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COVID-19 infection risk 2X higher in vaccinated than previously infected (28,000 in Netherlands) – preprint Nov 24, 2021

Increased risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variant compared to Alpha variant in vaccinated individuals

medRxiv preprint doi: https://doi.org/10.1101/2021.11.24.21266735; click here to see posts, Tweets

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3 Stijn P. Andeweg1*, Harry Vennema1*, Irene Veldhuijzen1, Naomi Smorenburg1, Dennis Schmitz1,
4 Florian Zwagemaker1, SeqNeth Molecular surveillance group2, RIVM COVID-19 Molecular
5 epidemiology group3, Arianne B. van Gageldonk-Lafeber1, Susan J.M. Hahné1, Chantal Reusken1,
6 Mirjam J. Knol1*# & Dirk Eggink1*#
7 1Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM),
8 Antonie van Leeuwenhoeklaan 9, 3720 BA, Bilthoven, The Netherlands. 3SeqNeth Molecular Surveillance group:
10 Janke Schinkel, Matthijs R.A. Welkers, Marcel Jonges, Jelle Koopsen, Menno D. de Jong (Amsterdam UMC)
12 Richard Molenkamp, David F. Nieuwenhuijse, Reina S. Sikkema, Bas B. Oude Munnink, Marion
13 Koopmans (Erasmus MC, Rotterdam)
14 Adri van der Zanden, Laura Manrho, Jessica de Beer (Labmicta, Hengelo)
15 Stefan A. Boers, Erin Meijers, Tom Vreeswijk, Igor A. Sidorov (LUMC, Leiden)
16 Djoo Dunk, Pieter W. Smit (Maasstad Hospital, Rotterdam)
17 Suzan D. Pas, Jaco J. Verweij en Joep J. J. M. Stohr (Microvida)
18 Jozef Dingemans, Brian van der Veer, Lieke van Alphen, Paul Savelkoul (MUMC, Maastricht)
19 Hubert G.M. Niesters, Erley F. Lizarazo Forero, Monika A Fliss, Lilli Gard (UMCG, Groningen)
20 Anniek A.N. Tanja, Rob Schuurman, Annemarie M.J. Wensing, L. Marije Hofstra (UMC Utrecht)
21 Jordy P.M. Coolen, Janette C. Rahamat-Langendoen, Willem J. G. Melchers, Heiman F. L. Wertheim (Radboud UMC, Nijmegen)
23 Remco Dijkman, Manon M.C. Holstege, Cornelis J. Vermeulen, Sander Schuurman (Royal GD, Deventer)
25 Karin van Leeuwen, Nadia Keijzer, Lianne Koets, Marco Koppelman (Sanquin Diagnostics, Amsterdam)
35 Correspondence to: mirjam.knol at rivm.nl and dirk.eggink at rivm.nl

36 Abstract
37 The extent to which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of
38 concern (VOC) break through infection- or vaccine-induced immunity is not well understood. Here,
39 we analyze 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status
40 obtained through national community testing in the Netherlands from March to August 2021. We
41 find evidence for an increased risk of infection by the Beta (B.1.351), Gamma (P.1), or Delta
42 (B.1.617.2) variants compared to the Alpha (B.1.1.7) variant after vaccination. No clear differences
43 were found between vaccines. However, the effect was larger in the first 14-59 days after complete
44 vaccination compared to 60 days and longer. In contrast to vaccine-induced immunity, no increased
45 risk for reinfection with Beta, Gamma or Delta variants relative to Alpha variant was found in
46 individuals with infection-induced immunity.
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