By Marek Ma, Julie R. Harris, and Amy L. Boore
Results from an Embassy Kampala investigation into COVID-19 breakthrough infections at post were published in the June volume of the scientific journal, “Emerging Infectious Diseases.” The research from Kampala showed the surprisingly high rate of COVID-19 breakthrough infections as well as the potential for transmission from fully vaccinated persons.
During the first wave of the pandemic, the Mission’s Health Unit (HU) and local Centers for Disease Control and Prevention (CDC) forged a close collaborative relationship, providing weekly updates to the Mission community about COVID-19 mitigation strategies and vaccines. They also facilitated town halls led by the ambassador and deputy chief of mission to help reinforce important take-home messages and dispel dangerous myths about COVID-19 and the vaccines.
Most of the embassy staff received the Moderna vaccine between March and May of 2021, leading to cautious optimism that the Mission community would weather subsequent waves of infection better than the first. However, in late May, as the second wave of the pandemic expanded rapidly in Uganda, two cases of COVID-19 were diagnosed in quick succession, both among fully vaccinated Mission staff. Over the next five weeks, 18 additional infections were reported in fully vaccinated Mission staff, including some that indicated transmission from one vaccinated person to another. While breakthrough infections are typical with any vaccine, the expected rate of COVID-19 breakthrough infections—as well as the potential for transmission from fully vaccinated persons—was not clear at the time. HU personnel discussed the situation with their CDC Uganda colleagues and launched an investigation. The HU and CDC Uganda held regular Zoom meetings with COVID-19 experts at the CDC headquarters in Atlanta, who provided insight into developments in the United States and globally. Information was also shared with embassies in the region and the Bureau of Medical Services in Washington, both to help understand common experiences and guide expectations for embassies worldwide.
Mission Uganda’s early diagnoses of multiple breakthrough infections and reports of vaccinated transmitters of the virus, combined with the experience of embassy staff affected by the disease, provided early information that helped inform responses elsewhere and supplied data that can be used by researchers studying the current and future disease outbreaks.
Dr. Marek Ma is a physician in the Health Unit at Embassy Kampala. Dr. Julie Harris is the Centers for Disease Control and Prevention (CDC) resident advisor for the Uganda Field Epidemiology Training Program in Kampala. Dr. Amy Boore is the CDC program director of the Division of Global Health Protection in Kampala.