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Background <p>We aimed to identify risk factors for breakthrough SARS-CoV-2 infection after at least one dose of any COVID-19 vaccine.</p> Methods <p>This is a case-control test-negative design study in hospitalized patients with a severe acute respiratory infection, at least one dose of any COVID-19 vaccine and a PCR-test for SARS-CoV-2/COVID-19 performed between 1 November 2021 and 28 June 2022. Cases and controls were matched by age and date of test. A logistic regression model with adjusted odds ratios was performed to determine factors related to breakthrough infection.</p> Results <p>We analyzed 1,340 breakthrough SARS-CoV-2 infections matched with 4,016 controls. After adjustment, the odds of a breakthrough infection were 64% higher in patients whose last vaccine dose was administered more than 6 months before hospitalization compared to those vaccinated within the previous 6 months (aOR 1.64; CI 95% 1.42–1.88). Moreover, immunosuppression was statistically associated with breakthrough infection (aOR 2.04; CI 95%, 1.58–2.62).</p> Discussion <p>The probability of breakthrough SARS-CoV-2 infection was significantly higher in hospitalized patients who had received their last vaccine dose more than six months before hospitalization; while immunosuppression was the most important risk factor for breakthrough infection.</p>

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Risk factors of COVID-19 breakthrough infection: a case-control test-negative design study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月17日

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  • Gabriela Tejada-Panduro,
  • Laia Pinós-Tella,
  • Susana Otero-Romero,
  • Blanca Borras-Bermejo,
  • Ingrid Carbones,
  • Andrés Antón,
  • Cristina Andrés,
  • Oleguer Parés-Badell

摘要

Background

We aimed to identify risk factors for breakthrough SARS-CoV-2 infection after at least one dose of any COVID-19 vaccine.

Methods

This is a case-control test-negative design study in hospitalized patients with a severe acute respiratory infection, at least one dose of any COVID-19 vaccine and a PCR-test for SARS-CoV-2/COVID-19 performed between 1 November 2021 and 28 June 2022. Cases and controls were matched by age and date of test. A logistic regression model with adjusted odds ratios was performed to determine factors related to breakthrough infection.

Results

We analyzed 1,340 breakthrough SARS-CoV-2 infections matched with 4,016 controls. After adjustment, the odds of a breakthrough infection were 64% higher in patients whose last vaccine dose was administered more than 6 months before hospitalization compared to those vaccinated within the previous 6 months (aOR 1.64; CI 95% 1.42–1.88). Moreover, immunosuppression was statistically associated with breakthrough infection (aOR 2.04; CI 95%, 1.58–2.62).

Discussion

The probability of breakthrough SARS-CoV-2 infection was significantly higher in hospitalized patients who had received their last vaccine dose more than six months before hospitalization; while immunosuppression was the most important risk factor for breakthrough infection.