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Association of mRNA Vaccination With Clinical and Virologic Features of COVID-19 Among US Essential and Frontline Workers.
Thompson, Mark G; Yoon, Sarang K; Naleway, Allison L; Meece, Jennifer; Fabrizio, Thomas P; Caban-Martinez, Alberto J; Burgess, Jefferey L; Gaglani, Manjusha; Olsho, Lauren E W; Bateman, Allen; Lundgren, Jessica; Grant, Lauren; Phillips, Andrew L; Groom, Holly C; Stefanski, Elisha; Solle, Natasha Schaefer; Ellingson, Katherine; Lutrick, Karen; Dunnigan, Kayan; Wesley, Meredith G; Guenther, Kyley; Hunt, Angela; Mak, Josephine; Hegmann, Kurt T; Kuntz, Jennifer L; Bissonnette, Adam; Hollister, James; Rose, Spencer; Morrill, Tyler C; Respet, Karley; Fowlkes, Ashley L; Thiese, Matthew S; Rivers, Patrick; Herring, Meghan K; Odean, Marilyn J; Yoo, Young M; Brunner, Matthew; Bedrick, Edward J; Fleary, Deanna E; Jones, John T; Praggastis, Jenna; Romine, James; Dickerson, Monica; Khan, Sana M; Lamberte, Julie Mayo; Beitel, Shawn; Webby, Richard J; Tyner, Harmony L.
  • Thompson MG; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Yoon SK; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Naleway AL; Kaiser Permanente Northwest Center for Health Research, Portland, Oregon.
  • Meece J; Marshfield Clinic Research Institute, Marshfield, Wisconsin.
  • Fabrizio TP; St Jude Children's Research Hospital, Memphis, Tennessee.
  • Caban-Martinez AJ; Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
  • Burgess JL; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Gaglani M; Baylor Scott and White Health, Temple, Texas.
  • Olsho LEW; Texas A&M University College of Medicine, Temple.
  • Bateman A; Abt Associates Inc, Rockville, Maryland.
  • Lundgren J; Wisconsin State Laboratory of Hygiene, Madison.
  • Grant L; St Luke's Regional Health Care System, Duluth, Minnesota.
  • Phillips AL; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Groom HC; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Stefanski E; Kaiser Permanente Northwest Center for Health Research, Portland, Oregon.
  • Solle NS; Marshfield Clinic Research Institute, Marshfield, Wisconsin.
  • Ellingson K; Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
  • Lutrick K; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Dunnigan K; College of Medicine - Tucson, University of Arizona, Tucson.
  • Wesley MG; Baylor Scott and White Health, Temple, Texas.
  • Guenther K; Abt Associates Inc, Rockville, Maryland.
  • Hunt A; Wisconsin State Laboratory of Hygiene, Madison.
  • Mak J; St Luke's Regional Health Care System, Duluth, Minnesota.
  • Hegmann KT; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Kuntz JL; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Bissonnette A; Kaiser Permanente Northwest Center for Health Research, Portland, Oregon.
  • Hollister J; Marshfield Clinic Research Institute, Marshfield, Wisconsin.
  • Rose S; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Morrill TC; Baylor Scott and White Health, Temple, Texas.
  • Respet K; Abt Associates Inc, Rockville, Maryland.
  • Fowlkes AL; St Luke's Regional Health Care System, Duluth, Minnesota.
  • Thiese MS; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Rivers P; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Herring MK; College of Medicine - Tucson, University of Arizona, Tucson.
  • Odean MJ; Abt Associates Inc, Rockville, Maryland.
  • Yoo YM; Whiteside Institute for Clinical Research, St Luke's, Duluth, Minnesota.
  • Brunner M; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Bedrick EJ; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Fleary DE; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Jones JT; Abt Associates Inc, Rockville, Maryland.
  • Praggastis J; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Romine J; Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah.
  • Dickerson M; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Khan SM; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Lamberte JM; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Beitel S; Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.
  • Webby RJ; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
  • Tyner HL; St Jude Children's Research Hospital, Memphis, Tennessee.
JAMA ; 328(15): 1523-1533, 2022 10 18.
Article in English | MEDLINE | ID: covidwho-2074838
ABSTRACT
Importance Data on the epidemiology of mild to moderately severe COVID-19 are needed to inform public health guidance.

Objective:

To evaluate associations between 2 or 3 doses of mRNA COVID-19 vaccine and attenuation of symptoms and viral RNA load across SARS-CoV-2 viral lineages. Design, Setting, and

Participants:

A prospective cohort study of essential and frontline workers in Arizona, Florida, Minnesota, Oregon, Texas, and Utah with COVID-19 infection confirmed by reverse transcriptase-polymerase chain reaction testing and lineage classified by whole genome sequencing of specimens self-collected weekly and at COVID-19 illness symptom onset. This analysis was conducted among 1199 participants with SARS-CoV-2 from December 14, 2020, to April 19, 2022, with follow-up until May 9, 2022, reported. Exposures SARS-CoV-2 lineage (origin strain, Delta variant, Omicron variant) and COVID-19 vaccination status. Main Outcomes and

Measures:

Clinical outcomes included presence of symptoms, specific symptoms (including fever or chills), illness duration, and medical care seeking. Virologic outcomes included viral load by quantitative reverse transcriptase-polymerase chain reaction testing along with viral viability.

Results:

Among 1199 participants with COVID-19 infection (714 [59.5%] women; median age, 41 years), 14.0% were infected with the origin strain, 24.0% with the Delta variant, and 62.0% with the Omicron variant. 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). Among those with Omicron infection, the risk of symptomatic infection did not differ significantly for the 2-dose vaccination status vs unvaccinated status and was significantly higher for the 3-dose recipients vs those who were unvaccinated (327/370 [88.4%] vs 85/107 [79.4%]; OR, 2.0 [95% CI, 1.1-3.5]). 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). Conclusions and Relevance In a cohort of US essential and frontline workers with SARS-CoV-2 infections, recent vaccination with 2 or 3 mRNA vaccine doses less than 150 days before infection with Delta or Omicron variants, compared with being unvaccinated, was associated with attenuated symptoms, duration of illness, medical care seeking, or viral load for some comparisons, although the precision and statistical significance of specific estimates varied.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccination / Viral Load / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Year: 2022 Document Type: Article Affiliation country: Jama.2022.18550

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccination / Viral Load / COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines / Variants Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Year: 2022 Document Type: Article Affiliation country: Jama.2022.18550