{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T17:03:04Z","timestamp":1775667784209,"version":"3.50.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"Task Force for Global Health","award":["GR-02312"],"award-info":[{"award-number":["GR-02312"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>To optimize vaccination strategies, it is useful to detect breakthrough infections and assess vaccine effectiveness in programmatic use. Monitoring emerging SARS-CoV-2 variants and vaccine effectiveness against them is also essential to determine the most effective vaccine options. This study aims to monitor SARS-CoV-2 breakthrough infections, the emergence of new SARS-CoV-2 variants, and host immune response during the peri-infection period of COVID-19. The study will also assess the uptake of the COVID-19 vaccine booster doses, and associated barriers or motivations among healthcare workers (HCWs).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Leveraging an existing HCW cohort in Bangladesh, HCWs will be enrolled from purposively selected health facilities from four different administrative divisions across Bangladesh. We captured cohort data on HCW\u2019s demographic information, clinical information, COVID-19 illness, and exposure, and vaccination histories for COVID-19. However, no biological specimens were collected for testing during the first phase of the cohort. In the current study, we plan to follow enrolled HCWs biweekly for suspected COVID-19 illness and capture relevant data including illness outcomes. Respiratory swab samples from symptomatic and a subset of asymptomatic HCWs will be tested for SARS-CoV-2 by rRT-PCR and positive samples will undergo Sanger sequencing to identify the SARS-CoV-2 variants of concern (VOCs). We will also perform Whole Genome Sequencing on a subset of SARS-CoV-2 positive samples with low CT values (Ct \u2264 30) to identify emerging SARS-CoV-2 variants. To examine the antibody response, we will collect blood samples from the participants at 12-week intervals for one year. We will use the EUROIMMUN kit and will also perform in-house ELISA to assess host immune factors with Luminex platform.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>This proposed study will generate useful data on COVID-19 breakthrough infection and the durability of anti-SARS-CoV-2 antibodies among HCWs following vaccination. The findings on booster vaccination intention and uptake will inform government COVID-19 vaccination strategies. Information on circulating and emerging strains of SARS-CoV-2 and vaccine performance against those strains will help understand population-level risks of COVID-19 infection. The study will generate data on facilitators and barriers to COVID-19 booster uptake among HCWs which can inform health communication messaging to improve booster acceptance in this population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0316121","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T18:48:42Z","timestamp":1735670922000},"page":"e0316121","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Study protocol for COVID-19 breakthrough infections and vaccine-induced immune response among a cohort of healthcare workers, Bangladesh"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5888-1558","authenticated-orcid":true,"given":"Md. Zakiul","family":"Hassan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahamed Khairul","family":"Basher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Ziaur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taufiqur Rahman","family":"Bhuiyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahmida","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Kamal","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aninda","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. 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Dahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdausi","family":"Qadri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"pone.0316121.ref001","volume-title":"Coronavirus disease 2019 (COVID-19) situation report\u2013 90","author":"WHO"},{"key":"pone.0316121.ref002","unstructured":"News PM. Among Healthcare Workers, Family and Primary Care Doctors May Have Been Most at Risk of Dying from COVID-19: Penn Medicine News; 2020 [Available from: https:\/\/www.pennmedicine.org\/news\/news-releases\/2020\/july\/among-healthcare-workers-family-primary-care-doctors-most-at-risk-of-dying-from-covid19]."},{"issue":"1","key":"pone.0316121.ref003","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3390\/ijerph19010146","article-title":"COVID-19 prevalence among healthcare workers. A systematic review and meta-analysis","volume":"19","author":"T Dzinamarira","year":"2022","journal-title":"International journal of environmental research and public health"},{"key":"pone.0316121.ref004","volume-title":"The impact of COVID-19 on health and care workers: a closer look at deaths","author":"WHO","year":"2021"},{"issue":"7858","key":"pone.0316121.ref005","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1038\/s41586-021-03470-x","article-title":"Assessing transmissibility of SARS-CoV-2 lineage B. 1.1. 7","volume":"593","author":"E Volz","year":"2021","journal-title":"England. Nature"},{"key":"pone.0316121.ref006","article-title":"Community transmission and viral load kinetics of the SARS-CoV-2 delta (B. 1.617. 2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study","author":"A Singanayagam","year":"2021","journal-title":"The lancet infectious diseases"},{"issue":"12","key":"pone.0316121.ref007","doi-asserted-by":"crossref","first-page":"e666","DOI":"10.1016\/S2666-5247(21)00219-6","article-title":"The durability of immunity against reinfection by SARS-CoV-2: a comparative evolutionary study","volume":"2","author":"JP Townsend","year":"2021","journal-title":"The Lancet Microbe"},{"key":"pone.0316121.ref008","article-title":"Enhancing response to Omicron SARS-CoV-2 variant","author":"WHO","year":"2022"},{"issue":"12","key":"pone.0316121.ref009","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.40906","article-title":"Analysis of Vaccine Effectiveness Against COVID-19 and the Emergence of Delta and Other Variants of Concern in Utah.","volume":"4","author":"LT Keegan","year":"2021","journal-title":"JAMA network open"},{"key":"pone.0316121.ref010","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1056\/NEJMoa2108891","article-title":"Effectiveness of Covid-19 vaccines against the B. 1.617. 2 (Delta) variant.","author":"J Lopez Bernal","year":"2021","journal-title":"N Engl J Med"},{"key":"pone.0316121.ref011","doi-asserted-by":"crossref","first-page":"100307","DOI":"10.1016\/j.puhip.2022.100307","article-title":"Vaccine breakthrough infections with SARS-CoV-2: Why older adults need booster vaccinations.","volume":"4","author":"MI Ventura","year":"2022","journal-title":"Public Health in Practice."},{"issue":"12","key":"pone.0316121.ref012","doi-asserted-by":"crossref","first-page":"e0244126","DOI":"10.1371\/journal.pone.0244126","article-title":"Antibody response to SARS-CoV-2 infection in humans: A systematic review.","volume":"15","author":"N Post","year":"2020","journal-title":"PloS one"},{"issue":"7","key":"pone.0316121.ref013","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1111\/all.14364","article-title":"Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19","volume":"75","author":"AK Azkur","year":"2020","journal-title":"Allergy"},{"key":"pone.0316121.ref014","doi-asserted-by":"crossref","first-page":"931061","DOI":"10.3389\/fcimb.2022.931061","article-title":"Mechanism of COVID-19 Causing ARDS: Exploring the Possibility of Preventing and Treating SARS-CoV-2","volume":"12","author":"J Zheng","year":"2022","journal-title":"Frontiers in cellular and infection microbiology"},{"key":"pone.0316121.ref015","first-page":"238","article-title":"Risk of COVID-19 morbidity and mortality among healthcare workers working in a Large Tertiary Care Hospital.","volume":"109","author":"MM Alshamrani","year":"2021","journal-title":"International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases"},{"issue":"1","key":"pone.0316121.ref016","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1186\/s12913-021-07071-2","article-title":"Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh.","volume":"21","author":"TK Nath","year":"2021","journal-title":"BMC Health Services Research."},{"key":"pone.0316121.ref017","article-title":"WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update","author":"WHO","year":"2022"},{"issue":"1","key":"pone.0316121.ref018","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1186\/s12913-022-08174-0","article-title":"Quality of life among health care workers with and without prior COVID-19 infection in Bangladesh.","volume":"22","author":"MA Rahman","year":"2022","journal-title":"BMC Health Services Research"},{"key":"pone.0316121.ref019","author":"A. Jazeera","year":"2021","journal-title":"Bangladesh starts COVID vaccination drive"},{"key":"pone.0316121.ref020","article-title":"COVID-19 Vaccination Dashboard for Bangladesh","author":"DGHS","year":"2023"},{"issue":"1","key":"pone.0316121.ref021","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/irv.12901","article-title":"Population-based assessment of risks for severe COVID-19 disease outcomes.","volume":"16","author":"O Zerbo","year":"2022","journal-title":"Influenza and Other Respiratory Viruses"},{"key":"pone.0316121.ref022","article-title":"Interim statement on booster doses for COVID-19 vaccination 2021","author":"WHO"},{"key":"pone.0316121.ref023","article-title":"WHO COVID-19: Case Definitions","author":"WHO","year":"2022"},{"issue":"2","key":"pone.0316121.ref024","doi-asserted-by":"crossref","first-page":"429","DOI":"10.3201\/eid2802.211689","article-title":"SARS-CoV-2 Seroprevalence before Delta Variant Surge, Chattogram, Bangladesh, March-June 2021","volume":"28","author":"TR Bhuiyan","year":"2022","journal-title":"Emerging infectious diseases"},{"issue":"3","key":"pone.0316121.ref025","article-title":"COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore.","volume":"10","author":"SWC Koh","year":"2022","journal-title":"Vaccines"},{"issue":"16","key":"pone.0316121.ref026","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1056\/NEJMoa2109072","article-title":"Covid-19 Breakthrough Infections in Vaccinated Health Care Workers.","volume":"385","author":"M Bergwerk","year":"2021","journal-title":"New England Journal of Medicine"},{"key":"pone.0316121.ref027","first-page":"113119","article-title":"The structural vulnerability of healthcare workers during COVID-19: Observations on the social context of risk and the equitable distribution of resources. 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