top of page

Breakthrough infections after COVID-19 vaccination: Insights, perspectives and challenges

Evropi Amanatidou1, Anna Gkiouliava1, Eva Pella1, Maria Serafidi1, Dimitrios Tsilingiris2, Natalia G Vallianou3, Irene Karampela4, Maria Dalamaga5


Vaccination programs against SARS-CoV-2 constitute the mainstay of public health interventions against the global COVID-19 pandemic. Currently available vaccines have shown 90% or better rates of protection against severe disease and mortality. Barely a year after vaccines became available, the Omicron variant and its unprecedented speed of transmission has posed a new challenge. Overall, Omicron presents increased immune escape, transmissibility, and decreased pathogenicity. Vaccines do not offer a full protection against SARS-CoV-2 acquisition, since "breakthrough" infections may occur in fully vaccinated individuals, who may in turn spread the virus to others. Breakthrough infections may be causally related to the viral profile (viral variant and load, incubation period, transmissibility, pathogenicity, immune evasion), immunity characteristics (mucosal versus systemic immunity, duration of immunity, etc.), host determinants (age, comorbidities, immune status, immunosuppressive drugs) and vaccination properties (platform, antigen dose, dose number, dose interval, route of administration). Determining the rate of breakthrough infections may be challenging and necessitates the conduction of population-based studies regarding vaccine effectiveness as well as neutralizing antibody testing, a surrogate of immune protection. In this review, we analyze the causes of breakthrough infections, their clinical consequences (severity of infection and transmission), methods of determining their incidence as well as challenges and perspectives. Long COVID as well as multi-inflammatory syndrome in adolescents may be significantly reduced in breakthrough infections. The need for universal pancoranavirus vaccines that would aim at protecting against a plethora of SARS-CoV-2 variants as well as emerging variants is discussed. Finally, novel vaccine strategies, such as nasal vaccines, may confer robust mucosal and systemic protection, reducing efficiently transmission.

6 views0 comments

Recent Posts

See All

This article was published by the New York Post on February 27,2023. Author is Marty Makary MD, MPH a professor at the Johns Hopkins University School of Medicine and author of “The Price We Pay.” I

NAC is a natural antioxidant produced by the body. It is used to synthesize Glutathione (the most potent antioxidant in the body) within the blood. NAC is the precursor for Glutathione. This means tha

bottom of page