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Symptom monitoring after coronavirus disease 2019 (COVID-19) vaccination in a large integrated healthcare system: Separating symptoms from severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection

Published online by Cambridge University Press:  02 November 2021

Erica S. Shenoy Open the ORCID record for Erica S. Shenoy [Opens in a new window] ,
Paige G. Wickner ,
Lauren R. West ,
Aleena Banerji ,
Kimberly G. Blumenthal ,
Amanda J. Centi ,
Andrew Gottlieb ,
Dean M. Hashimoto ,
Esther Kim  and
Marvel Kim
...Show all authors
Erica S. Shenoy*
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Paige G. Wickner
Affiliation:
Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
Lauren R. West
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Aleena Banerji
Affiliation:
Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Kimberly G. Blumenthal
Affiliation:
Harvard Medical School, Boston, Massachusetts Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
Amanda J. Centi
Affiliation:
Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts
Andrew Gottlieb
Affiliation:
Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Dean M. Hashimoto
Affiliation:
Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Esther Kim
Affiliation:
Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts
Marvel Kim
Affiliation:
Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Hang Lee
Affiliation:
Harvard Medical School, Boston, Massachusetts Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
Lynn A. Simpson
Affiliation:
Research Information Science and Computing, Massachusetts General Brigham, Boston, Massachusetts
Adam B. Landman
Affiliation:
Harvard Medical School, Boston, Massachusetts Enterprise Data and Digital Health, Mass General Brigham, Boston, Massachusetts Department of Emergency Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
*
Author for correspondence: Erica S. Shenoy, E-mail: eshenoy@mgh.harvard.edu
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Abstract

Objective:

To describe the incidence of systemic overlap and typical coronavirus disease 2019 (COVID-19) symptoms in healthcare personnel (HCP) following COVID-19 vaccination and association of reported symptoms with diagnosis of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in the context of public health recommendations regarding work exclusion.

Design:

This prospective cohort study was conducted between December 16, 2020, and March 14, 2021, with HCP who had received at least 1 dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine.

Setting:

Large healthcare system in New England.

Interventions:

HCP were prompted to complete a symptom survey for 3 days after each vaccination. Reported symptoms generated automated guidance regarding symptom management, SARS-CoV-2 testing requirements, and work restrictions. Overlap symptoms (ie, fever, fatigue, myalgias, arthralgias, or headache) were categorized as either lower or higher severity. Typical COVID-19 symptoms included sore throat, cough, nasal congestion or rhinorrhea, shortness of breath, ageusia and anosmia.

Results:

Among 64,187 HCP, a postvaccination electronic survey had response rates of 83% after dose 1 and 77% after dose 2. Report of ≥3 lower-severity overlap symptoms, ≥1 higher-severity overlap symptoms, or at least 1 typical COVID-19 symptom after dose 1 was associated with increased likelihood of testing positive. HCP with prior COVID-19 infection were significantly more likely to report severe overlap symptoms after dose 1.

Conclusions:

Reported overlap symptoms were common; however, only report of ≥3 low-severity overlap symptoms, at least 1 higher-severity overlap symptom, or any typical COVID-19 symptom were associated with infection. Work-related restrictions for overlap symptoms should be reconsidered.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 10 , October 2022 , pp. 1439 - 1446
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

Authors of equal contribution.

References

Oliver, SE, Gargano, JW, Marin, M, et al. The Advisory Committee on Immunization Practices’ interim recommendation for use of Moderna COVID-19 vaccine—United States, December 2020. Morb Mortal Wkly Rep 2021;69:1653–1656.Google ScholarPubMed
Oliver, SE, Gargano, JW, Marin, M, et al. The Advisory Committee on Immunization Practices’ interim recommendation for use of Pfizer-BioNTech COVID-19 vaccine—United States, December 2020. Morb Mortal Wkly Rep 2020;69:1922–1924.Google ScholarPubMed
Polack, FP, Thomas, SJ, Kitchin, N, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med 2020;383:2603–2615.Google ScholarPubMed
Baden, LR, El Sahly, HM, Essink, B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403–416.Google ScholarPubMed
Postvaccine considerations for healthcare personnel. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/community/workplaces-businesses/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fpost-vaccine-considerations-healthcare-personnel.html. Published 2020. Accessed December 16, 2020.Google Scholar
Considerations for healthcare personnel after COVID-19 vaccination. Massachusetts Department of Public Health website. https://www.mass.gov/doc/considerations-for-health-care-personnel-after-covid-19-vaccination/download. Published 2020. Accessed December 16, 2020.Google Scholar
Harris, PA, Taylor, R, Minor, BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Informat 2019;95:103208.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Informat 2009;42:377–381.CrossRefGoogle ScholarPubMed
V-safe after vaccination health checker. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html. Accessed April 19, 2021.Google Scholar
Zhang, H, Dimitrov, D, Simpson, L, et al. A web-based, mobile-responsive application to screen healthcare workers for COVID-19 symptoms: rapid design, deployment, and usage. JMIR Form Res 2020;4:e19533.CrossRefGoogle ScholarPubMed
Blumenthal, KG, Robinson, LB, Camargo, CA Jr, et al. Acute allergic reactions to mRNA COVID-19 vaccines. JAMA 2021;325:1562–1565.Google ScholarPubMed
Blumenthal, KG, Freeman, EE, Saff, RR, et al. Delayed large local reactions to mRNA-1273 vaccine against SARS-CoV-2. N Engl J Med 2021;384:1273–1277.CrossRefGoogle ScholarPubMed
Dowle, MS. data.table: extension of data.frame. R package version 1.14.0., 2021. https://CRAN.R-project.org/package=data.table.Google Scholar
Sjoberg, DC, Hannum, M, Whiting, M, Zabor, K, EC. gtsummary: presentation-ready data summary and analytic result tables, R package version 1.3.7. 2021. https://CRAN.R-project.org/package=gtsummary. Accessed April 19, 2021.Google Scholar
R Core Team. R: a language and environment for statistical computing. https://www.R-project.org/. Accessed April 19, 2021.Google Scholar
Local reactions, systemic reactions, adverse events, and serious adverse events: Pfizer-BioNTech COVID-19 vaccine. Centers for Disease Control and Prevention website. https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/reactogenicity.html. Accessed April 19, 2021.Google Scholar
Local reactions, systemic reactions, adverse events, and serious adverse events: Moderna COVID-19 vaccine. Centers for Disease Control and Prevention website. https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/reactogenicity.html. Accessed April 19, 2021.Google Scholar
Hall, VJ, Foulkes, S, Saei, A, et al. Effectiveness of BNT162b2 mRNA vaccine against infection and COVID-19 vaccine coverage in healthcare workers in England, multicentre prospective cohort study (the SIREN Study). Lancet 2021 8;397:1725–1735.Google Scholar
Pawlowski, C, Lenehan, P, Puranik, A, et al. FDA-authorized mRNA COVID-19 vaccines are effective per real-world evidence synthesized across a multistate health system. Med (N Y) 2021;2:979–992.Google Scholar
Thompson, MG, Burgess, JL, Naleway, AL, et al. Interim estimates of vaccine effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines in preventing SARS-CoV-2 infection among healthcare personnel, first responders, and other essential and frontline workers—eight US locations, December 2020–March 2021. Morbid Mortal Wkly Rep 2021;70:495.CrossRefGoogle Scholar
Moderna COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee December 17, 2020, meeting briefing document addendum- sponsor. Food and Drug Administration website. https://www.fda.gov/media/144453/. Published 2020. Accessed October 13, 2021.Google Scholar
Moderna COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee December 17, 2020, meeting briefing document- sponsor, 2020. Food and Drug Administration website. https://www.fda.gov/media/144452/. Published 2020. Accessed October 13, 2021.Google Scholar
Pfizer-BioNTech COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee briefing document – sponsor. Food and Drug Administration website. https://www.fda.gov/media/144246/. Published 2020. Accessed October 13, 2021.Google Scholar
Janssen COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee February 26, 2021, meeting briefing document – sponsor. Food and Drug Administration website. https://www.fda.gov/media/146219/. Published 2021. Accessed October 13, 2021.Google Scholar
Janssen COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee, February 26, 2021, meeting briefing document addendum – sponsor. 2021. Food and Drug Administration website. https://www.fda.gov/media/146218/. Published 2021. Accessed October 13, 2021.Google Scholar
COVID-19 dashboard. Massachusetts Department of Public Health Bureau of Infectious Diseases and Laboratory Sciences and the Registry of Vital Records and Statistics, Office of Integrated Surveillance and Informatics Services. State of Massachusetts website. https://www.mass.gov/info-details/covid-19-response-reporting#covid-19-interactive-data-dashboard-. Published 2021. Accessed October 13, 2021.Google Scholar
Menni, C, Klaser, K, May, A, et al. Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. Lancet Infect Dis 2021;21:939–949.CrossRefGoogle ScholarPubMed
Krammer, F, Srivastava, K, Alshammary, H, et al. Antibody responses in seropositive persons after a single dose of SARS-CoV-2 mRNA vaccine. N Engl J Med 2021;384:1372–1374.CrossRefGoogle ScholarPubMed
d’Arminio Monforte, A, Tavelli, A, Perrone, PM, et al. Association between previous infection with SARS CoV-2 and the risk of self-reported symptoms after mRNA BNT162b2 vaccination: data from 3,078 healthcare workers. EClinicalMedicine 2021;36:100914.Google Scholar
Lasater, KB, Aiken, LH, Sloane, DM, et al. Chronic hospital nurse understaffing meets COVID-19: an observational study. BMJ Qual Saf 2021;30:639–647.Google ScholarPubMed
Kadri, SS, Sun, J, Lawandi, A, et al. Association between caseload surge and COVID-19 survival in 558 US hospitals, March to August 2020. Ann Intern Med 2021;174:1240–1251.Google Scholar
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