Incidence of SARS‐CoV‐2 infection among COVID‐19 vaccinated and unvaccinated healthcare personnel, first responders, and other essential and frontline workers: Eight US locations, January–September 2021

COVID-19 symptoms and SARS-CoV-2 antibody positivity in a large survey of first responders and healthcare personnel, May-July 2020

Clinical Infectious Diseases ◽

10.1093/cid/ciab080 ◽

2021 ◽

Author(s):

Lara J Akinbami ◽

Lyle R Petersen ◽

Samira Sami ◽

Nga Vuong ◽

Susan L Lukacs ◽

...

Keyword(s):

First Responders ◽

Healthcare Personnel ◽

First Responder ◽

Antibody Positivity ◽

Large Survey

Abstract A SARS-CoV-2 serosurvey among first responder/healthcare personnel showed that loss of taste/smell was most predictive of seropositivity; percent seropositivity increased with number of COVID-19 symptoms. However, 22.9% with nine symptoms were seronegative, and 8.3% with no symptoms were seropositive. These findings demonstrate limitations of symptom-based surveillance and importance of testing.

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Prevention and Attenuation of COVID-19 by BNT162b2 and mRNA-1273 Vaccines

10.1101/2021.06.01.21257987 ◽

2021 ◽

Author(s):

Mark G Thompson ◽

Jefferey L Burgess ◽

Allison Naleway ◽

Harmony Tyner ◽

Sarang K Yoon ◽

...

Keyword(s):

Real World ◽

Messenger Rna ◽

Viral Rna ◽

Background Information ◽

Healthcare Personnel ◽

Post Dose ◽

Frontline Workers ◽

Nasal Swabs ◽

Working Age ◽

Prospective Cohorts

ABSTRACT BACKGROUND: Information is limited on messenger RNA (mRNA) BNT162b2 (Pfizer–BioNTech) and mRNA–1273 (Moderna) COVID–19 vaccine effectiveness (VE) in preventing SARS–CoV–2 infection or attenuating disease when administered in real–world conditions. METHODS: Prospective cohorts of 3,975 healthcare personnel, first responders, and other essential and frontline workers completed weekly SARS–CoV–2 testing during December 14 2020—April 10 2021. Self–collected mid–turbinate nasal swabs were tested by qualitative and quantitative reverse–transcription—polymerase–chain–reaction (RT–PCR). VE was calculated as 100%× (1−hazard ratio); adjusted VE was calculated using vaccination propensity weights and adjustments for site, occupation, and local virus circulation . RESULTS: SARS–CoV–2 was detected in 204 (5.1%) participants; 16 were partially (≥14 days post–dose–1 to 13 days after dose–2) or fully (≥14 days post–dose–2) vaccinated, and 156 were unvaccinated; 32 with indeterminate status (<14 days after dose–1) were excluded. Adjusted mRNA VE of full vaccination was 91% (95% confidence interval [CI]=76%—97%) against symptomatic or asymptomatic SARS–CoV–2 infection; VE of partial vaccination was 81% (95% CI=64%–90%). Among partially or fully vaccinated participants with SARS–CoV–2 infection, mean viral RNA load (Log10 copies/mL) was 40% lower (95% CI=16%–57%), the risk of self–reported febrile COVID–19 was 58% lower (Risk Ratio=0.42, 95% CI=0.18–0.98), and 2.3 fewer days (95% CI=0.8–3.7) were spent sick in bed compared to unvaccinated infected participants. CONCLUSIONS: Authorized mRNA vaccines were highly effective among working–age adults in preventing SARS–CoV–2 infections when administered in real–world conditions and attenuated viral RNA load, febrile symptoms, and illness duration among those with breakthrough infection despite vaccination.

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Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm7013e3 ◽

2021 ◽

Vol 70 (13) ◽

pp. 495-500 ◽

Cited By ~ 11

Author(s):

Mark G. Thompson ◽

Jefferey L. Burgess ◽

Allison L. Naleway ◽

Harmony L. Tyner ◽

Sarang K. Yoon ◽

...

Keyword(s):

Health Care ◽

First Responders ◽

Vaccine Effectiveness ◽

Health Care Personnel ◽

Frontline Workers

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Incidence of SARS-CoV-2 Infection among COVID-19 Vaccinated and Unvaccinated Healthcare Personnel, First Responders, and other Essential and Frontline Workers--- Eight U.S. Locations, January--September 2021

10.22541/au.163840666.67180024/v1 ◽

2021 ◽

Author(s):

Allison Naleway ◽

Lauren Grant ◽

Alberto Caban-Martinez ◽

Meredith Wesley ◽

Jefferey Burgess ◽

...

Keyword(s):

High Risk ◽

Lower Risk ◽

Infection Risk ◽

Healthcare Personnel ◽

Risk Of Infection ◽

Frontline Workers ◽

Nasal Swabs ◽

Frontline Worker ◽

The Impact ◽

Monthly Incidence

Background. We sought to evaluate the impact of changes in estimates of COVID-19 vaccine effectiveness on the incidence of laboratory-confirmed infection among frontline workers at high risk for SARS-CoV-2. Methods. We analyzed data from a prospective frontline worker cohort to estimate the incidence of COVID-19 by month as well as the association of COVID-19 vaccination, occupation, demographics, physical distancing and mask use with infection risk. Participants completed baseline and quarterly surveys, and each week self-collected mid-turbinate nasal swabs and reported symptoms. Results. Among 1,018 unvaccinated and 3,531 fully vaccinated workers, the monthly incidence of laboratory-confirmed SARS-CoV-2 infection in January 2021 was 13.9 (95% confidence interval [CI]: 10.4-17.4), declining to 0.5 (95% CI -0.4-1.4) per 1000 person-weeks in June. By September 2021, when the Delta variant predominated, incidence had once again risen to 13.6 (95% CI 7.8-19.4) per 1000 person-weeks. In contrast, there was no reportable incidence among fully vaccinated participants at the end of January 2021, and incidence remained low until September 2021 when it rose modestly to 4.1 (95% CI 1.9-3.8) per 1000. Below average facemask use was associated with a higher risk of infection for unvaccinated participants during exposure to persons who may have COVID-19, and vaccinated participants during hours in the community. Conclusions. COVID-19 vaccination was significantly associated with a lower risk of SARS-CoV-2 infection despite Delta variant predominance. Our data demonstrate the added protective benefit of facemask use among both unvaccinated and vaccinated frontline workers.

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High Burden of COVID-19 among Unvaccinated Law Enforcement Officers and Firefighters

10.1101/2021.11.24.21266396 ◽

2021 ◽

Author(s):

Alberto J. Caban-Martinez ◽

Manjusha Gaglani ◽

Lauren E.W. Olsho ◽

Lauren Grant ◽

Natasha Schaefer-Solle ◽

...

Keyword(s):

Law Enforcement ◽

Local Governments ◽

Health And Safety ◽

First Responders ◽

Law Enforcement Officers ◽

Vaccine Uptake ◽

Healthcare Personnel ◽

Increased Risk ◽

State And Local ◽

Using Data

Law Enforcement Officers (LEOs), firefighters, and other first responders are at increased risk of SARS-CoV-2 infection compared to healthcare personnel but have relatively low COVID-19 vaccine uptake. Resistance to COVID-19 vaccine mandates among first responders has the potential to disrupt essential public services and threaten public health and safety. Using data from the HEROES-RECOVER prospective cohorts, we report on the increased illness burden of COVID-19 among unvaccinated first responders. From January to September 2021, first responders contributed to weekly active surveillance for COVID-19-like illness (CLI). Self-collected respiratory specimens collected weekly, irrespective of symptoms, and at the onset CLI were tested by Reverse Transcription Polymerase Chain Reaction (RT-PCR) assay for SARS-CoV-2. Among 1415 first responders, 17% were LEOs, 68% firefighters, and 15% had other first responder occupations. Unvaccinated (41%) compared to fully vaccinated (59%) first responders were less likely to believe COVID-19 vaccines are very or extremely effective (17% versus 54%) or very or extremely safe (15% versus 54%). From January through September 2021, among unvaccinated LEOs, the incidence of COVID-19 was 11.9 per 1,000 person-weeks (95%CI=7.0-20.1) compared to only 0.6 (95%CI=0.2-2.5) among vaccinated LEOs. Incidence of COVID-19 was also higher among unvaccinated firefighters (9.0 per 1,000 person-weeks; 95%CI=6.4-12.7) compared to those vaccinated (1.8 per 1,000; 95%CI=1.1-2.8). Once they had laboratory-confirmed COVID-19, unvaccinated first responders were sick for a mean+/-SD of 14.7+/-21.7 days and missed a mean of 38.0+/-46.0 hours of work. These findings suggest that state and local governments with large numbers of unvaccinated first responders may face major disruptions in their workforce due to COVID-19 illness.

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The Effect of Ultraviolet C Radiation Against SARS-CoV-2 Inoculated N95 Respirators

10.1101/2020.05.31.20118588 ◽

2020 ◽

Cited By ~ 4

Author(s):

David M. Ozog ◽

Jonathan Z. Sexton ◽

Shanthi Narla ◽

Carla D. Pretto-Kernahan ◽

Carmen Mirabelli ◽

...

Keyword(s):

Healthcare Personnel ◽

Dependent Manner ◽

Infectious Dose ◽

Frontline Workers ◽

Viral Stock ◽

Fit Testing ◽

Ultraviolet C ◽

N95 Respirators ◽

Dose Dependent ◽

Uvc Radiation

AbstractSince March 31st, 2020, during the height of the pandemic, we have decontaminated thousands of 3M 1860 respirators with Ultraviolet C (UVC) for our frontline workers. There is no published peer-reviewed data regarding the dose required to effectively disinfect SARS-CoV-2 on N95 filtering facepiece respirators (FFRs). Four different locations (facepiece and strap) on 5 different N95 FFR models (3M 1860, 8210, 8511, 9211; Moldex 1511) were inoculated with a 10 μL drop of SARS-CoV-2 viral stock (8 × 107 TCID50/mL). The outside-facing and wearer-facing surfaces of the respirators were each irradiated with a dose of 1.5 J/cm2 UVC (254 nm).Viable SARS-CoV-2 was quantified by a median tissue culture infectious dose assay (TCID50). UVC delivered using a dose of 1.5 J/cm2, to each side, was an effective method of decontamination for the facepieces of 3M 1860 and Moldex 1511, and for the straps of 3M 8210 and the Moldex 1511. This dose is an appropriate decontamination method to facilitate reuse of respirators for healthcare personnel when applied to certain models/materials. Increasing the dose may improve decontamination for the other models and straps; however, UVC radiation can degrade certain polymers in a dose dependent manner, and the effects may vary greatly between different models. Therefore, fit-testing of UVC decontaminated respirators must be performed each time a new model and/or dose is introduced into the healthcare system.

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