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

Published online by Cambridge University Press:  21 July 2021

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.

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
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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