Swift, Melanie

Objective: To evaluate the effectiveness of a standardized hazardous medication surveillance program and identify occupational factors associated with adverse health outcomes among healthcare workers (HCWs). Methods: We analyzed data from 2,625 HCWs enrolled in a multi-site surveillance program (2020–2022). Participants completed a standardized questionnaire and underwent complete blood count testing. Exposure was categorized by weekly time handling hazardous medications. Associations were evaluated using univariate and multivariable analyses. Results: Higher exposure (>8 hours/week) was associated with increased symptom reporting, hazardous medication spills, and adverse reproductive outcomes. Female sex, older age, and spill exposure independently predicted symptom reporting and reproductive outcomes. No significant association was observed between exposure intensity and abnormal blood counts. Conclusion: Questionnaire-based surveillance effectively identified exposure-related health risks, whereas routine complete blood count testing showed limited utility.

The objective of this observational study is to determine whether vaccination for SARS-CoV-2 alters the clinical presentation of post-COVID conditions (PCC). Self-reported data provided by patients requesting care for PCC at the Mayo Clinic were analyzed to assess for a relationship between vaccination status prior to COVID infection and PCC symptoms. In all, 477 subjects were included in this study. In total, 245 (51.4%) were vaccinated. Vaccinated subjects with PCC reported less abdominal pain, anosmia, parosmia, chest pain/tightness, dizziness, numbness/tingling, dyspnea, spells/tremors, and weakness. For hospitalized patients who developed PCC, vaccinated patients reported less chest pain, cough, dizziness, and dyspnea. After applying Bonferroni correction for multiple comparisons, decreased abdominal pain remained significant. We conclude that vaccination against SARS-CoV-2 may reduce the symptoms of PCC, leading to improved morbidity and function. Further studies on the impact of vaccination on PCC and recovery are needed.

Abstract As of 2021 November 29, booster vaccination against SARS-CoV-2 infection has been recommended for all individuals aged 18 years and older in the United States. A key reason for this recommendation is the expectation that a booster vaccine dose can alleviate observed waning of vaccine effectiveness (VE). Although initial reports of booster effectiveness have been positive, the level of protection from booster vaccination is unclear. We conducted two studies to assess the impact of booster vaccination, with BNT162b2 or mRNA-1273, on the incidence of SARS-CoV-2 infection between August and December 2021. We first compared SARS-CoV-2 infection incidence in cohorts of 3-dose vaccine recipients to incidence in matched cohorts of 2-dose vaccine recipients (cohort size = 24,539 for BNT162b2 and 14,004 for mRNA-1273). Additionally, we applied a test-negative study design to compare the level of protection against symptomatic infection in 3-dose recipients to that observed in recent 2-dose primary vaccine series recipients. The 3-dose recipients experienced a significantly lower incidence rate of SARS-CoV-2 infection than the matched 2-dose cohorts (BNT162b2 Incidence Rate Ratio: 0.11, 95% CI: 0.09 to 0.13 and mRNA-1273 IRR: 0.11, 95% CI: 0.08 to 0.15). Results from the test-negative study showed the third vaccine dose mitigated waning of VE, with the risk of symptomatic infection in 3-dose recipients being comparable to that observed 7 to 73 days after the primary vaccine series. These results show that 3-dose vaccine regimens with BNT162b2 or mRNA-1273 are effective at reducing SARS-CoV-2 infection and support the widespread administration of booster vaccine doses.

Abstract Background Several vaccines are now available under emergency use authorization in the United States and have demonstrated efficacy against symptomatic COVID-19. Vaccine impact on asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is largely unknown. Methods We conducted a retrospective cohort study of consecutive, asymptomatic adult patients (n = 39 156) within a large US healthcare system who underwent 48 333 preprocedural SARS-CoV-2 molecular screening tests between 17 December 2020 and 8 February 2021. The primary exposure of interest was vaccination with ≥1 dose of an mRNA COVID-19 vaccine. The primary outcome was relative risk (RR) of a positive SARS-CoV-2 molecular test among those asymptomatic persons who had received ≥1 dose of vaccine compared with persons who had not received vaccine during the same time period. RR was adjusted for age, sex, race/ethnicity, patient residence relative to the hospital (local vs nonlocal), healthcare system regions, and repeated screenings among patients using mixed-effects log-binomial regression. Results Positive molecular tests in asymptomatic individuals were reported in 42 (1.4%) of 3006 tests and 1436 (3.2%) of 45 327 tests performed on vaccinated and unvaccinated patients, respectively (RR, .44; 95% CI, .33–.60; P < .0001). Compared with unvaccinated patients, risk of asymptomatic SARS-CoV-2 infection was lower among those >10 days after the first dose (RR, .21; 95% CI, .12–.37; P < .0001) and >0 days after the second dose (RR, .20; 95% CI, .09–.44; P < .0001) in the adjusted analysis. Conclusions COVID-19 vaccination with an mRNA-based vaccine showed a significant association with reduced risk of asymptomatic SARS-CoV-2 infection as measured during preprocedural molecular screening. Results of this study demonstrate the impact of the vaccines on reduction in asymptomatic infections supplementing the randomized trial results on symptomatic patients.