ReviewNature reviews. Immunology2022
SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact.
Review in Nature reviews. Immunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 214 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
214 citing papers in PubMed, 2 syntheses or guidelines pooled it, 351 citations in OpenAlex.
- Prior infections and effectiveness of SARS-CoV-2 vaccine in test-negative studies: a systematic review and meta-analysis.American journal of epidemiology · 2024Pooled it
- Efficacy and safety of baricitinib for the treatment of hospitalized adults with COVID-19: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Heterologous RBMRNA-405 mRNA booster enhances humoral immunity post-inactivated COVID-19 vaccination: a randomized clinical trial in adults and older through 12 months.Scientific reports · 2026Trial
- Efficacy and safety of baricitinib in hospitalized adults with severe or critical COVID-19 (Bari-SolidAct): a randomised, double-blind, placebo-controlled phase 3 trial.Critical care (London, England) · 2023Trial
- Safety and immunogenicity of a hybrid-type vaccine booster in BBIBP-CorV recipients in a randomized phase 2 trial.Nature communications · 2022Trial
- Respiratory mucosal vaccines for emerging viruses: promise and challenges.Journal of virology · 2026Review
- Dose-dependent effects of recombinant spike protein-based vaccination on SARS-CoV-2 evolutionary dynamics and the emergence of variants in hamster models.The Journal of general virology · 2026Article
- Integrative Multidimensional Profiling of Individuals Recovered from Mild COVID-19 Reveals Immune-Metabolic-Oxidative Network Interactions.International journal of molecular sciences · 2026Article
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- Enabling global access to potent subunit vaccines with a simple and scalable injectable hydrogel platform.Biomaterials science · 2026Article
- Remdesivir in COVID-19: pros and cons.Frontiers in pharmacology · 2026Review
- Hybrid immunity from bivalent vaccination and prior infection enhances humoral and innate protection against Omicron XBB.1.16 and EG.5.1.1 variants in Japan.Frontiers in immunology · 2026Article
- Serological responses to SARS-CoV-2 in urban and rural Ghana: Antibody waning and implications for long-term population immunity.PloS one · 2026Article
- Immunodominant T cell responses to SARS-CoV-2 nucleocapsid protein in Omicron breakthrough infection post-inactivated vaccination.Virulence · 2025Article
- Monocyte-eosinophil signaling axis promotes vaccine-mediated protection against SARS-CoV-2.PLoS pathogens · 2025Article
- Reading of human acute immune dynamics in omicron SARS-CoV-2 breakthrough infection.Emerging microbes & infections · 2025Article
- Comparison of fully-vaccinated and non/partially-vaccinated critically-ill COVID-19 patients in terms of disease severity: a retrospective observational study.BMC infectious diseases · 2025Observational
- Bivalent mRNA vaccine booster enhances immunity against XBB.1.5 more effectively than breakthrough infection in K18-hACE2 mice.iScience · 2025Article
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154 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fully vaccinated individuals are receiving intense scrutiny because of their importance in determining how long restrictions to control virus transmission will need to remain in place in highly vaccinated populations as well as in determining the need for additional vaccine doses or changes to the vaccine formulations and/or dosing intervals. Measurement of breakthrough infections is challenging outside of randomized, placebo-controlled, double-blind field trials. However, laboratory and observational studies are necessary to understand the impact of waning immunity, viral variants and other determinants of changing vaccine effectiveness against various levels of coronavirus disease 2019 (COVID-19) severity. Here, we describe the approaches being used to measure vaccine effectiveness and provide a synthesis of the burgeoning literature on the determinants of vaccine effectiveness and breakthrough rates. We argue that, rather than trying to tease apart the contributions of factors such as age, viral variants and time since vaccination, the rates of breakthrough infection are best seen as a consequence of the level of immunity at any moment in an individual, the variant to which that individual is exposed and the severity of disease being considered. We also address key open questions concerning the transition to endemicity, the potential need for altered vaccine formulations to track viral variants, the need to identify immune correlates of protection, and the public health challenges of using various tools to counter breakthrough infections, including boosters in an era of global vaccine shortages.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.