Medical Faculty Mannheim, Department of Hygiene, Heidelberg University, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Medical Faculty Mannheim, Heidelberg University, University Medical Center Mannheim, Institute for Medical Microbiology and Hygiene, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Infection. 2022 Jun;50(3):775-782. doi: 10.1007/s15010-022-01797-9. Epub 2022 Mar 16.
Vaccination is the key element for protection against COVID-19. Increased vaccination breakthroughs raise the question of whether additional prevention is necessary in case of individual risk factors for a severe course with hospitalization or death despite vaccination.
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.
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.
接种疫苗是预防 COVID-19 的关键因素。突破性感染的增加引发了这样一个问题，即在接种疫苗的情况下，对于有住院或死亡等严重疾病风险因素的个体，是否需要额外的预防措施。
自 2021 年 7 月 13 日起，德国法律规定了延长报告要求。我们分析了前 8 周内因 COVID-19 住院的突破性感染患者。
67 例因 COVID-19 住院的患者中有 9 例（13.4%）完全接种疫苗（中位年龄 75 岁）。其中 5 例患者接受了重症监护；2 例患者死亡。所有患者均接种了两剂 BNT162b2 疫苗（辉瑞-生物技术公司）。完全免疫接种和症状出现之间的中位数为 99 天。所有患者均患有≥3 种合并症。6 例患者（66.7%）在疫苗突破性感染时抗 SARS-CoV-2-N 滴度为阴性，其中 5 例患者的抗 SARS-CoV-2-S 滴度<100 U/ml。所有可确定的病例均为 Delta 变异株 B.1.617.2。
年龄较大、潜在的心肺疾病以及 SARS-CoV-2 的 Delta 变异株与我们的患者因突破性感染而住院有关。避免戴口罩、密切接触者未接种疫苗以及前往高风险地区等行为情况是可以改变的。对于有发生严重感染风险的患者，除了 COVID-19 加强针接种外，还可能需要采取一致的个人防护措施、密切护理者接种疫苗以及提高认识等措施。
