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\begin{document}

\title{Incidence of SARS-CoV-2 Infection among COVID-19 Vaccinated and
Unvaccinated Healthcare Personnel, First Responders, and other Essential
and Frontline Workers--- Eight U.S. Locations, January--September 2021}



\author[1]{Allison Naleway}%
\author[2]{Lauren Grant}%
\author[3]{Alberto Caban-Martinez}%
\author[4]{Meredith Wesley}%
\author[5]{Jefferey Burgess}%
\author[6]{Kimberly Groover}%
\author[7]{Manjusha Gaglani}%
\author[8]{Sarang Yoon}%
\author[9]{Harmony Tyner}%
\author[10]{Jennifer Meece}%
\author[1]{Jennifer Kuntz}%
\author[2]{Young Yoo}%
\author[3]{Natasha Schaefer-Solle}%
\author[11]{Lauren  Olsho}%
\author[12]{Joe Gerald}%
\author[13]{Spencer Rose}%
\author[8]{Matthew Thiese}%
\author[9]{ Jessica Lundgren}%
\author[1]{Holly Groom}%
\author[2]{Josephine Mak}%
\author[3]{Paola Feliciano}%
\author[6]{Laura Edwards}%
\author[12]{Karen Lutrick}%
\author[13]{Kayan Dunnigan}%
\author[8]{Andrew Phillips}%
\author[14]{Marilyn Odean}%
\author[12]{Katherine Ellingson}%
\author[9]{Karley Respet}%
\author[2]{Mark Thompson}%
\author[2]{Ashley Fowlkes}%
\affil[1]{Kaiser Permanente Center for Health Research Northwest Region}%
\affil[2]{Centers for Disease Control and Prevention}%
\affil[3]{University of Miami Miller School of Medicine}%
\affil[4]{CDC}%
\affil[5]{University of Arizona Medical Center - University Campus}%
\affil[6]{ABT Associates Inc}%
\affil[7]{Baylor Scott \& White Health, Texas A\&M HSC COM}%
\affil[8]{University of Utah Health}%
\affil[9]{St. Luke’s Regional Health Care System}%
\affil[10]{Marshfield Clinic Research Institute}%
\affil[11]{Abt Associates, Inc.}%
\affil[12]{The University of Arizona Mel and Enid Zuckerman College of Public Health}%
\affil[13]{Baylor Scott \& White Health}%
\affil[14]{Whiteside Institute for Clinical Research, St. Luke's}%


\vspace{-1em}



  
  \date{May 26, 2024}


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\begin{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 1,018 unvaccinated and 3,531
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.%
\end{abstract}%



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\verb`Naleway_Incidence_VaccineEra_IORV_112421.docx`  available at \url{https://authorea.com/users/449050/articles/547695-incidence-of-sars-cov-2-infection-among-covid-19-vaccinated-and-unvaccinated-healthcare-personnel-first-responders-and-other-essential-and-frontline-workers-eight-u-s-locations-january-september-2021}\selectlanguage{english}
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