{"doi":"10.1093/cid/ciab886","title":"Clinical and Genomic Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) Infections in mRNA Vaccinated Health Care Personnel in New York City","abstract":"BACKGROUND: Vaccine-induced clinical protection against severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) variants is an evolving target. There are limited genomic level data on SARS CoV-2 breakthrough infections and vaccine effectiveness (VE) since the global spread of the B.1.617.2 (Delta) variant. METHODS: In a retrospective study from 1 November 2020 to 31 August 2021, divided as pre-Delta and Delta-dominant periods, laboratory-confirmed SARS CoV-2 infections among healthcare personnel (HCP) at a large tertiary cancer center in New York City were examined to compare the weekly infection rate-ratio in vaccinated, partially vaccinated, and unvaccinated HCP. We describe the clinical and genomic epidemiologic features of post-vaccine infections to assess for selection of variants of concern (VOC)/variants of interest (VOI) in the early post-vaccine period and impact of B.1.617.2 (Delta) variant domination on VE. RESULTS: Among 13658 HCP in our cohort, 12379 received at least 1 dose of a messenger RNA (mRNA) vaccine. In the pre-Delta period overall VE was 94.5%. Whole genome sequencing (WGS) of 369 isolates in the pre-Delta period did not reveal a clade bias for VOC/VOI specific to post-vaccine infections. VE in the Delta dominant phase was 75.6%. No hospitalizations occurred among vaccinated HCP in the entire study period, compared to 17 hospitalizations and 1 death among unvaccinated HCP. CONCLUSIONS: Findings show high VE among HCP in New York City in the pre-Delta phase, with moderate decline in VE post-Delta emergence. SARS CoV-2 clades were similarly distributed among vaccinated and unvaccinated infected HCP without apparent clustering during the pre-Delta period of diverse clade circulation. Strong vaccine protection against hospitalization was maintained through the entire study period.","journal":"Clinical Infectious Diseases","year":2021,"id":201732,"datarank":0.5698402352716057,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.2579240040196303,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.2579240040196303,"corpus_percentile":65.53724762125783,"corpus_rank":4456,"citation_count":7,"citer_count":6,"citers_with_citation_signal":6,"citers_with_endowment":6,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.596,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":704740,"name":"Karissa Whiting","orcid":"0000-0002-4683-1868","position":1,"is_corresponding":false},{"id":437511,"name":"Anabella Lucca Bianchi","orcid":"0000-0002-0064-1081","position":2,"is_corresponding":false},{"id":780656,"name":"Chester Poon","orcid":"0000-0001-6931-2414","position":3,"is_corresponding":false},{"id":780657,"name":"Rebecca Guest","orcid":"0000-0002-9726-7427","position":4,"is_corresponding":false},{"id":383159,"name":"Tracy McMillen","orcid":"0000-0002-0383-1366","position":5,"is_corresponding":false},{"id":383160,"name":"Krupa Jani","orcid":"0000-0002-6536-3879","position":6,"is_corresponding":false},{"id":237349,"name":"Alexander Solovyov","orcid":"0000-0002-7682-4706","position":7,"is_corresponding":false},{"id":781158,"name":"Suzanne Kelson","orcid":null,"position":8,"is_corresponding":false},{"id":781159,"name":"Kevin P. Browne","orcid":null,"position":9,"is_corresponding":false},{"id":781160,"name":"Scott Freeswick","orcid":null,"position":10,"is_corresponding":false},{"id":228380,"name":"Tobias M. Hohl","orcid":"0000-0002-9097-5412","position":11,"is_corresponding":false},{"id":438218,"name":"Deborah Korenstein","orcid":"0000-0003-1859-0574","position":12,"is_corresponding":false},{"id":655484,"name":"Denis Ruchnewitz","orcid":"0000-0001-5740-6958","position":13,"is_corresponding":false},{"id":655492,"name":"Michael Lässig","orcid":"0000-0002-3575-6719","position":14,"is_corresponding":false},{"id":106865,"name":"Marta Łuksza","orcid":"0000-0002-8443-8135","position":15,"is_corresponding":false},{"id":86527,"name":"Benjamin D. Greenbaum","orcid":"0000-0001-6153-8793","position":16,"is_corresponding":false},{"id":246216,"name":"Venkatraman Seshan","orcid":"0000-0002-9258-2698","position":17,"is_corresponding":false},{"id":228382,"name":"N. Esther Babady","orcid":"0000-0003-4399-1249","position":18,"is_corresponding":false},{"id":228383,"name":"Mini Kamboj","orcid":"0000-0002-3122-6374","position":19,"is_corresponding":false},{"id":654342,"name":"Elizabeth Robilotti","orcid":null,"position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T23:50:56.394488Z","pmid":"34644393","pmcid":"PMC9612794","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}