CINXE.COM
Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India - PubMed
<!DOCTYPE html> <html lang="en" > <head itemscope itemtype="http://schema.org/WebPage" prefix="og: http://ogp.me/ns#" > <meta charset="UTF-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <!-- Mobile properties --> <meta name="HandheldFriendly" content="True"> <meta name="MobileOptimized" content="320"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link rel="preconnect" href="https://cdn.ncbi.nlm.nih.gov"> <link rel="preconnect" href="https://www.ncbi.nlm.nih.gov"> <link rel="preconnect" href="https://www.google-analytics.com"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/css/output.5ecf62baa0fa.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/css/output.452c70ce66f7.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/css/output.7bf600913d6e.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/css/output.0bfa59184c7a.css" type="text/css"> <link rel="stylesheet" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/css/output.b576742ffc3e.css" type="text/css"> <title>Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India - PubMed</title> <link rel="preload" as="font" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/uswds/dist/fonts/merriweather-bold-webfont.woff2" type="font/woff2" crossorigin /> <!-- Favicons --> <link rel="shortcut icon" type="image/ico" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon.ico" /> <link rel="icon" type="image/png" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon.png" /> <!-- 192x192, as recommended for Android http://updates.html5rocks.com/2014/11/Support-for-theme-color-in-Chrome-39-for-Android --> <link rel="icon" type="image/png" sizes="192x192" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-192.png" /> <!-- 57x57 (precomposed) for iPhone 3GS, pre-2011 iPod Touch and older Android devices --> <link rel="apple-touch-icon-precomposed" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-57.png"> <!-- 72x72 (precomposed) for 1st generation iPad, iPad 2 and iPad mini --> <link rel="apple-touch-icon-precomposed" sizes="72x72" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-72.png"> <!-- 114x114 (precomposed) for iPhone 4, 4S, 5 and post-2011 iPod Touch --> <link rel="apple-touch-icon-precomposed" sizes="114x114" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-114.png"> <!-- 144x144 (precomposed) for iPad 3rd and 4th generation --> <link rel="apple-touch-icon-precomposed" sizes="144x144" href="https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/favicons/favicon-144.png"> <!-- For Pinger + Google Optimize integration (NS-820) --> <meta name="ncbi_sg_optimize_id" content=""> <!-- Mobile browser address bar color --> <meta name="theme-color" content="#20558a"> <!-- Preserve the Referrer when going from HTTPS to HTTP --> <meta name="referrer" content="origin-when-cross-origin"> <meta name="ncbi_pinger_gtm_track" content="true"/> <!-- Logging params: Pinger defaults --> <meta name="ncbi_app" content="pubmed" /> <meta name="ncbi_db" content="pubmed" /> <meta name="ncbi_phid" content="4DC60001FAA5781500002EA56FD9FC98.1.m_7" /> <meta name="ncbi_pinger_stat_url" content="https://www.ncbi.nlm.nih.gov/stat" /> <meta name="log_category" content="literature" /> <meta name="ncbi_cost_center" content="pubmed" /> <!-- Logging params: Pinger custom --> <meta name="ncbi_pdid" content="abstract" /> <meta name="log_op" content="retrieve" /> <meta name="uid" content="34044037" /> <meta name="ncbi_uid" content="34044037" /> <meta name="log_displayeduids" content="34044037" /> <meta name="log_source_db" content="pubmed,pmc" /> <meta name="log_icons_present" content="true" /> <!-- Social meta tags for unfurling urls --> <meta name="description" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India"><meta name="keywords" content="pmid:34044037, PMC8143909, doi:10.1016/j.jinf.2021.05.018, Letter, Comment, Beena Philomina J, Bani Jolly, Chandni Radhakrishnan, Antibody Formation, COVID-19 Vaccines, COVID-19*, Genomics, Health Personnel, Humans, India / epidemiology, RNA, Messenger, SARS-CoV-2*, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/34044037/"><meta property="og:description" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India"><meta property="og:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:image:secure_url" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:type" content="website"><meta property="og:site_name" content="PubMed"><meta name="twitter:domain" content="pubmed.ncbi.nlm.nih.gov"><meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India - PubMed"><meta name="twitter:url" content="https://pubmed.ncbi.nlm.nih.gov/34044037/"><meta name="twitter:description" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India"><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"> <!-- OpenSearch XML --> <link rel="search" type="application/opensearchdescription+xml" href="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/opensearch.xml" title="PubMed search"> <!-- Disables severely broken elements when no JS --> <noscript> <link rel="stylesheet" type="text/css" href="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/core/no-script.css"> </noscript> <meta name="citation_title" content="Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India"> <meta name="citation_authors" content="Philomina J B;Jolly B;John N;Bhoyar RC;Majeed N;Senthivel V;Cp F;Rophina M;Vasudevan B;Imran M;Viswanathan P;Arvinden VR;Joseph A;Divakar MK;Nair PR;Shamnath A;Kumar PJ;Jain A;Geetha P;Bajaj A;Mathew S;Gupta V;Agrawal SJ;Scaria V;Sivasubbu S;Radhakrishnan C;"> <meta name="citation_date" content="2021 Aug"> <meta name="citation_publisher" content="J Infect"> <meta name="citation_journal_title" content="The Journal of infection"> <meta name="citation_pmid" content="34044037"> <meta name="citation_abstract_html_url" content="https://pubmed.ncbi.nlm.nih.gov/34044037/"> <meta name="citation_volume" content="83"> <meta name="citation_issue" content="2"> <meta name="citation_doi" content="10.1016/j.jinf.2021.05.018"> <meta name="citation_issn" content="1532-2742"> <link rel="canonical" href="https://pubmed.ncbi.nlm.nih.gov/34044037/" /> </head> <body > <noscript> <div class="no-script-banner" id="no-script-banner"> <div class="warning-message"> <div class="warning-message-text"> This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! </div> </div> </div> </noscript> <div class="no-session-banner" id="no-session-banner" hidden> <div class="warning-message"> <div class="warning-message-text"> Clipboard, Search History, and several other advanced features are temporarily unavailable. </div> <button class="close-banner-button" title="Close Clipboard and Search History not available warning banner" ref="linksrc=close_no_session_banner" aria-controls="no-session-banner" aria-label="Close Clipboard and Search History not available warning banner" aria-expanded="true"> </button> </div> </div> <a class="usa-skipnav" href="#article-details"> Skip to main page content </a> <!-- ========== BEGIN HEADER ========== --> <section class="usa-banner"> <div class="usa-accordion"> <header class="usa-banner-header"> <div class="usa-grid usa-banner-inner"> <img src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png" alt="U.S. flag" /> <p>An official website of the United States government</p> <button class="usa-accordion-button usa-banner-button" aria-expanded="false" aria-controls="gov-banner-top" > <span class="usa-banner-button-text">Here's how you know</span> </button> </div> </header> <div class="usa-banner-content usa-grid usa-accordion-content" id="gov-banner-top" > <div class="usa-banner-guidance-gov usa-width-one-half"> <img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg" alt="Dot gov" /> <div class="usa-media_block-body"> <p> <strong>The .gov means it’s official.</strong> <br /> Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. </p> </div> </div> <div class="usa-banner-guidance-ssl usa-width-one-half"> <img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg" alt="Https" /> <div class="usa-media_block-body"> <p> <strong>The site is secure.</strong> <br /> The <strong>https://</strong> ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. </p> </div> </div> </div> </div> </section> <div class="usa-overlay"></div> <header class="ncbi-header" role="banner" data-section="Header"> <div class="usa-grid"> <div class="usa-width-one-whole"> <div class="ncbi-header__logo"> <a href="https://www.ncbi.nlm.nih.gov/" class="logo" aria-label="NCBI Logo" data-ga-action="click_image" data-ga-label="NIH NLM Logo"> <img src="https://www.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg" alt="NIH NLM Logo" /> </a> </div> <div class="ncbi-header__account"> <a id="account_login" href="https://account.ncbi.nlm.nih.gov" class="usa-button header-button" style="display:none" data-ga-action="open_menu" data-ga-label="account_menu">Log in</a> <button id="account_info" class="header-button" style="display:none" aria-controls="account_popup"> <span class="fa fa-user" aria-hidden="true"></span> <span class="username desktop-only" aria-hidden="true" id="uname_short"></span> <span class="sr-only">Show account info</span> </button> </div> <div class="ncbi-popup-anchor"> <div class="ncbi-popup account-popup" id="account_popup" aria-hidden="true"> <div class="ncbi-popup-head"> <button class="ncbi-close-button" data-ga-action="close_menu" data-ga-label="account_menu"><span class="fa fa-times"></span><span class="usa-sr-only">Close</span></button> <h4>Account</h4> </div> <div class="account-user-info"> Logged in as:<br/> <b><span class="username" id="uname_long">username</span></b> </div> <div class="account-links"> <ul class="usa-unstyled-list"> <li><a id="account_myncbi" href="/myncbi/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_myncbi">Dashboard</a></li> <li><a id="account_pubs" href="/myncbi/collections/bibliography/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_pubs">Publications</a></li> <li><a id="account_settings" href="/account/settings/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_settings">Account settings</a></li> <li><a id="account_logout" href="/account/signout/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_logout">Log out</a></li> </ul> </div> </div> </div> </div> </div> </header> <div role="navigation" aria-label="access keys"> <a id="nws_header_accesskey_0" href="https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys" class="usa-sr-only" accesskey="0" tabindex="-1">Access keys</a> <a id="nws_header_accesskey_1" href="https://www.ncbi.nlm.nih.gov" class="usa-sr-only" accesskey="1" tabindex="-1">NCBI Homepage</a> <a id="nws_header_accesskey_2" href="/myncbi/" class="set-base-url usa-sr-only" accesskey="2" tabindex="-1">MyNCBI Homepage</a> <a id="nws_header_accesskey_3" href="#maincontent" class="usa-sr-only" accesskey="3" tabindex="-1">Main Content</a> <a id="nws_header_accesskey_4" href="#" class="usa-sr-only" accesskey="4" tabindex="-1">Main Navigation</a> </div> <section data-section="Alerts"> <div class="ncbi-alerts-placeholder"></div> </section> <!-- ========== END HEADER ========== --> <a id="maincontent" aria-label="Main page content below" role="navigation"></a> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <form action="/" method="get" autocomplete="off" class="usa-search usa-search-big search-form content-page-layout" id="search-form" role="search"> <div class="inner-wrap"> <a class="pubmed-logo" aria-label="Pubmed Logo" href="/" data-ga-category="featured_link" data-ga-action="pubmed_logo"> <img src="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/core/images/pubmed-logo-blue.svg" alt="pubmed logo" /> </a> <a href="#" class="search-input-trigger" data-alt-title="Hide search bar" title="Show search bar" aria-label="Show search bar"> </a> <div role="search" class="search-input"> <div class="form-field "> <label class="usa-sr-only" for="id_term"> Search: </label> <input type="search" name="term" data-skip-ie-scroll-to-top="" data-replace-term-with-exact="" data-exact-query="" placeholder="" class="term-input" required="required" id="id_term"/><a href="#" class="clear-btn" aria-label="Clear search input" title="Clear search input" role="button" data-pinger-ignore></a><button type="submit" class="search-btn" aria-label="Search" disabled data-pinger-ignore><span class="usa-search-submit-text">Search</span></button> </div> </div> <!-- Create alert and Create RSS are buttons that look like links --> <!-- Better for them to look like buttons but no space --> <div class="search-links-wrapper content-page-layout"> <div class="search-links"> <a href="/advanced/" class="search-input-link adv-search-link" data-ga-category="featured_link" data-ga-action="adv_search">Advanced</a> <a href="/clipboard/" class="search-input-link clipboard-link hidden" data-ga-category="featured_link" data-ga-action="clipboard"> Clipboard <span class="amount-in-clipboard"></span> </a> </div> <span class="search-input-link user-guide-link" role="navigation" aria-label="User guide"> <a href="/help/" data-ga-category="featured_link" data-ga-action="user_guide"> User Guide </a> </span> </div> </div> </form> <div id="article-page-header"> <div id="article-top-actions-bar" class="article-top-actions-bar"> <div class="inner-wrap"> <div class="actions-container"> <div class="return-to-search"> </div> <div class="multiple-results-actions " role="region" aria-label="save, email, send to"> <button id="save-results-panel-trigger" type="button" class="save-results save-results-panel-trigger" aria-expanded="false" aria-controls="save-action-panel" data-ga-category="save_share" data-ga-action="save" data-ga-label="open"> Save </button><button id="email-results-panel-trigger" type="button" class="email-results email-results-panel-trigger" aria-expanded="false" aria-controls="email-action-panel" data-ga-category="save_share" data-ga-action="email" data-ga-label="open"> Email </button><div class="more-actions dropdown-block"><button id="more-actions-trigger" type="button" class="trigger more-actions-trigger" ref="linksrc=show_moreactions_btn" aria-label="Send to" aria-controls="more-actions-dropdown">Send to</button><div id="more-actions-dropdown" class="dropdown dropdown-container" hidden><div class="content"><ul class="more-actions-links"><li><a class="clipboard-panel-trigger dropdown-block-link " href="#" role="button" data-ga-category="save_share" data-ga-action="clipboard" data-ga-label="send"> Clipboard </a></li><li><a role="button" class="dropdown-block-link bibliography-trigger-target" href="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F%23open-bibliography-panel">My Bibliography</a></li><li><a role="button" class="dropdown-block-link collections-trigger-target" href="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F%23open-collections-panel">Collections</a></li><li><a role="button" class="citation-manager-panel-trigger dropdown-block-link citation-manager-trigger-target" href="#">Citation manager</a></li></ul></div></div></div> </div> <div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"> <button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"> <span class="button-label">Display options</span> </button> <div class="dropdown" hidden> <div class="title"> Display options </div> <div class="content"> <div class="format-container"> <span class="option-label"> Format </span> <select name="format" data-initial-value="abstract" aria-label="Display format" id="article-display-format"> <option value="abstract">Abstract</option> <option value="pubmed">PubMed</option> <option value="pmid">PMID</option> </select> </div> </div> </div> </div> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> </div> </div> </div> <div id="article-panels-container" class="article-panels-container"> <div id="save-action-panel" class="save-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Save citation to file </h2> <form id="save-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="action-panel-control-wrap"> <label for="save-action-format" class="action-panel-label"> Format: </label> <select id="save-action-format" name="results-format" class="action-panel-selector"> <option value="summary-text">Summary (text)</option> <option value="pubmed-text">PubMed</option> <option value="pmid">PMID</option> <option value="abstract">Abstract (text)</option> <option value="csv">CSV</option> </select> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="save" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Save citations to file' panel" ref="linksrc=close_save_panel" aria-controls="save-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="save" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="email-action-panel" class="email-action-panel action-panel" aria-hidden="true" data-recaptcha-script-url="https://www.recaptcha.net/recaptcha/enterprise.js?render=explicit&onload=onloadCaptchaCallback" data-recaptcha-enabled="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Email citation </h2> <form id="email-action-panel-form" class="action-panel-content action-form" action="/send-email/" data-by-search-action="/results-export-email-by-search-data/" data-by-ids-action="/send-email/" data-by-search-method="post" data-by-ids-method="post" method="post" > <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="action-panel-control-wrap"> <span class="action-panel-label"> Subject: </span> <span class="email-subject" id="email-subject" aria-label="Email subject">1 selected item: 34044037 - PubMed</span> <input type="hidden" name="email-subject" value="1 selected item: 34044037"/> <input type="hidden" name="email-subject-hash" value="6d24dd1b16db65d248c42aa0c7ede0c03c71d8627c2294263a723a557a4aff52"/> </div> <div class="action-panel-control-wrap"> <label for="email-to" class="action-panel-label required-field-asterisk"> To: </label> <input type="email" aria-label="Recipient Email Address" placeholder="email@example.com" id="email-to" class="email-to" pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$" maxlength="100" required> </div> <div class="action-panel-control-wrap"> <label for="email-from" class="action-panel-label"> From: </label> <input type="email" aria-label="Sender Email Address" placeholder="email@example.com" id="email-from" class="email-from" pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$" maxlength="256"> </div> <div class="action-panel-control-wrap"> <label for="email-citation-format" class="action-panel-label"> Format: </label> <select id="email-citation-format" name="citation-format" class="action-panel-selector email-citation-format"> <option selected="selected" value="summary">Summary</option> <option value="summary-text">Summary (text)</option> <option value="abstract">Abstract</option> <option value="abstract-text">Abstract (text)</option> </select> </div> <div class="include-supplemental-container"> <input type="checkbox" aria-label="Include MeSH and other data" name="include-supplemental" id="email-include-supplemental" class="email-include-supplemental"> <label for="email-include-supplemental" class="email-include-supplemental-label">MeSH and other data</label> </div> <div class="form-field recaptcha "> <div class="g-recaptcha" id="id-recaptcha" data-sitekey="6LfsWHMdAAAAAClKbtOpjQ2pMjgsGxvv7NdZW9uI"></div> </div> <div id="captcha-error-message" class="usa-input-error-message captcha-validation-message" role="alert"></div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="email" data-ga-label="send"> Send email </button> <button class="action-panel-cancel" aria-label="Close 'Email citations' panel" ref="linksrc=close_email_panel" aria-controls="email-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="email" data-ga-label="cancel"> Cancel </button> </div> <input type="hidden" name="email-search-details" value="" /> <input type="hidden" name="email-search-details-hash" value="0e42663a6c3bd85498fcb88798998fed7bfdc45d457db35281e41afe13cc0524" /> </form> </div> </div> <div id="collections-action-panel" class="collections-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-collections-open-panel-enabled="false" data-collections-open-panel-url-hash="#open-collections-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to Collections </h3> <form id="collections-action-panel-form" class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-existing-collections-url="/list-existing-collections/" data-add-to-existing-collection-url="/add-to-existing-collection/" data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-myncbi-max-collection-name-length="100" data-add-to-collection-max-amount="1000" data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="choice-group" role="radiogroup"> <ul class="radio-group-items"> <li> <input type="radio" id="collections-action-panel-new" class="collections-new" name="collections" value="new" data-ga-category="save_share" data-ga-action="collections" data-ga-label="collections_radio_new"> <label for="collections-action-panel-new">Create a new collection</label> </li> <li> <input type="radio" id="collections-action-panel-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="save_share" data-ga-action="collections" data-ga-label="collections_radio_existing"> <label for="collections-action-panel-existing">Add to an existing collection</label> </li> </ul> </div> <div class="controls-wrapper"> <div class="action-panel-control-wrap new-collections-controls"> <label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label> <input type="text" name="add-to-new-collection" id="collections-action-panel-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="save_share" data-ga-action="create_collection" data-ga-label="non_favorties_collection"> <div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="34044037"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(21)00260-7" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=3048&itool=Abstract-def&log$=linkouticon&uid=34044037&db=pubmed&nlmid=7908424" title="See full text options at Elsevier Science" data-ga-category="full_text" data-ga-action="Elsevier Science" data-ga-label="34044037" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--linkinghub.elsevier.com-ihub-images-PubMedLink.gif" alt="full text provider logo"><span class="text"> Elsevier Science </span></a><a class="link-item pmc " href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/34044037/" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=True&PrId=3494&itool=Abstract-def&log$=linkouticon&uid=34044037&db=pubmed&nlmid=7908424" title="Free full text at PubMed Central" data-ga-category="full_text" data-ga-action="PMC" data-ga-label="34044037" ><span class="text"> Free PMC article </span></a> </div> </div> <div class="short-view"> <a href="#" class="full-text-links-button full-text-links-dialog-trigger"> Full text links </a> </div> </div> <div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/34044037/citations/" data-citation-style="nlm" data-pubmed-format-link="/34044037/export/"><span class="button-label">Cite</span></button><link type="text/css" href="ncbi-overlay-block/src/overlay-block.css"><div class="collections-button-container" data-article-id="34044037" data-article-db="pubmed"><button class="collections-button collections-dialog-trigger" aria-label="Save article in MyNCBI collections." data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_button" data-collections-open-dialog-enabled="false" data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F%23open-collections-dialog" data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog" class="dialog collections-dialog" aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form" class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-existing-collections-url="/list-existing-collections/" data-add-to-existing-collection-url="/add-to-existing-collection/" data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/" data-myncbi-max-collection-name-length="100" data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio" id="collections-action-dialog-new" class="collections-new" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio" id="collections-action-dialog-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"></select><div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br><a href="#">Please try again</a></div></div></div><div class="action-panel-actions"><button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button><button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="collections_button" data-ga-action="click" data-ga-label="cancel"> Cancel </button></div></form></div></div></div></div><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="sidebar-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="social-sharing"> <h3 class="title"> Share </h3> <ul class="social-sharing-links usa-unstyled-list"> <li> <a href="http://twitter.com/intent/tweet?text=Genomic%20survey%20of%20SARS-CoV-2%20vaccine%20breakthrough%20infections%20in%20healthcare%20workers%20from%20Kerala%2C%20India%20https%3A//pubmed.ncbi.nlm.nih.gov/34044037/" class="share-link share-link-twitter" rel="noreferrer noopener" target="Pubmed-Social-Media-Share-Popup" title="Share article on Twitter" data-ga-category="save_share" data-ga-action="social" data-ga-label="twitter"></a> </li> <li> <a href="http://www.facebook.com/sharer/sharer.php?u=https%3A//pubmed.ncbi.nlm.nih.gov/34044037/" class="share-link share-link-facebook" rel="noreferrer noopener" target="Pubmed-Social-Media-Share-Popup" title="Share article on Facebook" data-ga-category="save_share" data-ga-action="social" data-ga-label="fb"></a> </li> <li> <div class="share-permalink"> <button class="trigger" title="Show article permalink" ref="linksrc=show_permalink_btn"> </button> <div class="dropdown" hidden> <div class="title"> Permalink </div> <div class="content"> <input type="text" class="permalink-text" value="https://pubmed.ncbi.nlm.nih.gov/34044037/" aria-label="Article permalink"/><button class="permalink-copy-button usa-button-primary" title="Copy article permalink" data-ga-category="save_share" data-ga-action="link" data-ga-label="copy_link"><span class="button-title">Copy</span></button> </div> </div> </div> </li> </ul> </div> <nav class="page-navigator" role="navigation" aria-label="Page navigation"> <div class="full-view"> <h3 class="title"> Page navigation </h3> <ul class="items-list"> <li class="heading "> <a href="#heading" aria-label="navigate to Title & authors section" data-ga-category="page_nav" data-ga-action="heading"> Title & authors </a> </li> <li class="abstract "> <a href="#abstract" aria-label="navigate to Abstract section" data-ga-category="page_nav" data-ga-action="abstract"> Abstract </a> </li> <li class="conflict-of-interest "> <a href="#conflict-of-interest" aria-label="navigate to Conflict of interest statement section" data-ga-category="page_nav" data-ga-action="conflict-of-interest"> Conflict of interest statement </a> </li> <li class="figures "> <a href="#figures" aria-label="navigate to Figures section" data-ga-category="page_nav" data-ga-action="figures"> Figures </a> </li> <li class="linked-commentary current"> <a href="#linked-commentary" aria-label="navigate to Comment in section" data-ga-category="page_nav" data-ga-action="linked-commentary"> Comment in </a> </li> <li class="linked-commentary-article "> <a href="#linked-commentary-article" aria-label="navigate to Comment on section" data-ga-category="page_nav" data-ga-action="linked-commentary-article"> Comment on </a> </li> <li class="similar "> <a href="#similar" aria-label="navigate to Similar articles section" data-ga-category="page_nav" data-ga-action="similar"> Similar articles </a> </li> <li class="citedby "> <a href="#citedby" aria-label="navigate to Cited by section" data-ga-category="page_nav" data-ga-action="citedby"> Cited by </a> </li> <li class="references "> <a href="#references" aria-label="navigate to References section" data-ga-category="page_nav" data-ga-action="references"> References </a> </li> <li class="publication-types "> <a href="#publication-types" aria-label="navigate to Publication types section" data-ga-category="page_nav" data-ga-action="publication-types"> Publication types </a> </li> <li class="mesh-terms "> <a href="#mesh-terms" aria-label="navigate to MeSH terms section" data-ga-category="page_nav" data-ga-action="mesh-terms"> MeSH terms </a> </li> <li class="substances "> <a href="#substances" aria-label="navigate to Substances section" data-ga-category="page_nav" data-ga-action="substances"> Substances </a> </li> <li class="linkout "> <a href="#linkout" aria-label="navigate to LinkOut - more resources section" data-ga-category="page_nav" data-ga-action="linkout"> LinkOut - more resources </a> </li> </ul> </div> <select class="short-view" autocomplete="off" title="navigate to selected section" aria-label="Navigate to page section"> <option value="heading">Title & authors</option> <option value="abstract">Abstract</option> <option value="conflict-of-interest">Conflict of interest statement</option> <option value="figures">Figures</option> <option value="linked-commentary">Comment in</option> <option value="linked-commentary-article">Comment on</option> <option value="similar">Similar articles</option> <option value="citedby">Cited by</option> <option value="references">References</option> <option value="publication-types">Publication types</option> <option value="mesh-terms">MeSH terms</option> <option value="substances">Substances</option> <option value="linkout">LinkOut - more resources</option> </select> </nav> </div> </aside> <main class="article-details" id="article-details"> <!-- "Filters applied" shows only when page is redirected from search --> <!-- because search found one result --> <header class="heading" id="heading"> <div class="full-view" id="full-view-heading"> <div class="article-citation"> <div class="publication-type" >Comment</div> <div class="article-source"> <div class="journal-actions dropdown-block"><button id="full-view-journal-trigger" class="journal-actions-trigger trigger" ref="linksrc=journal_actions_btn" title="The Journal of infection" tabindex="0" aria-controls="full-view-journal" aria-expanded="false" aria-label="Toggle dropdown menu for journal The Journal of infection" data-pinger-ignore> J Infect </button><div id="full-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal The Journal of infection"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22J+Infect%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22J+Infect%22%5Bjour%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_journal_name_link&journal_abbrev=J Infect" data-ga-category="search" data-ga-action="journal_link" data-ga-label="J Infect"> Search in PubMed </a></li><li><a class="search-in-nlm-catalog-link dropdown-block-link" ref ="linksrc=search_in_nlm_catalog_link" href="https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Infect%22%5BTitle+Abbreviation%5D" data-ga-category="search_catalog" data-ga-action="journal_link" data-ga-label="J Infect"> Search in NLM Catalog </a></li><li><a class="add-to-search-link dropdown-block-link" ref ="linksrc=add_to_search_link" role="button" data-search-term='"J Infect"[jour]' data-ga-category="search" data-ga-action="add_to_search" data-ga-label='"J Infect"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2021 Aug;83(2):237-279.</span> </div> <span class="citation-doi"> doi: 10.1016/j.jinf.2021.05.018. </span> <span class="secondary-date"> Epub 2021 May 25. </span> </div> <h1 class="heading-title"> Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India </h1> <div class="inline-authors"> <div class="authors"> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Philomina+J+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Beena Philomina J">Beena Philomina J</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jolly+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Bani Jolly">Bani Jolly</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=John+N&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Neethu John">Neethu John</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Ernakulam, Kerala, India." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bhoyar+RC&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Rahul C Bhoyar">Rahul C Bhoyar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India." href="#full-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Majeed+N&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Nisha Majeed">Nisha Majeed</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Idukki, Kerala, India." href="#full-view-affiliation-5" ref="linksrc=author_aff"> 5 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Senthivel+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vigneshwar Senthivel">Vigneshwar Senthivel</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Cp+F&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Fairoz Cp">Fairoz Cp</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Rophina+M&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mercy Rophina">Mercy Rophina</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Vasudevan+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Bindhu Vasudevan">Bindhu Vasudevan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Community Medicine, Government Medical College, Ernakulam, Kerala, India." href="#full-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Imran+M&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mohamed Imran">Mohamed Imran</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Viswanathan+P&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Prasanth Viswanathan">Prasanth Viswanathan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-7" ref="linksrc=author_aff"> 7 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Arvinden+VR&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="V R Arvinden">V R Arvinden</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Joseph+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Anoop Joseph">Anoop Joseph</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Ernakulam, Kerala, India." href="#full-view-affiliation-8" ref="linksrc=author_aff"> 8 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Divakar+MK&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mohit Kumar Divakar">Mohit Kumar Divakar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Nair+PR&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Priyanka R Nair">Priyanka R Nair</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-7" ref="linksrc=author_aff"> 7 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Shamnath+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Afra Shamnath">Afra Shamnath</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India." href="#full-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kumar+PJ&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="P Jayesh Kumar">P Jayesh Kumar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-9" ref="linksrc=author_aff"> 9 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jain+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Abhinav Jain">Abhinav Jain</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Geetha+P&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="P Geetha">P Geetha</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Kozhikode, Kerala, India." href="#full-view-affiliation-9" ref="linksrc=author_aff"> 9 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bajaj+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Anjali Bajaj">Anjali Bajaj</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Mathew+S&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Samatha Mathew">Samatha Mathew</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Gupta+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vishu Gupta">Vishu Gupta</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Agrawal+SJ&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Srashti Jyoti Agrawal">Srashti Jyoti Agrawal</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Scaria+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vinod Scaria">Vinod Scaria</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: vinods@igib.in." href="#full-view-affiliation-10" ref="linksrc=author_aff"> 10 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Sivasubbu+S&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sridhar Sivasubbu">Sridhar Sivasubbu</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: sridhar@igib.in." href="#full-view-affiliation-11" ref="linksrc=author_aff"> 11 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Radhakrishnan+C&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Chandni Radhakrishnan">Chandni Radhakrishnan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India. Electronic address: chandnidr@gmail.com." href="#full-view-affiliation-12" ref="linksrc=author_aff"> 12 </a></sup></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/34044037/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="full-view-affiliation-1" id="full-view-affiliation-1" ><sup class="key">1</sup> Department of Microbiology, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-2" id="full-view-affiliation-2" ><sup class="key">2</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India.</li> <li data-affiliation-id="full-view-affiliation-3" id="full-view-affiliation-3" ><sup class="key">3</sup> Department of Microbiology, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-4" id="full-view-affiliation-4" ><sup class="key">4</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India.</li> <li data-affiliation-id="full-view-affiliation-5" id="full-view-affiliation-5" ><sup class="key">5</sup> Department of Microbiology, Government Medical College, Idukki, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-6" id="full-view-affiliation-6" ><sup class="key">6</sup> Department of Community Medicine, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-7" id="full-view-affiliation-7" ><sup class="key">7</sup> Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-8" id="full-view-affiliation-8" ><sup class="key">8</sup> Department of General Medicine, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-9" id="full-view-affiliation-9" ><sup class="key">9</sup> Department of General Medicine, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="full-view-affiliation-10" id="full-view-affiliation-10" ><sup class="key">10</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: vinods@igib.in.</li> <li data-affiliation-id="full-view-affiliation-11" id="full-view-affiliation-11" ><sup class="key">11</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: sridhar@igib.in.</li> <li data-affiliation-id="full-view-affiliation-12" id="full-view-affiliation-12" ><sup class="key">12</sup> Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India. Electronic address: chandnidr@gmail.com.</li> </ul> </div> </div> </div> <ul class="identifiers" id="full-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">34044037</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC8143909&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8143909/" data-ga-category="full_text" data-ga-action="PMCID" > PMC8143909 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1016/j.jinf.2021.05.018&id_type=DOI" href="https://doi.org/10.1016/j.jinf.2021.05.018" data-ga-category="full_text" data-ga-action="DOI" > 10.1016/j.jinf.2021.05.018 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> <div class="short-view" id="short-view-heading"> <div class="publication-type" >Comment</div> <h1 class="heading-title"> Genomic survey of SARS-CoV-2 vaccine breakthrough infections in healthcare workers from Kerala, India </h1> <div class="short-citation"> <span class="authors-list"> <span class="authors-list-item "><span class="full-name">Beena Philomina J</span><span class="citation-separator"> et al.</span></span> </span> <span class="citation-journal"> J Infect<span class="citation-separator">.</span> </span> <span class="date"> <span class="citation-year">2021 Aug</span><span class="citation-separator">.</span> </span> </div> <div class="more-article-details-section with-display-settings"> <button class="more-article-details" id="toggle-article-details" data-alt-text="Hide details" ref="linksrc=toggle_article_details" aria-controls="full-article-details" aria-expanded="false" data-fetch-url="/34044037/long-authors/" data-id-prefix=""> <span class="title">Show details</span> </button> <div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"> <button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"> <span class="button-label">Display options</span> </button> <div class="dropdown" hidden> <div class="title"> Display options </div> <div class="content"> <div class="format-container"> <span class="option-label"> Format </span> <select name="format" data-initial-value="abstract" aria-label="Display format" id="mobile-display-format"> <option value="abstract">Abstract</option> <option value="pubmed">PubMed</option> <option value="pmid">PMID</option> </select> </div> </div> </div> </div> </div> <div class="extended-article-details" id="full-article-details" aria-hidden="true"> <div class="article-citation"> <div class="article-source"> <div class="journal-actions dropdown-block"><button id="short-view-journal-trigger" class="journal-actions-trigger trigger" ref="linksrc=journal_actions_btn" title="The Journal of infection" tabindex="0" aria-controls="short-view-journal" aria-expanded="false" aria-label="Toggle dropdown menu for journal The Journal of infection" data-pinger-ignore> J Infect </button><div id="short-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal The Journal of infection"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22J+Infect%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22J+Infect%22%5Bjour%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_journal_name_link&journal_abbrev=J Infect" data-ga-category="search" data-ga-action="journal_link" data-ga-label="J Infect"> Search in PubMed </a></li><li><a class="search-in-nlm-catalog-link dropdown-block-link" ref ="linksrc=search_in_nlm_catalog_link" href="https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Infect%22%5BTitle+Abbreviation%5D" data-ga-category="search_catalog" data-ga-action="journal_link" data-ga-label="J Infect"> Search in NLM Catalog </a></li><li><a class="add-to-search-link dropdown-block-link" ref ="linksrc=add_to_search_link" role="button" data-search-term='"J Infect"[jour]' data-ga-category="search" data-ga-action="add_to_search" data-ga-label='"J Infect"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2021 Aug;83(2):237-279.</span> </div> <span class="citation-doi"> doi: 10.1016/j.jinf.2021.05.018. </span> <span class="secondary-date"> Epub 2021 May 25. </span> </div> <div class="expanded-authors" id="short-view-expanded-authors"> <div class="authors"> <h3 class="title"> Authors </h3> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Philomina+J+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Beena Philomina J">Beena Philomina J</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jolly+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Bani Jolly">Bani Jolly</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=John+N&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Neethu John">Neethu John</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Ernakulam, Kerala, India." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bhoyar+RC&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Rahul C Bhoyar">Rahul C Bhoyar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India." href="#short-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Majeed+N&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Nisha Majeed">Nisha Majeed</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Idukki, Kerala, India." href="#short-view-affiliation-5" ref="linksrc=author_aff"> 5 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Senthivel+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vigneshwar Senthivel">Vigneshwar Senthivel</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Cp+F&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Fairoz Cp">Fairoz Cp</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Microbiology, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Rophina+M&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mercy Rophina">Mercy Rophina</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Vasudevan+B&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Bindhu Vasudevan">Bindhu Vasudevan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Community Medicine, Government Medical College, Ernakulam, Kerala, India." href="#short-view-affiliation-6" ref="linksrc=author_aff"> 6 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Imran+M&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mohamed Imran">Mohamed Imran</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Viswanathan+P&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Prasanth Viswanathan">Prasanth Viswanathan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-7" ref="linksrc=author_aff"> 7 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Arvinden+VR&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="V R Arvinden">V R Arvinden</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Joseph+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Anoop Joseph">Anoop Joseph</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Ernakulam, Kerala, India." href="#short-view-affiliation-8" ref="linksrc=author_aff"> 8 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Divakar+MK&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mohit Kumar Divakar">Mohit Kumar Divakar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Nair+PR&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Priyanka R Nair">Priyanka R Nair</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-7" ref="linksrc=author_aff"> 7 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Shamnath+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Afra Shamnath">Afra Shamnath</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India." href="#short-view-affiliation-4" ref="linksrc=author_aff"> 4 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kumar+PJ&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="P Jayesh Kumar">P Jayesh Kumar</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-9" ref="linksrc=author_aff"> 9 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Jain+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Abhinav Jain">Abhinav Jain</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Geetha+P&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="P Geetha">P Geetha</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of General Medicine, Government Medical College, Kozhikode, Kerala, India." href="#short-view-affiliation-9" ref="linksrc=author_aff"> 9 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bajaj+A&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Anjali Bajaj">Anjali Bajaj</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Mathew+S&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Samatha Mathew">Samatha Mathew</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Gupta+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vishu Gupta">Vishu Gupta</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Agrawal+SJ&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Srashti Jyoti Agrawal">Srashti Jyoti Agrawal</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Scaria+V&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Vinod Scaria">Vinod Scaria</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: vinods@igib.in." href="#short-view-affiliation-10" ref="linksrc=author_aff"> 10 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Sivasubbu+S&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sridhar Sivasubbu">Sridhar Sivasubbu</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: sridhar@igib.in." href="#short-view-affiliation-11" ref="linksrc=author_aff"> 11 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Radhakrishnan+C&cauthor_id=34044037" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Chandni Radhakrishnan">Chandni Radhakrishnan</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India. Electronic address: chandnidr@gmail.com." href="#short-view-affiliation-12" ref="linksrc=author_aff"> 12 </a></sup></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> Department of Microbiology, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-2" id="short-view-affiliation-2" ><sup class="key">2</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India.</li> <li data-affiliation-id="short-view-affiliation-3" id="short-view-affiliation-3" ><sup class="key">3</sup> Department of Microbiology, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-4" id="short-view-affiliation-4" ><sup class="key">4</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India.</li> <li data-affiliation-id="short-view-affiliation-5" id="short-view-affiliation-5" ><sup class="key">5</sup> Department of Microbiology, Government Medical College, Idukki, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-6" id="short-view-affiliation-6" ><sup class="key">6</sup> Department of Community Medicine, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-7" id="short-view-affiliation-7" ><sup class="key">7</sup> Viral Research and Diagnostic Laboratories, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-8" id="short-view-affiliation-8" ><sup class="key">8</sup> Department of General Medicine, Government Medical College, Ernakulam, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-9" id="short-view-affiliation-9" ><sup class="key">9</sup> Department of General Medicine, Government Medical College, Kozhikode, Kerala, India.</li> <li data-affiliation-id="short-view-affiliation-10" id="short-view-affiliation-10" ><sup class="key">10</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: vinods@igib.in.</li> <li data-affiliation-id="short-view-affiliation-11" id="short-view-affiliation-11" ><sup class="key">11</sup> CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, New Delhi, India; Academy for Scientific and Innovative Research, Human Resource Development Centre Campus, Ghaziabad, Uttar Pradesh, India. Electronic address: sridhar@igib.in.</li> <li data-affiliation-id="short-view-affiliation-12" id="short-view-affiliation-12" ><sup class="key">12</sup> Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India. Electronic address: chandnidr@gmail.com.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">34044037</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC8143909&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8143909/" data-ga-category="full_text" data-ga-action="PMCID" > PMC8143909 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1016/j.jinf.2021.05.018&id_type=DOI" href="https://doi.org/10.1016/j.jinf.2021.05.018" data-ga-category="full_text" data-ga-action="DOI" > 10.1016/j.jinf.2021.05.018 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/34044037/citations/" data-citation-style="nlm" data-pubmed-format-link="/34044037/export/"><span class="button-label">Cite</span></button><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="inline-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="abstract" id="abstract"> <em class="empty-abstract">No abstract available</em> <p> <strong class="sub-title"> Keywords: </strong> Breakthrough infection; COVID-19; SARS-CoV-2; Vaccine; Whole-genome sequencing. </p> </div> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" ga_category="literature_resources" ga_action="disclaimer_link" ga_label="under_abstract">PubMed Disclaimer</a> </p> <div class="conflict-of-interest" id="conflict-of-interest"> <h2 class="title"> Conflict of interest statement </h2> <div class="statement"> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Declaration of Competing Interest The authors report no potential conflicts of interest.</p> </div> </div> <div class="figures" id="figures"> <h2 class="title"> Figures </h2> <div class="figures-list" id="slides-container" itemscope itemtype="http://schema.org/ImageGallery"> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="0" data-label-slug="fig-1"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faaa/8143909/468f32cb8028/gr1_lrg.jpg" itemprop="contentUrl" aria-describedby="figure-caption-0" role="button" data-image-width="722" data-image-height="1083" data-image-alt="Fig. 1" data-pmc-id="PMC8143909" data-figure-id="fig0001"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-0" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faaa/8143909/da9f064e573c/gr1_lrg.gif" alt="Fig. 1" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="722"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="1083"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Fig. 1 </p> </strong> <div class="figure-caption-contents"><p> (A) History and timelines of… </p></div> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Fig. 1 </p> </strong> <div class="figure-caption-contents"><p> (A) History and timelines of infection for the 6 patients and intervals between… </p></div> </div> <figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Fig. 1 </strong> <div class="figure-caption-contents">(A) History and timelines of infection for the 6 patients and intervals between the second dose of vaccine and date of RT-PCR testing (B) Presence of variants in the genome isolates of the 6 cases (P1–P6). (C) Phylogenetic context of the 6 genome isolates with 2630 additional SARS-CoV-2 genomes from the state of Kerala.</div> </figcaption> </figure> </div> <!-- Root element of PhotoSwipe. Must have class pswp. --> <div class="pswp figures-dialog" id="figures-dialog" tabindex="-1" role="dialog" aria-hidden="true" data-image-gallery-uid="article-figures" aria-label="Figures Dialog"> <!-- Background of PhotoSwipe. It's a separate element as animating opacity is faster than rgba(). --> <div class="pswp__bg"></div> <!-- Slides wrapper with overflow:hidden. --> <div class="pswp__scroll-wrap"> <!-- Container that holds slides. PhotoSwipe keeps only 3 of them in the DOM to save memory. Don't modify these 3 pswp__item elements, data is added later on. --> <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div> <!-- Default (PhotoSwipeUI_Default) interface on top of sliding area. Can be changed. --> <div class="pswp__ui pswp__ui--hidden"> <div class="pswp__top-bar"> <!-- Controls are self-explanatory. Order can be changed. --> <div class="pswp__counter"></div> <button class="pswp__button pswp__button--close" title="Close (Esc)"></button> <button class="pswp__button pswp__button--share" title="Share"></button> <button class="pswp__button pswp__button--fs" title="Toggle fullscreen"></button> <button class="pswp__button pswp__button--zoom" title="Zoom in/out"></button> <!-- Preloader demo http://codepen.io/dimsemenov/pen/yyBWoR --> <!-- element will get class pswp__preloader--active when preloader is running --> <div class="pswp__preloader"> <div class="pswp__preloader__icn"> <div class="pswp__preloader__cut"> <div class="pswp__preloader__donut"></div> </div> </div> </div> </div> <div class="pswp__share-modal pswp__share-modal--hidden pswp__single-tap"> <div class="pswp__share-tooltip"></div> </div> <button class="pswp__button pswp__button--arrow--left" title="Previous (arrow left)"> </button> <button class="pswp__button pswp__button--arrow--right" title="Next (arrow right)"> </button> <div class="pswp__caption"> <div class="pswp__caption__center"></div> </div> </div> </div> </div> <div class="figure-dialog-caption"> <div class="figure-caption-link-container"> <a class="figure-caption-link" href="#">See this image and copyright information in PMC</a> </div> <div class="figure-caption-center" data-expand-title="click to show full caption" data-collapse-title="click to hide full caption"> </div> <button class="figure-caption-toggle-btn" aria-label="show full caption" data-expand-text="show full caption" data-collapse-text="hide full caption"> <!-- Dynamic text --> </button> </div> </div> <div class="linked-articles" id="linked-commentary"> <h2 class="title"> Comment in </h2> <ul class="item-list usa-unstyled-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/34678389/" ref="article_id=34678389&linksrc=comments_link" data-ga-category="comment_correction" data-ga-action="abstract_page_link" data-ga-label="linked-commentary"> SARS-CoV-2 vaccine breakthrough infection following a previous infection in a healthcare worker. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Gupta A, Bhoyar R, Mirza S, Jolly B, Senthivel V, Shamnath A, Divakar MK, Imran M, Gupta V, Agrawal SJ, Mukhida S, Sivasubbu S, Scaria V.</span> <span class="docsum-authors short-authors">Gupta A, et al.</span> <span class="docsum-journal-citation full-journal-citation">J Infect. 2022 Mar;84(3):418-467. doi: 10.1016/j.jinf.2021.10.008. Epub 2021 Oct 19.</span> <span class="docsum-journal-citation short-journal-citation">J Infect. 2022.</span> <span class="citation-part">PMID: <span class="docsum-pmid">34678389</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="no-abstract spaced-citation-item citation-part">No abstract available.</span> </div> </div> </li> </ul> </div> <div class="linked-articles" id="linked-commentary-article"> <h2 class="title"> Comment on </h2> <ul class="item-list usa-unstyled-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/33811939/" ref="article_id=33811939&linksrc=comments_link" data-ga-category="comment_correction" data-ga-action="abstract_page_link" data-ga-label="linked-commentary-article"> Reactogenicity, safety and antibody response, after one and two doses of mRNA-1273 in seronegative and seropositive healthcare workers. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Tré-Hardy M, Cupaiolo R, Papleux E, Wilmet A, Horeanga A, Antoine-Moussiaux T, Della Vecchia A, Beukinga I, Vekemans M, Blairon L.</span> <span class="docsum-authors short-authors">Tré-Hardy M, et al.</span> <span class="docsum-journal-citation full-journal-citation">J Infect. 2021 Aug;83(2):237-279. doi: 10.1016/j.jinf.2021.03.025. Epub 2021 Apr 1.</span> <span class="docsum-journal-citation short-journal-citation">J Infect. 2021.</span> <span class="citation-part">PMID: <span class="docsum-pmid">33811939</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="no-abstract spaced-citation-item citation-part">No abstract available.</span> </div> </div> </li> </ul> </div> <div class="similar-articles" id="similar"> <h2 class="title"> Similar articles </h2> <ul class="articles-list" id="similar-articles-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/34678389/" ref="article_id=34678389&linksrc=similar_articles_link&ordinalpos=1" data-ga-category="similar_article" data-ga-action="34678389" data-ga-label=""> SARS-CoV-2 vaccine breakthrough infection following a previous infection in a healthcare worker. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Gupta A, Bhoyar R, Mirza S, Jolly B, Senthivel V, Shamnath A, Divakar MK, Imran M, Gupta V, Agrawal SJ, Mukhida S, Sivasubbu S, Scaria V.</span> <span class="docsum-authors short-authors">Gupta A, et al.</span> <span class="docsum-journal-citation full-journal-citation">J Infect. 2022 Mar;84(3):418-467. doi: 10.1016/j.jinf.2021.10.008. Epub 2021 Oct 19.</span> <span class="docsum-journal-citation short-journal-citation">J Infect. 2022.</span> <span class="citation-part">PMID: <span class="docsum-pmid">34678389</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="no-abstract spaced-citation-item citation-part">No abstract available.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/36412471/" ref="article_id=36412471&linksrc=similar_articles_link&ordinalpos=2" data-ga-category="similar_article" data-ga-action="36412471" data-ga-label=""> Breakthrough infection with SARS-CoV-2 delta variant in old-age homes in a Southern District of Kerala, India. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Chandran D, Sreekumar E, Prajitha KC, Sharahudeen A, Raveendran CL; Research team.</span> <span class="docsum-authors short-authors">Chandran D, et al.</span> <span class="docsum-journal-citation full-journal-citation">Indian J Public Health. 2022 Nov;66(Supplement):S36-S40. doi: 10.4103/ijph.ijph_1084_22.</span> <span class="docsum-journal-citation short-journal-citation">Indian J Public Health. 2022.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36412471</span></span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/34391088/" ref="article_id=34391088&linksrc=similar_articles_link&ordinalpos=3" data-ga-category="similar_article" data-ga-action="34391088" data-ga-label=""> Antibody responses after a single dose of ChAdOx1 nCoV-19 vaccine in healthcare workers previously infected with SARS-CoV-2. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Havervall S, Marking U, Greilert-Norin N, Ng H, Gordon M, Salomonsson AC, Hellström C, Pin E, Blom K, Mangsbo S, Phillipson M, Klingström J, Hober S, Nilsson P, Åberg M, Thålin C.</span> <span class="docsum-authors short-authors">Havervall S, et al.</span> <span class="docsum-journal-citation full-journal-citation">EBioMedicine. 2021 Aug;70:103523. doi: 10.1016/j.ebiom.2021.103523. Epub 2021 Aug 12.</span> <span class="docsum-journal-citation short-journal-citation">EBioMedicine. 2021.</span> <span class="citation-part">PMID: <span class="docsum-pmid">34391088</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/35358727/" ref="article_id=35358727&linksrc=similar_articles_link&ordinalpos=4" data-ga-category="similar_article" data-ga-action="35358727" data-ga-label=""> Genomic profiles of vaccine breakthrough SARS-CoV-2 strains from Odisha, India. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Ghosh A, Walia S, Rattan R, Kanampalliwar A, Jha A, Aggarwal S, Fatma S, Das N, Chayani N, Prasad P, Raghav SK, Parida A.</span> <span class="docsum-authors short-authors">Ghosh A, et al.</span> <span class="docsum-journal-citation full-journal-citation">Int J Infect Dis. 2022 Jun;119:111-113. doi: 10.1016/j.ijid.2022.03.042. Epub 2022 Mar 28.</span> <span class="docsum-journal-citation short-journal-citation">Int J Infect Dis. 2022.</span> <span class="citation-part">PMID: <span class="docsum-pmid">35358727</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="no-abstract spaced-citation-item citation-part">No abstract available.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/36938809/" ref="article_id=36938809&linksrc=similar_articles_link&ordinalpos=5" data-ga-category="similar_article" data-ga-action="36938809" data-ga-label=""> Assessment of early and post COVID-19 vaccination antibody response in healthcare workers: a critical review. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Goodwin B, Zia H, Lo DF.</span> <span class="docsum-authors short-authors">Goodwin B, et al.</span> <span class="docsum-journal-citation full-journal-citation">Epidemiol Infect. 2023 Mar 20;151:e52. doi: 10.1017/S0950268823000390.</span> <span class="docsum-journal-citation short-journal-citation">Epidemiol Infect. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36938809</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="publication-type spaced-citation-item citation-part">Review.</span> <span class="no-abstract spaced-citation-item citation-part">No abstract available.</span> </div> </div> </li> </ul> <div class="actions-bar"> <a class="show-all-linked-articles" data-href="/?linkname=pubmed_pubmed&from_uid=34044037" data-ga-category="similar_article" data-ga-action="show_all" > See all similar articles </a> </div> </div> <div class="citedby-articles" id="citedby"> <h2 class="title"> Cited by </h2> <ul class="articles-list" id="citedby-articles-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/38948609/" ref="article_id=38948609&linksrc=citedby_articles_link&ordinalpos=1" data-ga-category="cited_by" data-ga-action="38948609" data-ga-label=""> Severity of respiratory illness among Covid-19-vaccinated and non-vaccinated admitted patients-An observational study from a teaching hospital of Tripura. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Majumder V, Choudhury C, Goswami B, Sengupta S, Bhattacharjee B.</span> <span class="docsum-authors short-authors">Majumder V, et al.</span> <span class="docsum-journal-citation full-journal-citation">J Family Med Prim Care. 2024 May;13(5):2111-2115. doi: 10.4103/jfmpc.jfmpc_1643_23. Epub 2024 May 24.</span> <span class="docsum-journal-citation short-journal-citation">J Family Med Prim Care. 2024.</span> <span class="citation-part">PMID: <span class="docsum-pmid">38948609</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/38146559/" ref="article_id=38146559&linksrc=citedby_articles_link&ordinalpos=2" data-ga-category="cited_by" data-ga-action="38146559" data-ga-label=""> Acceptance of Annual Booster Doses of COVID-19 Vaccines Among Indian Healthcare Professionals: A Pan-India Cross-Sectional Survey. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Krishna E, Karthikeyan V, Ahmad S, Ranjan A, Hasan Km A, Pandey S, Kumar P, Singh CM.</span> <span class="docsum-authors short-authors">Krishna E, et al.</span> <span class="docsum-journal-citation full-journal-citation">Cureus. 2023 Nov 24;15(11):e49363. doi: 10.7759/cureus.49363. eCollection 2023 Nov.</span> <span class="docsum-journal-citation short-journal-citation">Cureus. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">38146559</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/36938906/" ref="article_id=36938906&linksrc=citedby_articles_link&ordinalpos=3" data-ga-category="cited_by" data-ga-action="36938906" data-ga-label=""> Death Reporting in Breakthrough and Unvaccinated SARS-CoV-2 Infection Cases. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Emami A, Javanmardi F, Bakhtiari H, Rezaei T, Hemmati A, Akbari A, Pirbonyeh N.</span> <span class="docsum-authors short-authors">Emami A, et al.</span> <span class="docsum-journal-citation full-journal-citation">Disaster Med Public Health Prep. 2023 Mar 20;17:e359. doi: 10.1017/dmp.2023.4.</span> <span class="docsum-journal-citation short-journal-citation">Disaster Med Public Health Prep. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36938906</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/36795274/" ref="article_id=36795274&linksrc=citedby_articles_link&ordinalpos=4" data-ga-category="cited_by" data-ga-action="36795274" data-ga-label=""> COVID-19 Breakthrough Infection Among Vaccinated Population in the United Arab Emirates. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Dash NR, Barqawi HJ, Obaideen AA, Al Chame HQ, Samara KA, Qadri R, Eldesouki S.</span> <span class="docsum-authors short-authors">Dash NR, et al.</span> <span class="docsum-journal-citation full-journal-citation">J Epidemiol Glob Health. 2023 Mar;13(1):67-90. doi: 10.1007/s44197-023-00090-8. Epub 2023 Feb 16.</span> <span class="docsum-journal-citation short-journal-citation">J Epidemiol Glob Health. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36795274</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/36759335/" ref="article_id=36759335&linksrc=citedby_articles_link&ordinalpos=5" data-ga-category="cited_by" data-ga-action="36759335" data-ga-label=""> Anti-SARS-CoV-2 spike immunoglobulin G and immunoglobulin M titers decline as interval from the second inactivated vaccine dose to the onset of illness is prolonged in breakthrough infection patients. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Xu CC, He ZS, Lei W, Zhu JZ, Zhao DG, Kong JD, Wei Y, Xu Y, Huang JA.</span> <span class="docsum-authors short-authors">Xu CC, et al.</span> <span class="docsum-journal-citation full-journal-citation">Clin Respir J. 2023 Apr;17(4):270-276. doi: 10.1111/crj.13590. Epub 2023 Feb 9.</span> <span class="docsum-journal-citation short-journal-citation">Clin Respir J. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36759335</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> </ul> <div class="actions-bar"> <a class="show-all-linked-articles" data-href="/?linkname=pubmed_pubmed_citedin&from_uid=34044037" data-ga-category="cited_by" data-ga-action="show_all" > See all "Cited by" articles </a> </div> </div> <div class="references" id="references"> <h2 class="title"> References </h2> <div id='top-references-list' class="references-lists-container"> <div class="refs-list"> <ol id="top-references-list-1" class="references-list"> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Tré-Hardy M., Cupaiolo R., Papleux E. Reactogenicity, safety and antibody response, after one and two doses of mRNA-1273 in seronegative and seropositive healthcare workers. J Infect. 2021 doi: 10.1016/j.jinf.2021.03.025. S0163-4453(21)00158-4. - <a class="reference-link" href="https://doi.org/10.1016/j.jinf.2021.03.025" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1016/j.jinf.2021.03.025" > DOI </a> - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8012163/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="PMC8012163" > PMC </a> - <a class="reference-link" href="/33811939/" ref="linksrc=references_link&ordinalpos=3" data-ga-category="reference" data-ga-action="33811939" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Ella R., Vadrevu K.M., Jogdand H. Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBV152: a double-blind, randomised, phase 1 trial. Lancet Infect Dis. 2021;21:637–646. - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7825810/" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="PMC7825810" > PMC </a> - <a class="reference-link" href="/33485468/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="33485468" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Voysey M., Clemens S.A.C., Madhi S.A. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397:99–111. - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7723445/" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="PMC7723445" > PMC </a> - <a class="reference-link" href="/33306989/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="33306989" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Breakthrough COVID19 Infections after vaccinations in healthcare and other workers in a chronic care medical facility in New Delhi, India. Diabetes Metab Syndr. 2021 Available at: <a class="external-link-urlize" href="http://dx.doi.org/10.1016/j.dsx.2021.05.001" rel="nofollow noopener" target="_blank">http://dx.doi.org/10.1016/j.dsx.2021.05.001</a>. Accessed 9 May 2021. - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8091733/" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="PMC8091733" > PMC </a> - <a class="reference-link" href="/33991805/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="33991805" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Emary K.R.W., Golubchik T., Aley P.K. Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012/01 (B.1.1.7): an exploratory analysis of a randomised controlled trial. Lancet. 2021;397:1351–1362. - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8009612/" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="PMC8009612" > PMC </a> - <a class="reference-link" href="/33798499/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="33798499" > PubMed </a> </li> </ol> </li> </ol> <div class="actions-bar"> <button class="show-all" ref="linksrc=show_all_references_link" aria-controls="top-references-list-1" data-next-page-url="/34044037/references/" data-ga-category="reference" data-ga-action="show_more" > Show all 10 references </button> </div> </div> </div> </div> <div id="publication-types" class="publication-types keywords-section"> <h2 class="title"> Publication types </h2> <ul class="keywords-list"><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Letter" tabindex="0" aria-controls="keyword-actions-publication-types-0" aria-expanded="false" data-pinger-ignore> Letter </button><div id="keyword-actions-publication-types-0" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Letter"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Letter%22%5Bpt%5D&sort=date&sort_order=desc" data-href="/?term=%22Letter%22%5Bpt%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="Letter"[pt]" data-ga-category="search" data-ga-action="pub_type" data-ga-label="Letter"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Letter" data-ga-category="search_mesh" data-ga-action="pub_type_link" data-ga-label="Letter"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Letter"[pt]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Letter"[pt]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Comment" tabindex="0" aria-controls="keyword-actions-publication-types-1" aria-expanded="false" data-pinger-ignore> Comment </button><div id="keyword-actions-publication-types-1" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Comment"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Comment%22%5Bpt%5D&sort=date&sort_order=desc" data-href="/?term=%22Comment%22%5Bpt%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="Comment"[pt]" data-ga-category="search" data-ga-action="pub_type" data-ga-label="Comment"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Comment" data-ga-category="search_mesh" data-ga-action="pub_type_link" data-ga-label="Comment"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Comment"[pt]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Comment"[pt]" href="#"> Add to Search </a></li></ul></div></div></div></li></ul> </div> <div id="mesh-terms" class="mesh-terms keywords-section"> <h2 class="title"> MeSH terms </h2> <ul class="keywords-list"><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Antibody Formation" tabindex="0" aria-controls="keyword-actions-mesh-terms-0" aria-expanded="false" data-pinger-ignore> Antibody Formation </button><div id="keyword-actions-mesh-terms-0" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Antibody Formation"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Antibody+Formation%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Antibody+Formation%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Antibody Formation"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Antibody Formation"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Antibody+Formation" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Antibody Formation"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Antibody Formation"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Antibody Formation"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword COVID-19 Vaccines" tabindex="0" aria-controls="keyword-actions-mesh-terms-1" aria-expanded="false" data-pinger-ignore> COVID-19 Vaccines </button><div id="keyword-actions-mesh-terms-1" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword COVID-19 Vaccines"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22COVID-19+Vaccines%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22COVID-19+Vaccines%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="COVID-19 Vaccines"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="COVID-19 Vaccines"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=COVID-19+Vaccines" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="COVID-19 Vaccines"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""COVID-19 Vaccines"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""COVID-19 Vaccines"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword COVID-19*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-2" aria-expanded="false" data-pinger-ignore> COVID-19* </button><div id="keyword-actions-mesh-terms-major-2" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword COVID-19*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22COVID-19%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22COVID-19%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="COVID-19"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="COVID-19*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=COVID-19" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="COVID-19*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""COVID-19"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""COVID-19"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Genomics" tabindex="0" aria-controls="keyword-actions-mesh-terms-3" aria-expanded="false" data-pinger-ignore> Genomics </button><div id="keyword-actions-mesh-terms-3" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Genomics"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Genomics%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Genomics%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Genomics"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Genomics"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Genomics" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Genomics"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Genomics"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Genomics"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Health Personnel" tabindex="0" aria-controls="keyword-actions-mesh-terms-4" aria-expanded="false" data-pinger-ignore> Health Personnel </button><div id="keyword-actions-mesh-terms-4" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Health Personnel"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Health+Personnel%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Health+Personnel%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Health Personnel"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Health Personnel"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Health+Personnel" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Health Personnel"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Health Personnel"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Health Personnel"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Humans" tabindex="0" aria-controls="keyword-actions-mesh-terms-5" aria-expanded="false" data-pinger-ignore> Humans </button><div id="keyword-actions-mesh-terms-5" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Humans"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Humans"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Humans"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Humans" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Humans"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Humans"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Humans"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword India / epidemiology" tabindex="0" aria-controls="keyword-actions-mesh-terms-6" aria-expanded="false" data-pinger-ignore> India / epidemiology </button><div id="keyword-actions-mesh-terms-6" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword India / epidemiology"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22India%2Fepidemiology%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22India%2Fepidemiology%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="India/epidemiology"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="India / epidemiology"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=India" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="India / epidemiology"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""India/epidemiology"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""India/epidemiology"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword RNA, Messenger" tabindex="0" aria-controls="keyword-actions-mesh-terms-7" aria-expanded="false" data-pinger-ignore> RNA, Messenger </button><div id="keyword-actions-mesh-terms-7" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword RNA, Messenger"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22RNA%2C+Messenger%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22RNA%2C+Messenger%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="RNA, Messenger"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="RNA, Messenger"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=RNA%2C+Messenger" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="RNA, Messenger"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""RNA, Messenger"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""RNA, Messenger"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword SARS-CoV-2*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-8" aria-expanded="false" data-pinger-ignore> SARS-CoV-2* </button><div id="keyword-actions-mesh-terms-major-8" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword SARS-CoV-2*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22SARS-CoV-2%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22SARS-CoV-2%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="SARS-CoV-2"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="SARS-CoV-2*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=SARS-CoV-2" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="SARS-CoV-2*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""SARS-CoV-2"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""SARS-CoV-2"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li></ul> </div> <div id="substances" class="substances keywords-section"> <h2 class="title"> Substances </h2> <ul class="keywords-list"><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword COVID-19 Vaccines" tabindex="0" aria-controls="keyword-actions-substances-0" aria-expanded="false" data-pinger-ignore> COVID-19 Vaccines </button><div id="keyword-actions-substances-0" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword COVID-19 Vaccines"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22COVID-19+Vaccines%22%5Bnm%5D&sort=date&sort_order=desc" data-href="/?term=%22COVID-19+Vaccines%22%5Bnm%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="COVID-19 Vaccines"[nm]" data-ga-category="search" data-ga-action="substance" data-ga-label="COVID-19 Vaccines"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=%22COVID-19+Vaccines%22" data-ga-category="search_mesh" data-ga-action="substance_link" data-ga-label="COVID-19 Vaccines"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""COVID-19 Vaccines"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""COVID-19 Vaccines"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword RNA, Messenger" tabindex="0" aria-controls="keyword-actions-substances-1" aria-expanded="false" data-pinger-ignore> RNA, Messenger </button><div id="keyword-actions-substances-1" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword RNA, Messenger"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22RNA%2C+Messenger%22%5Bnm%5D&sort=date&sort_order=desc" data-href="/?term=%22RNA%2C+Messenger%22%5Bnm%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="RNA, Messenger"[nm]" data-ga-category="search" data-ga-action="substance" data-ga-label="RNA, Messenger"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=%22RNA%2C+Messenger%22" data-ga-category="search_mesh" data-ga-action="substance_link" data-ga-label="RNA, Messenger"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""RNA, Messenger"[nm]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""RNA, Messenger"[nm]" href="#"> Add to Search </a></li></ul></div></div></div></li></ul> </div> <div id="linkout" class="linkout"> <h2 class="title"> LinkOut - more resources </h2> <ul class="linkout-list"><li><h3 class="linkout-category">Full Text Sources</h3><ul class="linkout-category-links"><li><a href="https://www.clinicalkey.com/content/playBy/pii?v=S0163-4453(21)00260-7" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=8412&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Full Text Sources" data-ga-label="ClinicalKey" > ClinicalKey </a></li><li><a href="https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(21)00260-7" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=3048&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Full Text Sources" data-ga-label="Elsevier Science" > Elsevier Science </a></li><li><a href="https://europepmc.org/abstract/MED/34044037" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=6082&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Full Text Sources" data-ga-label="Europe PubMed Central" > Europe PubMed Central </a></li><li><a href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/34044037/" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=3494&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Full Text Sources" data-ga-label="PubMed Central" > PubMed Central </a></li></ul></li><li><h3 class="linkout-category">Other Literature Sources</h3><ul class="linkout-category-links"><li><a href="https://scite.ai/reports/34044037" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=10307&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Other Literature Sources" data-ga-label="scite Smart Citations" > scite Smart Citations </a></li></ul></li><li><h3 class="linkout-category">Medical</h3><ul class="linkout-category-links"><li><a href="https://medlineplus.gov/covid19coronavirusdisease2019.html" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=3162&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Medical" data-ga-label="MedlinePlus Health Information" > MedlinePlus Health Information </a></li></ul></li><li><h3 class="linkout-category">Miscellaneous</h3><ul class="linkout-category-links"><li><a href="https://assays.cancer.gov/CPTAC-438" target="_blank" rel="noopener" ref="linksrc=linkout_link&PrId=8855&uid=34044037&db=pubmed&itool=Abstract&log$=linkoutlink&nlmid=7908424" data-ga-category="link_out" data-ga-action="Miscellaneous" data-ga-label="NCI CPTAC Assay Portal" > NCI CPTAC Assay Portal </a></li></ul></li></ul> </div> </main> <div class="overlay" role="dialog" aria-label="Full Text Links Dialog"> <div id="full-text-links-dialog" class="dialog full-text-links-dialog"> <strong class="title">Full text links</strong> <button class="close-overlay" tabindex="3">[x]</button> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(21)00260-7" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=3048&itool=Abstract-def&log$=linkouticon&uid=34044037&db=pubmed&nlmid=7908424" title="See full text options at Elsevier Science" tabindex="1" data-ga-category="full_text" data-ga-action="Elsevier Science" data-ga-label="34044037" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--linkinghub.elsevier.com-ihub-images-PubMedLink.gif" alt="full text provider logo"><span class="text"> Elsevier Science </span></a><a class="link-item pmc " href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/34044037/" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=True&PrId=3494&itool=Abstract-def&log$=linkouticon&uid=34044037&db=pubmed&nlmid=7908424" title="Free full text at PubMed Central" tabindex="2" data-ga-category="full_text" data-ga-action="PMC" data-ga-label="34044037" ><span class="text"> Free PMC article </span></a> </div> </div> </div> <div class="overlay" role="dialog" aria-label="Citation Dialog"> <div class="dialog citation-dialog"> <button class="close-overlay" tabindex="1">[x]</button> <div class="title">Cite</div> <div class="citation-text-block"> <div class="citation-text"></div> <div class="citation-actions"> <button class="copy-button dialog-focus" data-ga-category="save_share" data-ga-action="cite" data-ga-label="copy" tabindex="2"> Copy </button> <form method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="ICMkAFIdlE64YwRocPaa9qXR0GnJ16k4152iAQlt8vHFkHB5U0w34QdYAMpZBLVT"> <button type="submit" class="export-button" data-ga-category="save_share" data-ga-action="cite" data-ga-label="download" title="Download a file for external citation management software" tabindex="3"> <span class="download-title">Download .nbib</span> <span class="download-title-mobile">.nbib</span> </button> </form> <div class="citation-style-selector-wrapper"> <label class="selector-label">Format:</label> <select aria-label="Format" class="citation-style-selector" tabindex="4"> <option data-style-url-name="ama" value="AMA" > AMA </option> <option data-style-url-name="apa" value="APA" > APA </option> <option data-style-url-name="mla" value="MLA" > MLA </option> <option data-style-url-name="nlm" value="NLM" selected="selected"> NLM </option> </select> </div> </div> </div> </div> </div> <div class="overlay" role="dialog" aria-label="More Actions Dialog"> <div id="more-actions-dialog" class="dialog more-actions-dialog"> <strong class="title">Send To</strong> <ul class="more-actions-links"> <li><a id="clipboard-trigger" role="button" class="submit-button clipboard-trigger clipboard-trigger-target dialog-focus link-item " href="#">Clipboard</a></li> <li><a class="email-trigger link-item" role="button" href="#">Email</a></li> <li><a class="save-trigger link-item" role="button" href="#">Save</a></li> <li><a class="link-item" role="button" href="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F%23open-bibliography-panel">My Bibliography</a></li> <li><a class="link-item" role="button" href="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F%23open-collections-panel">Collections</a></li> <li><a class="citation-manager-trigger link-item" role="button" href="#">Citation Manager</a></li> </ul> <button class="close-overlay">[x]</button> </div> </div> </div> <div id="ncbi-footer"> <div class="literature-footer" role="complementary" title="Links to NCBI Literature Resources"> <div class="usa-grid"> <p class="literature-footer-text">NCBI Literature Resources</p> <p class="literature-footer-text"> <a class="literature-footer-link" data-ga-category="literature_resources" data-ga-action="mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh/">MeSH</a> <a class="literature-footer-link" data-ga-category="literature_resources" data-ga-action="pmc_link" href="https://www.ncbi.nlm.nih.gov/pmc/">PMC</a> <a class="literature-footer-link" data-ga-category="literature_resources" data-ga-action="bookshelf_link" href="https://www.ncbi.nlm.nih.gov/books">Bookshelf</a> <a class="literature-footer-link" data-ga-category="literature_resources" data-ga-action="disclaimer_link" href="/disclaimer/">Disclaimer</a> </p> <p class="literature-footer-text attribution-statement">The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.</p> </div> </div> <!-- ========== BEGIN FOOTER ========== --> <footer> <section class="icon-section"> <div id="icon-section-header" class="icon-section_header">Follow NCBI</div> <div class="grid-container container"> <div class="icon-section_container"> <a class="footer-icon" id="footer_twitter" href="https://twitter.com/ncbi" aria-label="Twitter"> <svg width="40" height="40" viewBox="0 0 40 37" fill="none" xmlns="http://www.w3.org/2000/svg"> <title>Twitter</title> <g id="twitterx1008"> <path id="path1008" d="M6.06736 7L16.8778 20.8991L6.00001 32.2H10.2L18.6 23.1L25.668 32.2H34L22.8 17.5L31.9 7H28.4L20.7 15.4L14.401 7H6.06898H6.06736ZM9.66753 8.73423H12.9327L29.7327 30.4658H26.5697L9.66753 8.73423Z" fill="#5B616B"/> </g> </svg> </a> <a class="footer-icon" id="footer_facebook" href="https://www.facebook.com/ncbi.nlm" aria-label="Facebook"><svg data-name="Layer 1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 300 300"> <title>Facebook</title> <path class="cls-11" d="M210.5,115.12H171.74V97.82c0-8.14,5.39-10,9.19-10h27.14V52l-39.32-.12c-35.66,0-42.42,26.68-42.42,43.77v19.48H99.09v36.32h27.24v109h45.41v-109h35Z"> </path> </svg></a> <a class="footer-icon" id="footer_linkedin" href="https://www.linkedin.com/company/ncbinlm" aria-label="LinkedIn"><svg data-name="Layer 1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 300 300"> <title>LinkedIn</title> <path class="cls-11" d="M101.64,243.37H57.79v-114h43.85Zm-22-131.54h-.26c-13.25,0-21.82-10.36-21.82-21.76,0-11.65,8.84-21.15,22.33-21.15S101.7,78.72,102,90.38C102,101.77,93.4,111.83,79.63,111.83Zm100.93,52.61A17.54,17.54,0,0,0,163,182v61.39H119.18s.51-105.23,0-114H163v13a54.33,54.33,0,0,1,34.54-12.66c26,0,44.39,18.8,44.39,55.29v58.35H198.1V182A17.54,17.54,0,0,0,180.56,164.44Z"> </path> </svg></a> <a class="footer-icon" id="footer_github" href="https://github.com/ncbi" aria-label="GitHub"><svg data-name="Layer 1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 300 300"> <defs> <style> .cls-11, .cls-12 { fill: #737373; } .cls-11 { fill-rule: evenodd; } </style> </defs> <title>GitHub</title> <path class="cls-11" d="M151.36,47.28a105.76,105.76,0,0,0-33.43,206.1c5.28,1,7.22-2.3,7.22-5.09,0-2.52-.09-10.85-.14-19.69-29.42,6.4-35.63-12.48-35.63-12.48-4.81-12.22-11.74-15.47-11.74-15.47-9.59-6.56.73-6.43.73-6.43,10.61.75,16.21,10.9,16.21,10.9,9.43,16.17,24.73,11.49,30.77,8.79,1-6.83,3.69-11.5,6.71-14.14C108.57,197.1,83.88,188,83.88,147.51a40.92,40.92,0,0,1,10.9-28.39c-1.1-2.66-4.72-13.42,1-28,0,0,8.88-2.84,29.09,10.84a100.26,100.26,0,0,1,53,0C198,88.3,206.9,91.14,206.9,91.14c5.76,14.56,2.14,25.32,1,28a40.87,40.87,0,0,1,10.89,28.39c0,40.62-24.74,49.56-48.29,52.18,3.79,3.28,7.17,9.71,7.17,19.58,0,14.15-.12,25.54-.12,29,0,2.82,1.9,6.11,7.26,5.07A105.76,105.76,0,0,0,151.36,47.28Z"> </path> <path class="cls-12" d="M85.66,199.12c-.23.52-1.06.68-1.81.32s-1.2-1.06-.95-1.59,1.06-.69,1.82-.33,1.21,1.07.94,1.6Zm-1.3-1"> </path> <path class="cls-12" d="M90,203.89c-.51.47-1.49.25-2.16-.49a1.61,1.61,0,0,1-.31-2.19c.52-.47,1.47-.25,2.17.49s.82,1.72.3,2.19Zm-1-1.08"> </path> <path class="cls-12" d="M94.12,210c-.65.46-1.71,0-2.37-.91s-.64-2.07,0-2.52,1.7,0,2.36.89.65,2.08,0,2.54Zm0,0"></path> <path class="cls-12" d="M99.83,215.87c-.58.64-1.82.47-2.72-.41s-1.18-2.06-.6-2.7,1.83-.46,2.74.41,1.2,2.07.58,2.7Zm0,0"> </path> <path class="cls-12" d="M107.71,219.29c-.26.82-1.45,1.2-2.64.85s-2-1.34-1.74-2.17,1.44-1.23,2.65-.85,2,1.32,1.73,2.17Zm0,0"> </path> <path class="cls-12" d="M116.36,219.92c0,.87-1,1.59-2.24,1.61s-2.29-.68-2.3-1.54,1-1.59,2.26-1.61,2.28.67,2.28,1.54Zm0,0"> </path> <path class="cls-12" d="M124.42,218.55c.15.85-.73,1.72-2,1.95s-2.37-.3-2.52-1.14.73-1.75,2-2,2.37.29,2.53,1.16Zm0,0"></path> </svg></a> <a class="footer-icon" id="footer_blog" href="https://ncbiinsights.ncbi.nlm.nih.gov/" aria-label="Blog"> <svg id="Layer_1" data-name="Layer 1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 40"><defs><style>.cls-1{fill:#737373;}</style></defs><path class="cls-1" d="M14,30a4,4,0,1,1-4-4,4,4,0,0,1,4,4Zm11,3A19,19,0,0,0,7.05,15a1,1,0,0,0-1,1v3a1,1,0,0,0,.93,1A14,14,0,0,1,20,33.07,1,1,0,0,0,21,34h3a1,1,0,0,0,1-1Zm9,0A28,28,0,0,0,7,6,1,1,0,0,0,6,7v3a1,1,0,0,0,1,1A23,23,0,0,1,29,33a1,1,0,0,0,1,1h3A1,1,0,0,0,34,33Z"/></svg> </a> </div> </div> </section> <section class="container-fluid bg-primary"> <div class="container pt-5"> <div class="row mt-3"> <div class="col-lg-3 col-12"> <p><a class="text-white" href="https://www.nlm.nih.gov/socialmedia/index.html">Connect with NLM</a></p> <ul class="list-inline social_media"> <li class="list-inline-item"><a href="https://twitter.com/NLM_NIH" aria-label="Twitter" target="_blank" rel="noopener noreferrer"> <svg width="35" height="35" viewBox="0 0 38 35" fill="none" xmlns="http://www.w3.org/2000/svg"> <title>Twitter</title> <g id="twitterx1009" clip-path="url(#clip0_65276_3946)"> <path id="Vector" d="M17.5006 34.6565C26.9761 34.6565 34.6575 26.9751 34.6575 17.4996C34.6575 8.02416 26.9761 0.342773 17.5006 0.342773C8.02514 0.342773 0.34375 8.02416 0.34375 17.4996C0.34375 26.9751 8.02514 34.6565 17.5006 34.6565Z" fill="#205493" stroke="white" stroke-width="1.2" stroke-miterlimit="10"></path> <path id="path1009" d="M8.54811 8.5L16.2698 18.4279L8.50001 26.5H11.5L17.5 20L22.5486 26.5H28.5L20.5 16L27 8.5H24.5L19 14.5L14.5007 8.5H8.54927H8.54811ZM11.1197 9.73873H13.4519L25.4519 25.2613H23.1926L11.1197 9.73873Z" fill="white"></path> </g> <defs> <clipPath id="clip0_65276_3946"> <rect width="38" height="38" fill="white"></rect> </clipPath> </defs> </svg></a> </li> <li class="list-inline-item"><a href="https://www.facebook.com/nationallibraryofmedicine" aria-label="Facebook" rel="noopener noreferrer" target="_blank"> <svg version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve"> <style type="text/css"> .st10 { fill: #FFFFFF; } .st110 { fill: none; stroke: #FFFFFF; stroke-width: 8; stroke-miterlimit: 10; } </style> <title>SM-Facebook</title> <g> <g> <path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path> </g> </g> <circle class="st110" cx="123.6" cy="123.2" r="108.2"></circle> </svg> </a></li> <li class="list-inline-item"><a href="https://www.youtube.com/user/NLMNIH" aria-label="Youtube" target="_blank" rel="noopener noreferrer"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve"> <title>SM-Youtube</title> <style type="text/css"> .st4 { fill: none; stroke: #FFFFFF; stroke-width: 8; stroke-miterlimit: 10; } .st5 { fill: #FFFFFF; } </style> <circle class="st4" cx="124.2" cy="123.4" r="108.2"></circle> <g transform="translate(0,-952.36218)"> <path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path> </g> </svg></a></li> </ul> </div> <div class="col-lg-3 col-12"> <p class="address_footer text-white">National Library of Medicine<br> <a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white" target="_blank" rel="noopener noreferrer">8600 Rockville Pike<br> Bethesda, MD 20894</a></p> </div> <div class="col-lg-3 col-12 centered-lg"> <p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br> <a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br> <a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p> </div> <div class="col-lg-3 col-12 centered-lg"> <p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br> <a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br> <a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p> </div> </div> <div class="row"> <div class="col-lg-12 centered-lg"> <nav class="bottom-links"> <ul class="mt-3"> <li> <a class="text-white" href="//www.nlm.nih.gov/">NLM</a> </li> <li> <a class="text-white" href="https://www.nih.gov/">NIH</a> </li> <li> <a class="text-white" href="https://www.hhs.gov/">HHS</a> </li> <li> <a class="text-white" href="https://www.usa.gov/">USA.gov</a> </li> </ul> </nav> </div> </div> </div> </section> </footer> <!-- ========== END FOOTER ========== --> <!-- javascript to inject NWDS meta tags. Note: value of nwds_version is updated by "npm version" command --> <script type="text/javascript"> var nwds_version = "1.2.3"; var meta_nwds_ver = document.createElement('meta'); meta_nwds_ver.name = 'ncbi_nwds_ver'; meta_nwds_ver.content = nwds_version; document.getElementsByTagName('head')[0].appendChild(meta_nwds_ver); var meta_nwds = document.createElement('meta'); meta_nwds.name = 'ncbi_nwds'; meta_nwds.content = 'yes'; document.getElementsByTagName('head')[0].appendChild(meta_nwds); var alertsUrl = "/core/alerts/alerts.js"; if (typeof ncbiBaseUrl !== 'undefined') { alertsUrl = ncbiBaseUrl + alertsUrl; } </script> </div> <!-- jQuery with plugins --> <script src="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/js/output.293fbf76aa18.js"></script> <!-- Project base scripts --> <script src="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/js/output.550e9c8906a2.js"></script> <script> ncbi.awesome.basePage.init({ userInfo: { isLoggedIn: false, username: "", loginUrl: "https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34044037%2F", logoutUrl: "https://www.ncbi.nlm.nih.gov/account/signout/?back_url=https%3A//pubmed.ncbi.nlm.nih.gov/34044037/" }, baseUrl: 'https://www.ncbi.nlm.nih.gov', noSessionCookieName: "pm-ns", searchIdCookieName: "pm-sid", adjNavSearchIdCookieName: "pm-adjnav-sid", searchFormSubmittedCookieName: "pm-sfs", isOnSearchPageCookieName: "pm-iosp", backToSearchCookieName: "pm-btsl", clinicalSeeAllCookieName: "pm-csa", jsCookieDomain: "pubmed.ncbi.nlm.nih.gov", userShareRequestFailed: "", noSharedSettings: "myncbi_no_shared_settings", noSharedAccount: "myncbi_no_shared_account" }); </script> <script type="module"> import dismissableNCBIAlert from "https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/core/dismissable-ncbi-alert.js"; jQuery.getScript("https://www.ncbi.nlm.nih.gov/core/alerts/alerts.js", function () { galert(['body > *:last-child']); dismissableNCBIAlert(); }).fail(function() { }); </script> <script defer type="text/javascript" src="https://cdn.ncbi.nlm.nih.gov/core/pinger/pinger.js"> </script> <script src="https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/CACHE/js/output.04d45d85d031.js"></script> <script> ncbi.awesome.articlePage.init({ baseSuggestionsUrl: "/suggestions/", mathJaxUrl: "https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/mathjax/unpacked/MathJax.js?config=MML_CHTML", clipboardAPIRoot: "/ajax/clipboard/", clipboardNextPageUrl: "/clipboard-next-page/", searchIdCookieName: "pm-sid", searchFormSubmittedCookieName: "pm-sfs", backToSearchCookieName: "pm-btsl", jsCookieDomain: "pubmed.ncbi.nlm.nih.gov", longTermPrefix: "longquery", adjNavURLPath: "/34044037/adj-nav/", adjNavSearchIdCookieName: "pm-adjnav-sid", articlePageUrl: "/34044037/", markJSUrl: "https://cdn.ncbi.nlm.nih.gov/pubmed/0d576970-ea4f-4f8d-9bab-bf51569c42d2/mark.js/dist/jquery.mark.js", termHighlightColor: "", highlightedTokens: "", citeFormatPreferenceCookieName: "pm-cf" }); </script> </body> </html>