{"id":14264,"date":"2020-03-02T12:13:22","date_gmt":"2020-03-02T04:13:22","guid":{"rendered":"https:\/\/id-ea.org\/tbe\/?p=14264"},"modified":"2021-02-19T10:18:21","modified_gmt":"2021-02-19T02:18:21","slug":"snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections","status":"publish","type":"post","link":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/","title":{"rendered":"Snapshot week 10\/2020
Analysis of TBE vaccination breakthrough infections"},"content":{"rendered":"\n

Dobler et al.
Tick-borne encephalitis virus vaccination breakthrough infections in Germany \u2013 a retrospective analysis from 2001-2018
Clin. Microbiol. Infect. 2020<\/em>, in press, doi.org\/10.1016\/j.cmi.2019.12.001<\/p>\n\n\n\n

Currently\nlicensed TBE vaccines are highly effective. However, breakthrough infections occur,\nand it is debated if these infections may be associated with a more severe\ncourse of infection compared to disease in non-immunized patients. The\nunderlying mechanism for this phenomenon may be explained by antibody dependent\nenhancement (ADE), which is known from other flaviviral infections, especially\nby dengue virus.<\/p>\n\n\n\n

During the\nperiod 2001 to 2018, a total of 6,073 TBE cases have been notified in Germany,\nfor which the vaccination status was available for 5,777 patients (95.1%). TBE\ndisease severity was analyzed for four vaccination categories. These were i) \u201eunvaccinated\u201c,\nii) \u201eever vaccinated\u201c: individuals had received at least one vaccine dose, iii)\n\u201evaccinated, protected\u201c: individuals who had received more than one vaccine\ndose (primary immunization and possibly booster doses) and assumed to be\nprotected, and iv) \u201evaccinated, no protection assumed at symptom onset\u201c: a\nsubset of \u201eever vaccinated\u201c-group, which was assumed not to be protected due to\nnon-regular vaccination course.<\/p>\n\n\n\n

Comparing\nunvaccinated patients to those \u201eever vaccinated\u201c with at least one dose (n=334)\nan OR 2.73 was found for fatal outcome, but this result did not reach\nstatistical significance. Patients never having received a TBE vaccine dose\nwere more likely hospitalized that patients who had received at least one\nvaccine dose (OR 0.72). Analyses for the symptoms \u201eCNS symptoms\u201c, and\n\u201emyelitis\u201c revealed no differences between the groups \u201ewithout any vaccination\u201c\nand \u201epatients with at least one vaccination\u201c (OR 0.86 and 1.30, respectively). In\ncomparison, vaccinated patients with no assumed protection at onset of symptoms\nhad no significantly higher risk for a fatal outcome or myelitis, and there was\na significantly decreased risk of hospitalization and for development of CNS\nsymptoms compared to unvaccinated patients. More comparisons between the four\ngroups are described and led the authors to the conclusion that their findings\ncould neither verify that vaccination breakthrough infections might cause a\nmore severe disease than infections in non-vaccinated individuals nor prove a\nclear ADE phenomenon. Patients without any vaccination were more often hospitalized\nshowing the efficacy of TBE vaccine, even with one single dose.<\/p>\n<\/span>","protected":false},"excerpt":{"rendered":"

Dobler et al.Tick-borne encephalitis virus vaccination breakthrough infections in Germany \u2013 a retrospective analysis from 2001-2018Clin. Microbiol. Infect. 2020, in press, doi.org\/10.1016\/j.cmi.2019.12.001 Currently licensed TBE vaccines are highly effective. However, breakthrough infections occur, and it is debated if these infections may be associated with a more severe course of infection compared to disease in non-immunized patients. The underlying mechanism for this phenomenon may be explained by antibody dependent enhancement (ADE), which is known from other flaviviral infections, especially by dengue virus. During the period 2001 to 2018, a total of 6,073 TBE cases have been notified in Germany, for which the vaccination status was available for 5,777 patients (95.1%). TBE disease severity was analyzed for four vaccination categories. These were i) \u201eunvaccinated\u201c, ii) \u201eever vaccinated\u201c: individuals had received at least one vaccine dose, iii) \u201evaccinated, protected\u201c: individuals who had received more than one vaccine dose (primary immunization and possibly booster doses) and assumed to be protected, and iv) \u201evaccinated, no protection assumed at symptom onset\u201c: a subset of \u201eever vaccinated\u201c-group, which was assumed not to be protected due to non-regular vaccination course. Comparing unvaccinated patients to those \u201eever vaccinated\u201c with at least one dose (n=334) an OR 2.73 was found for fatal outcome, but this result did not reach statistical significance. Patients never having received a TBE vaccine dose were more likely hospitalized that patients who had received at least one vaccine dose (OR 0.72). Analyses for the symptoms \u201eCNS symptoms\u201c, and \u201emyelitis\u201c revealed no differences between the groups \u201ewithout any vaccination\u201c and \u201epatients with at least one vaccination\u201c (OR 0.86 and 1.30, respectively). In comparison, vaccinated patients with no assumed protection at onset of symptoms had no significantly higher risk for a fatal outcome or myelitis, and there was a significantly decreased risk of hospitalization and for development of CNS symptoms compared to unvaccinated patients. More comparisons between the four groups are described and led the authors to the conclusion that their findings could neither verify that vaccination breakthrough infections might cause a more severe disease than infections in non-vaccinated individuals nor prove a clear ADE phenomenon. Patients without any vaccination were more often hospitalized showing the efficacy of TBE vaccine, even with one single dose.<\/p>\n","protected":false},"author":6,"featured_media":12864,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[18],"tags":[270,439,441,440],"coauthors":[81],"class_list":["post-14264","post","type-post","status-publish","format-standard","has-post-thumbnail","category-snapshot","tag-antibody-dependent-enhancement","tag-breakthrough-infection","tag-symptoms-of-tbe","tag-tbe-vaccination"],"yoast_head":"\nSnapshot week 10\/2020 Analysis of TBE vaccination breakthrough infections - TBE Book<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Snapshot week 10\/2020 Analysis of TBE vaccination breakthrough infections - TBE Book\" \/>\n<meta property=\"og:description\" content=\"Dobler et al.Tick-borne encephalitis virus vaccination breakthrough infections in Germany \u2013 a retrospective analysis from 2001-2018Clin. Microbiol. Infect. 2020, in press, doi.org\/10.1016\/j.cmi.2019.12.001 Currently licensed TBE vaccines are highly effective. However, breakthrough infections occur, and it is debated if these infections may be associated with a more severe course of infection compared to disease in non-immunized patients. The underlying mechanism for this phenomenon may be explained by antibody dependent enhancement (ADE), which is known from other flaviviral infections, especially by dengue virus. During the period 2001 to 2018, a total of 6,073 TBE cases have been notified in Germany, for which the vaccination status was available for 5,777 patients (95.1%). TBE disease severity was analyzed for four vaccination categories. These were i) \u201eunvaccinated\u201c, ii) \u201eever vaccinated\u201c: individuals had received at least one vaccine dose, iii) \u201evaccinated, protected\u201c: individuals who had received more than one vaccine dose (primary immunization and possibly booster doses) and assumed to be protected, and iv) \u201evaccinated, no protection assumed at symptom onset\u201c: a subset of \u201eever vaccinated\u201c-group, which was assumed not to be protected due to non-regular vaccination course. Comparing unvaccinated patients to those \u201eever vaccinated\u201c with at least one dose (n=334) an OR 2.73 was found for fatal outcome, but this result did not reach statistical significance. Patients never having received a TBE vaccine dose were more likely hospitalized that patients who had received at least one vaccine dose (OR 0.72). Analyses for the symptoms \u201eCNS symptoms\u201c, and \u201emyelitis\u201c revealed no differences between the groups \u201ewithout any vaccination\u201c and \u201epatients with at least one vaccination\u201c (OR 0.86 and 1.30, respectively). In comparison, vaccinated patients with no assumed protection at onset of symptoms had no significantly higher risk for a fatal outcome or myelitis, and there was a significantly decreased risk of hospitalization and for development of CNS symptoms compared to unvaccinated patients. More comparisons between the four groups are described and led the authors to the conclusion that their findings could neither verify that vaccination breakthrough infections might cause a more severe disease than infections in non-vaccinated individuals nor prove a clear ADE phenomenon. Patients without any vaccination were more often hospitalized showing the efficacy of TBE vaccine, even with one single dose.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/\" \/>\n<meta property=\"og:site_name\" content=\"TBE Book\" \/>\n<meta property=\"article:published_time\" content=\"2020-03-02T04:13:22+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-02-19T02:18:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/11\/TBE-Snapshots.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1180\" \/>\n\t<meta property=\"og:image:height\" content=\"250\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Michael Br\u00f6ker\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Michael Br\u00f6ker\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/\"},\"author\":{\"name\":\"augustine\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#\\\/schema\\\/person\\\/2f903afeb7534df7457d2e3f6d30f64c\"},\"headline\":\"Snapshot week 10\\\/2020 Analysis of TBE vaccination breakthrough infections\",\"datePublished\":\"2020-03-02T04:13:22+00:00\",\"dateModified\":\"2021-02-19T02:18:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/\"},\"wordCount\":370,\"publisher\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/wp-content\\\/uploads\\\/2017\\\/11\\\/TBE-Snapshots.jpg\",\"keywords\":[\"antibody dependent enhancement\",\"breakthrough infection\",\"symptoms of TBE\",\"TBE vaccination\"],\"articleSection\":[\"Snapshot\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/\",\"url\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\\\/\",\"name\":\"Snapshot week 10\\\/2020 Analysis of TBE vaccination breakthrough infections - 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TBE Book","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/","og_locale":"en_US","og_type":"article","og_title":"Snapshot week 10\/2020 Analysis of TBE vaccination breakthrough infections - TBE Book","og_description":"Dobler et al.Tick-borne encephalitis virus vaccination breakthrough infections in Germany \u2013 a retrospective analysis from 2001-2018Clin. Microbiol. Infect. 2020, in press, doi.org\/10.1016\/j.cmi.2019.12.001 Currently licensed TBE vaccines are highly effective. However, breakthrough infections occur, and it is debated if these infections may be associated with a more severe course of infection compared to disease in non-immunized patients. The underlying mechanism for this phenomenon may be explained by antibody dependent enhancement (ADE), which is known from other flaviviral infections, especially by dengue virus. During the period 2001 to 2018, a total of 6,073 TBE cases have been notified in Germany, for which the vaccination status was available for 5,777 patients (95.1%). TBE disease severity was analyzed for four vaccination categories. These were i) \u201eunvaccinated\u201c, ii) \u201eever vaccinated\u201c: individuals had received at least one vaccine dose, iii) \u201evaccinated, protected\u201c: individuals who had received more than one vaccine dose (primary immunization and possibly booster doses) and assumed to be protected, and iv) \u201evaccinated, no protection assumed at symptom onset\u201c: a subset of \u201eever vaccinated\u201c-group, which was assumed not to be protected due to non-regular vaccination course. Comparing unvaccinated patients to those \u201eever vaccinated\u201c with at least one dose (n=334) an OR 2.73 was found for fatal outcome, but this result did not reach statistical significance. Patients never having received a TBE vaccine dose were more likely hospitalized that patients who had received at least one vaccine dose (OR 0.72). Analyses for the symptoms \u201eCNS symptoms\u201c, and \u201emyelitis\u201c revealed no differences between the groups \u201ewithout any vaccination\u201c and \u201epatients with at least one vaccination\u201c (OR 0.86 and 1.30, respectively). In comparison, vaccinated patients with no assumed protection at onset of symptoms had no significantly higher risk for a fatal outcome or myelitis, and there was a significantly decreased risk of hospitalization and for development of CNS symptoms compared to unvaccinated patients. More comparisons between the four groups are described and led the authors to the conclusion that their findings could neither verify that vaccination breakthrough infections might cause a more severe disease than infections in non-vaccinated individuals nor prove a clear ADE phenomenon. Patients without any vaccination were more often hospitalized showing the efficacy of TBE vaccine, even with one single dose.","og_url":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/","og_site_name":"TBE Book","article_published_time":"2020-03-02T04:13:22+00:00","article_modified_time":"2021-02-19T02:18:21+00:00","og_image":[{"width":1180,"height":250,"url":"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/11\/TBE-Snapshots.jpg","type":"image\/jpeg"}],"author":"Michael Br\u00f6ker","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Michael Br\u00f6ker","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/#article","isPartOf":{"@id":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/"},"author":{"name":"augustine","@id":"https:\/\/tbenews.com\/tbe\/#\/schema\/person\/2f903afeb7534df7457d2e3f6d30f64c"},"headline":"Snapshot week 10\/2020 Analysis of TBE vaccination breakthrough infections","datePublished":"2020-03-02T04:13:22+00:00","dateModified":"2021-02-19T02:18:21+00:00","mainEntityOfPage":{"@id":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/"},"wordCount":370,"publisher":{"@id":"https:\/\/tbenews.com\/tbe\/#organization"},"image":{"@id":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/#primaryimage"},"thumbnailUrl":"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/11\/TBE-Snapshots.jpg","keywords":["antibody dependent enhancement","breakthrough infection","symptoms of TBE","TBE vaccination"],"articleSection":["Snapshot"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/","url":"https:\/\/tbenews.com\/tbe\/snapshot-week-10-2020-analysis-of-tbe-vaccination-breakthrough-infections\/","name":"Snapshot week 10\/2020 Analysis of TBE vaccination breakthrough infections - 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