Household transmission of SARS-CoV-2 Omicron variant of concern subvariants BA.1 and BA.2 in Denmark

Frederik Plesner Lyngse, Carsten Kirkeby, Matt Denwood, Lasse Engbo Christiansen, Kåre Mølbak, Camilla Holten Møller, Robert Leo Skov, Tyra Grove Krause, Morten Rasmussen, Raphael Sieber, Thor Bech Johannesen, Troels Lillebæk, Jannik Fonager, Anders Fomsgaard, Frederik Trier Møller, Marc Stegger, Maria Overvad, Katja Spiess, Laust Hvas Mortensen

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Abstract

SARS coronavirus 2 (SARS-CoV-2) continues to evolve and new variants emerge. Using nationwide Danish data, we estimate the transmission dynamics of SARS-CoV-2 Omicron subvariants BA.1 and BA.2 within households. Among 22,678 primary cases, we identified 17,319 secondary infections among 50,588 household contacts during a 1–7 day follow-up. The secondary attack rate (SAR) was 29% and 39% in households infected with Omicron BA.1 and BA.2, respectively. BA.2 was associated with increased susceptibility of infection for unvaccinated household contacts (Odds Ratio (OR) 1.99; 95%–CI 1.72-2.31), fully vaccinated contacts (OR 2.26; 95%–CI 1.95–2.62) and booster-vaccinated contacts (OR 2.65; 95%–CI 2.29–3.08), compared to BA.1. We also found increased infectiousness from unvaccinated primary cases infected with BA.2 compared to BA.1 (OR 2.47; 95%–CI 2.15–2.84), but not for fully vaccinated (OR 0.66; 95%–CI 0.57–0.78) or booster-vaccinated primary cases (OR 0.69; 95%–CI 0.59–0.82). Omicron BA.2 is inherently more transmissible than BA.1. Its immune-evasive properties also reduce the protective effect of vaccination against infection, but do not increase infectiousness of breakthrough infections from vaccinated individuals.
Original languageEnglish
Article number5760
JournalNature Communications
Volume13
Number of pages7
ISSN2041-1723
DOIs
Publication statusPublished - 2022

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