Coronavirus Disease 2019 Vaccine Impact on Rates of Severe Acute Respiratory Syndrome Coronavirus 2 Cases and Postvaccination Strain Sequences Among Health Care Workers at an Urban Academic Medical Center: A Prospective Cohort Study
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Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccine trials and post-implementation data suggest that vaccination decreases infections. We examine vaccination’s impact on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case rates and viral diversity among health care workers (HCWs) during a high community prevalence period. Methods: In this prospective cohort study, HCW received 2 doses of BNT162b2 or mRNA-1273. We included confirmed cases among HCWs from 9 December 2020 to 23 February 2021. Weekly SARS-CoV-2 rates per 100,000 person-days and by time from first injection (1–14 and ≥15 days) were compared with surrounding community rates. Viral genomes were sequenced. Results: SARS-CoV-2 cases occurred in 1.4% (96/7109) of HCWs given at least a first dose and 0.3% (17/5913) of HCWs given both vaccine doses. Adjusted rate ratios (95% confidence intervals) were 0.73 (.53–1.00) 1–14 days and 0.18 (.10–.32) ≥15 days from first dose. HCW ≥15 days from initial dose compared to 1-14 days were more often older (46 vs 38 years, P = .007), Latinx (10% vs 8%, P = .03), and asymptomatic (48% vs 11%, P = .0002). SARS-CoV-2 rates among HCWs fell below the surrounding community, an 18% vs 11% weekly decrease, respectively (P = .14). Comparison of 50 genomes from post–first dose cases did not indicate selection pressure toward known spike antibody escape mutations. Conclusions: Our results indicate an early positive impact of vaccines on SARS-CoV-2 case rates. Post-vaccination isolates did not show unusual genetic diversity or selection for mutations of concern.
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- Authors
- Bouton, T. C., Lodi, S., Turcinovic, J., Schaeffer, B., Weber, S. E., Quinn, E., Korn, C., Steiner, J., Schechter-Perkins, E. M., Duffy, E., Ragan, E. J., Taylor, B. P., Miller, N., Davidoff, R., Hanage, W. P., Connor, J., Pierre, C., & Jacobson, K. R.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Boston Medical Center (US)
- Department of Emergency Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
- Corresponding author
- Bouton, Tara C
- ORCID
- Venue
- Open Forum Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-09-17
- Volume
- 8
- Issue
- 10
- Pages
- ofab465-ofab465
- ISSN
- 2328-8957 (ISSN-L)
- PMC
- PMC8500299
- OpenAlex
- W3206421067
- Cited by
- 49
- References
- 25
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 5 · 2022: 22 · 2021: 19 · 2020: 1
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Open Forum Infectious Diseases (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Funders
- National Institutes of Health (T32-DA013911;, 1UL1TR001430)
- Burroughs Wellcome Fund
- American Society for Tropical Medicine and Hygiene Postdoctoral Fellowship in Tropical Infectious Diseases
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- COVID-19 vaccines, SARS-CoV-2, healthcare workers, BNT162b2, mRNA-1273, vaccine effectiveness, breakthrough infection, viral genome sequencing, spike protein mutations, antibody escape mutations, viral genetic diversity, asymptomatic infection, academic medical centers
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