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Incidence of SARS-CoV-2 Infection among COVID-19 Vaccinated and Unvaccinated Healthcare Personnel, First Responders, and other Essential and Frontline Workers--- Eight U.S. Locations, January--September 2021
  • +27
  • Allison Naleway,
  • Lauren Grant,
  • Alberto Caban-Martinez,
  • Meredith Wesley,
  • Jefferey Burgess,
  • Kimberly Groover,
  • Manjusha Gaglani,
  • Sarang Yoon,
  • Harmony Tyner,
  • Jennifer Meece,
  • Jennifer Kuntz,
  • Young Yoo,
  • Natasha Schaefer-Solle,
  • Lauren Olsho,
  • Joe Gerald,
  • Spencer Rose,
  • Matthew Thiese,
  • Jessica Lundgren,
  • Holly Groom,
  • Josephine Mak,
  • Paola Feliciano,
  • Laura Edwards,
  • Karen Lutrick,
  • Kayan Dunnigan,
  • Andrew Phillips,
  • Marilyn Odean,
  • Katherine Ellingson,
  • Karley Respet,
  • Mark Thompson,
  • Ashley Fowlkes
Allison Naleway
Kaiser Permanente Center for Health Research Northwest Region

Corresponding Author:allison.naleway@kpchr.org

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Lauren Grant
Centers for Disease Control and Prevention
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Alberto Caban-Martinez
University of Miami Miller School of Medicine
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Meredith Wesley
CDC
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Jefferey Burgess
University of Arizona Medical Center - University Campus
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Kimberly Groover
ABT Associates Inc
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Manjusha Gaglani
Baylor Scott & White Health, Texas A&M HSC COM
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Sarang Yoon
University of Utah Health
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Harmony Tyner
St. Luke’s Regional Health Care System
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Jennifer Meece
Marshfield Clinic Research Institute
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Jennifer Kuntz
Kaiser Permanente Center for Health Research Northwest Region
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Young Yoo
Centers for Disease Control and Prevention
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Natasha Schaefer-Solle
University of Miami Miller School of Medicine
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Lauren Olsho
Abt Associates, Inc.
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Joe Gerald
The University of Arizona Mel and Enid Zuckerman College of Public Health
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Spencer Rose
Baylor Scott & White Health
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Matthew Thiese
University of Utah Health
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Jessica Lundgren
St. Luke’s Regional Health Care System
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Holly Groom
Kaiser Permanente Center for Health Research Northwest Region
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Josephine Mak
Centers for Disease Control and Prevention
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Paola Feliciano
University of Miami Miller School of Medicine
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Laura Edwards
ABT Associates Inc
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Karen Lutrick
The University of Arizona Mel and Enid Zuckerman College of Public Health
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Kayan Dunnigan
Baylor Scott & White Health
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Andrew Phillips
University of Utah Health
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Marilyn Odean
Whiteside Institute for Clinical Research, St. Luke's
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Katherine Ellingson
The University of Arizona Mel and Enid Zuckerman College of Public Health
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Karley Respet
St. Luke’s Regional Health Care System
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Mark Thompson
Centers for Disease Control and Prevention
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Ashley Fowlkes
Centers for Disease Control and Prevention
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Abstract

Background. We sought to evaluate the impact of changes in estimates of COVID-19 vaccine effectiveness on the incidence of laboratory-confirmed infection among frontline workers at high risk for SARS-CoV-2. Methods. We analyzed data from a prospective frontline worker cohort to estimate the incidence of COVID-19 by month as well as the association of COVID-19 vaccination, occupation, demographics, physical distancing and mask use with infection risk. Participants completed baseline and quarterly surveys, and each week self-collected mid-turbinate nasal swabs and reported symptoms. Results. Among 1,018 unvaccinated and 3,531 fully vaccinated workers, the monthly incidence of laboratory-confirmed SARS-CoV-2 infection in January 2021 was 13.9 (95% confidence interval [CI]: 10.4-17.4), declining to 0.5 (95% CI -0.4-1.4) per 1000 person-weeks in June. By September 2021, when the Delta variant predominated, incidence had once again risen to 13.6 (95% CI 7.8-19.4) per 1000 person-weeks. In contrast, there was no reportable incidence among fully vaccinated participants at the end of January 2021, and incidence remained low until September 2021 when it rose modestly to 4.1 (95% CI 1.9-3.8) per 1000. Below average facemask use was associated with a higher risk of infection for unvaccinated participants during exposure to persons who may have COVID-19, and vaccinated participants during hours in the community. Conclusions. COVID-19 vaccination was significantly associated with a lower risk of SARS-CoV-2 infection despite Delta variant predominance. Our data demonstrate the added protective benefit of facemask use among both unvaccinated and vaccinated frontline workers.
29 Nov 2021Submitted to Influenza and other respiratory viruses
30 Nov 2021Submission Checks Completed
30 Nov 2021Assigned to Editor
02 Dec 2021Reviewer(s) Assigned
02 Dec 2021Review(s) Completed, Editorial Evaluation Pending
02 Dec 2021Editorial Decision: Revise Minor
13 Dec 20211st Revision Received
14 Dec 2021Submission Checks Completed
14 Dec 2021Assigned to Editor
14 Dec 2021Editorial Decision: Accept
May 2022Published in Influenza and Other Respiratory Viruses volume 16 issue 3 on pages 585-593. 10.1111/irv.12956