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COVID-19 in Vaccinated U.S. Essential and Frontline Workers

The severity and duration of COVID-19 symptoms in essential and frontline U.S. workers were reduced when they recently had an mRNA vaccination, according to findings from the HEROES-RECOVER Network. Compared with being unvaccinated, vaccinated workers had attenuated symptoms, shorter duration of illness, less medical care seeking, or lower viral load for some comparisons.

The prospective cohort study included 1,199 workers from Arizona, Florida, Minnesota, Oregon, Texas, and Utah during a period of delta and omicron spread ( Dec. 14, 2020, to Apr. 19, 2022). Results showed that “participants vaccinated with the second vaccine dose 14 to 149 days before Delta infection were significantly less likely to be symptomatic compared with unvaccinated participants (21/27 [77.8%] vs 74/77 [96.1%]; OR, 0.13 [95% CI, 0-0.6]) and, when symptomatic, those vaccinated with the third dose 7 to 149 days before infection were significantly less likely to report fever or chills (5/13 [38.5%] vs 62/73 [84.9%]; OR, 0.07 [95% CI, 0.0-0.3]) and reported significantly fewer days of symptoms (10.2 vs 16.4; difference, −6.1 [95% CI, −11.8 to −0.4] days).…”

Symptomatic infections were not reduced by the 2-dose vaccination in comparison with unvaccinated status but were significantly lower among those with 3 doses. The authors report: “Among symptomatic Omicron infections, those vaccinated with the third dose 7 to 149 days before infection compared with those who were unvaccinated were significantly less likely to report fever or chills (160/311 [51.5%] vs 64/81 [79.0%]; OR, 0.25 [95% CI, 0.1-0.5]) or seek medical care (45/308 [14.6%] vs 20/81 [24.7%]; OR, 0.45 [95% CI, 0.2-0.9]). Participants with Delta and Omicron infections who received the second dose 14 to 149 days before infection had a significantly lower mean viral load compared with unvaccinated participants (3 vs 4.1 log10 copies/μL; difference, −1.0 [95% CI, −1.7 to −0.2] for Delta and 2.8 vs 3.5 log10 copies/μL, difference, −1.0 [95% CI, −1.7 to −0.3] for Omicron).”

Source: JAMA