Dong Shuaibing, Sun Ying, Ni Shuyu, Tian Yi, Feng Zhaomin, Jia Lei, Wang Xiaoli, Zhang Daitao, Wang Quanyi, Tsang Tim K, Yang Peng
Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China.
Beijing Research Center for Respiratory Infectious Diseases, Beijing 100013, China.
Vaccines (Basel). 2025 Mar 19;13(3):329. doi: 10.3390/vaccines13030329.
BACKGROUND/OBJECTIVES: Understanding the factors influencing breakthrough infections following COVID-19 vaccination is critical for disease prevention, especially in households where transmission risks are high. Factors such as age, symptoms, living conditions, and viral load contribute to household transmission dynamics.
To elucidate this complex interplay of these factors, we analyzed a detailed household transmission study of COVID-19 involving 839 households and 1598 vaccinated individuals during the Omicron variant outbreak in Beijing, China, from April to June 2022. Using multivariate logistic regression models, we analyzed the impact of demographic, environmental, clinical, and virological factors on the risk of breakthrough infections.
In multivariate analysis. we estimated that index cases aged 45-59 and 60+ years were associated with 80% (95% confidence interval [CI]: 35%, 140%) and 288% (95% CI: 160%, 481%) higher infectivity compared with index cases aged 18-44 years. We estimated that index cases with fever, headache and cough were associated with 43% (95% CI: 11%, 84%), 78% (95% CI: 18%, 168%) and 67% (25%, 123%) higher infectivity compared with those without. Index cases with higher viral loads were associated with higher infectivity in univariate analysis, but this was no longer significant in multivariate analysis. Smaller living space and two-member households were associated with higher odds of breakthrough infections.
Age, symptoms, and living conditions were significant risk factors for breakthrough infections during the Omicron outbreak. Suburban settings, smaller spaces, and two-member households enhance transmission risks. These findings inform targeted interventions to reduce household transmission.
背景/目的：了解影响新冠病毒疫苗接种后突破性感染的因素对于疾病预防至关重要，尤其是在传播风险较高的家庭中。年龄、症状、生活条件和病毒载量等因素会影响家庭传播动态。
为阐明这些因素之间的复杂相互作用，我们分析了一项关于新冠病毒的详细家庭传播研究，该研究涉及2022年4月至6月中国北京奥密克戎变异株暴发期间的839户家庭和1598名接种疫苗的个体。我们使用多变量逻辑回归模型分析了人口统计学、环境、临床和病毒学因素对突破性感染风险的影响。
在多变量分析中，我们估计45 - 59岁和60岁及以上的索引病例与18 - 44岁的索引病例相比，传染性分别高80%（95%置信区间[CI]：35%，140%）和288%（95% CI：160%，481%）。我们估计有发热、头痛和咳嗽症状的索引病例与没有这些症状的索引病例相比，传染性分别高43%（95% CI：11%，84%）、78%（95% CI：18%，168%）和67%（25%，123%）。在单变量分析中，病毒载量较高的索引病例与较高的传染性相关，但在多变量分析中这不再显著。居住空间较小和两口之家与突破性感染的较高几率相关。
年龄、症状和生活条件是奥密克戎毒株暴发期间突破性感染的重要风险因素。郊区环境、较小空间和两口之家会增加传播风险。这些发现为减少家庭传播的针对性干预措施提供了依据。
