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, Sara Lodi, Jacquelyn Turcinovic, Beau Schaeffer, Sarah E. Weber, Emily Quinn, Cathy Korn, Jacqueline Steiner, Elissa M. Schechter-Perkins, Elizabeth Duffy, Elizabeth J. Ragan, Bradford P. Taylor, Nancy Miller, Ravin Davidoff, William P. Hanage, John Connor, Cassandra Pierre, Karen R. Jacobson

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

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.

Original languageEnglish (US)
Article numberofab465
JournalOpen Forum Infectious Diseases
Volume8
Issue number10
DOIs
StatePublished - Oct 1 2021
Externally publishedYes

Keywords

  • COVID-19 vaccine
  • Infection control
  • SARS-CoV-2 infections
  • Viral evolution
  • Whole genome sequencing

ASJC Scopus subject areas

  • Oncology
  • Infectious Diseases

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