (SAR) in household contacts stratified by contact vaccination status and the index cases’ vaccination status. Primary outcomes for the viral load kinetics analysis were to detect differences in the peak viral load, viral growth rate, and viral decline rate between participants according to SARS-CoV-2 variant and vaccination status.”
CONCLUSION: The SAR in household contacts exposed to the delta variant was 25% (95% CI 18–33) for fully vaccinated individuals compared with 38% (24–53) in unvaccinated individuals. The median time between second vaccine dose and study recruitment in fully vaccinated contacts was longer for infected individuals (median 101 days [IQR 74–120]) than for uninfected individuals (64 days [32–97], p=0·001). SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15–35] for vaccinated vs 23% [15–31] for unvaccinated). 12 (39%) of 31 infections in fully vaccinated household contacts arose from fully vaccinated epidemiologically linked index cases, further confirmed by genomic and virological analysis in three index case–contact pairs. Although peak viral load did not differ by vaccination status or variant type, it increased modestly with age (difference of 0·39 [95% credible interval –0·03 to 0·79] in peak log10 viral load per mL between those aged 10 years and 50 years). Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections. Within individuals, faster viral load growth was correlated with higher peak viral load (correlation 0·42 [95% credible interval 0·13 to 0·65]) and slower decline (–0·44 [–0·67 to –0·18]).
Vaccination reduces the risk of delta variant infection and accelerates viral clearance. Nonetheless, fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts. Host–virus interactions early in infection may shape the entire viral trajectory.
17. Clinical Infectious Diseases (Published March 10, 2022)
TITLE: SARS-CoV-2 Delta vaccine breakthrough transmissibility in Alachua County, Florida
METHODS: “Between October 2020 and July 2021, we sequenced 4,439 SARS-CoV-2 full genomes, 23% of all known infections in Alachua County, Florida, including 109 vaccine breakthrough cases. Univariate and multivariate regression analyses were conducted to evaluate associations between viral RNA burden and patient characteristics. Contact tracing and phylogenetic analysis were used to investigate direct transmissions involving vaccinated individuals.”
CONCLUSION: “Delta infection transmissibility and general viral RNA quantification patterns in vaccinated individuals suggest limited levels of sterilizing immunity that need to be considered by public health policies. In particular, ongoing evaluation of vaccine boosters should specifically address whether extra vaccine doses curb breakthrough contribution to epidemic spread.”
18. Viruses (February 7, 2022)
TITLE: Risk of Vaccine Breakthrough SARS-CoV-2 Infection and Associated Factors in Healthcare Workers of Trieste Teaching Hospitals (North-Eastern Italy)
METHODS: “We conducted a retrospective cohort study designed to estimate the impact of the vaccination campaign, the course of SARS-CoV-2 infection among HCWs, and risk factors of breakthrough infection.The study included 4394 subjects working at ASUGI hospitals in Trieste and other healthcare facilities of the Giuliano area, North-eastern Italy. All of them were exposed to SARS-CoV-2 and were at risk of COVID-19; for this reason, an anti-COVID-19 vaccine was offered to all personnel, including administrative and logistic employees, according to national and hospital protocol for the COVID-19 emergency.”
CONCLUSION [EXCERPT]: “From 1 February 2021 to 30 November 2021, 236 SARS-CoV-2 infections were detected among 3814 total susceptible HCWs (a rate of 6.9%), 4.9% (=81/657) among fully unvaccinated or partially vaccinated individuals and 12.3% (=155/3157) in vaccinated individuals.”
19. International Journal of Biological Sciences (Published January 1, 2022)
TITLE: A systematic review of Vaccine Breakthrough Infections by SARS-CoV-2 Delta Variant
METHODS: “[W]e examined the biological characteristics and epidemiological profile of Delta variant, the current status of Delta variant vaccine breakthrough infection and the mechanism of vaccine breakthrough infection in this article.
CONCLUSION: “The Delta variant of SARS-CoV-2 has become one of the most worrisome variants thus far during the pandemic and has been rapidly spreading worldwide, making it responsible for the recent surges in infections and deaths. Although current vaccines are still shown to be protective against this variant, it is also becoming clearer that the variant can evade the immune system by rendering neutralizing antibodies from prior infections or vaccination less sensitive to binding with the spike protein. In short, existing vaccinations do not block Delta variant, but the efficacy of vaccines to slow down the evolution of virus is credible as outcomes show an obvious advantage in averting severe symptoms, hospitalization and deaths. In addition, vaccine breakthrough cases are often undercounted and fully vaccinated populations should still practice preventive measures. Along with the possible emergence of various SARS-CoV-2 variants in the future, there is a predictable challenge to develop targeted vaccines against mutations on the S protein and terminate the COVID-19 pandemic as soon as possible. Therefore, aside from a series of vaccine roll-out measures, continuous monitoring of post-vaccination breakthrough infections must be adopted by all countries.”
20. Emerging Infectious Diseases (January 28, 2022)
TITLE: Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States
METHODS: “The town of Provincetown, at the northern tip of Cape Cod in Massachusetts, has a population of ≈3,000 permanent residents and, during peak summer months, can reportedly reach a population size of up to 60,000 persons. During July 3–17, thousands of visitors from across the United States traveled to Provincetown and participated in large, densely packed indoor and outdoor gatherings marketed to adult male participants. Multiple continuous events were held at venues such as restaurants, bars, and guest houses. Local advisories at the time did not recommend mask wearing for fully vaccinated persons, and venues did not require participants to wear masks indoors.”
“By July 10, MA DPH received multiple reports of an increasing cluster of COVID-19 cases among Massachusetts residents who resided in or recently visited Provincetown, including cases among fully vaccinated persons. On July 14, Massachusetts state and local health officials responded to the increase in cases by expanding access to SARS-CoV-2 mobile testing and recommending testing for all persons who traveled to Provincetown since July 1 or had close contact with persons who showed positive test results for SARS-CoV-2, regardless of vaccination status. On July 15 and July 21, MA DPH issued Epidemic Information Exchange notifications to identify additional cases among residents of US public health jurisdictions outside Massachusetts.”
CONCLUSION/DISCUSSION: “This investigation highlights that the Delta variant of SARS-CoV-2 can spread quickly through a highly vaccinated population and can be transmitted to others regardless of vaccination status. Although vaccination remains a key mitigation strategy to decrease illness and death associated with COVID-19, the Delta variant of SARS-CoV-2 is highly transmissible, and several studies have suggested lower vaccine effectiveness during Delta variant predominance compared with earlier months, probably driven by waning immunity from increased time since vaccination. In this outbreak, 99% of cluster-associated cases that had available sequencing were caused by the Delta variant, and 81% of cluster-associated cases were classified as vaccine breakthrough infections. The large number of breakthrough infections is probably representative of a highly vaccinated underlying population; as a greater proportion of the US population becomes fully vaccinated, vaccine breakthrough infections are likely to be more frequently observed.”
21. Frontiers in Public Health (Published March 15, 2022)
TITLE: How to Deal With Vaccine Breakthrough Infection With SARS-CoV-2 Variants
METHODS: “In this mini-review, we focus on the characteristics of SARS-CoV-2 and its mutant strains and vaccine breakthrough infections. We have found that outbreaks of vaccine-breaking SARS-CoV-2 Delta infections in many countries are primarily the result of declining vaccine-generated antibody titers and relaxed outbreak management measures. For this reason, we believe that the main response to vaccine-breaking infections with the SARS-CoV-2 variant is to implement a rigorous outbreak defense policy and vaccine application. Only by intensifying the current vaccination intensity, gradually improving the vaccine and its application methods, and strengthening non-pharmaceutical measures such as travel restrictions, social distancing, masking and hand hygiene, can the COVID-19 outbreak be fully controlled at an early date.”
CONCLUSION/EXCERPTS: “An article published online 21 April by Hacisuleyman et al. reinforces the understanding of SARS-CoV-2 mutation and vaccine breakthrough. Two women aged over 50 years were identified among 417 people who had received a second dose of BNT162b2 (Pfizer Biotech) or mRNA-1273 (Modena) vaccine at least 2 weeks earlier Presence of vaccine breakthrough infection. This suggests that despite high levels of neutralizing antibodies (where the vaccine remains effective), infection by variant viruses can occur even at high viral loads. Therefore there is still a potential risk of infection after vaccination and precautions for COVID-19 infection are also taken. Around a wedding outside Houston, Texas, two patients from India may have transmitted the delta-mutant virus to other guests, six of whom were fully vaccinated (Pfizer BNT162b2, Moderna mRNA-1273 and Covaxin BBV152). This means that the delta variant is highly transmissible and prone to vaccine breakthrough infections.”
22. Archives of Family Medicine and General Practice (Published March 13, 2022)
TITLE: Risk Factors and Incidence Rates of Covid-19 Breakthrough Infections in Vaccinated People in General Medicine Practice in Toledo (Spain)
METHODS: A longitudinal and prospective case-control study of COVID-19 breakthrough infections in vaccinated people was carried out from February 1, 2021 to September 30, 2021, in a general practitioner (GP) office in Toledo (Spain).
RESULTS/CONCLUSION:
“IR of COVID-19 breakthrough infections in vaccinated people > 14 years in GP consultation was 1.5% cases × 8 months; higher in people > = 65 years vs. 14-65 years (2.3% vs. 1.3%), and higher in women vs. men (1.6% vs. 1.4%). IR according to the type of vaccine ranged from 0.4% cases with mRNA-1273 vaccine, to 5% cases with Janssen vaccine. The statistically significant protective factors were: complex family and chronic illnesses of the mental group; and statistically significant risk factors: chronic diseases of the digestive and musculoskeletal groups. Vaccination with BNT162-2 mRNA and mRNA-1273 were protective factors; and with ChAdOx1 nCoV-19 shown a moderate risk. Vaccination with Janssen was a statistically significant strong risk.”
“COVID-19 breakthrough infections in vaccinated people were rare, with higher rates in women and old
people. Chronic diseases and social factors behaved mixed. Each of the vaccines has associated COVID-19 breakthrough infections, but the Janssen vaccine posed a strong risk; however, the small numbers prevent definitive conclusions.”
23. Blood Reviews (Published January 31, 2022)
TITLE: COVID-19 breakthrough infections, hospitalizations and mortality in fully vaccinated patients with hematologic malignancies: A clarion call for maintaining mitigation and ramping-up research
METHODS: “We used the TriNetX Analytics Network Platform that allows access to fully de-identified data of 84.5 million unique patients from 63 health care organizations of inpatient and outpatient settings in US. TriNetX Analytics provides web-based, real-time, secure access to patient EHR data from hospitals, primary care, and specialty treatment providers, covering diverse geographic, age, race/ethnic, income and insurance groups. Though the data are de-identified, end-users can use TriNetX Analytics built-in statistical and informatics functions to work on patient-level data for cohort selection, propensity-score matching, analyzing incidence and prevalence of events in a cohort, and comparing characteristics and outcomes between matched cohorts. Because this study used only de-identified patient records and did not involve the collection, use, or transmittal of individually identifiable data, this study was exempted from Institutional Review Board approval.”
CONCLUSION: This study shows that the incidence proportions of breakthrough SARS-CoV-2 infections in vaccinated patients with HM [hematologic malignancies] steadily increased from December 2020 to October 2021, higher than those in patients without cancer, indicating general waning immunity of vaccine, especially in patients with HM. The cumulative risk of breakthrough infections in patients with HM was 13.4%, higher than 4.5% in patients without cancer, indicating that HM is a risk for breakthrough infections in fully vaccinated patients. These findings are consistent with previous reports of low seroconversion in patients with HM and provide robust real-world evidence that impaired seroconversion could have resulted in significant breakthrough infections in patients with HM, even when they are fully vaccinated. Our previous studies, in the early pandemic when vaccines were not available, showed disproportionate COVID-19 infections between Black and White patients with HM. In contrast, this study shows no signs of racial or ethnic disparities for breakthrough infections in any of the seven HMs once patients were fully vaccinated. Findings in this study show that risks for hospitalization and mortality in patients with HM who had breakthrough infections were not only significantly higher than in those who had no breakthrough infections, but also substantial, with an overall risk of 37.8% for hospitalization, and 5.7% for mortality. While our finding shows that HM itself is a risk factor for breakthrough infections in fully vaccinated patients, we identified subsets of patients with HM who were more vulnerable to breakthrough infections: older patients and patients with significant comorbidities (e.g., hypertension, heart diseases, cerebrovascular diseases, obesity, type 2 diabetes, chronic respiratory diseases, chronic kidney diseases, liver diseases, substance use disorders, depression, and anxiety) and patients who received chemotherapies or targeted therapies. In addition, we show that among vaccinated patients with HM who had breakthrough infections, age was an additional significant risk factor for both hospitalization and death.
24. Infection (Published February 7, 2022)
TITLE: Incidence and severity of COVID-19 infection post-vaccination: a sur
METHODS: We conducted an online voluntary survey among Indian doctors who received one or two doses of ChAdOx1 nCoV-19 or BBV152. Questions pertaining to the incidence and severity of COVID-19 infection following vaccination were asked. Data thus obtained were analysed.
CONCLUSION: “9146 doctors were included in this study. 8301 of these received ChAdOx1 nCoV-19, while 845 received BBV152. 2842 (31.07%) respondents reported having a COVID-19 infection following vaccination. Presence of pre-existing medical comorbidities was associated with a higher incidence, while prior COVID-19 infection and two doses of either vaccine were associated with a lower incidence of COVID-19 infection post-vaccination. Exposure to COVID-19 patients on a daily basis did not increase the incidence of COVID-19 infection among doctors who were vaccinated. Increasing age, male gender, presence of pre-existing medical comorbidities, and daily exposure to COVID-19 patients were associated with increased severity of COVID-19 infection after vaccination. Two doses of either vaccine resulted in less severity of disease compared to one dose.”
“ChAdOx1 nCoV-19 and BBV152 confer immunity against severe forms of COVID-19 infections. COVID-19 infections prior to vaccination result in a lower incidence of breakthrough infection. Presence of pre-existing medical comorbidities is associated with increased incidence and severity of breakthrough infections.”
25. Clinical Gastroenterology and Hepatology (Published February 19, 2022)
TITLE: Effectiveness and Durability of COVID-19 Vaccination in 9447 Patients With IBD: A Systematic Review and Meta-Analysis
METHODS: “Electronic databases were searched to identify studies reporting response to COVID-19 vaccination in IBD. Pooled seroconversion rates after complete vaccination were calculated. Subgroup analysis for vaccine types was also performed. Pooled seroconversion rates for various drugs or classes were also estimated. The pooled rates of breakthrough infections in vaccinated IBD patients were estimated. The pooled neutralization rates after complete vaccination were also estimated. The studies reporting durability of titers were systematically assessed.”
CONCLUSION: “A total of 46 studies were included. The pooled seroconversion rate for complete vaccination (31 studies, 9447 patients) was 0.96 (95% confidence interval [CI], 0.94–0.97; I2 = 90%). When compared with healthy control subjects, the pooled relative risk of seroconversion was lower (0.98; 95% CI, 0.98–0.99; I2 = 39%). The pooled seroconversion rates were statistically similar among various drug classes. The pooled positivity of neutralization assays (8 studies, 771 participants) was 0.80 (95% CI, 0.70–0.87; I2 = 82%). The pooled relative risk of breakthrough infections in vaccinated IBD patients was similar to vaccinated control subjects (0.60; 95% CI, 0.25–1.42; I2 = 79%). Most studies suggested that titers fall after 4 weeks of COVID-19 vaccination, and the decay was higher in patients on anti-tumor necrosis factor alone or combination with immunomodulators. An additional dose of COVID-19 vaccine elicited serological response in most nonresponders to complete vaccination.”
“Complete COVID-19 vaccination is associated with seroconversion in most patients with IBD. The decay in titers over time necessitates consideration of additional doses in these patients.”
26. International Research In Medical & Health Sciences (Published March 1, 2022)
TITLE: Family Secondary Cases from Covid-19 Breakthrough Infections in Vaccinated People
METHODS: “An observational, longitudinal, and prospective study of families with one primary case of COVID-19 breakthrough infection was conducted from February 1 to November 30, 2021, in a general medicine office in Toledo, Spain.”
CONCLUSION: “13 primary cases in 13 families (46 people) were included. The crude secondary attack rate (secondary cases / exposed population with complete or incomplete vaccination (15/23) was 45%. The crude secondary attack rate in contacts with complete vaccination (9/17) was 53%. The vaccine effectiveness against transmission among households among contacts (Secondary attack rate in vaccinated / Secondary attack rate in unvaccinated) × 100%= 53/69) was 77%. All secondary cases were mild. Secondary cases were more young women with a lower socio-occupational level.”
“In the context of general medicine in Toledo (Spain), when the delta variant became dominant, but before the rise of omicron, vaccination reduces but does not eliminate the risk of COVID-19 transmission within homes (crowded indoor environments), which remain important places for transmission. It is suggested to re-evaluate the protocol that vaccinated family contacts do not require isolation.”
27. NEJM Evidence (December 20, 2021)
TITLE: Covid-19 Rates by Time since Vaccination during Delta Variant Predominance
METHODS: “Covid-19 case and death data from 15 U.S. jurisdictions during January 3 to September 4, 2021 were used to estimate weekly hazard rates among fully vaccinated persons, stratified by age group and vaccine product. Case and death rates during August 1 to September 4, 2021 were presented across four cohorts defined by month of vaccination. Poisson models were used to estimate adjusted rate ratios comparing the earlier cohorts to July rates.”
CONCLUSION: “During August 1 to September 4, 2021, case rates per 100,000 person-weeks among all vaccine recipients for the January to February, March to April, May to June, and July cohorts were 168.8 (95% confidence interval [CI], 167.5 to 170.1), 123.5 (95% CI, 122.8 to 124.1), 83.6 (95% CI, 82.9 to 84.3), and 63.1 (95% CI, 61.6 to 64.6), respectively. Similar trends were observed by age group for BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) vaccine recipients. Rates for the Ad26.COV2.S (Janssen-Johnson & Johnson) vaccine were higher; however, trends were inconsistent. BNT162b2 vaccine recipients 65 years of age or older had higher death rates among those vaccinated earlier in the year. Protection against death was sustained for the mRNA-1273 vaccine recipients. Across age groups and vaccine types, people who were vaccinated 6 months ago or longer (January-February) were 3.44 (3.36 to 3.53) times more likely to be infected and 1.70 (1.29 to 2.23) times more likely to die from COVID-19 than people vaccinated recently in July 2021.”
“Our study suggests that protection from SARS-CoV-2 infection among all ages or death among older adults waned with increasing time since vaccination during a period of delta predominance. These results add to the evidence base that supports U.S. booster recommendations, especially for older adults vaccinated with BNT162b2 and recipients of the Ad26.COV2.S vaccine. (Funded by the Centers for Disease Control and Prevention.)”
28. Medical Archive (Posted January 6, 2022)
TITLE: Durability of Protection against COVID-19 Breakthrough Infections and Severe Disease by Vaccines in the United States
METHODS: “Using claims and laboratory data covering 168 million lives, we conducted a matched case-control study with fully vaccinated individuals between January 1 and September 7, 2021. Odds ratios (OR) for developing outcomes in months two through six following full vaccination were estimated relative to the first month after full vaccination for each vaccine separately.”
CONCLUSION: “Evidence of waning protection against infections started in month 2 from vaccination for both BNT162b2 (OR [95% CI] in month 6+, 2.93 [2.72, 3.15]) and mRNA-1273 (OR [95% CI] in month 6+, 2.76 [2.51, 3.04]), and in month 4 for Ad26.COV2.S (OR [95% CI] in month 5+, 1.31 [1.18, 1.47]). Evidence of waning protection against hospitalization started in month 2 for BNT162b2 (OR [95% CI], 3.97 [3.26, 4.83] in month 6+) and in month 3 for mRNA-1273 (OR 95% CI, 1.66 [1.26, 2.19] in month 6+). There was no evidence of waning protection against hospitalization for Ad26.COV2.S (OR [95% CI], 1.25 [0.86, 1.80] in month 5+). No waning of protection was observed at any time for ICU admissions for all three vaccines.”
29. The New England Journal of Medicine (Published January 13, 2022)
TITLE: Covid-19 Vaccine Effectiveness in New York State
METHODS: “We used data for 8,690,825 adults in New York State to assess the effectiveness of the BNT162b2, mRNA-1273, and Ad26.COV2.S vaccines against laboratory-confirmed Covid-19 and hospitalization with Covid-19 (i.e., Covid-19 diagnosed at or after admission). We compared cohorts defined according to vaccine product received, age, and month of full vaccination with age-specific unvaccinated cohorts by linking statewide testing, hospital, and vaccine registry databases. We assessed vaccine effectiveness against Covid-19 from May 1 through September 3, 2021, and against hospitalization with Covid-19 from May 1 through August 31, 2021.”
CONCLUSION: “There were 150,865 cases of Covid-19 and 14,477 hospitalizations with Covid-19. During the week of May 1, 2021, when the delta variant made up 1.8% of the circulating variants, the median vaccine effectiveness against Covid-19 was 91.3% (range, 84.1 to 97.0) for BNT162b2, 96.9% (range, 93.7 to 98.0) for mRNA-1273, and 86.6% (range, 77.8 to 89.7) for Ad26.COV2.S. Subsequently, effectiveness declined contemporaneously in all cohorts, from a median of 93.4% (range, 77.8 to 98.0) during the week of May 1 to a nadir of 73.5% (range, 13.8 to 90.0) around July 10, when the prevalence of the delta variant was 85.3%. By the week of August 28, when the prevalence of the delta variant was 99.6%, the effectiveness was 74.2% (range, 63.4 to 86.8). Effectiveness against hospitalization with Covid-19 among adults 18 to 64 years of age remained almost exclusively greater than 86%, with no apparent time trend. Effectiveness declined from May through August among persons 65 years of age or older who had received BNT162b2 (from 94.8 to 88.6%) or mRNA-1273 (from 97.1 to 93.7%). The effectiveness of Ad26.COV2.S was lower than that of the other vaccines, with no trend observed over time (range, 80.0 to 90.6%).”
“The effectiveness of the three vaccines against Covid-19 declined after the delta variant became predominant. The effectiveness against hospitalization remained high, with modest declines limited to BNT162b2 and mRNA-1273 recipients 65 years of age or older.”
30. Infectious Diseases (Published December 14, 2021)
TITLE: An episode of transmission of COVID-19 from a vaccinated healthcare worker to co-workers
METHODS: “Index case (IC): After the second dose of the ChAdOx1 nCoV-19 vaccine, a HCW – our IC was diagnosed of COVID-19 by a rapid antigen test (RAT). A reverse transcription-polymerase chain reaction (RT-PCR) test done on the same day showed a cycle threshold (Ct) value of 10.02 (a very high viral load). Contact tracing and findings: The authors traced IC’s contacts and seven contacts were identified. Four of those (P 1–4) were tested positive for COVID-19 on day12 after the contact. P1–2 were vaccinated and had slept near the IC in an enclosed 5.5 × 2.7 × 2.4 m room without air change and without masks, while IC was symptomatic. P3 and P4 came in immediately after IC left that room and slept there without masks. We did not find any other exposures of P1–4 within the 14 days (d) before they tested positive.”
CONCLUSION: “P1 and P2 are COVID-19 vaccine breakthrough infections. P3 and P4 contracting infection in the physical absence of IC indicates probable aerosol transmission of COVID-19. The factors that led to this episode, namely, unfamiliarity of breakthrough COVID-19 infections, ignoring the risk of contracting COVID-19 from vaccinated co-workers, hesitancy in seeking medical care soon after the onset of symptoms, poorly ventilated and cramped resting rooms for HCW exists worldwide. This episode reiterates the importance of adhering to basic COVID-19 preventive measures even after vaccination.”
31. Clinical Kidney Journal (February 2, 2022)
TITLE: Diminished and waning immunity to COVID-19 vaccination among hemodialysis patients in Israel: the case for a third vaccine dose
METHODS: “We compared 409 COVID-19-naïve HD patients from 13 HD units in Israel to 148 non-dialysis-dependent COVID-19-naïve controls. Twenty-four previously infected (antinucleocapsid positive) HD patients were analysed separately. Blood samples were obtained ≥14 days post-vaccination (BNT162b2, Pfizer/BioNTech) to assess seroconversion rates and titers of anti-spike (anti-S) and neutralizing antibodies.”
CONCLUSION: “The median time from vaccination to blood sample collection was 82 days [interquartile range (IAR) 64–87] and 89 days (IQR 68–96) for HD patients and controls, respectively. Seroconversion rates were lower in HD patients compared with controls for both anti-S and neutralizing antibodies (89% and 77% versus 99.3%, respectively; P < 0.0001). Antibody titers were also significantly lower in HD patients compared with controls {median 69.6 [IQR 33.2–120] versus 196.5 [IQR 118.5–246], P < 0.0001; geometric mean titer [GMT] 23.3 [95% confidence interval (CI) 18.7–29.1] versus 222.7 [95% CI 174–284], P < 0.0001, for anti-S and neutralizing antibodies, respectively}. Multivariate analysis demonstrated dialysis dependence to be strongly associated with lower antibody responses and antibody titers waning with time. Age, low serum albumin and low lymphocyte count were also associated with lower seroconversion rates and antibody titers. HD patients previously infected with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had no difference in their seroconversion rates or antibody titers compared with COVID-19-naïve patients.”
“This study demonstrates diminished and waning humoral responses following COVID-19 vaccination in a large and diverse cohort of HD patients, including those previously infected with SARS-CoV-2. Considering these results and reduced vaccine effectiveness against variants of concern, in addition to continued social distancing precautions, a third booster dose should be considered in this population.”
32. Journal of Positive School Psychology (Published 2022)
TITLE: Omicron Breakthrough Infections in Fully Vaccinated Individuals during Omicron Wave in Kashmir, India and Current Regional Scenario
METHODS: “Samples were taken from within the officially declared period ofOmicron wave in our state of Jammu and Kashmir India (January 2022-march 2022). Vaccination status and other demographic information of the patients was collected via a proforma filled at the time of sample collection. All the health care workers (HCW’s) involved in sample collection and transport were trained appropriately and provided relevant SOP’s. Before initiating sample collection, a full personal protective equipment (PPE) was worn. For initial diagnostic testing of SARS-CoV-2 infections, CDC recommends collecting and testing an upper respiratory specimen. Upper respiratory tract specimens, which include Nasopharyngeal (NP) swabs, oropharyngeal (OP) swabs, Nasal mid-turbinate (NMT) swabs, nasopharyngeal wash/aspirate, and saliva have all been used. All samples were taken according to CDC recommendations for taking covid sample. [18]. On receipt, the samples collected from different locations spread around the state were processed in the biosafety level III lab (BSL III), negative pressure room. A real-time RT-PCR assay in accordance with the manufacturer’s instructions was used for the detection of ribonucleic acid (RNA) from SARS-CoV-2 present in the NP swabs from patients suspected of COVID-19. RNA extraction and purification was done for all the specimen using the Invitrogen, PureLink Viral RNA/DNA Mini Kit by ThermoFisher scientific. Extracted and purified RNA was reverse transcribed to c DNA and subsequently amplified using the ABI 7500 Fast DX RT-PCR thermocycler.Meril COVID-19 One Step RT-PCR Kitwasused which is a one step kit wherein the N-geneand ORF-1ab was used for detection of SARS-CoV-2 specific RNA.”
CONCLUSION: “In this study 80.6% patients were symptomatic with omicron infection. Also it was observed that majority (85.18%) of patients who were fully vaccinated still got the infection. This can be explained asa result of Vaccine Breakthrough infection. Essentially, the current COVID-19 vaccines in use mainly target the S protein. The 32 amino acid changes, including three small deletions and one small insertion in the spike protein, in the Omicron variant give it antibody resistance. Also , these mutations may dramatically enhance the variant’s ability to evade current vaccines.
“In general, it is essentially impossible to accurately characterize the full impact of Omicron’s S protein mutation son the current vaccines in the world’s populations. First, different types of vaccines may lead to different immune responses from the same individual. Additionally, different individuals characterized by race, gender, age, and underlying medical conditions may produce different sets of antibodies from the same vaccine. Moreover, the reliability of statistical analysis over populations may be limited because of the inability to fully control various experimental conditions.
“Omicron is about 10 times more infectious than the original virus or about2.8 times as infectious as the Delta variant.Omicron’s vaccine-escape capability is near 14 times as high as that of the Delta variant. Our results call for the development of a new generation of vaccines and mAbs that will not be easily affected by viral mutations.”
33. Medical Archive (Posted January 23, 2022)
TITLE: Risk of COVID-19 Reinfection and Vaccine Breakthrough Infection, Madera County, California, 2021
ABSTRACT/METHODS: “The hazard ratio (HR) for death (from all causes) after COVID-19 infection vs. vaccination was 11.7 (95% CI 5.91-23.1, p<0.05). The HR for testing positive for COVID-19 >14 days after initial COVID-19 infection or after completing primary COVID-19 vaccination was 1.98 (95% CI 1.53-2.58 p<0.001). As the majority of positive COVID-19 tests in the post COVID-19 cohort occurred within 90 days of the initial infection, and as these early positives may not represent a new infection, we also compared rates of testing COVID-19 positive 90 days after initial infection or vaccination. After removing these early positive ≥ COVID-19 tests that occurred between days 14-90, the HR ratio for testing COVID-19 positive is now lower for the post COVID-19 cohort compared with the vaccinated cohort. The risk for having a positive COVID-19 test occurring 90 days after an initial COVID-19 infection or after vaccination was 0.54 (95% CI 0.33-0.87, p<0.05) for the post COVID-19 group vs Vaccinated group.”
“COVID-19 testing results (negative and positive, including antigen tests, molecular testing and COVID-19 antibody tests) must be reported to the California Reportable Disease Exchange system (CalREDIE). Commercial, public health and most clinical laboratories report results electronically directly to CalREDIE.
Rapid antigen testing may be reported by manual entry through internet or app-based access. The
extent to which home self-testing results are reported is not known. All reported COVID-19 test results with demographic information in CalREDIE for residents of Madera County, California were accessed.
COVID-19 Immunization data for California are reported to a statewide database SNOWFLAKE. Death
data for Madera County are reported directly to the Department of Public Health Vital Statistics
department.
“Persons were identified and all duplicates were removed by grouping results based on a unique DOB,
gender and first three initials of their first and last names. For each person the following information
was determined: their first and last COVID-19 positive test dates, their first COVID-19 negative test date,
their vaccination status and administration dates, whether they completed the primary vaccine series,
and their date of death if deceased (all cause mortality). Vaccine recipients who had no COVID-19 test
data were also included in this dataset.”
CONCLUSION/DISCUSSION: “In this analysis, the risk of death after testing positive for COVID-19 was, as expected, significantly higher than for the vaccinated and unvaccinated cohorts. For subjects that survived their initial COVID-19 infection, the risk of testing positive for COVID-19 positive again was higher in the first 14-90 days for the post COVID-19 cohort compared with the vaccinated cohort. However, the hazard ratio for retesting COVID-19 positive between 90-300 days after the initial COVID-19 infection or after completing vaccination, for the post COVID-19 cohort was significantly lower than for the vaccinated cohort (HR 0.54, 95% CI 0.44-0.87, p<0.05). The unvaccinated cohort had, as expected, the highest risk of COVID-19 infection during this 300-day time period.”
34. Annals of Oncology (Published online December 24, 2021)
TITLE: COVID-19 vaccination and breakthrough infections in patients with cancer
METHODS: The large international CCC19 registry captures data on patients with a current or prior history of cancer who develop COVID-19 through a REDCap survey with methodology outlined previously. Deidentified data are collected using a comprehensive set of variables related to demographics, cancer status, anticancer therapies, SARS-CoV-2 infection, and COVID-19 vaccination. Data on COVID-19 vaccination were routinely collected on every newly entered case beginning with the first global approval in November 2020. Eligible cases included adult patients (>18 years of age) accrued from 1 November 2020 to 31 May 2021 with current or prior history of invasive cancer and laboratory-confirmed SARS-CoV-2 infection. Patients were excluded if vaccination status or timing was unknown or if the vaccine was administered after SARS-CoV-2 infection. We also excluded cases with poor data quality (score ≥5 using the previously defined metric).
CONCLUSION: Patients with cancer who develop COVID-19 following vaccination have substantial comorbidities and can present with severe and even lethal infection. Patients harboring hematologic malignancies are over-represented among vaccinated patients with cancer who develop symptomatic COVID-19.
Vaccination against COVID-19 remains an essential strategy in protecting vulnerable populations, including patients with cancer. Patients with cancer who develop breakthrough infection despite full vaccination, however, remain at risk of severe outcomes. A multilayered public health mitigation approach that includes vaccination of close contacts, boosters, social distancing, and mask-wearing should be continued for the foreseeable future.
35. Human Vaccines & Immunotherapeutics (Published October 18, 2021)
TITLE: Breakthrough SARS-CoV-2 infections after vaccination: a critical review
METHODS: “The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in many individuals becoming infected, more than four million deaths, and has placed an unprecedented burden on public health services worldwide. At the beginning of the coronavirus 2019 (COVID-19) pandemic, it was speculated that SARS-CoV-2 infection would result in lifelong immunity, and reinfections would be unlikely. However, there have been several documented cases of reinfection with SARS-CoV-2. A cohort study reports reinfection rates among a large north Indian HCW (n = 4978) with SARS-CoV-2 infection in 15 months (including the second wave, which was closely linked to the delta variant). As the result of this study, 124 cases of reinfection (2.5%) were identified. Another study from India from January 22 to 7 October 2020, reported that out of 1300 individuals, 58 (4.5%) were reinfected. Therefore, waning humoral immunity is increasingly recognized as a significant concern. Accordingly, long-term and durable vaccine-induced antibody protection against infection is now a significant challenge facing scientists. Since the SARS-CoV-2 vaccination program started, several breakthroughs of COVID-19 infection have been identified in individuals who had been vaccinated. This article reviews the literature on breakthrough SARS-CoV-2 infections following vaccination.”
CONCLUSION/DISCUSSION:
As previously mentioned, waning immunity after a de novo infection or vaccination can be the reason that some people get infected or reinfected following COVID-19 vaccines. Moreover, some individuals with diminished capacity to produce protective antibodies, such as immunosuppressed patients, are also susceptible to being infected even after being naturally infected with this virus or receiving both vaccine doses. Ineffective antibody production, due to relatively ineffective vaccines, an inadequate number of doses, and the time after the vaccination are also involved in the pathogenesis of post-vaccination infections. It is not unusual to get infected in the first 14 days following the first dose of the vaccine since protective immunity cannot build within this period. For example, it has been estimated that the Pfizer COVID-19 vaccine has efficacy in preventing COVID-19 infection of 52.4% before and 90.5% one week after the second dose, respectively, vaccinated people may develop an infection before the booster shot takes full effect.
There have been studies regarding the effectiveness of anti-SARS-CoV-2 vaccinations in preventing infection by the newly discovered SARS- CoV-2 variants. For instance, one study was conducted to evaluate the effectiveness of the mRNA- 1273 vaccine against SARS-CoV-2 variants and assess its effectiveness by time against the delta variant since vaccination. In this study, 8153 cases were studied, and the result is as follows: two-dose vaccine effectiveness was 86.7% against infection with the delta variant, 98.4% against alpha, 96–98% against other identified variants, and 79.9% against unidentified variants (specimens that failed sequencing). In general, vaccinated individuals are less likely to get infected than those who are unvaccinated, although the level of prevention strongly depends on the specific variant of concern (VOC). The evolution of mutations in the genes of SARS-CoV-2 can affect the efficacy of vaccine- or natural-induced immunity. The emergence of new SARS-CoV-2 variants, including the alpha (B.1.351) or delta (B.1.617.2) variants, with higher transmissibility and less susceptibility to the previously produced protective antibodies, is another reason why some individuals become infected even after being fully vaccinated. Thus, these variants could be the reason why vaccine breakthrough infections occur two weeks post-vaccination, even with high titers of vaccine-induced antibodies. However, some new variants are less likely to escape vaccine-induced immunity and, therefore, less problematic. Although most cases of post-vaccination infections are because of VOCs, it does not appear that these cases are due to remarkable genetic diversity or spike protein mutations in VOCs.”
Researchers have found that vaccination with the ChAdOx1 or BNT162b2 vaccines can significantly decrease new positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) from 21 days after the first dose onwards, with greater immunity following a second dose and significant reductions for symptomatic infections and infections with higher viral loads (cycle threshold, Ct < 30). However, breakthrough infections with lower viral loads can further reduce onward transmission. Nevertheless, there is some concern that the new variants which evade vaccine-induced immunity may also lead to asymptomatic infection, resulting in more viral spread. Moreover, since the COVID-19 vaccine is administered by injection and designed to prevent viremia, they are thought to be unable to prevent nasal SARS-CoV-2 infection, resulting in more asymptomatic shedding and more viral spread through asymptomatic patients’ upper airways. However, it is thought that those vaccinated against COVID-19 would have less severe and shorter breakthrough infections with lower viral loads. Studies have shown that post-vaccination COVID-19 infection less commonly requires hospitalization and admission to an intensive care unit (ICU) than infections in non-vaccinated individuals. The risk factors of SARS-CoV-2 infection after COVID-19 vaccination have been reported to include younger age, adverse health determinants, such as extended social isolation, obesity, unhealthy lifestyle, less adherence to preventive measures, and the presence of concomitant comorbidities, including renal disease, and receiving immunosuppressant medication.”
“All the issues mentioned above reinforce the fact that vaccination does not entirely prevent SARS-CoV-2 infections but will lead to less morbidity and mortality, as demonstrated by less hospitalization and less need for ICU care. In addition, the reality that vaccinated individuals may develop asymptomatic breakthrough infections should be a concerning issue, as this increases the risk of viral transmission and spread in the community. Moreover, the relatively high rates of post-vaccination infection, either due to insufficient efficacy of the vaccines or through the evolution of new variants, highlight the importance of maintaining social distancing and other preventive measures, even when vaccinated.”
36. Medical Archive (Posted online February 26, 2022)
TITLE: Waning Effectiveness of the Third Dose of the BNT162b2 mRNA COVID-19 Vaccine
METHODS: “The study population included all MHS members aged 16 or older who received at least two
doses of the BNT162b2 vaccine by August 1, 2021. Individuals were excluded from the study if
they had a positive SARS-CoV-2 polymerase chain reaction (PCR) assay test result, disengaged
from MHS for any reason prior to the start of the study period or joined MHS prior to March
2020, hence might have an incomplete COVID-19-related history. Anonymized Electronic
Medical Records (EMRs) were retrieved from MHS’ centralized computerized database, a statemandated, non-for-profit, health fund in Israel which covers 26.7% of the population. This
centralized database has been maintained for over three decades, allowing for a comprehensive
longitudinal medical follow-up, including demographic data, clinical measurements, outpatient
and hospital diagnoses and procedures, medications dispensed, imaging performed and
comprehensive laboratory data from a single central laboratory.”
CONCLUSION/RESULTS: “546,924 PCR tests by 389,265 MHS members were performed during the outcome period of January 1 to January 21, 2022. 53,486 tests (performed by 38,145 individuals) were excluded from the main analysis, as they were conducted after the administration of the fourth dose (see
additional analyses)… . Overall, those vaccinated early were more chronically ill, likely correlating with earlier compliance to vaccination by the older population, emphasizing the need for adjustment. The follow-up period exemplified Omicron’s rapid spread, with an increase in the daily numbers of infections and severe disease. During the examined Omicron-dominant period, a total of 101,737 booster breakthrough infections and 482 breakthrough infections resulting in COVID-19 hospitalizations or deaths were detected, of which 30,870 infections, 208 hospitalizations and 9 deaths were among those who received the booster dose early, in August 2021, whereas 1,082 infections, 4 hospitalizations and zero mortality were among the ‘newly vaccinated’ booster recipients, receiving their booster dose in December 2021. In that same Omicron period, 16,938 infections and 122 hospitalizations were recorded among those who received only two doses.”
“Our main analysis took a test-negative approach, comparing VE between recipients of the
booster at different time points from inoculation. The analysis is based on the premise that had
there been no waning of the booster protection over time, we would have seen no difference in
infection odds at different times from vaccination (within the same calendrical outcome period).
Nonetheless, we found that the effectiveness in each month since vaccination decreased
significantly, whereas VE against infection compared to the first month of eligibility of the
booster (August 2021) declined from 53.4% a month after vaccination to 16.5% three months
after the booster dose. As for marginal protection of the third dose compared to the second dose
(that is, protection gained on top of the one gained from two doses), we found a residual vaccine
effectiveness of 16% after 5 months. Though the data suggests a milder waning of protection
against severe disease, number of hospitalizations and mortality were too small to reach a
reliable conclusion.”
“Studies have demonstrated that the third dose increases immunogenicity against SARS-CoV-2 as
reflected by a rapid and broad immune response to the third BNT162b2 dose. Our results
suggested a time dependent response with a primary increase in VE followed by waning of
effectiveness. Overall, this waning of protection matches our knowledge of the course of the second dose of the BNT162b2, where protection increases immediately after a dose, but decreases rapidly within a few months. However, it seems that effectiveness could be declining faster than that of the second dose. The faster decline might partly be explain by an escape of the Omicron variant from neutralizing antibody responses,18 though further variant-specific evidence need to be established. Our results further point to the fact that waning of VE is not primarily affected by comorbidities, but rather that the most important factor in long-term VE is time from the last inoculation.”
37. Infection (Published March 16, 2022)
TITLE: A case series of severe breakthrough infections observed in nine patients with COVID‑19 in a southwestern German university hospital
METHODS: “Since July 13, 2021, there is an extended reporting requirement by German law. We analyzed our hospitalized patients with vaccine breakthrough infection during the first 8 weeks.”
CONCLUSION: “Nine of 67 patients (13.4%) hospitalized for COVID-19 (median age 75 years) were fully vaccinated. Five of these patients received intensive care; two patients died. All had received two doses of BNT162b2 vaccines (Pfizer-BioNTech). There was a median of 99 days between complete immunization and symptom onset. All patients suffered from ≥ three comorbidities. Six patients (66.7%) showed a negative Anti-SARS-CoV-2-N titer at the time of vaccine breakthrough, five of these also had Anti-SARS-CoV-2-S titers < 100 U/ml. All determinable cases were Delta variant B.1.617.2.”
“Advanced age, underlying cardiorespiratory disease, and the Delta variant of SARS-CoV-2 were associated with hospitalization of our patients, suffering from vaccine breakthrough infection. Avoidance of face masks, lack of immunization of close contacts, and travel to high-risk areas have been observed as modifiable behavioural circumstances. Consistent personal protective measures, vaccination of close caregivers, and increased awareness might be effective measures in addition to COVID-19 booster vaccination for patients at a high risk to suffer a severe course of infection.”
38. Clinical Microbiology and Infection (Published February 7, 2022)
TITLE: The effect of a third BNT162b2 vaccine on breakthrough infections in health care workers: a cohort analysis
METHODS: “Infections with severe acute respiratory syndrome coronavirus 2 are monitored systematically among HCWs at the Hadassah tertiary care medical centre in Jerusalem, Israel. In this cohort, we included breakthrough infections, defined as those occurring >180 days since the second vaccine dose. The follow-up period lasted 120 days. We compared infection rates between HCWs who received the booster dose and those who received only the two-dose regimen.”
RESULTS/CONCLUSION: “The rate of breakthrough infections among HCWs who received only the two-dose regimen was 21.4% (85 of 398). The rate in the boosted group was 0.7% (35/4973; relative risk 30, 95% CI 20-50). Those results were seen in all age groups.”
“The significantly lower rate of breakthrough infections in boosted HCWs indicates substantial protection by a third vaccine dose.”
39. Open Forum Infectious Diseases (March 13, 2022)
TITLE: Clinical Outcomes in Hospitalized Vaccine-Breakthrough Coronavirus Disease 2019 Cases Compared With Contemporary Unvaccinated Hospitalized Adults
METHODS: “We reviewed clinical and demographic information of disease characteristics in 2 groups: (1) fully vaccinated (Fvac; at least 14 days post–second dose, but not boosted) and (2) unvaccinated adults (Unvac), aged >17 years, admitted for COVID-19 in a 353-bed private hospital. We used data extracted from a disease-specific database created at the beginning of the COVID-19 pandemic and enhanced data with relevant information incorporated in real time. Data were extracted from 27 March 2021 (the day the first fully vaccinated case was admitted) to 31 August 2021; this Southern Hemisphere winter season coincided with the second wave of COVID-19 in Chile. Data included age, sex, CCU admission, use of invasive mechanical ventilation, length of hospitalization, and intrahospital death.”
ABSTRACT/CONCLUSION: “Chile has implemented an early and expansive vaccination program that enabled 2-dose immunization in 88% of its population of 19.5 million (older children included) by the end of the third quarter of 2021. CoronaVac (Sinovac Biotech Ltd, Beijing, China), is an inactivated vaccine that has been the cornerstone of the program, used in 75% of vaccinated adults. The BNT162b2 mRNA vaccine (Pfizer with BioNTech and Fosun Pharma, New York, New York) has been used mostly in immunocompromised adults and minors, to a much lesser degree. CoronaVac immunogenicity is comparatively less robust, though substantial antibody levels are achieved; real-world effectiveness was assessed in a Chilean study of 4 million vaccinees, demonstrating a 65.9% (95% confidence interval [CI], 65.2%–66.6%) preventive effect for symptomatic infection and a much higher prevention of hospitalization (87.5% [95% CI, 86.7%–88.2%]), CCU admissions (90.3% [95% CI, 89.1%–91.4%]), and death (86.3% [95% CI, 84.5%–87.9%]) in the short run. Effectiveness declined with time, suggesting the benefit of boosting doses.”
“Chilean data have confirmed inactivated vaccine efficacy in clinical trials [8] and effectiveness for multiple outcomes from a state-sponsored vaccination program in several million people. Our study demonstrates the value of inactivated vaccines in reducing severity of disease in hospitalized patients with COVID-19 at multiple age strata. Among the hospitalized COVID-19 cases, 1 in 4 had received full primary vaccination, overwhelmingly CoronaVac (96.5%), much higher than its 75% participation in the mix of vaccines used in the country, consistent with the superior hospitalization prevention effect found with BNT162b2 in the country compared with the former during the same period of this study (97.2% vs 86%) [5]. Our vaccinated hospitalized subjects were 2 decades older, on average, than the unvaccinated hospitalized subjects, almost certainly representing a population with more baseline comorbidities and naturally more prone to have severe disease and death when infected compared to younger people. The higher mortality in the vaccinated group as a whole is misleading; once age is controlled for by stratum-specific analysis, death rates in each decade group from the 40s to the 70s were lower in vaccinees, with too few cases aged ≥80 years in the unvaccinated group for meaningful comparison. This older cohort also had fewer admissions to the CCU, less need for mechanical ventilation, and shorter length of hospital stay as a whole; these differences were more pronounced and statistically significant in those aged ≥60 years. These clinical outcomes data suggest that full prior vaccination with the inactivated vaccine provides significant protection from serious disease. At a national level, the aggressive vaccination program in Chile of early 2021 seems to have blunted the magnitude of the epidemic, including the more salutary consequences for those with breakthrough disease, reinforcing confidence in the vaccines used. We will be unable to follow up this study since unvaccinated persons are now scarce, due to special incentives toward vaccination and restrictions on the unvaccinated being put in place for adults and children in a national effort to maximize immunization in these populations. A vigorous booster vaccination campaign for all persons with full primary vaccination, beginning with the elderly, has been conducted in late 2021 and 2022. We intend to compare COVID-19 cases in vaccinated people with and without booster doses. Limitations of our study include lack of evaluation of comorbidities and viral variants, being a single-site study, risk of patients’ profile not being an accurate representation of the COVID-19 population at large, and portraying a situation prior to the Omicron surge. Our study does not evaluate the decline of the preventive effect of CoronaVac over time. We believe that Chilean data are reassuring for LMICs since there are many countries with vaccination programs in their infancy, which are or will be heavily dependent on CoronaVac, and these findings add necessary relevant information to complete its profile performance. The global community may wish to consider mRNA-based vaccines, or others of similar robust immunogenicity, for heterologous boosters for persons with primary vaccination with inactivated vaccines given highly favorable immunological results of these combinations noted from the Dominican Republic and enhanced preventive effectiveness reported from Chile [10], to maintain the beneficial effects in hospitalized breakthrough COVID-19 cases found in this study.”
NOTE: The total mortality by percentage was higher in the vaccinated group (17.3%) than in the unvaccinated group (13.4%).

40. JAMA International Medicine (Published December 28, 2021)
TITLE: Association Between Immune Dysfunction and COVID-19 Breakthrough Infection After SARS-CoV-2 Vaccination in the US
METHODS: “This retrospective cohort study analyzed data from the National COVID Cohort Collaborative (N3C), a partnership that developed a secure, centralized electronic medical record–based repository of COVID-19 clinical data from academic medical centers across the US. Persons who received at least 1 dose of a SARS-CoV-2 vaccine between December 10, 2020, and September 16, 2021, were included in the sample.”
CONCLUSION: “A total of 664 722 patients in the N3C sample were included. These patients had a median (IQR) age of 51 (34-66) years and were predominantly women (n = 378 307 [56.9%]). Overall, the incidence rate for COVID-19 breakthrough infection was 5.0 per 1000 person-months among fully vaccinated persons but was higher after the Delta variant became the dominant SARS-CoV-2 strain (incidence rate before vs after June 20, 2021, 2.2 [95% CI, 2.2-2.2] vs 7.3 [95% CI, 7.3-7.4] per 1000 person-months). Compared with partial vaccination, full vaccination was associated with a 28% reduced risk for breakthrough infection (adjusted IRR [AIRR], 0.72; 95% CI, 0.68-0.76). People with a breakthrough infection after full vaccination were more likely to be older and women. People with HIV infection (AIRR, 1.33; 95% CI, 1.18-1.49), rheumatoid arthritis (AIRR, 1.20; 95% CI, 1.09-1.32), and solid organ transplant (AIRR, 2.16; 95% CI, 1.96-2.38) had a higher rate of breakthrough infection.”
“This cohort study found that full vaccination was associated with reduced risk of COVID-19 breakthrough infection, regardless of the immune status of patients. Despite full vaccination, persons with immune dysfunction had substantially higher risk for COVID-19 breakthrough infection than those without such a condition. For persons with immune dysfunction, continued use of nonpharmaceutical interventions (eg, mask wearing) and alternative vaccine strategies (eg, additional doses or immunogenicity testing) are recommended even after full vaccination.”
41. Emerging Infectious Diseases (Published February, 2022)
TITLE: Comparative Effectiveness of Coronavirus Vaccine in Preventing Breakthrough Infections among Vaccinated Persons Infected with Delta and Alpha Variants
METHODS: “We developed an observational case–case study (10) comparing odds of vaccination (partial or complete) between RT-PCR–positive cases (symptomatic or asymptomatic) classified as infected with Delta versus Alpha VOCs. The study period was May 17–July 4, 2021 (epidemiologic weeks 20–26), to cover the period of VOC replacement in Portugal, from the Alpha (84.8%, week 19) to Delta dominance (96.1%, week 27) (1). Our analysis included persons with data on wholegenome sequencing (WGS) or spike (S) gene target failure (SGTF) who were >40 years of age and eligible for vaccination during the study period. Persons for whom data on national health registry number, age, sex, or diagnosis date were missing, and those vaccinated with Ad26.COV2-S (Johnson & Johnson/Janssen, https://www.janssen.com) or ChAdOx1 nCoV19 (AstraZeneca, https://www.astrazeneca.com) vaccines were excluded from the study.”
CONCLUSION: A total of 22,784 SARS-CoV-2–positive cases were reported in Portugal during May 17–July 4, 2021, among persons >40 years of age. Of 2,097 cases included in the analysis, 966 (46.1%) were variant-classified with WGS and 1,131 (53.9%) with SGTF. During the study period, 94.7% (827/873) of the S-positive sequenced samples were confirmed as Delta and 96.9% (372/384) of SGTF samples were classified as Alpha through WGS, thus indicating that the SGTF-derived VOC classification was robust. Among Delta case-patients, we observed a higher proportion of persons >70 years of age (p<0.001), and a higher proportion of vaccinated persons (p<0.001) than among the Alpha case-patients. We report a statistically significant higher odds of being partially vaccinated (OR 1.70 [95% CI 1.18–2.47]) or completely vaccinated (OR 1.96 [95% CI 1.22–3.14]) among the Delta case-patients than among the Alpha case-patients, suggesting lower mRNA vaccine effectiveness for the Delta variant. After adjustment for age group and sex, similar estimated ORs were observed for the complete vaccination scheme (OR 1.96 [95% CI 1.43–2.69]) or for partial vaccination (OR 1.81 [95% CI 1.37–2.39]).
42. Vaccines (Published March 11, 2022)
TITLE: Risk Stratification of SARS-CoV-2 Breakthrough Infections Based on an Outbreak at a Student Festive Event
METHODS: “The festive event took place on 21 October 2021, in Northern Bavaria, Germany, with a duration of about 8 h. The venue was a private setting, with a main room of approximately 85 m2 and 250 m3 of airspace. Assuming an equispaced distribution of all guests in the main room, the arithmetic mean of the area per person was 0.85 m2, corresponding to a personal radius of 0.52 m. Some party activities took place in a larger and less-frequented garage. To avoid noise pollution in the surrounding neighborhood, the windows in the main room were closed approximately 2 h after the start of the event.”
CONCLUSION: “A student festive event in Fall 2021 in Northern-Bavaria, Germany, emerged as a SARS-CoV-2 delta outbreak with a high rate of breakthrough infections. We retrospectively examined the spread of SARS-CoV-2 associated with the event. The primary infection rate was 25% among participants, of whom 96% were fully vaccinated. Accordingly, infection rates for the delta variant have been reported between 10.6% and 23.7% in a cohort with 96.2% vaccination rate during a nosocomial outbreak. Extensive correlation analyses between 15 variables identified three significant factors for infection at the event.”
“This study shows that time spent at the event, conversation with the supposed index person, and a homologous viral vector vaccination regime were significant risk factors for SARS-CoV-2 breakthrough infection with the delta variant. While practicing social distancing, hand hygiene, and the use of face masks remain important measures in preventing the spread of SARS-CoV-2, high-quality testing of participants at in-person events could be considered mandatory to limit risk of infection, irrespective of the participants’ vaccination status. Further studies that include larger and more diverse cohorts and provide comprehensive datasets of several variables are required to shed further light on the interplay of risk factors for transmission of SARS-CoV-2 and its variants of concern—whether they are already known or have yet to emerge.”
43. Journal of Korean Medical Science (Published December 17, 2021)
TITLE: SARS-CoV-2 Delta Variant Breakthrough Infection and Onward Secondary Transmission in Household
METHODS: We included all [adult day service center (ADSC) of Jeju, South Korea] participants, staff and their household members. All COVID-19 infected cases were confirmed by reverse transcriptase polymerase chain reaction. We calculated attack rate in ADSC and the secondary attack rate (SAR) in household members by vaccination status.
CONCLUSION: Among a total of 42 participants and 16 staff, of which 96.6% were fully vaccinated with BNT162b2 mRNA COVID-19 vaccine, 12 symptomatic cases and 13 asymptomatic confirmed cases of COVID-19 were found. The attack rate was 43.1%, with 13 isolates identified as SARS-CoV-2 virus, delta variant. The SAR in unvaccinated and partially vaccinated household members were 27.8% (5/18) and 25.0% (5/20), respectively, while the SAR in fully vaccinated household members was 12.5% (1/8).
We describe a SARS-CoV-2 delta variant outbreak in ADSC with high vaccine coverage rate, characterized by high infection rate, high transmissibility, and low clinical severity. The outbreak proceeded to unvaccinated or partially vaccinated household members, emphasizing the need for immunizing close contacts of high-risk groups.
44. Medical Archive (Posted March 24, 2022)
TITLE: Relative Effectiveness of Four Doses Compared to Three Dose of the BNT162b2 Vaccine in Israel
METHODS: “A retrospective test-negative case-control study, performing both a matched analysis and an unmatched multiple-tests analysis… . The study population included 97,499 MHS members aged 60 or older who were eligible to receive a fourth vaccine dose and performed at least one PCR test during the study period. Of them, 27,876 received the fourth dose and 69,623 received only three doses.”
CONCLUSION: “A fourth dose provided considerable additional protection against both SARS-CoV-2 infection and severe disease relative to three doses of the vaccine. However, vaccine effectiveness against infection varied over time, peaking during the third week with a VE of 64% (95% CI: 62.0%-65.9%) and declining to 29.2% (95% CI: 17.7%-39.1%) by the end of the 10-week follow-up period. Unlike VE against infection, the relative effectiveness of a fourth dose against severe COVID-19 was maintained at high level (>73%) throughout the 9-week follow-up period. Importantly, severe disease was a relatively rare event, occurring in <1% of both fourth dose and third dose only recipients.
A fourth dose of the BNT162b2 vaccine provided considerable additional protection against both SARS-CoV-2 infection and severe disease relative to three doses of the vaccine. However, effectiveness of the fourth dose against infection wanes sooner than that of the third dose.”
45. Emerging Microbes & Infections (Published April 12, 2022)
TITLE: COVID-19 breakthrough infections and humoral immune response among BNT162b2 vaccinated healthcare workers in Malaysia
METHODS: “This prospective, single-arm cohort study was conducted in Malaysia between March and October 2021. Five hundred and fifty-one healthcare workers, who received two doses of BNT162b2 vaccines three weeks apart, were recruited from three tertiary public hospitals, of which two were designated for the management of COVID-19 patients. Participant recruitment was by quota sampling considering the population of the healthcare staff in each hospital. The study was approved by the Medical Research and Ethics Committee (MREC) Ministry of Health Malaysia and registered (NMRR-21-56-58212). All participants provided written informed consent before enrolment.”
RESULTS/DISCUSSION:
“Post-vaccination, one case of breakthrough infection occurred before 10 weeks, while 56 breakthrough cases (10%) occurred between 10 and 24 weeks. Of the 56 cases, 3, 20, 27 and 6 cases occurred at 3-, 4-, 5- and 6-month post-vaccination, respectively. For these cases, 45 (80%) presented mild symptoms without pneumonia, and 11 (20%) were asymptomatic cases detected during contact tracing. Of the 45 mildly symptomatic participants, the six most common symptoms were fever (n = 34, 75.5%), runny nose (n = 31, 68.9%), cough (n = 29, 64.4%), loss of smell (n = 28, 62.2%), headache (n = 24, 53.3%) and sore throat (n = 23, 51.1%). All breakthrough cases did not require hospitalization. Interestingly, none of the convalescents vaccinated participants had a breakthrough infection. More breakthrough cases occurred in the Malay ethnic group, among nurses and those working in the surgery and internal medicine departments. We found no significant difference when comparing the demographic and occupational exposure variables of breakthrough and non-breakthrough individuals.
“At 10 weeks (before the surge of breakthrough infections), the GMT was not different between the breakthrough and non-breakthrough individuals; at 24 weeks (after the surge of infections), the GMT was significantly higher in individuals with a record of breakthrough infection (2038 BAU/ml [95%CI, 1547–2685]) compared to those without (254 BAU/ml [95%CI, 233–278]). By stratifying the infections and clinical category, at 24 weeks, the post-breakthrough GMT among symptomatic individuals was significantly higher than those who were asymptomatic and uninfected (2991 BAU/ml vs. 422 BAU/ml vs. 236 BAU/ml, p < 0.001). Anti-S1-RBD antibodies rose sharply or maintained above ceiling value in 95% of the mildly symptomatic individuals. In contrast, antibody levels waned in 80% of the asymptomatic individuals, an observation similar to the uninfected individuals. (Figure 2(a,b)) The number of symptoms correlated with the likelihood of increased anti-S1-RBD antibody titre post-infection (odds ratio = 5.78 (95%CI 2.55, 22.3), p < 0.001).”

46. Emerging Infectious Diseases (Published May 28, 2022)
TITLE: Effectiveness of BNT162b2 Vaccine Booster against SARS-CoV-2 Infection and Breakthrough Complications, Israel
METHODS: “We conducted a retrospective longitudinal cohort study using 2 MOH national repositories: the COVID-19 vaccine repository and the SARS-CoV-2 test repository. The national COVID-19 vaccine repository includes vaccine type, vaccine lot number, and date of dose administration for each person vaccinated in Israel. The national SARS-CoV-2 PCR test database includes the results of each test performed, the date of testing, and the date results were obtained for each person. It also includes the date of hospitalization, severity of illness, and date of death of persons with COVID-19, if applicable. Personal identifiers such as unique personal identity number, age, and sex of each person registered in the repositories (because of PCR testing or vaccination) are included in both databases. We retrieved individual deidentified data from both databases and matched persons by using twice-encrypted unique personal identity numbers.”
RESULTS/DISCUSSION: “Our results demonstrate that, after the BNT16b2 booster dose, VE against SARS-CoV-2 infection reached levels that were observed shortly after the second vaccine dose. VE point estimates of >90% were observed in week 2 in persons 16–59 years of age and in week 3 in persons >60 years of age. Similar delay in achieving high VE among elderly persons was also shown after the second BNT162b2 vaccine dose. Highest-level VE was maintained for up to 11 weeks, as shown in persons >60 years of age included in our study. The decline in VE that occurred afterward was initially mild, still maintaining VE point estimates >90% for up to week 17 of the evaluation period in persons >60 years of age. The decline in VE became steeper during the last 2 weeks of the evaluation period.
“The B.1.617.2 (Delta) variant was the most prevalent variant in Israel through November 2021. However, the last 2 evaluation weeks, which occurred in December 2021, coincided with the beginning of a new wave of illness and the sharp rise in the B.1.1.529 (Omicron) variant in Israel. Waning immunity was shown several months after the second BNT162b2 vaccine dose and was temporarily associated with the rise of the B.1.617.2 (Delta) variant in Israel. However, a fresh 2-dose BNT162b2 vaccination regimen was found to be highly effective against the B.1.617.2 (Delta) variant.”
47. Medical Archive (Posted April 18, 2022)
TITLE: ‘Anatomy of SARS-CoV-2 outbreak of ‘vaccinated’: An observational case-control study of COVID-19 breakthrough infections, COVID-19 appropriate behavior and anti-spike-IgG response as a correlate of protection in Medical college students at Rural Medical College, India
METHODS: “A total of 74 students studying at BKL Walawalkar Rural Medical College and vaccinated for COVID-19 were included in the study. RT-PCR diagnosis was done from 5 to 10 October 2021. The breakthrough infection in the cases was characterized using self-assessment questionnaires in comparison to the controls. The cases were assessed clinically and also using biochemical parameters. Both cases and controls were also assessed for their adherence to COVID-19 appropriate behavior using a separate semi-quantitative questionnaire and scoring system.”
RESULTS/CONCLUSION: “In our study, out of the total subjects, 50% of Covaxin recipients had experienced vaccine breakthrough infection and 20% of Covishield recipients experienced breakthrough infection. Also, 6 out of the 35 cases were asymptomatic, and the rest were either having mild symptoms. None of them required any hospitalization or O2 therapy. The CAB score was lower in the cases when compared to controls. All the vaccine recipients show seroconversion. Anti-spike IgG antibodies titers are dynamic over time and across the clinically distinct groups. Irrespective of varying IgG titer, the vaccine protects against severity and possibly mortality.”
48. Journal of Medical Virology (Accepted October 5, 2021)
TITLE: Breakthrough SARS‐CoV‐2 infections among BBV‐152(COVAXIN®) and AZD1222 (COVISHIELDTM) recipients:Report from the eastern state of India
METHODS: From March 1 to June 10, 2021, nasopharyngeal swab and serumsamples were collected from vaccinated individuals who reported tothe various healthcare facilities of Odisha state with COVID‐19symptoms and sent to ICMR‐Regional Medical Research Centre Bhubaneswar, for testing and confirmation. Individuals who tested positive by real time polymerase chain reaction (RT‐PCR) after≥14days of complete doses of either BBV‐152 (Covaxin) or AZD1222(Covishield) vaccine were considered as breakthrough cases and in-cluded in the study. Covaxin (BBV152), developed by Bharat Biotech,India, in collaboration with the Indian Council of Medical Research, isan inactivated severe acute respiratory syndrome‐coronavirus‐2(SARS‐CoV‐2) vaccine, whereas Covishield is manufactured by Ser-um Institute of India under license from Astra Zeneca (adenovirusvectored ChAdOx1 nCoV‐19 vaccine–AZD1222). Demographiccharacteristics, symptoms present, medical history, vaccination de-tails, and duration of hospital/home isolation of the individuals werecollected using a questionnaire. The data for the study were part ofthe diagnostic service provided to the participants as part of theroutine procedure and available in the laboratory and were analyzedand hence no additional written consent was obtained. The Institu-tional Human Ethics Committee of ICMR‐Regional Medical ResearchCentre, Bhubaneswar, approved the study.”
RESULTS/DISCUSSION: “A total of 274 cases were found to be infected with the SARS-CoV-2 virus ≥14 days after receiving a second COVID-19 vaccine (Covaxin or Covishield) dose and were defined as breakthrough infections. Only 16.8% of individuals were asymptomatic with no difference in the ct values between the symptomatic and asymptomatic. Out of the 27 individuals with breakthrough infections and requiring hospitalizations, one died. Odisha administered more than 10.07 million doses of vaccine out of which 1.09 million doses are of Covaxin and 8.98 million doses are of Covishield till mid-June. A total of 379,505 persons were fully vaccinated with Covaxin whereas around 1 ,508,294 persons were fully vaccinated with Covishield. A higher number of fully vaccinated individuals with Covishield could have led to more breakthrough cases in individuals who received Covishield in comparison to Covaxin in the state. As COVID-19 vaccines do not provide 100% protection, post vaccination breakthrough infection is possible but rare. Earlier studies have suggested that COVID-19 vaccines might protect against the occurrence of severe illness and might help in preventing infection. A study on HCWs had found symptomatic breakthrough infections occurring in 15 persons (13.3%), out of which one required hospitalization. The study on the variants of the breakthrough cases would help further to enlighten knowledge toward various mutations and their effect on the vaccine’s capacity in preventing severe illness. The mean ct value of the infections in our study was in line with another study in Cleveland, which showed a mean ct value of 20 in about 5 (12%) fully vaccinated individuals detected positive post vaccination.”
49. JCI Insight (Published April 7, 2022)
TITLE: SARS-CoV-2 -specific immune responses in boosted vaccine recipients with breakthrough infections during the Omicron variant surge
METHODS: “We analyzed SARS-CoV-2 specific antibody and cellular responses in healthy vaccine recipients who experienced breakthrough infections a median of 50 days after receiving a booster mRNA vaccine with an ACE2 binding inhibition assay and an ELISpot assay respectively.Results: We found high levels of antibodies that inhibited vaccine strain spike protein binding to ACE2 but lower levels that inhibited Omicron variant spike protein binding to ACE2 in four boosted vaccine recipients prior to infection. The levels of antibodies that inhibited vaccine strain and Omicron spike protein binding after breakthrough in 18 boosted vaccine recipients were similar to levels seen in COVID-19 negative boosted vaccine recipients. In contrast, boosted vaccine recipients had significantly stronger T cells responses to both vaccine strain and Omicron variant spike proteins at the time of breakthrough.”
CONCLUSION: “Our data suggest that breakthrough infections with the Omicron variant can occur despite robust immune responses to the vaccine strain spike protein.”
50. Medical Archive (Posted April 27, 2022)
TITLE: Risk of COVID-19 breakthrough infection and hospitalization in individuals with comorbidities
METHODS: Using a population of fully-vaccinated patients in the de-identified Truveta Platform of electronic health records from January 1, 2019, to January 10, 2022, we used logistic regression to estimate risk of 1) a patient experiencing a breakthrough COVID-19 infection after being fully vaccinated, and 2) rate of hospitalization in those experiencing breakthrough infection. Potential confounding was adjusted with inverse probability weighting for each comorbidity by age, race, ethnicity, and sex. We present ORs and percentages of breakthrough infections by comorbidity status.
RESULTS/CONCLUSION: “Fully-vaccinated individuals with certain comorbidities experienced increased risk of breakthrough COVID-19 infection and subsequent hospitalizations compared to the general population. Individuals with comorbidities should remain vigilant against infection even if vaccinated.”
“Here we found that the incidence of SARS-CoV-2 breakthrough infection and COVID-19 hospitalization following breakthrough infection were significantly greater among patients with select comorbid medical conditions when compared to the general population. Specifically, people with diabetes, chronic lung disease, or CKD have increased incidence of breakthrough infection compared to the general population after adjusting for age, sex, race, and ethnicity. These conditions are thought to lead to impaired immune function (32–34). This is consistent with studies in unvaccinated people showing higher risk of infection in these populations as well as a study in mostly male U.S. veterans which showed reduced vaccine effectiveness in patients with a high Charlson comorbidity index.”
“In our study, patients with comorbidities had nearly twice the odds of being hospitalized than the general vaccinated population. Overall, these findings add to prior studies showing worse outcomes following COVID-19 infection in people who are immunocompromised, with diabetes, CKD, or with chronic lung disease and adds additional support for recommendations of booster vaccines given these groups continue to fare worse than the general vaccinated population. One study in an unvaccinated population reported ORs of greater than 2 for in hospital mortality following COVID-19 infection in patients with diabetes, CKD, or pulmonary disease when compared with the general population. We identified CKD as the highest risk comorbidity for hospitalization, even after adjustment for age and demographic factors. Notably, a large study in male U.S. veterans did not show an elevated risk of severe outcomes in breakthrough infections in patients with diabetes, chronic lung disease, or CKD (10). This was possibly due to their study design which matched patients by comorbidity burden thereby reducing any differences between groups. In contrast our study compared patients with identified comorbidities to a control group without these comorbidities and did not exclude or match patients with multiple comorbidities.”
51. JAMA (Published May 13, 2022)
TITLE: Association of Prior BNT162b2 COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection in Children and Adolescents During Omicron Predominance
METHODS: “A test-negative, case-control analysis was conducted using data from 6897 pharmacy-based, drive-through SARS-CoV-2 testing sites across the US from a single pharmacy chain in the Increasing Community Access to Testing platform. This analysis included 74 208 tests from children 5 to 11 years of age and 47 744 tests from adolescents 12 to 15 years of age with COVID-19–like illness who underwent SARS-CoV-2 nucleic acid amplification testing from December 26, 2021, to February 21, 2022.”
DISCUSSION/CONCLUSION: “Previous analyses among adults have shown lower estimated VE against the Omicron variant than against the Delta variant and waning of mRNA vaccine protection against symptomatic infection, regardless of predominant variant. A recent analysis from the same testing platform as this analysis demonstrated the estimated VE of the 2-dose BNT162b2 primary series against symptomatic Omicron infection among adults 18 years or older was 42% at 2 to 4 weeks after the second dose. This decreased to not significantly different from 0 by 3 months after the second dose. In this analysis, the estimated VE against symptomatic infection among adolescents 12 to 15 years old also was not significantly different from 0 during month 3 after the second dose. Among children 5 to 11 years old, the duration of protection could only be assessed up through month 2 since the second dose, and continued monitoring will be important.”
NOTE: The “vaccines” not only decline in efficacy, but clearly NEGATIVE EFFICACY after the four-month mark.
52. The New England Journal of Medicine (Published April 5, 2022)
TITLE: Protection by a Fourth Dose of BNT162b2 against Omicron in Israel
METHODS: “Using the Israeli Ministry of Health database, we extracted data on 1,252,331 persons who were 60 years of age or older and eligible for the fourth dose during a period in which the B.1.1.529 (omicron) variant of SARS-CoV-2 was predominant (January 10 through March 2, 2022). We estimated the rate of confirmed infection and severe Covid-19 as a function of time starting at 8 days after receipt of a fourth dose (four-dose groups) as compared with that among persons who had received only three doses (three-dose group) and among persons who had received a fourth dose 3 to 7 days earlier (internal control group). For the estimation of rates, we used quasi-Poisson regression with adjustment for age, sex, demographic group, and calendar day.”
CONCLUSION: “Rates of confirmed SARS-CoV-2 infection and severe Covid-19 were lower after a fourth dose of BNT162b2 vaccine than after only three doses. Protection against confirmed infection appeared short-lived, whereas protection against severe illness did not wane during the study period.”
53. The New England Journal of Medicine (Published June 15, 2022)
TITLE: Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections
METHODS: “We conducted a national, matched, test-negative, case–control study in Qatar from December 23, 2021, through February 21, 2022, to evaluate the effectiveness of vaccination with BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna), natural immunity due to previous infection with variants other than omicron, and hybrid immunity (previous infection and vaccination) against symptomatic omicron infection and against severe, critical, or fatal coronavirus disease 2019 (Covid-19).”
CONCLUSION: “The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1% (95% confidence interval [CI], 39.5 to 51.9). The effectiveness of vaccination with two doses of BNT162b2 and no previous infection was negligible (−1.1%; 95% CI, −7.1 to 4.6), but nearly all persons had received their second dose more than 6 months earlier. The effectiveness of three doses of BNT162b2 and no previous infection was 52.2% (95% CI, 48.1 to 55.9). The effectiveness of previous infection and two doses of BNT162b2 was 55.1% (95% CI, 50.9 to 58.9), and the effectiveness of previous infection and three doses of BNT162b2 was 77.3% (95% CI, 72.4 to 81.4). Previous infection alone, BNT162b2 vaccination alone, and hybrid immunity all showed strong effectiveness (>70%) against severe, critical, or fatal Covid-19 due to BA.2 infection. Similar results were observed in analyses of effectiveness against BA.1 infection and of vaccination with mRNA-1273.”
54. Preprint (Posted November 15, 2021)
TITLE: Worldwide Bayesian Causal Impact Analysis of Vaccine Administration on Deaths and Cases Associated with COVID-19: A BigData Analysis of 145 Countries
METHODS: “This study analyzed publicly available COVID-19 data from OWID (Hannah Ritchie and Roser 2020) utlizing the R package CausalImpact (Brodersen et al. 2015) to determine the causal effect of the administration of vaccines on two dependent variables that have been measured cumulatively throughout the pandemic: total deaths per million (y1) and total cases per million (y2). After eliminating all results from countries with p > 0.05, there were 128 countries for y1 and 103 countries for y2 to analyze in this fashion, comprising 145 unique countries in total (avg. p < 0.004).”
CONCLUSION: “The statistically significant and overwhelmingly positive causal impact after vaccine deployment on the dependent variables total deaths and total cases per million should be
highly worrisome for policy makers. They indicate a marked increase in both COVID-19
related cases and death due directly to a vaccine deployment that was originally sold to
the public as the “key to gain back our freedoms.” The effect of vaccines on total cases
per million and its low positive association with total vaccinations per hundred signifies a
limited impact of vaccines on lowering COVID-19 associated cases. These results should
encourage local policy makers to make policy decisions based on data, not narrative, and
based on local conditions, not global or national mandates.”
55. The New England Journal of Medicine (Published October 6, 2021)
TITLE: Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar
METHODS: “We used a matched test-negative, case–control study design to estimate vaccine effectiveness against any SARS-CoV-2 infection and against any severe, critical, or fatal case of Covid-19, from January 1 to September 5, 2021.”
CONCLUSION: “BNT162b2-induced protection against SARS-CoV-2 infection appeared to wane rapidly following its peak after the second dose, but protection against hospitalization and death persisted at a robust level for 6 months after the second dose. (Funded by Weill Cornell Medicine–Qatar and others.)”
56. The New England Journal of Medicine (Published December 9, 2021)
TITLE: Waning Immunity after the BNT162b2 Vaccine in Israel
METHODS: “We used data on confirmed infection and severe disease collected from an Israeli national database for the period of July 11 to 31, 2021, for all Israeli residents who had been fully vaccinated before June 2021. We used a Poisson regression model to compare rates of confirmed SARS-CoV-2 infection and severe Covid-19 among persons vaccinated during different time periods, with stratification according to age group and with adjustment for possible confounding factors.”
CONCLUSION: “These findings indicate that immunity against the delta variant of SARS-CoV-2 waned in all age groups a few months after receipt of the second dose of vaccine.”
57. Vaccines (Published December 31, 2021)
TITLE: Large-Scale Study of Antibody Titer Decay following BNT162b2 mRNA Vaccine or SARS-CoV-2 Infection
METHODS: “We conducted a population-based study among adult members of Leumit Health Services (LHS), a large nation-wide health maintenance organization (HMO) in Israel, which provides services to over 700,000 members. LHS has a comprehensive computerized database, continuously updated regarding subjects’ demographics, medical diagnoses, medical encounters, hospitalizations, and laboratory tests. The socio-economic status (SES) was defined according to a person’s home address. The Israeli Central Bureau of Statistics classifies all cities and settlements into 20 levels of SES. Demographic groups were also defined according to the home address of the HMO member, and categorized into three groups: General population, Ultra-orthodox Jews and Arabs; the latter two groups are of interest because a large-scale epidemiology study showed that they had significantly higher rates of infection than the rest of the Israeli population.”
CONCLUSION: “Remarkably, after BNT162b2 mRNA vaccination, we observed higher SARS-CoV-2 antibody titers in the convalescent individuals aged ≥60 years, while in the vaccinated population higher SARS-CoV-2 antibody titers were seen in younger patients. Clinically, in a recent study performed in our health organization among individuals who had received two doses of the BNT162b2 vaccine, we observed that the rate of SARS-CoV-2 infection among patients who have received their second vaccine dose increased significantly for each 30 days elapsed after the initial 90 days post-second dose; the increase was significant for all age groups. The decrease of SARS-CoV-2 IgG antibodies observed in the present study provides one explanation for the increased infection rate with increased time elapsed post-vaccination. Our observations call for replication in other populations to further correlate of protection against SARS-CoV-2 reinfection and/or COVID-19 disease and the duration of antibody-mediated protection.”
58. Nature Communications (Posted April 1, 2022)
TITLE: High failure rate of ChAdOx1-nCoV19 immunization against asymptomatic infection in healthcare workers during a Delta variant surge
METHODS: “Here, based on serial serological studies of an observational cohort of healthcare workers, we show that during a Severe Acute Respiratory Syndrome -Coronavirus 2 Delta-variant outbreak in Delhi, 25.3% (95% Confidence Interval 16.9-35.2) of previously uninfected, ChAdOx1-nCoV19 double vaccinated, healthcare workers were infected within less than two months, based on serology. Induction of anti-spike response was similar between groups with breakthrough infection (541 U/ml, Inter Quartile Range 374) and without (342 U/ml, Inter Quartile Range 497), as was the induction of neutralization activity to wildtype.”
CONCLUSION: “Amongst fully vaccinated and uninfected HCWs, i.e. completed 2 weeks beyond the second dose and Anti-NCnegative at D45, the breakthrough infection prevalence at D90 was 25.3% (95% CI 16.9–35.2%) with 24 of 95 subjects getting an infection. Adjusted protection effectiveness of 70% (95% CI 52–83%) for fully vaccinated subjects was observed when adjusted for age and gender. Anti-S concentration or surrogate assays for nAb were poor predictors of vaccination breakthrough. We also utilized relaxed criteria, at D90, where the CoI at D90 could be between 0.2 and 1, instead of CoI > =1, and, should show an Anti-NC increase greater than two-fold and Anti-S increase greater than five-fold to qualify as a breakthrough. Using this relaxed criterion to determine infection, adjusted vaccine effectiveness fell to 60% (95% CI 42–76%). These estimates are similar to reports from elsewhere, ranging from 67 to 79%.”
“We observed an adjusted vaccine effectiveness of 45% (95% CI 16–73%) for a single dose, using a similar methodology. Model-based evaluation to study the effect of confounders such as age and gender for fully and partially vaccinated subjects did not lead to substantial changes in the estimates.”
EXAMPLES OF COVID-19 INFECTION RATES INCREASING ON COUNTRY WIDE SCALE AFTER ‘VACCINE’ ROLLOUT
Immediately below are just a handful of examples of country wide COVID-19 infection levels increasing (or even skyrocketing) after the rollout of the “vaccinations.” Note that some countries that completely shut themselves off from the world to avoid disease spread developed their highest infection rates *after* the “vaccine” rollout. In Australia, for example, COVID-19 deaths hit record highs after the rollout.
Note as well, in the graph immediately below, that the U.S. saw a monstrous winter spike in infections—far larger than the previous winter spike—after the vaccine rollout.
Beneath the list of examples of country wide infection booming after “vaccination” rollout is a study that was published in the European Journal of Epidemiology online on September 30, 2021. The authors of the study, including S. V. Subramanian, et al. write that “There… appears to be no significant signaling of COVID-19 cases decreasing with higher percentages of population fully vaccinated…” and that “Of the top 5 counties that have the highest percentage of population fully vaccinated (99.9–84.3%), the US Centers for Disease Control and Prevention (CDC) identifies 4 of them as ‘High’ Transmission counties.“
The authors add in their study that “of the 57 counties that have been classified as ‘low”’transmission counties by the CDC, 26.3%… have percentage of population fully vaccinated below 20%.”
(Shoutout to PLC and Ian Miller, who both post excellent graphs and analyses of COVID-19 happenings on Twitter.)


– Ireland reimposes COVID-19 restrictions including a midnight curfew. 93% of the adult population are fully vaccinated. pic.twitter.com/UODBBAFAy5
— SuzeeB🙂 (@NatalieSuB) November 18, 2021

Quoted paragraphs from Yahoo! News article authored by Dylan Stableford and Andrew Romano:
“On paper, the latest case numbers seem ominous. In Vermont, which has the highest vaccination rate of any state in the country, new daily cases are up 49 percent in the past two weeks. More than 72 percent of Vermonters have been fully vaccinated, compared with 59 percent nationally.
“In neighboring New Hampshire, new daily cases are up 84 percent in the past two weeks (compared with a 7 percent jump over the same period nationwide), despite 63 percent of its population being fully inoculated.
“In New Mexico, new daily cases are up 46 percent in the same period, even though 63 percent of its residents are fully vaccinated.”
1. European Journal of Epidemiology (Published online September 30, 2021)
TITLE: Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States
METHODS: “We used COVID-19 data provided by the Our World in Data for cross-country analysis, available as of September 3, 2021… . We included 68 countries that met the following criteria: had second dose vaccine data available; had COVID-19 case data available; had population data available; and the last update of data was within 3 days prior to or on September 3, 2021. For the 7 days preceding September 3, 2021 we computed the COVID-19 cases per 1 million people for each country as well as the percentage of population that is fully vaccinated.”
CONCLUSION: “At the country-level, there appears to be no discernable relationship between percentage of population fully vaccinated and new COVID-19 cases in the last 7 days… . In fact, the trend line suggests a marginally positive association such that countries with higher percentage of population fully vaccinated have higher COVID-19 cases per 1 million people.”
“Notably, Israel with over 60% of their population fully vaccinated had the highest COVID-19 cases per 1 million people in the last 7 days. The lack of a meaningful association between percentage population fully vaccinated and new COVID-19 cases is further exemplified, for instance, by comparison of Iceland and Portugal. Both countries have over 75% of their population fully vaccinated and have more COVID-19 cases per 1 million people than countries such as Vietnam and South Africa that have around 10% of their population fully vaccinated.
“Across the US counties too, the median new COVID-19 cases per 100,000 people in the last 7 days is largely similar across the categories of percent population fully vaccinated… . Notably there is also substantial county variation in new COVID-19 cases within categories of percentage population fully vaccinated. There also appears to be no significant signaling of COVID-19 cases decreasing with higher percentages of population fully vaccinated… .”
“Of the top 5 counties that have the highest percentage of population fully vaccinated (99.9–84.3%), the US Centers for Disease Control and Prevention (CDC) identifies 4 of them as “High” Transmission counties. Chattahoochee (Georgia), McKinley (New Mexico), and Arecibo (Puerto Rico) counties have above 90% of their population fully vaccinated with all three being classified as “High” transmission. Conversely, of the 57 counties that have been classified as “low” transmission counties by the CDC, 26.3%… have percentage of population fully vaccinated below 20%.
“The sole reliance on vaccination as a primary strategy to mitigate COVID-19 and its adverse consequences needs to be re-examined, especially considering the Delta (B.1.617.2) variant and the likelihood of future variants. Other pharmacological and non-pharmacological interventions may need to be put in place alongside increasing vaccination rates. Such course correction, especially with regards to the policy narrative, becomes paramount with emerging scientific evidence on real world effectiveness of the vaccines.”
Examples of Prominent Individuals Who’ve Been Vaccinated or Vaccinated and Boosted But Still Contracted COVID
Not only is it crystal clear that the COVID-19 “vaccines” do nothing to stop disease transmission—and, evidently, promote it—but we also see a litany of anecdotal examples in which some of the most prominent politicians and celebrities loudly pronounce they caught COVID post “vaccination.” And, often times, post vaccination and booster.
On March 13, 2022, for example, former U.S. President Barack Obama said he “tested positive for COVID” but was “grateful to be vaccinated and boosted… .” On April 21, 2022, talkshow host Stephen Colbert tweeted out: “I tested positive for Covid, but basically I’m feeling fine- grateful to be vaxxed and boosted.”
Immediately below are another 23 examples of prominent people noting their “breakthrough” infections on Twitter.

























New Zealand Prime Minister Jacinda Ardern tested positive for COVID and has moderate symptoms, her office says https://t.co/psaoWM7qo2 https://t.co/psaoWM7qo2
— Reuters (@Reuters) May 13, 2022

DOCTORS’ AND SCIENTISTS’ PEER-REVIEWED JOURNAL LETTERS EVINCING COVID-19 ‘VACCINES” INEFFICACY
Along with the overwhelming number of studies in the scientific literature, the population-level trends, and the anecdotal examples of “breakthrough cases” from some of the most prominent public figures in the world, evidence of the COVID-19 “vaccines'” failure to mitigate transmission is also evinced in doctors’ and scientists’ commentary and letters made in major, peer-reviewed journals.


In a letter to the editor of the Journal of Infection, Paula de Michelena, et al. looked at 107 “breakthrough” infection cases in “vaccinated” patients and noted that, as time went on after the “vaccination,” the viral load inside of the patients’ nasopharyngeal cavities (NP) increased. (See image immediately above.)
The authors of the letter in Infection also noted that “A number of studies concur on that although SARS-CoV-2 RNA loads in the upper respiratory tract of individuals with Delta variant breakthrough infection are comparable to those found in unvaccinated infected individuals…” and that “Taking the cohort as a whole, we noticed an increase in initial SARS-CoV-2 RNA loads in NP, positively associated with time since vaccination, irrespective of the vaccine used… .”
Likewise, in a study published in the journal Nature Medicine on November 2, 2021, authors Matan Levine-Tiefenbrun, et al. reported that “The effectiveness of the coronavirus disease 2019 (COVID-19) BNT162b2 vaccine in preventing disease and reducing viral loads of breakthrough infections (BTIs) has been decreasing, concomitantly with the rise of the Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).” The authors added that “By analyzing viral loads of over 16,000 infections during the current, Delta-variant-dominated pandemic wave in Israel, we found that BTIs in recently fully vaccinated individuals have lower viral loads than infections in unvaccinated individuals. However, this effect starts to decline 2 months after vaccination and ultimately vanishes 6 months or longer after vaccination.”

In an invited commentary published in JAMA Internal Medicine on December 28, 2021, authors Alfred H.J. Kim, et al. noted—in effect—the COVID-19 “vaccines'” failure to protect those dealing with immune suppression. “The odds of a breakthrough infection also varied with the underlying immunocompromising diagnosis, with vaccinated patients who underwent a solid organ transplant being among those with the highest risk for contracting a breakthrough infection (adjusted IRR [AIRR], 2.16; 95% CI, 1.96-2.38).” The authors add that “Increased risk for a breakthrough infection was also observed in vaccinated patients with rheumatoid arthritis (AIRR, 1.20; 95% CI, 1.09-1.32) and HIV infection (AIRR, 1.33; 95% CI, 1.18-1.49).”
Kim, et al. go on to say that “Findings from these studies suggest that blunted immune responses after SARS-CoV-2 vaccination in some patients with immune dysfunction may be associated with an increased risk for a breakthrough COVID-19 infection that can have severe and even fatal outcomes.”

In the summary of a research article written by John P. Evans, et al. published in Science Translational Medicine, a journal editor writes that “Here… The authors observed that immunity waned by 6 months after vaccination, including against the Alpha, Beta, and Delta variants.” The journal editor adds that “Minimal neutralizing antibody responses to the Omicron variant were observed, regardless of sample collecting timing.” For their research article, Evans, et al. “examined the neutralizing antibody response against the spike protein of five major SARS-CoV-2 variants, D614G, Alpha (B.1.1.7), Beta (B.1.351), Delta (B.1.617.2), and Omicron (B.1.1.529), in health care workers (HCWs) vaccinated with SARS-CoV-2 mRNA vaccines.”
Not only do doctors and scientists discuss the failure of the COVID-19 “vaccines” to mitigate the risk of infection or transmission in the general population, but also specifically in the population that is immune-compromised; i.e. the population that is purportedly the one that is at the most risk of getting ill with, and dying from, COVID-19.

“Transplant recipients were excluded from the initial clinical trials determining safety and efficacy of the landmark COVID-19 vaccines,” wrote the authors of a piece of commentary published in The Journal of Clinical Investigation published on June 18, 2021. The authors, including Peter G. Stock, et al. added that “Further, there is increasing evidence that immunosuppressed transplant recipients have a blunted antibody response to COVID-19 vaccination” and that “In a concerning report by Sattler et al. in this issue of [The Journal of Clinical Investigation], kidney transplant recipients not only lacked a humoral response following two doses of Pfizer BNT162b2, but also displayed substantial impairment of the cellular response to SARS-CoV-2 antigens.”
Regarding kidney transplant recipients in particular, Veerle Wijtvliet, et al. wrote in a letter to the editor published in the Clinical Kidney Journal that “Better anti-SARS-CoV-2 antibody responses have been described after infection versus vaccination in kidney transplant recipients.”
‘VACCINE’ BREAKTHROUGH ANECDOTES FROM THE MEDIA
Along with the myriad studies in the literature, the population-scale data, the anecdotal examples of “breakthrough cases” from celebrities and politicians, and the letters from scientists and doctors to peer-reviewed journals, news headlines have also evinced the COVID-19 “vaccines'” inefficacy.
Take, for example, a New York Post report from November 16, 2021, in which a COVID-19 outbreak took place in a nursing home in Connecticut. The Post reported that “Of the 89 people infected, 87 staffers and residents were fully vaccinated at the nursing home, which houses only 70 residents… .” Eight residents died.
On October 6, 2021 Guy Page, writing for the Vermont Daily Chronicle, noted in an article—now deleted on the Chronicle‘s website, but available elsewhere—that 76% of the September, 2021 COVID-19 deaths were “vax breakthrough” cases. Page added in the article that “Despite recent emphatic references by Gov. Phil Scott and Health Department Commissioner Mark Levine to a ‘pandemic of the unvaccinated,’ the per capita rate of vaccinated breakthrough deaths has risen in recent weeks. “

On December 4, 2021, the Associated Press reported an outbreak of COVID-19 aboard a Norwegian cruise ship that required all passengers and crew members to be “vaccinated” against COVID-19—at least two weeks prior to the cruise as well. (The status of the ten people involved in the outbreak was unknown at the time of the report.)
“A group of seven Germans aged 25 to 39 have been infected with the omicron variant of the coronavirus in South Africa, although all have already received their booster vaccination,” Tagesspiegel reported on December 14, 2021. “We are seeing a lot of breakthrough infections right now. What we didn’t know is that even a booster vaccination with Biontech/Pfizer doesn’t prevent this,” Wolfgang Preiser, a member of the research consortium that discovered the variant, told Tagesspiegel.
On December 14, 2021 NPR reported that “469 active student cases of the coronavirus and that, for the week of Dec. 6, about 3% of tests were positive among the students tested… .” Joel Malina, vice president for university relations, told NPR in a statement that “Virtually every case of the Omicron variant to date has been found in fully vaccinated students, a portion of whom had also received a booster shot.”
On January 2, 2022 The Epoch Times reported that a cruise ship had become stuck in a port in Portugal due to “a COVID-19 outbreak among fully vaccinated crew members… .” All passengers aboard the cruise ship 12 years and older had to be vaccinated to board. Everyone on board had passed a COVID-19 screening test.
IN SUMMARY
While health authorities have been able to sweep the most serious adverse effects of the COVID-19 “vaccines”—including myocarditis, blood clots, hepatitis, shingles reactivation, menstrual issues, and potential genome disruption—under the rug, the inability of the so-called biologics to limit the spread of the disease is clear as day to everyone.
In the lists above we see consilience—or agreement between disparate types of evidence—evincing the COVID-19 “vaccines” don’t work to stop or slow the spread of disease transmission. Evidence of their not working is ample in peer-reviewed medical literature, and this is reflected in population-scale data that shows as countries increase their “vaccination” uptake their collective COVID-19 infection rate increases accordingly.
Along with the studies in the literature and population-level data, we also have countless examples of the world’s most prominent politicians and celebrities boldly claiming on Twitter that they are “vaxxed” or “vaxxed and boosted,” yet still caught COVID-19.

We also see from letters and other commentary in peer-reviewed medical journals that many, if not all of those in the health field are now fully aware of the fact that the COVID-19 “vaccines” cannot stop or slow the transmission of the disease. They’re even aware the COVID-19 “vaccines” perform particularly poorly amongst those with immune-compromising issues; i.e. the exact group of people who needs them most.
And finally, on top of the extraordinary number of studies in the peer-reviewed medical literature, the population-scale data, the anecdotal examples from celebrities and politicians presenting with “breakthrough infections,” and the letters from scientists and doctors to peer-reviewed journals, news headlines have also evinced the COVID-19 “vaccines'” inefficacy. News outlets have reported—and continue to report—COVID-19 outbreaks on fully vaccinated cruise ships, in fully vaccinated nursing homes, and around fully vaccinated campuses.
This is happening because the COVID-19 “vaccines” don’t work. And, worse yet, they’re enormously harmful: the evidence of that is everywhere.
Feature image: Jerneg Furman
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CDC Report: 44% of People Hospitalized With COVID-19 Had One Booster Dose; 5% of Those Who’ve Had Two Booster Doses or More
A CDC report from late August states 39.1% of people hospitalized with COVID-19 had a "primary vaccination series" plus one booster dose. The same...
FDA Limits Use of Johnson & Johnson ‘Vaccine’ to ‘Certain Individuals’ Age 18 and Older
Due to concerns with the risk of thrombosis with thrombocytopenia syndrome (TTS), the FDA is limiting the authorized use of the Johnson & Johnson...
Author of Study Showing No Statistical Effect of mRNA ‘Vaccines’ on All-Cause Mortality Worried About ‘Cardiovascular Danger Signal’
In an interview with Freddie Sayers of UnHeard Professor of Global Health at the University of Southern Denmark Christine Stabell Benn says her data...