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Symptom monitoring after coronavirus disease 2019 (COVID-19) vaccination in a large integrated healthcare system: Separating symptoms from severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection

Published online by Cambridge University Press:  02 November 2021

Erica S. Shenoy*
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Paige G. Wickner
Affiliation:
Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
Lauren R. West
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Aleena Banerji
Affiliation:
Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Kimberly G. Blumenthal
Affiliation:
Harvard Medical School, Boston, Massachusetts Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
Amanda J. Centi
Affiliation:
Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts
Andrew Gottlieb
Affiliation:
Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Dean M. Hashimoto
Affiliation:
Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Esther Kim
Affiliation:
Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts
Marvel Kim
Affiliation:
Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Hang Lee
Affiliation:
Harvard Medical School, Boston, Massachusetts Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
Lynn A. Simpson
Affiliation:
Research Information Science and Computing, Massachusetts General Brigham, Boston, Massachusetts
Adam B. Landman
Affiliation:
Harvard Medical School, Boston, Massachusetts Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts Department of Emergency Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
*
Author for correspondence: Erica S. Shenoy, E-mail: eshenoy@mgh.harvard.edu

Abstract

Objective:

To describe the incidence of systemic overlap and typical coronavirus disease 2019 (COVID-19) symptoms in healthcare personnel (HCP) following COVID-19 vaccination and association of reported symptoms with diagnosis of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in the context of public health recommendations regarding work exclusion.

Design:

This prospective cohort study was conducted between December 16, 2020, and March 14, 2021, with HCP who had received at least 1 dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine.

Setting:

Large healthcare system in New England.

Interventions:

HCP were prompted to complete a symptom survey for 3 days after each vaccination. Reported symptoms generated automated guidance regarding symptom management, SARS-CoV-2 testing requirements, and work restrictions. Overlap symptoms (ie, fever, fatigue, myalgias, arthralgias, or headache) were categorized as either lower or higher severity. Typical COVID-19 symptoms included sore throat, cough, nasal congestion or rhinorrhea, shortness of breath, ageusia and anosmia.

Results:

Among 64,187 HCP, a postvaccination electronic survey had response rates of 83% after dose 1 and 77% after dose 2. Report of ≥3 lower-severity overlap symptoms, ≥1 higher-severity overlap symptoms, or at least 1 typical COVID-19 symptom after dose 1 was associated with increased likelihood of testing positive. HCP with prior COVID-19 infection were significantly more likely to report severe overlap symptoms after dose 1.

Conclusions:

Reported overlap symptoms were common; however, only report of ≥3 low-severity overlap symptoms, at least 1 higher-severity overlap symptom, or any typical COVID-19 symptom were associated with infection. Work-related restrictions for overlap symptoms should be reconsidered.

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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Footnotes

a

Authors of equal contribution.

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