TY - BOOK AU - Shenoy, Aarthi TI - Adaptive immune responses in vaccinated patients with symptomatic SARS-CoV-2 Alpha infection PY - 2022/// KW - *Adaptive Immunity KW - *Antibodies, Viral/im [Immunology] KW - *COVID-19 Vaccines/pd [Pharmacology] KW - *COVID-19/vi [Virology] KW - *mRNA Vaccines/pd [Pharmacology] KW - *SARS-CoV-2/im [Immunology] KW - *Vaccination/mt [Methods] KW - *Vaccines, Synthetic/pd [Pharmacology] KW - Adult KW - Aged KW - COVID-19/ep [Epidemiology] KW - COVID-19/pc [Prevention & Control] KW - Female KW - Follow-Up Studies KW - Humans KW - Male KW - Middle Aged KW - Pandemics KW - Population Surveillance KW - Retrospective Studies KW - United States/ep [Epidemiology] KW - Young Adult KW - Washington Cancer Institute KW - Journal Article N2 - Benchmarks for protective immunity from infection or severe disease after SARS-CoV-2 vaccination are still being defined. Here we characterized virus neutralizing and ELISA antibody levels, cellular immune responses, and viral variants in 4 separate groups: Healthy control participants weeks (early) or months (late) following vaccination in comparison to symptomatic SARS-CoV-2 infections after partial or full mRNA vaccination. During the study time, most symptomatic breakthrough infections were caused by the SARS-CoV-2 Alpha variant. Neutralizing antibody levels in the healthy controls were sustained over time against the vaccine parent virus, but decreased against the Alpha variant, whereas IgG titers and T cell responses against the parent virus and Alpha variant declined over time in healthy controls. Both partially and fully vaccinated patients with symptomatic infections had lower virus neutralizing antibody levels against parent virus than the healthy controls, similar IgG antibody titers and similar virus-specific T cell responses measured by IFN-gamma. Compared to healthy controls, neutralization activity against the Alpha variant was lower in the partially vaccinated infected patients and tended toward lower in the fully vaccinated infected patients. In this cohort of breakthrough infections, parent virus neutralization was the superior predictor of breakthrough infections with the Alpha variant of SARS-CoV-2 UR - https://dx.doi.org/10.1172/jci.insight.155944 ER -