Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection
- Cambridge University Hospitals NHS Trust, United Kingdom
- University of Cambridge, United Kingdom
- Cambridge Biomedical Campus, United Kingdom
- AstraZeneca, Anne McLaren Building, United Kingdom
Abstract
The BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) is being utilised internationally for mass COVID-19 vaccination. Evidence of single-dose protection against symptomatic disease has encouraged some countries to opt for delayed booster doses of BNT162b2, but the effect of this strategy on rates of asymptomatic SARS-CoV-2 infection remains unknown. We previously demonstrated frequent pauci- and asymptomatic SARS-CoV-2 infection amongst healthcare workers (HCWs) during the UK’s first wave of the COVID-19 pandemic, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates, and find a four-fold reduction in asymptomatic infection amongst HCWs ≥12 days post-vaccination. These data provide real-world evidence of short-term protection against asymptomatic SARS-CoV-2 infection following a single dose of BNT162b2 vaccine, suggesting that mass first-dose vaccination will reduce SARS-CoV-2 transmission, as well as the burden of COVID-19 disease.
Data availability
All data generated or analysed during this study are included in the manuscript and supporting files. Source data files have been provided for Figure 1
Article and author information
Author details
Nicholas J Matheson
Funding
Wellcome Trust (108070/Z/15/Z)
- Michael P Weekes
Wellcome Trust (207498/Z/17/Z)
- Ian G Goodfellow
Wellcome Trust (210688/Z/18/Z)
- Paul J Lehner
Medical Research Council (MR/P008801/1)
- Nicholas J Matheson
NHS Blood and Transplant (WPA15-02)
- Nicholas J Matheson
EPSRC Centre for Doctoral Training in Medical Imaging (EP/P031447/1,EP/N031938/1)
- Richard J Samworth
Medical Research Council (MC_UU_00002/10)
- Shaun Seaman
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- Jos WM van der Meer, Radboud University Medical Centre, Netherlands
Ethics
Human subjects: This study was conducted as a service evaluation of the CUHNFT staff testing and vaccination services (CUHNFT clinical project ID ID3682). As a study of healthcare-associated infections, this investigation is exempt from requiring ethical approval under Section 251 of the NHS Act 2006 (see also the NHS Health Research Authority algorithm, available at http://www.hra-decisiontools.org.uk/research/, which concludes that no formal ethical approval is required).
Version history
- Received: March 26, 2021
- Accepted: April 7, 2021
- Accepted Manuscript published: April 8, 2021 (version 1)
- Version of Record published: April 23, 2021 (version 2)
Copyright
© 2021, Jones et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection
eLife 10:e68808.
https://doi.org/10.7554/eLife.68808
Further reading
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- Epidemiology and Global Health
- Medicine
Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK ‘lockdown’. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent ‘hubs’ of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.
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- Epidemiology and Global Health
- Medicine
Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff.
