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As more of the world's population becomes vaccinated against SARS-CoV-2, understanding the characteristics of breakthrough COVID-19 assumes greater importance. In a case-control study involving 11,453 healthcare workers (HCWs) in Israel who had received two doses of BNT162b2 vaccine, investigators sought to identify correlates of breakthrough infections. In HCWs who had been exposed to an infected individual or were symptomatic, antibody titers were obtained during the peri-infection period (i.e., within a week before SARS-CoV-2 was detected). Cases were matched with uninfected controls.
In all, 39 breakthrough infections were noted among 1497 HCWs with RT-PCR results (median time since second vaccine dose, 39 days). Of 33 evaluable isolates…