Breakthrough cases of COVID-19 in vaccinated United States Veterans with spinal cord injuries and disorders

Spinal Cord, 2021 · DOI: https://doi.org/10.1038/s41393-021-00690-w · Published: August 17, 2021

Simple Explanation

This study reviewed medical records to identify cases of COVID-19 infection in vaccinated veterans with spinal cord injuries and disorders (SCI/D). A breakthrough infection was defined as a positive SARS-CoV-2 test at least 14 days after completing the COVID-19 vaccination series. The study found that the rate of vaccine breakthrough in veterans with SCI/D was higher than the rate reported for the general population by the CDC, but similar to rates observed in skilled nursing facilities.

Study Duration

Not specified

Participants

17,777 living Veterans with SCI/D

Evidence Level

Not specified

Key Findings

1
COVID-19 vaccine breakthrough was identified in 17 out of 8319 (0.20%) of fully vaccinated Veterans with SCI/D as of April 20, 2021.
2
The median time from the final vaccine dose to positive COVID test was 50 days.
3
Of those diagnosed with COVID-19, 6 (35.3%) were symptomatic and 11 (64.7%) were asymptomatic.

Research Summary

This review indicates a similar rate of COVID-19 Vaccine breakthrough in individuals with SCI/D compared to residents of SNFs in which frequent surveillance testing is occurring. The predominance of asymptomatic cases in vaccinated individuals with SCI/D highlights the importance of vaccination in decreasing morbidity and mortality associated with COVID-19 infection. Our ﬁndings support ongoing efforts to minimize COVID-19 exposure and spread in fully vaccinated individuals with SCI/D, particularly in congregate living settings at high risk of COVID-19 outbreak.

Practical Implications

Targeted Prevention

Ongoing efforts should focus on minimizing COVID-19 exposure and spread in vaccinated SCI/D individuals, especially in congregate living settings.

Continued Vaccination

Vaccination remains crucial for decreasing morbidity and mortality associated with COVID-19 in the SCI/D population, despite breakthrough infections.

Surveillance Testing

The importance of surveillance testing, particularly in congregate living settings, is highlighted by the identification of asymptomatic breakthrough cases.

Study Limitations

1
Uncertainty about the completeness of the CDC data for the general population.
2
Relatively few symptomatic COVID-19 breakthrough cases.
3
Unable to draw deﬁnitive conclusions about the effectiveness of the vaccine in preventing COVID-19 in the SCI/D population.

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