ArticleEmerging microbes & infections2022
COVID-19 breakthrough infections and humoral immune response among BNT162b2 vaccinated healthcare workers in Malaysia.
Article in Emerging microbes & infections, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 25 citations in OpenAlex.
- Tracking the shifting landscape of SARS-CoV-2 variants in Lebanon among healthcare workers and hospitalized patients.Microbiology spectrum · 2026Article
- Beyond the blood: Tissue-resident immunity shapes SARS-CoV-2 vaccine antibody responses.bioRxiv : the preprint server for biology · 2026Article
- SARS-CoV-2 breakthrough infection incidence, risk factors, and antibody correlates in Belgian nursing homes residents and staff (2021-2022).Archives of public health = Archives belges de sante publique · 2026Article
- Comparative analysis of humoral immunity kinetics following three COVID-19 vaccines in a multi-ethnic cohort of medical students and healthcare professionals across Malaysia.Scientific reports · 2025Observational
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- Higher Delta variant-specific neutralizing antibodies prevented infection in close contacts vaccinated with ancestral mRNA vaccines during the SARS-CoV-2 Delta wave.Scientific reports · 2023Article
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- Article
- Cellular and Humoral Immune Responses after Breakthrough Infection in Patients Undergoing Hemodialysis.Vaccines · 2023Article
- Intertwined Dysregulation of Ribosomal Proteins and Immune Response Delineates SARS-CoV-2 Vaccination Breakthroughs.Microbiology spectrum · 2023Article
- The role of immune activation and antigen persistence in acute and long COVID.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2023Review
- SARS-CoV-2 Breakthrough Infections According to the Immune Response Elicited after mRNA Third Dose Vaccination in COVID-19-Naïve Hospital Personnel.Biomedicines · 2023Article
- Article
- Time from last immunity event against infection during Omicron-dominant period in Malaysia.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Low humoral and cellular immune responses early after breakthrough infection may contribute to severe COVID-19.Frontiers in immunology · 2023Article
- COVID-19 vaccination in healthcare workers: Long-term benefits and protection.Central-European journal of immunology · 2023Article
- Cellular basis of enhanced humoral immunity to SARS-CoV-2 upon homologous or heterologous booster vaccination analyzed by single-cell immune profiling.Cell discovery · 2022Article
- Evaluation of BNT162b2 vaccine effectiveness in Malaysia: test negative case-control study.Vaccine · 2022Article
- Usefulness and Limitations of Anti-S IgG Assay in Detecting Previous SARS-CoV-2 Breakthrough Infection in Fully Vaccinated Healthcare Workers.Diagnostics (Basel, Switzerland) · 2022Article
- Immunologic features of asymptomatic postvaccination infections with the Delta variant of SARS-CoV-2 in adults.Immunity, inflammation and disease · 2022Article
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Authors and funding
19 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The evaluation of breakthrough infection and humoral immunity responses are important outcomes for vaccination policy for healthcare staff. This prospective cohort study collected blood samples at 5-time points; before primary vaccine doses, and at 2, 10 and 24 weeks after BNT162b2 vaccination from 551 HCWs, between March and October 2021. We investigated the association between anti-spike-1 protein receptor-binding domain (anti-S1-RBD) antibody geometric mean titre (GMT) and breakthrough infections. Two weeks post-vaccination, the GMT of anti-S1-RBD antibodies was measured at almost maximum detectable value (3115 BAU/ml [95% CI, 3051-3180]); it decreased to 1486 BAU/ml (95% CI, 1371-1610) at 10 weeks; and to 315 BAU/ml (95% CI, 283-349) at 24 weeks. Prior COVID-19 infection and age significantly affected the antibody titres. Fifty-six participants, none of whom were COVID-19 convalescents, had breakthrough infections between 10 and 24 weeks post-vaccination. Before breakthrough infections, the GMT was not different between the breakthrough and non-breakthrough individuals. After infection, the GMT was significantly higher in individuals with breakthrough infections (2038 BAU/ml [95%CI, 1547-2685]), specifically in symptomatic breakthroughs, compared to those without infection (254 BAU/ml [95%CI, 233-278]). A notable surge in breakthrough infections among healthcare workers coincided with the emergence of the Delta variant and when BNT162b2-elicited antibody responses waned in 10-24 weeks (i.e. approximately 3-6 months). Post-breakthrough, the antibody response was boosted in individuals with symptomatic presentations, but not asymptomatic individuals. The study finding supports administering booster vaccination for healthcare staff, including those who recovered from asymptomatic breakthrough infection.
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