Vaccines (Jul 2022)
SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers
- Stefano Porru,
- Maria Grazia Lourdes Monaco,
- Gianluca Spiteri,
- Angela Carta,
- Maria Diletta Pezzani,
- Giuseppe Lippi,
- Davide Gibellini,
- Evelina Tacconelli,
- Ilaria Dalla Vecchia,
- Emma Sala,
- Emanuele Sansone,
- Giuseppe De Palma,
- Carlo Bonfanti,
- Massimo Lombardo,
- Luigina Terlenghi,
- Enrico Pira,
- Ihab Mansour,
- Maurizio Coggiola,
- Catalina Ciocan,
- Alessandro Godono,
- Adonina Tardon,
- Marta-Maria Rodriguez-Suarez,
- Guillermo Fernandez-Tardon,
- Francisco-Jose Jimeno-Demuth,
- Rafael-Vicente Castro-Delgado,
- Tania Iglesias Cabo,
- Maria Luisa Scapellato,
- Filippo Liviero,
- Angelo Moretto,
- Paola Mason,
- Sofia Pavanello,
- Anna Volpin,
- Luigi Vimercati,
- Silvio Tafuri,
- Luigi De Maria,
- Stefania Sponselli,
- Pasquale Stefanizzi,
- Antonio Caputi,
- Fabriziomaria Gobba,
- Alberto Modenese,
- Loretta Casolari,
- Denise Garavini,
- Cristiana D’Elia,
- Stefania Mariani,
- Francesca Larese Filon,
- Luca Cegolon,
- Corrado Negro,
- Federico Ronchese,
- Francesca Rui,
- Paola De Michieli,
- Nicola Murgia,
- Marco Dell’Omo,
- Giacomo Muzi,
- Tiziana Fiordi,
- Angela Gambelunghe,
- Ilenia Folletti,
- Dana Mates,
- Violeta Claudia Calota,
- Andra Neamtu,
- Ovidiu Perseca,
- Catalin Alexandru Staicu,
- Angelica Voinoiu,
- Eleonóra Fabiánová,
- Jana Bérešová,
- Zora Kľocová Adamčáková,
- Roman Nedela,
- Anna Lesňáková,
- Jana Holčíková,
- Paolo Boffetta,
- Mahsa Abedini,
- Giorgia Ditano,
- Shuffield Seyram Asafo,
- Giovanni Visci,
- Francesco Saverio Violante,
- Carlotta Zunarelli,
- Giuseppe Verlato
Affiliations
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Maria Diletta Pezzani
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy
- Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Evelina Tacconelli
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy
- Ilaria Dalla Vecchia
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy
- Emanuele Sansone
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
- Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy
- Carlo Bonfanti
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy
- Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, 25121 Brescia, Italy
- Luigina Terlenghi
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy
- Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Ihab Mansour
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Maurizio Coggiola
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy
- Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Adonina Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Marta-Maria Rodriguez-Suarez
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Guillermo Fernandez-Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Francisco-Jose Jimeno-Demuth
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Rafael-Vicente Castro-Delgado
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Tania Iglesias Cabo
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain
- Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Anna Volpin
- University Hospital of Padova, 35128 Padova, Italy
- Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy
- Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy
- Denise Garavini
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy
- Cristiana D’Elia
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy
- Stefania Mariani
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy
- Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Corrado Negro
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Federico Ronchese
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Francesca Rui
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Paola De Michieli
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy
- Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Marco Dell’Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Giacomo Muzi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Tiziana Fiordi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Ilenia Folletti
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania
- Violeta Claudia Calota
- National Institute of Public Health, 050463 Bucharest, Romania
- Andra Neamtu
- National Institute of Public Health, 050463 Bucharest, Romania
- Ovidiu Perseca
- National Institute of Public Health, 050463 Bucharest, Romania
- Catalin Alexandru Staicu
- National Institute of Public Health, 050463 Bucharest, Romania
- Angelica Voinoiu
- National Institute of Public Health, 050463 Bucharest, Romania
- Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia
- Jana Bérešová
- Epidemiology Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia
- Zora Kľocová Adamčáková
- Health Promotion Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia
- Roman Nedela
- Health Informatics Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia
- Anna Lesňáková
- Infectology Clinic, Central Military Hospital, 03426 Ružomberok, Slovakia
- Jana Holčíková
- Occupational Medicine Clinic, University Hospital, 83105 Bratislava, Slovakia
- Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Shuffield Seyram Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Francesco Saverio Violante
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- DOI
- https://doi.org/10.3390/vaccines10081193
- Journal volume & issue
-
Vol. 10,
no. 8
p. 1193
Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
Keywords
- breakthrough infections
- health workers
- COVID-19
- occupational and socio-demographic determinants
- SARS-CoV-2 vaccination
