SARS-CoV-2 Reinfection Cases in a Household-Based Prospective Cohort in Rio de Janeiro

• Published in: The Journal of infectious diseases Vol. 228; no. 12; pp. 1680 - 1689
• Main Authors: Penetra, Stephanie L S, Santos, Heloisa F P, Resende, Paola Cristina, Bastos, Leonardo Soares, da Silva, Michele F B, Pina-Costa, Anielle, Lopes, Renata Serrano, Saboia-Vahia, Leonardo, de Oliveira, Any Caroline Alves, Pereira, Elisa Cavalcante, Filho, Fernando Medeiros, Wakimoto, Mayumi D, Calvet, Guilherme A, Fuller, Trevon L, Whitworth, Jimmy, Smith, Christopher, Nielsen-Saines, Karin, Carvalho, Marilia Sá, Espíndola, Otávio M, Guaraldo, Lusiele, Siqueira, Marilda M, Brasil, Patricia
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 20.12.2023
• Subjects: Brazil - epidemiology; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Humans; Major; Prospective Studies; Reinfection - epidemiology; SARS-CoV-2; Brazil; COVID-19; SARS-CoV-2 infection; Omicron; vaccine breakthrough; variants of concern; reinfections
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiad336

Abstract This was a household-based prospective cohort study conducted in Rio de Janeiro, in which people with laboratory-confirmed coronavirus disease 2019 (COVID-19) and their household contacts were followed from April 2020 through June 2022. Ninety-eight reinfections were identified, with 71 (72.5%) confirmed by genomic analyses and lineage definition in both infections. During the pre-Omicron period, 1 dose of any COVID-19 vaccine was associated with a reduced risk of reinfection, but during the Omicron period not even booster vaccines had this effect. Most reinfections were asymptomatic or milder in comparison with primary infections, a justification for continuing active surveillance to detect infections in vaccinated individuals. Our findings demonstrated that vaccination may not prevent infection or reinfection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Therefore we highlight the need to continuously update the antigenic target of SARS CoV-2 vaccines and administer booster doses to the population regularly, a strategy well established in the development of vaccines for influenza immunization programs. We followed families in Rio de Janeiro, from April 2020 to June 2022, to characterize the frequency and severity of SARSCoV-2 reinfection. Vaccination prevented severe illness and death throughout the study, but only reduced the risk of reinfection before the Omicron variant.