@article{84de63928e7148d6bb164311970278fa,
title = "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",
abstract = "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 1018 unvaccinated and 3531 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.",
keywords = "SARS-CoV-2, essential worker, vaccine",
author = "Naleway, {Allison L.} and Lauren Grant and Caban-Martinez, {Alberto J.} and Wesley, {Meredith G.} and Burgess, {Jefferey L.} and Kimberly Groover and Manjusha Gaglani and Yoon, {Sarang K.} and Tyner, {Harmony L.} and Jennifer Meece and Kuntz, {Jennifer L.} and Yoo, {Young M.} and Natasha Schaefer-Solle and Olsho, {Lauren E.W.} and Gerald, {Joe K.} and Spencer Rose and Thiese, {Matthew S.} and Jessica Lundgren and Groom, {Holly C.} and Josephine Mak and {Louzado Feliciano}, Paola and Edwards, {Laura J.} and Karen Lutrick and Kayan Dunnigan and Phillips, {Andrew L.} and Lamberte, {Julie Mayo} and Roger Noriega and Sokol, {Brian E.} and Marilyn Odean and Ellingson, {Katherine D.} and Michael Smith and Hegmann, {Kurt T.} and Karley Respet and Monica Dickerson and Alexandra Cruz and Fleary, {Deanna E.} and Kempapura Murthy and Angela Hunt and Eduardo Azziz-Baumgartner and Damena Gallimore-Wilson and Harder, {Jenna A.} and Leah Odame-Bamfo and Jennifer Viergutz and Melissa Arvay and Jones, {John M.} and Peenaz Mistry and Thompson, {Mark G.} and Fowlkes, {Ashley L.}",
note = "Funding Information: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Allison L. Naleway reported institutional funding from Pfizer and Vir Biotechnology for studies unrelated to the submitted work and Jennifer Kuntz receives research funding from Pfizer, Novartis, and Vir Biotechnology for unrelated studies. Matthew S. Thiese reports grants and personal fees from Reed Group and the American College of Occupational and Environmental Medicine, outside the submitted work. No other potential conflicts of interest were disclosed. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Funding Information: This work is supported by US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases Grants 75D30120C08150 and 75D30120C08379. The following are acknowledged: Danielle R. Hunt, Laura J. Edwards, Meghan K. Herring, Tyler C. Morrill, Brandon P. Poe, John Thacker, Tana Brummer, James Carr, Hala Deeb, Sauma Doka, Claire Douglas, Kate Durocher, Tara Earl, Jini Nwando Etolue, Isaiah Gerber, Louise S. Hadden, Ed Hock, Keya Jacoby, Ryan Klein, Lindsay B. LeClair, Nancy McGarry, Kelly Patlan, Steve Pickett, Khaila Prather, Rajbansi Raorane, Alfredo Rodriguez‐Nogues, Meghan Shea, Chao Zhou, Tnelda Zunie, Nicole Calhoun, Eric Hoffman, Martha Zayed, Joel Blais, Jason Ettlinger, Angela Kennedy, Jacob Sartor, Natalie Settele, Rupande Patel, Elisa Priest, Jennifer Thomas, Muralidhar Jatla, Madhava Beeram, Michael Mack, Alejandro Arroliga, Gregory Joseph, Preeta Kutty, Alicia M. Fry, Aron Hall, Adam MacNeil, Cria Perrine, L. Clifford McDonald, Vic Veguilla, Stephanie Bialek, Yolanda Prado, Daniel Sapp, Mi Lee, Chris Eddy, Matt Hornbrook, Donna Eubanks, Danielle Millay, Dorothy Kurdyla, Kristin Bialobok, Ambrosia Bass, Kristi Bays, Kimberly Berame, Cathleen Bourdoin, Carlea Buslach, Stephen Fortmann, Jennifer Gluth, Kenni Graham, Tarika Holness, Kelley Jewell, Enedina Luis, Abreeanah Magdaleno, DeShaun Martin, Joyce Smith‐McGee, Martha Perley, Sam Peterson, Aaron Piepert, Krystil Phillips, Joanna Price, Sperry Robinson, Katrina Schell, Emily Schield, Natosha Shirley, Anna Shivinsky, Britta Torgrimson‐Ojerio, Brooke Wainwright, Shawn Westaway, Adam Bissonnette, Elisha Stefanski, Samantha Kendrick, Daniel Stafki, Jill Dolezilek, Catherine Diluzio Mary Robinson, Leiah Hoffman, Kelley Philips, Zoe Baccam, Drew Baldwin, Genesis Barron, Ed Bedrick, Maiya Ngaybe Block, Dimaye Calvo, Esteban Cardona, Adam Carl, Andrea Carmona, Alissa Coleman, Emily Cooksey, David Dawley, Carly Deal, Stacy Delgado, Kiara Earley, Lynn Gerald, Natalie Giroux, Anna Giudici, Sofia Grijalva, Allan Guidos, Hanna Hanson, Adrianna Hernandez, James Hollister, Theresa Hopkins, Rezwana Islam, Gabriella Jimenez, Krystal Jovel, Sana Kahn, Olivia Kavanagh, Karl Krupp, Karla Ledezma, Sally Littau, Amelia Lobos, James Lopez, Veronica Lugo, Purnima Madhivanan, Jeremy Makar, Taylor Maldonado, Enrique Marquez, Christina Mortensen, Allyson Munoz, Flavia Nakayima Miiro, Sandra Norman, Assumpta Nsengiyunva, Kennedy Obrien, Jonathan Perez Leyva, Celia Pikowski, Cynthia Porter, Patrick Rivers, James Romine, Alexa Roy, Jennifer Scott, Priyanka Sharma, Alison Slocum, Saskia Smidt, Gianna Taylor, Isabella Terrazas, Tahlia Thompson, Heena Timisina, Italia Trejo, Jennifer Uhrlaub, Erica Vanover, Mandie White, April Yingst, Carlos Silvera, Cynthia Beaver, Rachel Reyes, Christian Rojas, Catalina Gonzalez, Testoff, Alex Stewart, Kemi Ogunsina, Aimee Green, Johanna Garibaldi, Nathaly Suarez, Olga Carrera, Hannah Kling, Aimee Green, Johanna Garibaldi, Matthew Bruner, Rachel Brown, Jenna Praggastis, Marcus Stucki, Arlyne Arteaga, Riley Campbell, Madeleine Smith, Adriele Fugal, Maya Wheeler, Gretchen Maughan, Allana Soriano, Nikki Gallacher, Anika Dsouza, Lauren Anderson, Jenna Vo, Iman Ibrahim, Tristen Forbes, Taryn Hunt‐Smith, Ryder Jordin, Michael Langston, Timina Powaukee, Daniel Dawson, Kathy Tran, Fiona Tsang, Hannah Whiting, Brock Bourelle, Emilee Eden, Braydon Black, Madison Tallman, Chapman Cox, Derrick Wong, Camie Schaefer, Jeanmarie Mayer, Joseph Stanford, Abt Associates, Inc.; Baylor Scott & White Health; CDC; Kaiser Permanente Northwest; Marshfield Clinic Research Institute; St. Luke's Regional Health Care System; University of Arizona; University of Miami; University of Utah. Publisher Copyright: {\textcopyright} 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.",
year = "2022",
month = may,
doi = "10.1111/irv.12956",
language = "English (US)",
volume = "16",
pages = "585--593",
journal = "Influenza and other Respiratory Viruses",
issn = "1750-2640",
publisher = "Wiley-Blackwell",
number = "3",
}