High levels of exposure to the virus that causes COVID-19 may reduce or overcome the protection that vaccination and prior infection provides, according to a new study by researchers from Yale University, the University of Florida, and the Connecticut Department of Correction.
The findings, published Aug. 19 in Nature Communications, suggest that in densely crowded settings, control measures that reduce levels of exposure to the virus — such as masking, improved ventilation, and distancing — may afford additional benefit in preventing new infections among people who have been vaccinated or previously infected.
Dr. Byron Kennedy, chief medical officer for the Connecticut Department of Correction and associate clinical professor at the Yale School of Public Health, added, "We had a unique opportunity to answer this question because the Department of Correction had mounted an intensive COVID-19 testing program and we were identifying and isolating infected individuals."
Specifically, during the Delta wave, vaccination was 68% effective at preventing infection in residents without a documented exposure but was just 26% effective in residents with exposure to an infected cellmate. A previous infection was 79% effective in preventing infection in residents without a documented exposure but was 41% effective when a resident was exposed to an infected person in their cell.
"This research is the first study, as far as we are aware, that provides real-world evidence for the exposure-dependent or 'leaky' nature of the immunity afforded by vaccination and infection," Lind said.
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