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Salvatore PP, Lee CC, Sleweon S, McCormick DW, Nicolae L, Knipe K, Dixon T, Banta R, Ogle I, Young C, Dusseau C, Salmonson S, Ogden C, Godwin E, Ballom T, Rhodes T, Wynn NT, David E, Bessey TK, Kim G, Suppiah S, Tamin A, Harcourt JL, Sheth M, Lowe L, Browne H, Tate JE, Kirking HL, Hagan LM. Transmission potential of vaccinated and unvaccinated persons infected with the SARS-CoV-2 Delta variant in a federal prison, July-August 2021. Vaccine 2023; 41:1808-1818. [PMID: 36572604 PMCID: PMC9744684 DOI: 10.1016/j.vaccine.2022.11.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The extent to which vaccinated persons who become infected with SARS-CoV-2 contribute to transmission is unclear. During a SARS-CoV-2 Delta variant outbreak among incarcerated persons with high vaccination rates in a federal prison, we assessed markers of viral shedding in vaccinated and unvaccinated persons. METHODS Consenting incarcerated persons with confirmed SARS-CoV-2 infection provided mid-turbinate nasal specimens daily for 10 consecutive days and reported symptom data via questionnaire. Real-time reverse transcription-polymerase chain reaction (RT-PCR), viral whole genome sequencing, and viral culture was performed on these nasal specimens. Duration of RT-PCR positivity and viral culture positivity was assessed using survival analysis. RESULTS A total of 957 specimens were provided by 93 participants, of whom 78 (84 %) were vaccinated and 17 (16 %) were unvaccinated. No significant differences were detected in duration of RT-PCR positivity among vaccinated participants (median: 13 days) versus those unvaccinated (median: 13 days; p = 0.50), or in duration of culture positivity (medians: 5 days and 5 days; p = 0.29). Among vaccinated participants, overall duration of culture positivity was shorter among Moderna vaccine recipients versus Pfizer (p = 0.048) or Janssen (p = 0.003) vaccine recipients. In post-hoc analyses, Moderna vaccine recipients demonstrated significantly shorter duration of culture positivity compared to unvaccinated participants (p = 0.02). When restricted to participants without reported prior infection, the difference between Moderna vaccine recipients and unvaccinated participants was more pronounced (medians: 3 days and 6 days, p = 0.002). CONCLUSIONS Infectious periods for vaccinated and unvaccinated persons who become infected with SARS-CoV-2 are similar and can be highly variable, though some vaccinated persons are likely infectious for shorter durations. These findings are critically important, especially in congregate settings where viral transmission can lead to large outbreaks. In such settings, clinicians and public health practitioners should consider vaccinated, infected persons to be no less infectious than unvaccinated, infected persons.
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Affiliation(s)
- Phillip P Salvatore
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service, Rockville, MD, United States.
| | - Christine C Lee
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States; Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sadia Sleweon
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - David W McCormick
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service, Rockville, MD, United States; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lavinia Nicolae
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kristen Knipe
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tom Dixon
- Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Robert Banta
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Isaac Ogle
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Cristen Young
- Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Charles Dusseau
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Shawn Salmonson
- Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Charles Ogden
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Eric Godwin
- Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - TeCora Ballom
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Tara Rhodes
- United States Public Health Service, Rockville, MD, United States; Bureau of Prisons, U.S. Department of Justice, Washington, DC, United States
| | - Nhien Tran Wynn
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ebenezer David
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Theresa K Bessey
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gimin Kim
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Suganthi Suppiah
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Azaibi Tamin
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jennifer L Harcourt
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Mili Sheth
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Luis Lowe
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hannah Browne
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jacqueline E Tate
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service, Rockville, MD, United States
| | - Hannah L Kirking
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service, Rockville, MD, United States
| | - Liesl M Hagan
- COVID-19 Pandemic Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States
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