Family Secondary Cases from Covid-19 Breakthrough Infections in Vaccinated People
Abstract
Background: It is not clear whether vaccinating individual people against SARS-CoV-2 protects members of their households.
Objective: To study the prevalence and characteristics of secondary cases in family members after the appearance of a primary case of COVID-19 breakthrough infection
Methodology: An observational, longitudinal, and prospective study of families with one primary case of COVID-19 breakthrough infection was conducted from February 1 to November 30, 2021, in a general medicine office in Toledo, Spain.
Results: 13 primary cases in 13 families (46 people) were included. The crude secondary attack rate (secondary cases / exposed population with complete or incomplete vaccination (15/23) was 45%. The crude secondary attack rate in contacts with complete vaccination (9/17) was 53%. The vaccine effectiveness against transmission among households among contacts (Secondary attack rate in vaccinated / Secondary attack rate in unvaccinated) × 100%= 53/69) was 77%. All secondary cases were mild. Secondary cases were more young women with a lower socio-occupational level.
Conclusion: In the context of general medicine in Toledo (Spain), when the delta variant became dominant, but before the rise of omicron, vaccination reduces but does not eliminate the risk of COVID-19 transmission within homes (crowded indoor environments), which remain important places for transmission. It is suggested to re-evaluate the protocol that vaccinated family contacts do not require isolation.
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