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Real-world impact of vaccination on coronavirus disease 2019 (COVID-19) incidence in healthcare personnel at an academic medical center

Published online by Cambridge University Press:  21 July 2021

Sarah E. Waldman*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Jason Y. Adams
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Timothy E. Albertson
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Maya M. Juárez
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Sharon L. Myers
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Ashish Atreja
Affiliation:
Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Sumeet Batra
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Elena E. Foster
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Cy V. Huynh
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Anna Y. Liu
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
David A. Lubarsky
Affiliation:
Human Health Sciences and Chief Executive Office, University of California-Davis, UC Davis Health, Sacramento, California
Victoria T. Ngo
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Christian E. Sandrock
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Sandra L. Taylor
Affiliation:
Division of Biostatistics, Department of Public Health Sciences, University of California-Davis, UC Davis Health, Sacramento, California
Ann M. Tompkins
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Stuart H. Cohen
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
*
Author for correspondence: Sarah Waldman, E-mail: sewaldman@ucdavis.edu.

Abstract

Objective:

Coronavirus disease 2019 (COVID-19) vaccination effectiveness in healthcare personnel (HCP) has been established. However, questions remain regarding its performance in high-risk healthcare occupations and work locations. We describe the effect of a COVID-19 HCP vaccination campaign on SARS-CoV-2 infection by timing of vaccination, job type, and work location.

Methods:

We conducted a retrospective review of COVID-19 vaccination acceptance, incidence of postvaccination COVID-19, hospitalization, and mortality among 16,156 faculty, students, and staff at a large academic medical center. Data were collected 8 weeks prior to the start of phase 1a vaccination of frontline employees and ended 11 weeks after campaign onset.

Results:

The COVID-19 incidence rate among HCP at our institution decreased from 3.2% during the 8 weeks prior to the start of vaccinations to 0.38% by 4 weeks after campaign initiation. COVID-19 risk was reduced among individuals who received a single vaccination (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.40–0.68; P < .0001) and was further reduced with 2 doses of vaccine (HR, 0.17; 95% CI, 0.09–0.32; P < .0001). By 2 weeks after the second dose, the observed case positivity rate was 0.04%. Among phase 1a HCP, we observed a lower risk of COVID-19 among physicians and a trend toward higher risk for respiratory therapists independent of vaccination status. Rates of infection were similar in a subgroup of nurses when examined by work location.

Conclusions:

Our findings show the real-world effectiveness of COVID-19 vaccination in HCP. Despite these encouraging results, unvaccinated HCP remain at an elevated risk of infection, highlighting the need for targeted outreach to combat vaccine hesitancy.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

COVID data tracker. Centers for Disease Control and Prevention website. https://covid.cdc.gov/covid-data-tracker. Accessed July 1, 2021.Google Scholar
Cohen, J. The line starts to form for a coronavirus vaccine. Science 2020;369:1516.CrossRefGoogle ScholarPubMed
Kambhampati, AK, O’Halloran, AC, Whitaker, M, et al. COVID-19–associated hospitalizations among healthcare personnel—COVID-NET, 13 states, March 1–May 31, 2020. Morb Mortal Wkly Rep 2020;69:15761583.CrossRefGoogle Scholar
Stubblefield, WB, Talbot, HK, Feldstein, L, et al. Seroprevalence of SARS-CoV-2 among frontline healthcare personnel during the first month of caring for COVID-19 patients— Nashville, Tennessee. Clin Infect Dis 2021;72:16451648.CrossRefGoogle ScholarPubMed
Self, WH, Tenforde, MW, Stubblefield, WB, et al. Seroprevalence of SARS-CoV-2 among frontline healthcare personnel in a multistate hospital network—13 academic medical centers, April–June 2020. Morb Mortal Wkly Rep 2020;69:12211226.CrossRefGoogle Scholar
Dooling, K, Marin, M, Wallace, M, et al. The Advisory Committee on Immunization Practices’ updated interim recommendation for allocation of COVID-19 vaccine—United States, December 2020. Morb Mortal Wkly Rep 2021;69:16571660.CrossRefGoogle ScholarPubMed
Baden, LR, El Sahly, HM, Essink, B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Eng J Med 2021;384:403416.CrossRefGoogle Scholar
Polack, FP, Thomas, SJ, Kitchin, N, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 Vaccine. N Engl J Med 2020;383:26032615.CrossRefGoogle ScholarPubMed
Benenson, S, Oster, Y, Cohen, MJ, Nir-Paz, R. BNT162b2 mRNA COVID-19 vaccine effectiveness among healthcare workers. N Engl J Med 2021;384:17751777.CrossRefGoogle Scholar
Keehner, J, Horton, LE, Pfeffer, MA, et al. SARS-CoV-2 infection after vaccination in healthcare workers in California. N Engl J Med 2021;384:17741775.CrossRefGoogle ScholarPubMed
Daniel, W, Nivet, M, Warner, J, Podolsky, DK. Early evidence of the effect of SARS-CoV-2 vaccine at one medical center. N Engl J Med 2021;384:19621963.CrossRefGoogle ScholarPubMed
Angel, Y, Spitzer, A, Henig, O, et al. Association between vaccination with BNT162b2 and incidence of symptomatic and asymptomatic SARS-CoV-2 infections among healthcare workers. JAMA 325:24572465.CrossRefGoogle Scholar
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. The Equator Network website. https://www.equator-network.org/reporting-guidelines/strobe/. Published 2021. Accessed July 20, 2021.Google Scholar
R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2020.Google Scholar
rms: regression modeling strategies. version R package version 6.1-12021. R Project website. https://cran.r-project.org/web/packages/rms/index.html. Accessed July 20, 2021.Google Scholar
Dagan, N, Barda, N, Kepten, E, et al. BNT162b2 mRNA COVID-19 vaccine in a nationwide mass vaccination setting. N Engl J Med 2021;384:14121423.CrossRefGoogle Scholar
Thompson, MG, Burgess, JL, Naleway, AL, et al. Interim estimates of vaccine effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines in preventing SARS-CoV-2 infection among healthcare personnel, first responders, and other essential and frontline workers—eight US locations, December 2020–March 2021. Morb Mortal Wkly Rep 2021;70:495–500.CrossRefGoogle Scholar
Elder, AG, O’Donnell, B, McCruden, EA, Symington, IS, Carman, WF. Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993–1994 epidemic: results of serum testing and questionnaire. BMJ 1996;313:12411242.CrossRefGoogle Scholar
Lietz, J, Westermann, C, Nienhaus, A, Schablon, A. The occupational risk of influenza a (H1N1) infection among healthcare personnel during the 2009 pandemic: a systematic review and meta-analysis of observational studies. PloS One 2016;11:e0162061.CrossRefGoogle ScholarPubMed
Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O’Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in healthcare professionals: a randomized trial. JAMA 1999;281:908913.CrossRefGoogle ScholarPubMed
Imai, C, Toizumi, M, Hall, L, Lambert, S, Halton, K, Merollini, K. A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers. PloS One 2018;13:e0198685.CrossRefGoogle ScholarPubMed
Lobo, RD, Oliveira, MS, Garcia, CP, Caiaffa Filho, HH, Levin, AS. Pandemic 2009 H1N1 influenza among healthcare workers. Am J Infect Control 2013;41:645647.CrossRefGoogle Scholar
Chen, MI, Lee, VJ, Barr, I, et al. Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore. Emerg Infect Dis 2010;16:15541561.CrossRefGoogle ScholarPubMed
CDC seasonal flu vaccine effectiveness studies. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/vaccines-work/effectiveness-studies.htm. Accessed June 24, 2021.Google Scholar
Tenforde, MW, Kondor, RJG, Chung, JR, et al. Effect of antigenic drift on influenza vaccine effectiveness in the United States—2019–2020. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa1884.CrossRefGoogle Scholar
Rosenbaum, L. Escaping catch-22—overcoming COVID vaccine hesitancy. N Engl J Med 2021;384:13671371.CrossRefGoogle ScholarPubMed
Acero, C, Razzaghi, H, Black, CL, Wesley, MG, Jeddy, Z, Lindley, MC. Influenza vaccination coverage among healthcare personnel—United States, 2019–20 influenza season. 2020. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/fluvaxview/hcp-coverage_1920estimates.htm. Accessed June 24, 2021.Google Scholar
Meyer, MN, Gjorgjieva, T, Rosica, D. Trends in healthcare worker intentions to receive a COVID-19 vaccine and reasons for hesitancy. JAMA Netw Open 2021;4:e215344.CrossRefGoogle ScholarPubMed
Kirzinger, A, Kearney, A, Hamel, L, Brodie, M. KFF/The Washington Post frontline healthcare workers survey—vaccine intentions. Kaiser Family Foundation website. https://www.kff.org/report-section/kff-washington-post-frontline-health-care-workers-survey-vaccine-intentions/. Published 2021. Accessed April 19, 2021.Google Scholar

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