tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 Sep 17;8(10)
fab465.
doi: 10.1093/ofid/ofab465. eCollection 2021 Oct.
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
Tara C Bouton[SUP] 1 [/SUP], Sara Lodi[SUP] 2 [/SUP], Jacquelyn Turcinovic[SUP] 3 [/SUP], Beau Schaeffer[SUP] 4 [/SUP], Sarah E Weber[SUP] 1 [/SUP], Emily Quinn[SUP] 5 [/SUP], Cathy Korn[SUP] 6 [/SUP], Jacqueline Steiner[SUP] 6 [/SUP], Elissa M Schechter-Perkins[SUP] 7 [/SUP], Elizabeth Duffy[SUP] 8 [/SUP], Elizabeth J Ragan[SUP] 1 [/SUP], Bradford P Taylor[SUP] 4 [/SUP], Nancy Miller[SUP] 8 [/SUP], Ravin Davidoff[SUP] 9 [/SUP], William P Hanage[SUP] 4 [/SUP], John Connor[SUP] 3 10 [/SUP], Cassandra Pierre[SUP] 1 6 [/SUP], Karen R Jacobson[SUP] 1 [/SUP]
Affiliations
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.
Keywords: COVID-19 vaccine; SARS-CoV-2 infections; infection control; viral evolution; whole genome sequencing.
. 2021 Sep 17;8(10)
fab465.doi: 10.1093/ofid/ofab465. eCollection 2021 Oct.
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
Tara C Bouton[SUP] 1 [/SUP], Sara Lodi[SUP] 2 [/SUP], Jacquelyn Turcinovic[SUP] 3 [/SUP], Beau Schaeffer[SUP] 4 [/SUP], Sarah E Weber[SUP] 1 [/SUP], Emily Quinn[SUP] 5 [/SUP], Cathy Korn[SUP] 6 [/SUP], Jacqueline Steiner[SUP] 6 [/SUP], Elissa M Schechter-Perkins[SUP] 7 [/SUP], Elizabeth Duffy[SUP] 8 [/SUP], Elizabeth J Ragan[SUP] 1 [/SUP], Bradford P Taylor[SUP] 4 [/SUP], Nancy Miller[SUP] 8 [/SUP], Ravin Davidoff[SUP] 9 [/SUP], William P Hanage[SUP] 4 [/SUP], John Connor[SUP] 3 10 [/SUP], Cassandra Pierre[SUP] 1 6 [/SUP], Karen R Jacobson[SUP] 1 [/SUP]
Affiliations
- PMID: 34646910
- PMCID: PMC8500299
- DOI: 10.1093/ofid/ofab465
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.
Keywords: COVID-19 vaccine; SARS-CoV-2 infections; infection control; viral evolution; whole genome sequencing.