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Real-world impact of vaccination on coronavirus disease 2019 (COVID-19) incidence in healthcare personnel at an academic medical center

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  21 July 2021

Sarah E. Waldman Open the ORCID record for Sarah E. Waldman [Opens in a new window] ,
Jason Y. Adams ,
Timothy E. Albertson ,
Maya M. Juárez ,
Sharon L. Myers ,
Ashish Atreja ,
Sumeet Batra ,
Elena E. Foster ,
Cy V. Huynh  and
Anna Y. Liu
...Show all authors
Sarah E. Waldman*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Jason Y. Adams
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Timothy E. Albertson
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Maya M. Juárez
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Sharon L. Myers
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Ashish Atreja
Affiliation:
Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Sumeet Batra
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Elena E. Foster
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Cy V. Huynh
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
Anna Y. Liu
Affiliation:
Data Center of Excellence, Innovation Technology Division, University of California-Davis, UC Davis Health, Sacramento, California
David A. Lubarsky
Affiliation:
Human Health Sciences and Chief Executive Office, University of California-Davis, UC Davis Health, Sacramento, California
Victoria T. Ngo
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Christian E. Sandrock
Affiliation:
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
Sandra L. Taylor
Affiliation:
Division of Biostatistics, Department of Public Health Sciences, University of California-Davis, UC Davis Health, Sacramento, California
Ann M. Tompkins
Affiliation:
Employee Health Services, University of California-Davis, UC Davis Health, Sacramento, California
Stuart H. Cohen
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of California-Davis, School of Medicine, Sacramento, California
*
Author for correspondence: Sarah Waldman, E-mail: sewaldman@ucdavis.edu.
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Abstract

Objective:

Coronavirus disease 2019 (COVID-19) vaccination effectiveness in healthcare personnel (HCP) has been established. However, questions remain regarding its performance in high-risk healthcare occupations and work locations. We describe the effect of a COVID-19 HCP vaccination campaign on SARS-CoV-2 infection by timing of vaccination, job type, and work location.

Methods:

We conducted a retrospective review of COVID-19 vaccination acceptance, incidence of postvaccination COVID-19, hospitalization, and mortality among 16,156 faculty, students, and staff at a large academic medical center. Data were collected 8 weeks prior to the start of phase 1a vaccination of frontline employees and ended 11 weeks after campaign onset.

Results:

The COVID-19 incidence rate among HCP at our institution decreased from 3.2% during the 8 weeks prior to the start of vaccinations to 0.38% by 4 weeks after campaign initiation. COVID-19 risk was reduced among individuals who received a single vaccination (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.40–0.68; P < .0001) and was further reduced with 2 doses of vaccine (HR, 0.17; 95% CI, 0.09–0.32; P < .0001). By 2 weeks after the second dose, the observed case positivity rate was 0.04%. Among phase 1a HCP, we observed a lower risk of COVID-19 among physicians and a trend toward higher risk for respiratory therapists independent of vaccination status. Rates of infection were similar in a subgroup of nurses when examined by work location.

Conclusions:

Our findings show the real-world effectiveness of COVID-19 vaccination in HCP. Despite these encouraging results, unvaccinated HCP remain at an elevated risk of infection, highlighting the need for targeted outreach to combat vaccine hesitancy.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1194 - 1200
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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