In Wisconsin, household transmission during patient G’s reinfection likely resulted in reinfections of patients F and H. The seven remaining patients were unvaccinated. COVID 19 OMICRON REINFECTION SERIESPatient E had completed a 2-dose mRNA COVID-19 vaccination series 6–10 weeks before the first infection patients A and B each had received a single dose of mRNA COVID-19 vaccine between infections. Intervals between initial and subsequent specimen collections ranged from 23 to 87 days (median = 54.5 days). Eight patients were aged <18 years, one was a long-term care facility resident, and one was a health care worker ††† five were male. WGS identified Delta variant in all specimens from first infections and Omicron in all reinfection specimens.*** Median age at first infection was 11 years. Ten patients with early reinfections were identified ( Table). Rhode Island screening protocols for hospitals and long-term care facilities led to collection of two NAAT-positive specimens within 90 days from a long-term care facility resident. ¶¶ Public Health – Seattle & King County was notified after Washington testing guidance for K–12 schools led to identification of a suspected early reinfection in a student at a school sporting event. §§ Wisconsin Department of Health Services was notified by university researchers of suspected early reinfections in members of a household enrolled in a longitudinal respiratory disease surveillance study. Vermont Department of Health case investigators noted an increase in suspected early reinfections five of these cases were confirmed through Vermont’s passive WGS surveillance system, which sequences the highest percentage (15.8%) of total state cases nationwide. This activity was reviewed by CDC, approved by respective institutional review boards, and was conducted consistent with applicable federal law and CDC policy.**Īn early reinfection was defined as a SARS-CoV-2 WGS test result (performed at a state, university, or contracted commercial laboratory ††) from a new NAAT-positive specimen, collected during October 2021–January 2022 and <90 days after a first positive specimen from a previous WGS-confirmed SARS-CoV-2 infection, that demonstrated a different lineage from the first infection. This report describes 10 patients from four states, with whole genome sequencing (WGS)–confirmed Omicron variant infections within 90 days of a previous Delta infection. Because some persons have prolonged detection of viral RNA after infection, ¶ repeat positive nucleic acid amplification test (NAAT) results within 90 days could reflect prolonged shedding from earlier infection, presenting technical challenges to documenting and characterizing early reinfections. Early reinfections (those occurring within 90 days of previous infection) are not well understood ( 4). Since the SARS-CoV-2 B.1.1.529 (Omicron) variant became predominant in the United States in late December 2021, reported reinfections have increased § ( 3). Vaccination protects against infection with SARS-CoV-2 (the virus that causes COVID-19) and related hospitalizations ( 1, 2), and surviving a previous infection protects against B.1.1.7 (Alpha) and B.1.617.2 (Delta) variant reinfections † ( 2).
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