News Analysis India

Tag: breakthrough Covid infections

  • Breakthrough infections in those vaccinated may be higher in India, finds study

    Express News Service
    NEW DELHI: Among those fully vaccinated, the rate of breakthrough infections of Covid-19 was found to be 1.6 % in the largest such study from India so far while another one by top government agencies has found the B.1617.2 variant to be causing a large number of such cases in Delhi.  

    A person is considered fully vaccinated two weeks after the second dose of the vaccine is administered.

    The study had been carried out at the Post Graduate Institute of Medical Science and Research, Chandigarh and has been published in the prestigious The New England journal of Medicine. It followed 12,248 health care workers, 7170 of whom had received the first dose of vaccine, with 3650 subsequently receiving the second dose.

    A total of 5078 health care workers were unvaccinated while the rest had all received Covishield. 

    The researchers found that a total of 184 of the 7170 health care workers (2.6%) tested positive after receiving at least one dose of vaccine and the median time between receipt of the first dose and the positive test was 44 days.

    ALSO READ | AIIMS Delhi found 63 breakthrough infection cases among staffers in April-May, but no deaths

    A total of 72 of the 3650 health care workers (2 %) on the other hand tested positive after the second dose and the median time from receipt of the second dose to the positive test was 20 days.

    Among the health care workers who received both doses and completed at least 14 days of follow-up after the second dose, the incidence of breakthrough infection was 1.6%  (48 of the 3000 health care workers) and the median time from receipt of the second dose to breakthrough infection was 29.5 days.

    These findings come soon after cases of 47 breakthrough infections — at a rate of 0.5 % — were reported from a hospital in the US among healthcare workers who were fully vaccinated with Covid-19 vaccines either by Pfizer-BioNTech or Moderna.

    Back home, in a separate scientific research carried out by the National Centre for Disease Control, Delhi, CSIR Institute of Genomics and Integrative Biology and the Academy for Scientific and Innovative Research in the national capital to understand the Covid-19 second wave genomically, a total of 27 cases of breakthrough infections were seen.

    Among these cases, B.617.1 lineage was seen in 8 % of the breakthrough infections and a whopping 76 % cases were caused by B.1.617.2 — the variant now considered far more transmissible and capable of evading immunity than other variants of the Covid virus.  

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    “It is noted that when compared to population prevalence, B.1.617.2 was over-represented and B.1.1.7 was not even detected in vaccination breakthroughs, suggesting a higher breakthrough risk of B.1.617.2 compared to B.1.1.7,” the researchers noted in their paper Genomic characterization and Epidemiology of an emerging SARS-CoV-2 variant in Delhi, India.

    Despite a Covid19 vaccination drive underway in India with two vaccines — Covishield and Covaxin –there have been some concerns against their potential to protect people from Covid-19, especially in the wake of new variants of the virus in circulation.  

  • B.1.617.2 variant behind majority of breakthrough Covid infections in India: Study

    Express News Service
    NEW DELHI: Majority of the breakthrough infections following vaccination with Covishield and Covaxin were caused by SARS CoV2 lineage B.1.617.2, which is a variant of concern (VoC), according to study based on the genomic analysis of vaccine breakthrough infections in collaboration with clinicians at the AIIMS, New Delhi.

    The analysis included 63 cases of vaccine breakthrough infections in Delhi, out of which 36 patients received two doses, while 27 had received one dose of vaccine. Ten patients received Covishield while 53 received Covaxin.

    “B.1.617.2 was found to be the predominant lineage with 23 samples (63.9%) out of which 12 were in fully vaccinated and 11 in partially vaccinated groups. Four samples with 11.1% and 1 sample with 2.8% were assigned the lineages B.1.617.1 and B.1.1.7 respectively,” according to the study in preprints.

    The patients had a mean age of 37 (21-92), in which 41 were males and 22 were females. None of the patients had any comorbidities which could act as a predisposing factor for breakthrough infections. AIIMS collaborated with the CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB) for the study.

    Variants of concern B.1.617.2, first detected in India, and B.1.1.7, detected in Maharashtra, were responsible for cases surge in April-May 2021 in Delhi, were the predominant lineages among breakthrough infections.

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    Of the breakthrough infection cases analysed, 10 patients (8 with double doses of vaccine and 2 with single vaccine dose) additionally had total Immunoglobulin G (IgG) antibodies assessed by Chemiluminescent Immunoassay (Siemens), of which 6 patients had IgG antibodies a month before the infection, while 4 had antibodies after the disease episode.

    “While antibody levels for a subset of patients were available, they became infected nevertheless and presented to the emergency just like other patients, putting in doubt the protection offered and or clinical relevance of total IgG as a surrogate of Covid immunity,” the study noted.

    Of the 63 cases of vaccine breakthrough infections, including 36 who received full doses, there are no reports of mortality even though almost all cases presented with high-grade unremitting fever for 5-7 days.

    “Viral load at the time of diagnosis was high in all the patients irrespective of vaccination status or type of vaccine received. The initial course of disease with high-grade non-remitting fever lasted for five to seven days in the vaccinated group, similar to the clinical presentation in unvaccinated patients,” it further said.

    The authors said the present report is unique in many aspects as this is one of the first reports of symptomatic vaccine breakthrough infections, and breakthrough infections in a tertiary care setting apart from being the earliest reports of breakthrough infections with BBV152/Covaxin and B.1.617.2 variant of SARS-CoV-2.

  • Keeping a close watch on vaccine breakthrough cases, deaths: Centre

    Express News Service
    NEW DELHI: Amid concerns that breakthrough Covid infections and risk of severe disease despite vaccinations against coronavirus may be much higher than the results from clinical trial data, the Centre on Monday maintained that it had kept a close watch on such incidences.

    “The risk of infection in the recipients of Covid vaccines is much lesser (than the unvaccinated population) but there is a small chance that a tiny fraction of people can get the infection despite the vaccinations as vaccines are not 100% efficacious,” said Lav Agarwal, joint secretary in the Union Ministry of Health and Family Welfare on Tuesday.

    There is one more advantage of the vaccines that even those who get the infection despite the shots, will likely not get the severe disease and recovery will be faster, he said.

    VK Paul, member health, Niti Aayog said that ICMR is keeping a record of breakthrough infections.

    “As said earlier, breakthrough infections are rare but in a dynamic situation we should watch it carefully,” he said. “But we should remember that vaccine recipients are protected to (only) a certain level and therefore in an overwhelming situation, risk remains and therefore all are requested to continue taking precaution.”

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    The response comes on a day the Indian Medical Association released a list of 270 doctors who have died in India during the second wave of the pandemic, the highest deaths reported from Bihar (78) and Uttar Pradesh (37), followed by Delhi (29).

    Though the association has not made the vaccination status available of each of the doctors who have died, its office bearers said many of them had taken either both or at least one dose of Covid19 vaccine.

    Sixty-three-year-old K K Agarwal, leading cardiologist and former IMA president who succumbed to the infectious disease on Tuesday, for instance, had also completed his two dose Covid vaccination schedule as per information provided by the association sources. 

    Last month, ICMR director general Balram Bhargava had said that breakthrough infection rates seen in India thus far were negligible with only 2 to 4 infections reported per 10,000 inoculations.

    He, however, had not elaborated on whether or how many of these infections led to severe disease or deaths.

    Many experts have pointed out that this data collection by the ICMR has been patchy and delayed and may not be giving the actual picture on breakthrough infections and severe disease despite vaccinations.