Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA.
Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA.
Nat Med. 2023 Feb;29(2):358-365. doi: 10.1038/s41591-022-02138-x. Epub 2023 Jan 2.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infections in vaccinated individuals and reinfections in previously infected individuals have become increasingly common. Such infections highlight a broader need to understand the contribution of vaccination, including booster doses, and natural immunity to the infectiousness of individuals with SARS-CoV-2 infections, especially in high-risk populations with intense transmission, such as in prisons. Here we show that both vaccine-derived and naturally acquired immunity independently reduce the infectiousness of persons with Omicron variant SARS-CoV-2 infections in a prison setting. Analyzing SARS-CoV-2 surveillance data from December 2021 to May 2022 across 35 California state prisons with a predominately male population, we estimate that unvaccinated Omicron cases had a 36% (95% confidence interval (CI): 31-42%) risk of transmitting infection to close contacts, as compared to a 28% (25-31%) risk among vaccinated cases. In adjusted analyses, we estimated that any vaccination, prior infection alone and both vaccination and prior infection reduced an index case's risk of transmitting infection by 22% (6-36%), 23% (3-39%) and 40% (20-55%), respectively. Receipt of booster doses and more recent vaccination further reduced infectiousness among vaccinated cases. These findings suggest that, although vaccinated and/or previously infected individuals remain highly infectious upon SARS-CoV-2 infection in this prison setting, their infectiousness is reduced compared to individuals without any history of vaccination or infection. This study underscores benefit of vaccination to reduce, but not eliminate, transmission.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)突破性感染在接种疫苗的个体中以及在既往感染个体中的再感染变得越来越普遍。这些感染突出表明,需要更广泛地了解疫苗接种(包括加强针)和自然免疫对 SARS-CoV-2 感染个体传染性的贡献,特别是在感染传播强烈的高风险人群中,如监狱。在这里,我们表明,疫苗衍生的和自然获得的免疫都独立地降低了在监狱环境中感染奥密克戎变异 SARS-CoV-2 的个体的传染性。我们分析了 2021 年 12 月至 2022 年 5 月在加利福尼亚州 35 个主要为男性人口的州立监狱进行的 SARS-CoV-2 监测数据,我们估计未接种疫苗的奥密克戎病例将感染密切接触者的风险增加 36%(95%置信区间(CI):31-42%),而接种疫苗的病例的风险增加 28%(25-31%)。在调整后的分析中,我们估计,任何疫苗接种、既往感染单独以及疫苗接种和既往感染都分别降低了感染指数病例的传播风险 22%(6-36%)、23%(3-39%)和 40%(20-55%)。加强针的接种和最近的疫苗接种进一步降低了接种病例的传染性。这些发现表明,尽管在这种监狱环境中接种疫苗和/或既往感染的个体在 SARS-CoV-2 感染后仍然具有高度传染性,但与没有任何疫苗接种或感染史的个体相比,其传染性降低。这项研究强调了疫苗接种的益处,可以降低但不能消除传播。