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Incidence of SARS-CoV-2 Infection in Health Care Workers After a Single Dose of mRNA-1273 Vaccine

Educational Objective
To identify the key insights or developments described in this article

A 2021 randomized clinical trial1 demonstrated remarkably high efficacy of mRNA-1273 vaccine in reducing symptomatic SARS-CoV-2 infection after 2 doses administered 28 days apart; however, low numbers of infection during the first 2 weeks following dose 1 prevented full assessment of early vaccine efficacy. VA Boston Healthcare System (VABHS) began vaccinating health care workers (HCWs) during an early winter surge in SARS-CoV-2 infections in Massachusetts.2 A concomitant large increase in SARS-CoV-2 infections in our workforce provided an opportunity to evaluate the association between receipt of dose 1 of mRNA-1273 vaccine and SARS-CoV-2 infection.

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Article Information

Accepted for Publication: May 5, 2021.

Published: June 16, 2021. doi:10.1001/jamanetworkopen.2021.16416

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Gupta K et al. JAMA Network Open.

Corresponding Author: Michael E. Charness, MD, VA Boston Healthcare System, 1400 VFW Pkwy, West Roxbury, MA 02312 (michael.charness@va.gov).

Author Contributions: Drs Charness and Gupta had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Gupta, Charness.

Acquisition, analysis, or interpretation of data: O’Brien, Bellino, Linsenmeyer, Doshi, Sprague, Charness.

Drafting of the manuscript: Gupta, Bellino, Charness.

Critical revision of the manuscript for important intellectual content: Gupta, O’Brien, Linsenmeyer, Doshi, Sprague, Charness.

Statistical analysis: Gupta, O’Brien.

Administrative, technical, or material support: Bellino, Linsenmeyer, Doshi, Sprague.

Supervision: Gupta, Charness.

Conflict of Interest Disclosures: Dr Gupta reported ownership of equity in Moderna and Abbot Pharmaceuticals in the previous 3 years outside the submitted work. Dr Charness reported ownership of equity in Pfizer currently or in the past 3 years outside the submitted work. No other disclosures were reported.

Funding/Support: This study was not externally funded. All authors are employees of the US Department of Veterans Affairs.

Role of the Funder/Sponsor: The Department of Veterans Affairs had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We are grateful to Kelly Cho, PhD, for statistical expertise regarding the study design and Denver Audyatis, BS, for assistance in obtaining demographic information. These contributions were uncompensated.

References
1.
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(5):403-416. doi:10.1056/NEJMoa2035389PubMedGoogle ScholarCrossref
2.
State of Massachusetts. Archive of COVID-19 cases in Massachusetts. Mass.gov. Created March 9, 2020. Accessed March 23, 2021. https://www.mass.gov/info-details/archive-of-covid-19-cases-in-massachusetts
3.
Gupta  K , Bellino  P , Samano  J ,  et al.  Minimal population prevalence and mortality of COVID-19 in health care personnel.   Open Forum Infect Dis. 2021;8(2):ofaa618. doi:10.1093/ofid/ofaa618Google Scholar
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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 health care personnel, first responders, and other essential and frontline workers—eight US locations, December 2020-March 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(13):495-500. doi:10.15585/mmwr.mm7013e3PubMedGoogle ScholarCrossref
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Keehner  J , Horton  LE , Pfeffer  MA ,  et al.  SARS-CoV-2 infection after vaccination in health care workers in California.   N Engl J Med. 2021;384(18):1774-1775. doi:10.1056/NEJMc2101927PubMedGoogle ScholarCrossref
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Daniel  W , Nivet  M , Warner  J , Podolsky  DK .  Early evidence of the effect of SARS-CoV-2 vaccine at one medical center.   N Engl J Med. 2021. doi:10.1056/NEJMc2102153PubMedGoogle Scholar
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