Incidence and severity of COVID-19 infection among health care workers following vaccination: a cross sectional survey in Maharashtra
Keywords:Breakthrough infections, COVID-19, Severity, Risk factors, Vaccines
Background: Despite the vaccines against COVID-19 being proven to be effective, there is the possibility of infection despite vaccination. Such risk may be potentially greater in healthcare workers (HCWs), because of enhanced rates of exposure to the virus at the workplace. The present study was executed to estimate the incidence of COVID-19 infection post vaccination as well as to assess its severity.
Methods: A cross-sectional study was initiated in field practice area of one of the tertiary health care institutes in Pune district of Maharashtra. All 700 HCWs were investigated through questionnaire method and detailed data was collected about their vaccination status and related details. Data analysed using Jeffreys's amazing statistics program (JASP), version 0.17.1.0.
Results: In the study, 29.23% of the participants showed COVID-19 infection after vaccination. The majority of clinical illnesses were of mild type. Vaccinated participants with pre-existing illnesses had more incidence of COVID-19 infection following vaccination and also the participants with complete doses had a significantly lesser rate of COVID-19 infection post vaccination compared to those with partial doses of the concerned vaccine.
Conclusions: Vaccinated individuals pose less risk of severe COVID-19 infections following vaccination than those who are unvaccinated against COVID-19. Pre-existing disease is one of the major risk factors for enhanced incidence and severity of breakthrough infections.
World Health Organization. COVID-19 updates. Available at: https://www.who.int/campaigns/ connecting-the-world-to-combat-coronavirus/healthy athome?gclid=EAIaIQobChMIgpjGvvvS_QIVjNhRCh2ChAoKEAAYASAAEgIfDvD_BwE. Accessed on 28 January 2023.
Chagla Z. In adults, the Oxford/AstraZeneca vaccine had 70% efficacy against COVID-19 more than 14 days after the 2nd dose. Ann Intern Med. 2021;3:174-7.
World Health Organization. Coronavirus disease (COVID-19): vaccines. Available at: https://www.who.int/news-room/q-a-detail/corona virus-disease-(covid-19)-vaccines. Accessed on 28 February 2023.
Centre for Disease Control and Prevention. COVID-19 vaccination. Available at: https://www.cdc.gov/ coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html. Accessed on February 23, 2022.
Ella R, Vadrevu KM, Jogdand H, Prasad S, Reddy S, Sarangi V, et al. Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBV152: a double-blind, randomised, phase 1 trial. Lancet Infect Dis. 2021;21:637-46.
Mandal S, Arinaminpathy N, Bhargava B. India’s pragmatic vaccination strategy against COVID-19: a mathematical modelling-based analysis BMJ Open. 2021;11:1-10.
Bhatia R, Abraham P. COVID-19 vaccines and pandemic. Indian J Med Res. 2021;153:517-21.
Parameswaran A, Apsingi S, Eachempati KK, Dannana CS, Jagathkar G, Iyer M, et al. Incidence and severity of COVID-19 infection post-vaccination: a survey among Indian doctors. Infection. 2022;50:889-95.
Letizia AG, Ge Y, Vangeti S, Goforth C, Weir DL, Kuzmina NA, et al. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. Lancet Respir Med. 2021;9:712-20.
Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20:533-4.
Buss LF, Prete CA, Jr, Abrahim CMM. Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic. Science. 2021;371:288-92.
Altmann DM, Douek DC, Boyton RJ. What policy makers need to know about COVID-19 protective immunity. Lancet. 2020;395:1527-9.
Gudbjartsson DF, Norddahl GL, Melsted P. Humoral immune response to SARS-CoV-2 in Iceland. N Engl J Med. 2020;383:1724-34.
Self WH, Tenforde MW, Stubblefield WB. Decline in SARS-CoV-2 antibodies after mild infection among frontline health care personnel in a multistate hospital network-12 states, April-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1762-6.
Katherine A, Jillian PR, Diya S, Manjusha G, Adit AG, Tresa M. Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study. BMJ. 2022;379:1-10.
Viana R, Moyo S, Amoako DG. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa. Nature. 2022;603:679-86.
Lambrou AS, Shirk P, Steele MK. Strain Surveillance and Emerging Variants Bioinformatic Working Group, Strain Surveillance and Emerging Variants NS3 Working Group. Genomic Surveillance for SARS-CoV-2 Variants: Predominance of the Delta (B.1.617.2) and Omicron (B.1.1.529) Variants-United States, June 2021-January 2022. MMWR Morb Mortal Wkly Rep. 2022;71:206-11.