SARS-CoV-2 Breakthrough Infections in Fully Vaccinated Individuals

Importance While COVID-19 vaccines are highly effective against disease, breakthrough infections may occur in the context of rising variants of concern. Objective We paired random and passive surveillance nucleic acid testing with analysis of viral whole genomic sequences to detect and describe breakthrough infections, focusing in a university community. Design Anterior nasal swabs were collected from individuals for a nucleic acid amplification test (NAAT) for detection of SARS-CoV-2. A subset of NAAT positive samples was sequenced to determine variants associated with infections. Included in the testing and sequencing protocol were individuals that were fully vaccinated. Setting This study was performed as part of a surveillance program for SARS-CoV-2 on a university campus with 49,700 students and employees. Participants Surveillance testing was random and included approximately 10% of the population each week. Additionally, individuals self-identified with COVID-19 related symptoms or those that had close contact with SARS-CoV-2 positive individuals were also tested.