Active Covid-19 infection and transmission after the first dose of the BNT162b2 mRNA vaccination in Saudi Arabia: A case report

J Infect Public Health. 2021 Aug;14(8):1123-1125. doi: 10.1016/j.jiph.2021.07.006. Epub 2021 Jul 13.


A 47-year-old non-smoker male who has received the first dose of the BNT162b2 mRNA Covid-19 vaccine in Saudi Arabia. At day 3 post-vaccination, he tested negative for Covid-19 and travelled to Egypt. On day 12 he developed runny nose, body ache and fever, and he reportedly tested (PCR) negative for Covid-19 Upon his return to Saudi on day 15, his symptoms have worsened and he presented to the Emergency Department, at which he tested positive for Covid-19. The patient was overweight (BMI = 29), was not suffering from any comorbidities and was not taking any medication. Upon examination, he was vitally stable and his laboratory investigation only revealed a slightly increased Creatinine. His chest X-ray was unremarkable. His condition did not require hospital admission, so he was discharged and advised to home-isolate himself. Four days after his discharge, his entire household came to the hospital and tested positive for Covid-19. This is the first case report, in Saudi Arabia, of a person receiving the first dose of the BNT162b2 vaccine and got infected with Covid-19 afterwards. The report highlights the significance of receiving the second dose of the vaccine to be effective. It also demonstrates that those with a single dose mRNA vaccine, could get infected and transmit the infection.

Keywords: COVID-19; Post-vaccination infection; SARS-CoV-2; Saudi Arabia; Vaccine efficacy.

Publication types

  • Case Reports

MeSH terms

  • BNT162 Vaccine
  • COVID-19 Vaccines
  • COVID-19*
  • Egypt
  • Humans
  • Male
  • Middle Aged
  • RNA, Messenger
  • SARS-CoV-2
  • Saudi Arabia
  • Vaccination


  • COVID-19 Vaccines
  • RNA, Messenger
  • BNT162 Vaccine