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Fig 1.

Number vaccination and breakthrough infection density by week by rurality, January 1, 2021—December 20, 2021.

aBars represent number vaccinated and lines represent breakthrough infection rates.

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Table 1.

Baseline characteristics of all patients in N3C receiving 2 doses of mRNA vaccine between January 1, 2021, and September 21, 2021.

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Fig 2.

Kaplan Meier cumulative incidence curves for SARS-CoV-2 breakthrough infection following two mRNA vaccinations in adults, January 1, 2021 –December 20, 2021.

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Fig 3.

Univariable and multivariable Cox-proportional hazard ratios for SARS-CoV-2 breakthrough infection following two mRNA vaccinations by community factors, January 1, 2021 –December 20, 2021.

A. Univariable Hazard Ratios for Key Factors Evaluated Independently. B. Multivariable* Hazard Ratios for Key Factors Evaluated Independently. *Models adjusted for age, gender, race/ethnicity, comorbid conditions, prior SARS-CoV-2 infection, vaccine manufacturer, period of vaccination (relative to Delta dominance), and US Census region. Full model specifications available in S2 and S3 Tables in S1 File.

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Fig 4.

Multivariable Cox-proportional hazard ratios for SARS-CoV-2 breakthrough infection following two mRNA vaccinations in adults by combined key factors, January 1, 2021 –December 20, 2021.

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Fig 5.

Differences in 30-day severity* based on vaccination status in persons infected with SARS-CoV-2, January 1, 2021 –December 20, 2021.

*Severity categories following SARS-CoV-2 infection classified as outpatient-only visit (no hospitalization within 30 days of diagnosis), COVID-associated hospitalization (within 30 days of diagnosis), COVID-19-associated adverse event (mechanical ventilation, ECMO, or death or transfer to hospice within 30 days of diagnosis).

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