Breakthrough Infections

Infections by the same infectious agent (e.g., virus, fungus) occurring during exposure to prophylaxis, vaccine and treatment.

Also Known As:

Breakthrough Infection; Breakthrough Infection, Vaccine; Emergent Infections, Treatment; Infection, Treatment Emergent; Treatment Emergent Infection; Vaccine Breakthrough Infection; Treatment Emergent Infections; Vaccine Breakthrough Infections

Networked: 1177 relevant articles (91 outcomes, 115 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	COVID-19
2.	Infections
3.	Reinfection
4.	Hepatitis B
5.	Measles

Experts

1.	Kontoyiannis, Dimitrios P: 10 articles (03/2019 - 07/2005)
2.	Lewis, Russell E: 8 articles (12/2015 - 07/2005)
3.	Pekosz, Andrew: 6 articles (08/2022 - 09/2021)
4.	Gazit, Sivan: 6 articles (01/2022 - 01/2021)
5.	Patalon, Tal: 6 articles (01/2022 - 01/2021)
6.	Karaba, Andrew H: 5 articles (08/2022 - 10/2021)
7.	Diamond, Michael S: 5 articles (02/2022 - 08/2021)
8.	Chodick, Gabriel: 5 articles (01/2022 - 01/2021)
9.	McElrath, M Juliana: 5 articles (01/2022 - 09/2004)
10.	Montefiori, David C: 5 articles (01/2022 - 01/2014)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Breakthrough Infections:

1.	VaccinesIBA 06/01/2023 - "While highly effective against severe disease, there is reduced effectiveness of these vaccines in preventing breakthrough infection and/or onward transmission, likely due to poor immunity elicited at the respiratory mucosa. " 01/01/2017 - "In the 1980's a highly effective and safe vaccine against HBV was developed, although breakthrough infection still occasionally occurs because of the emergence of escape mutants. " 01/01/2022 - "Only a small proportion of deaths (0.6%) occurred after breakthrough infection beyond 14 days of two doses. COVID-19 vaccines have shown promising efficacy against severe disease, thus high vaccination coverage needs to be achieved to prevent morbidity and mortality." 10/01/2023 - "Breakthrough infections may occur after vaccination; however, vaccines are overall effective in preventing severe symptoms. " 01/01/2022 - "SARS-CoV-2 breakthrough infections have been reported because of the reduced efficacy of vaccines against the emerging variants globally. "
2.	COVID-19 VaccinesIBA 05/07/2022 - "COVID-19 vaccines are highly protective against severe disease; however, vaccine breakthrough infections resulting in hospitalization may still occur in a small percentage of vaccinated individuals. " 01/01/2022 - "COVID-19 vaccines prevent severe forms of the disease, but do not warrant complete protection against breakthrough infections. " 11/24/2022 - "High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection." 06/01/2022 - "However, the continuous emergence of SARS-CoV-2 variants, the persistence of breakthrough infections, and the seemingly rapid decline in the protective efficacy of SARS-CoV-2 vaccines have presented additional challenges for the next phase. " 02/17/2022 - "In conclusion, our results suggest that mixing different SARS-CoV-2 vaccines might lead to more efficacious and longer-lasting humoral protection against breakthrough infections."
3.	mRNA VaccinesIBA 11/21/2023 - "To address this, we investigate antibody responses in 72 participants given three doses of a monovalent mRNA vaccine, followed by a bivalent or monovalent booster, or those with breakthrough infections with BA.5 or BQ. " 03/15/2023 - "Effect of a Fourth Dose of mRNA Vaccine and of Immunosuppression in Preventing SARS-CoV-2 Breakthrough Infections in Heart Transplant Patients." 01/01/2023 - "Lower T cell response against SARS-CoV-2 variants of concern after mRNA vaccine and risk of breakthrough infections in people with HIV." 01/01/2023 - "We report that Omicron BA.4/BA.5 breakthrough infection of individuals immunized with SARS-CoV-2 wild-type-strain-based mRNA vaccines results in a boost of Omicron BA.4.6, BF.7, BQ.1.1, and BA.2.75 neutralization but does not efficiently boost BA.2.75.2, XBB, or XBB.1.5 neutralization. " 01/01/2023 - "Impaired SARS-CoV-2 Variant Neutralization and CD8+ T-cell Responses Following 3 Doses of mRNA Vaccines in Myeloma: Correlation with Breakthrough Infections."
4.	AntibodiesIBA 01/01/2023 - "Vaccinees showed SARS-CoV-2-specific T cell responses, which were further improved and specified after Omicron breakthrough infections in parallel to the appearance of new variant-specific antibodies. " 09/01/2023 - "CD4+ and CD8+ T cells and antibodies are associated with protection against Delta vaccine breakthrough infection: a nested case-control study within the PITCH study." 01/01/2022 - "To determine the duration of specific T cells, antibodies and neutralization after 2-dose vaccination, to assess the effect of a third dose on adaptive immunity and to explore correlates of protection against breakthrough infection. " 11/25/2023 - "Irrespective of the level of antibodies, the risk of breakthrough infection was similar, ranging from 19 to 23% (P = 0.78). " 11/25/2023 - "Association between levels of receptor binding domain antibodies of SARS-CoV-2, receipt of booster and risk of breakthrough infections: LA pandemic surveillance cohort study."
5.	Messenger RNA (mRNA)IBA 01/01/2022 - "A prior COVID-19-infection was protective against a breakthrough infection (HR0.23, 95%CI 0.23-0.24), as was an mRNA booster (HR0.44, 95%CI 0.43-0.45). " 05/23/2023 - "We performed immune profiling studies during breakthrough infections in mRNA-vaccinated hamsters to evaluate hybrid immunity induction. " 05/23/2023 - "Breakthrough infections by SARS-CoV-2 variants boost cross-reactive hybrid immune responses in mRNA-vaccinated Golden Syrian Hamsters." 05/22/2023 - "This transcriptional imprint was minimally altered following subsequent mRNA vaccination or breakthrough infection, reflecting the strong bias induced by the inflammatory environment during initial memory differentiation. " 04/23/2023 - "SARS-CoV-2 Breakthrough Infections According to the Immune Response Elicited after mRNA Third Dose Vaccination in COVID-19-Naïve Hospital Personnel."
6.	N-methyl-valyl-amiclenomycin (BA 2)IBA 03/01/2023 - "Although BA.2 conferred the highest neutralization resistance compared with variants of concern tested before the emergence of BA.2.12.1 and BA.4/5, the third dose vaccination-activated S-specific memory B cells and Omicron cross-reactive T cell responses contributed to reduced frequencies of breakthrough infection and disease severity. " 01/01/2023 - "Naive and breakthrough infections with BA.2, BA.5 and BF.7 variants provide poor cross protection against XBB related variants." 01/01/2023 - "XBB.1 is the variant most profoundly resistant to BA.2/5 breakthrough infection sera to date and is more fusogenic than BA.2.75. " 01/01/2023 - "We collected 1077 serum samples from 877 individuals, including 189 with Omicron BA.2 breakthrough infection and 688 post-immunized participants. " 11/25/2022 - "Omicron BA.2 breakthrough infection enhances cross-neutralization of BA.2.12.1 and BA.4/BA.5."
7.	BNT162 VaccineIBA 01/01/2023 - "Additionally, oncology patients' humoral immune response was significantly greater after breakthrough-infection than in response to the 4th dose of BNT162b2." 01/01/2022 - "We performed a single-center observational trial to monitor the mid- (3 months) and long-term (10 months) adaptive immune response and to document breakthrough infections (BTI) in healthcare workers (n = 84) upon BNT162b2 vaccination in a real-world setting. " 11/01/2023 - "The study cohort comprised 59 HT recipients aged 58 (49,65) years with breakthrough infections after three or four monovalent BNT162b2 doses; 41 (69.5%) were men. " 11/01/2023 - "Fifty-six participants without breakthrough infection (BI) (ChAdOx1/BNT162b2 group: N=27; BNT162b2 group: N=29) and 33 with BI were included. " 10/26/2023 - "Correlation between specific antibody response to wild-type BNT162b2 booster and the risk of breakthrough infection with omicron variants: Impact of household exposure in hospital healthcare workers."
8.	N-(2-cyanoethylene)urea (BA 1)IBA 12/01/2023 - "Longitudinal SARS-CoV-2 neutralization of Omicron BA.1, BA.5 and BQ.1.1 after four vaccinations and the impact of breakthrough infections in haemodialysis patients." 12/01/2023 - "Omicron sublineages, especially for those emerged after BA.4/5 strain, evade NAb responses induced by BA.1 breakthrough infection. " 12/01/2023 - "SARS-CoV-2 Omicron BA.1 breakthrough infection drives late remodeling of the memory B cell repertoire in vaccinated individuals." 12/01/2023 - "Breakthrough infection elicits minimal de novo Omicron BA.1-specific B cell responses but drives affinity maturation of pre-existing cross-reactive MBCs toward BA.1, which translates into enhanced breadth of activity across other variants. " 12/01/2023 - "Evolution of antibody immunity following Omicron BA.1 breakthrough infection."
9.	Immunoglobulin G (IgG)IBA 06/28/2022 - "Nevertheless, breakthrough infections were present in 6.65% of all participants, without any correlation with the previous level of anti-S/RBD IgG. Protection against the ancestral and Omicron variants is maintained at least three months after a booster in HCW, possibly reflecting a continuous antigenic stimulation in the professional setting." 09/04/2022 - "This study thus evaluates the performance of the anti-S IgG assay in identifying subjects with breakthrough infections (BIs) and its potential usefulness for screening healthcare workers (HCWs). " 01/01/2024 - "Low anti-spike IgG levels after third vaccination in kidney transplant recipients were associated with symptomatic breakthrough infection and, particularly, with hospitalization during the Omicron surge. " 01/01/2024 - "Lower anti-receptor-binding domain (RBD) IgG levels (<400 AU/mL) post-third vaccination were a risk factor for symptomatic breakthrough infection (hazard ratio [HR]=3.46, P<0.001). " 11/27/2023 - "The elevated anti-RBD IgG4 Ab levels observed after repeated vaccinations were unlikely to increase the risk of breakthrough infection. "
10.	Ad26COVS1IBA 01/01/2022 - "Enhanced immunity after Ad26.COV2.S vaccine breakthrough infection." 08/06/2021 - "The data underscore the importance of surveillance for breakthrough infections that result in severe COVID-19 and suggest the benefit of a second immunization following Ad26.COV2.S to increase protection against the variants." 01/01/2022 - "The data underscore the importance of surveillance for breakthrough infections that result in severe COVID-19 and suggest a potential benefit by second immunization following Ad26.COV2.S to increase protection from current and future variants." 01/01/2022 - "Ad26.COV2.S breakthrough infections induce high titers of neutralizing antibodies against Omicron and other SARS-CoV-2 variants of concern." 01/01/2022 - "Vaccination with Ad26.COV2.S (HR1.54, 95%CI 1.52-1.56) or ChAdOx1 (HR1.68, 95%CI 1.66-1.69) was associated with a higher risk of a breakthrough infection compared to BNT162b2, while mRNA-1273 was associated with a lower risk (HR0.68, 95%CI 0.67-0.69). "

Therapies and Procedures

1.	Therapeutics 10/01/2002 - "In cured children there were no breakthrough infections during or since therapy and post-void residual urine decreased from an average of 40% before to 10% after therapy. " 01/01/2020 - "The main reasons for failure of prophylaxis and pre-emptive therapy were adverse events and breakthrough infections, which were described in 54% (13 studies) and 38% (9 studies) of the included studies, respectively. " 09/01/2023 - "The pooled rate of breakthrough infections in IBD patients receiving anti-TNF therapy was 0.04. " 05/08/2023 - "Retaining prosthetics in higher surgical risk patients presents us with unique clinical and pharmacological challenges regarding breakthrough infections, drug interaction, and side effects from prolonged suppressive therapies." 01/01/2023 - "Our follow-up provides a detailed evaluation of Ab, especially in terms of neutralizing activity, and T cell responses after anti-SARS-CoV-2 vaccination in MS context, over time, considering a wide number of therapies, and eventually breakthrough infection. "
2.	Injections 10/01/2022 - "Though CAB-LA was highly effective in preventing HIV, breakthrough infections did occur in trials of CAB-LA despite on-time injections, resulting in selection of single and combinations of INSTI resistance mutations. " 01/01/2023 - "Although first-generation injectable COVID-19 vaccines continue to be critical tools in controlling the current global health crisis, continuous emergence of SARS-CoV-2 variants of concern has eroded the efficacy of these vaccines, leading to staggering breakthrough infections and posing threats to poor vaccine responders. " 01/01/2022 - "The injectable systemic vaccines that have been successfully developed to prevent serious disease and its consequences do not induce antibodies in mucosal secretions of naïve subjects, but they may recall SIgA antibody responses in secretions of previously infected subjects, thereby helping to explain enhanced resistance to repeated (breakthrough) infection. "
3.	Kidney Transplantation 01/01/2021 - "Preliminary data to date, especially in HIV-to-HIV kidney transplantation, suggest overall excellent patient and graft survival outcomes with no HIV breakthrough infection. " 01/01/2022 - "In this special report, the ERA DESCARTES (Developing Education Science and Care for Renal Transplantation in European States) Working Group addresses several questions related to everyday clinical practice concerning kidney transplant recipients and to the assessment of deceased and live kidney donors: what is the current risk of severe disease and of breakthrough infection, the optimal management of immunosuppression in kidney transplant recipients with COVID-19, the role of passive immunization and the efficacy of antiviral drugs in ambulatory patients, the management of drug-to-drug interactions, safety criteria for the use of SARS-CoV-2-positive donors, issues related to the use of T cell depleting agents as induction treatment, and current recommendations for shielding practices."
4.	Renal Dialysis (Hemodialysis) 09/01/2022 - "This study was carried out to assess if seroconversion could predict SARS-CoV-2 breakthrough infection in a cohort of vaccinated patients undergoing hemodialysis. " 07/06/2023 - "Breakthrough infections may induce stronger cellular and humoral immune responses than booster immunizations in hemodialysis patients." 07/06/2023 - "We evaluated the humoral and cellular immunity of hemodialysis patients after breakthrough infection. " 07/06/2023 - "Cellular and Humoral Immune Responses after Breakthrough Infection in Patients Undergoing Hemodialysis." 09/01/2022 - "Correlation of Breakthrough Infection During the Omicron Wave With Seropositivity of Vaccinated Patients Undergoing Hemodialysis."
5.	Liver Transplantation 01/01/2023 - "Clinical Outcomes of SARS-CoV-2 Breakthrough Infections in Liver Transplant Recipients during the Omicron Wave." 04/01/2003 - "Prolonged therapy as well as prophylactic therapy, for example, in liver transplant recipients, is feasible and not limited by breakthrough infections. " 01/01/2000 - "New strategies are being sought to decrease the risks of breakthrough infection and to increase the cost-effectiveness of liver transplantation for hepatitis B. " 11/01/2023 - "Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant." 10/19/2023 - "This will provide reassurance to patients with chronic liver disease who were deemed at high risk of severe COVID-19 during the pre-vaccination era, however, liver transplant recipients had the lowest antibody titres and remained vulnerable to severe breakthrough infection. "