Fig. 4: Participants who experience a breakthrough infection have lower level of anti-Spike/RBD IgA at 2–4 weeks post-vaccination.

Serum samples from vaccinated Toronto LTCH residents were taken at 2–4 weeks post-dose 2. Serum anti-Spike/RBD IgG (A) and IgA (B) levels were compared in participants who were subsequently exposed to P.1 gamma SARS-CoV-2 and either infected (exposed infected, n = 5) or not infected (exposed uninfected, n = 12). In a separate cohort of double vaccinated healthcare workers from the Sheba Medical Center in Ramat Gan, Israel, serum samples were taken at 2–4 weeks post-dose 2. Serum anti-Spike/RBD IgG (C) and IgA (D) levels were compared in participants who experienced a breakthrough infection (cases, n = 11) vs. controls who did not (control, n = 56). Solid black lines denote the median for each cohort. Kruskal–Wallis test with a correction for multiple comparisons was used to conduct statistical analysis between groups. NS not significant, *p < 0.5; **p < 0.01.