COVID-19 Infection, Reinfection, and Vaccine Effectiveness in Arizona Frontline and Essential Workers: Protocol for a Longitudinal Cohort Study (Preprint)

Lutrick, Karen; Ellingson, Katherine; Baccam, Zoe; Rivers, Patrick; Beitel, Shawn; Parker, Joel; Hollister, James; Sun, Xiaoxiao; Gerald, Joe K.; Komatsu, Kenneth; Kim, Elizabeth; LaFleur, Bonnie; Grant, Lauren; Yoo, Young M; Kumar, Archana; Lamberte, Julie Mayo; Cowling, Benjamin J.; Cobey, Sarah; Thornburg, Natalie J.; Kutty, Preeta K.; Nikolich‐Žugich, Janko; Thompson, Mark G.; Burgess, Jefferey L.

doi:10.2196/preprints.28925

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…To assess cross-reactive T cell immune memory to the Omicron variant we have analyzed a large cohort of participants recruited into the CDC-sponsored AZ HEROES research study 17 . Participants in this cohort included subjects sampled post SARS-CoV-2 infection; fully vaccinated subjects (2 doses of mRNA vaccine); subjects post infection receiving 2 doses of mRNA vaccine; fully vaccinated and boosted (three doses of mRNA vaccine) participants; as well as pre-pandemic controls.…”

Section: Introductionmentioning

confidence: 99%

Resilient T cell responses to B.1.1.529 (Omicron) SARS-CoV-2 variant

Jergović

Coplen

Uhrlaub

et al. 2022

Preprint

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Emergence of the SARS-CoV-2 variant-of-concern (VOC) B.1.1.529 (Omicron) in late 2021 has raised alarm among scientific and health care communities due to a surprisingly large number of mutations in its spike protein. Public health surveillance indicates that the Omicron variant is significantly more contagious than the previously dominant VOC, B.1.617.2 (Delta). Several early reports demonstrated that Omicron exhibits a higher degree (~10-30-fold) of escape from antibody neutralization compared to earlier lineage variants. Therefore, it is critical to determine how well the second line of adaptive immunity, T cell memory, performs against Omicron in people following COVID-19 infection and/or vaccination. To that purpose, we analyzed a cohort (n=345 subjects) of two- or three- dose messenger RNA (mRNA) vaccine recipients and COVID-19 post infection subjects (including those receiving 2 doses of mRNA vaccine after infection), recruited to the CDC-sponsored AZ HEROES research study, alongside 32 pre-pandemic control samples. We report that T cell responses against Omicron spike peptides were largely preserved in all cohorts with established immune memory. IFN-gamma producing T cell responses remained equivalent to the response against the ancestral strain (WA1/2020), with some (<20%) loss in IL-2 single- or IL-2+IFN-gamma+ poly-functional responses. Three-dose vaccinated participants had similar responses to Omicron relative to convalescent or convalescent plus two-dose vaccinated groups and exhibited responses significantly higher than those receiving two mRNA vaccine doses. These results provide further evidence that a three-dose vaccine regimen benefits the induction of optimal functional T cell immune memory.

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Section: Introductionmentioning

confidence: 99%

Resilient T cell responses to B.1.1.529 (Omicron) SARS-CoV-2 variant

Jergović

Coplen

Uhrlaub

et al. 2022

Preprint

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“…RECOVER) sites in Arizona, Florida, Minnesota, Oregon, Texas, and Utah[14,15]. Briefly, eligible participants included adults who worked at least 20 hours per week in occupations that required frequent direct contact with non-household members (i.e., healthcare workers, first responders, and other essential workers).…”

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confidence: 99%

Risk reduction in SARS-CoV-2 infection and reinfection conferred by humoral antibody levels among essential workers during Omicron predominance

Hollister,

Porter,

Sprissler

et al. 2024

Preprint

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The extent to which semi-quantitative antibody levels confer protection against SARS-CoV-2 infection in populations with heterogenous immune histories is unclear. Two nested case-control studies were designed within the multisite HEROES/RECOVER prospective cohort of frontline workers to study the relationship between antibody levels and protection against first-time post-vaccination infection and reinfection with SARS-CoV-2 from December 2021 to January 2023. All participants submitted weekly nasal swabs for rRT-PCR testing and blood samples quarterly and following infection or vaccination. Cases of first-time post-vaccination infection following a third dose of monovalent (origin strain WA-1) mRNA vaccine (n=613) and reinfection (n=350) were 1:1 matched to controls based on timing of blood draw and other potential confounders. Conditional logistic regression models were fit to estimate infection risk reductions associated with 3-fold increases in end titers for receptor binding domain (RBD). In first-time post-vaccination and reinfection study samples, most were female (67%, 57%), non-Hispanic (82%, 68%), and without chronic conditions (65%, 65%). The odds of first-time post-vaccination infection were reduced by 21% (aOR=0.79, 95% CI=[0.66-0.96]) for each 3-fold increase in RBD end titers. The odds of reinfection associated with a 3-fold increase in RBD end titers were reduced by 23% (aOR=0.77, 95% CI=[0.65-0.92] for unvaccinated individuals and 58% (aOR=0.42, 95% CI=0.22-0.84) for individuals with three mRNA vaccine doses following their first infection. Frontline workers with higher antibody levels following a third dose of mRNA COVID-19 vaccine were at reduced risk of SARS-CoV-2 during Omicron predominance. Among those with previous infections, the point estimates of risk reduction associated with antibody levels was greater for those with three vaccine doses compared to those who were unvaccinated.

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COVID-19 Vaccine Perceptions and Uptake in a National Prospective Cohort of Essential Workers

Lutrick

Groom

Fowlkes

et al. 2021

Preprint

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Introduction: In a multi-center prospective cohort of essential workers, we assessed knowledge, attitudes, and practices (KAP) by vaccine intention, prior SARS-CoV-2 positivity, and occupation, and their impact on vaccine uptake over time. Methods: Initiated in July 2020, HEROES-RECOVER cohort provided socio-demographics and COVID-19 vaccination data. Using follow-up two surveys approximately three months apart, COVID-19 vaccine KAP, intention, and receipt was collected; the first survey categorized participants as reluctant, reachable, or endorsers. Results: A total of 4,803 participants were included in the analysis. Most (70%) were vaccine endorsers, 16% were reachable, and 14% were reluctant. By May 2021, 77% had received at least one vaccine dose. KAP responses strongly predicted vaccine uptake, particularly positive attitudes about safety (aOR=5.46, 95% CI: 1.4-20.8) and effectiveness (aOR=5.0, 95% CI: 1.3-19.1). Participants prior SARS-CoV-2 infection were 22% less likely to believe the COVID-19 vaccine was effective compared with uninfected participants (aOR 0.78, 95% CI: 0.64-0.96). This was even more pronounced in first responders compared with other occupations, with first responders 42% less likely to believe in COVID-19 vaccine effectiveness (aOR=0.58, 95% CI 0.40-0.84). KAP responses shifted positively, with reluctant and reachable participant scores modestly increasing in positive responses for perceived vaccine effectiveness (7% and 12%, respectively) on the second follow-up survey; 25% of initially reluctant participants received the COVID-19 vaccine. Discussion: Our study demonstrates attitudes associated with COVID-19 vaccine uptake and a positive shift in attitudes over time. First responders, despite potential high exposure to SARS-CoV-2, and participants with a history of SARS-CoV-2 infection were more vaccine reluctant. Conclusions: COVID-19 vaccine KAP responses predicted vaccine uptake and associated attitudes improved over time. Perceptions of the COVID-19 vaccine can shift over time. Targeting messages about vaccines safety and effectiveness in reducing SARS-CoV-2 virus infection and illness severity may increase vaccine uptake for reluctant and reachable participants.

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COVID-19 Infection, Reinfection, and Vaccine Effectiveness in Arizona Frontline and Essential Workers: Protocol for a Longitudinal Cohort Study (Preprint)

Cited by 3 publications

References 32 publications

Resilient T cell responses to B.1.1.529 (Omicron) SARS-CoV-2 variant

Resilient T cell responses to B.1.1.529 (Omicron) SARS-CoV-2 variant

Risk reduction in SARS-CoV-2 infection and reinfection conferred by humoral antibody levels among essential workers during Omicron predominance

COVID-19 Vaccine Perceptions and Uptake in a National Prospective Cohort of Essential Workers

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