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Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model
OBJECTIVE: To describe the incidence of, risk factors for, and impact of vaccines on primary SARS-CoV-2 infection during the second wave of the covid-19 pandemic in susceptible hospital healthcare workers in England. DESIGN: Multicentre prospective cohort study. SETTING: National Health Service seco...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295077/ https://www.ncbi.nlm.nih.gov/pubmed/35858689 http://dx.doi.org/10.1136/bmj-2022-070379 |
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author | Pople, Diane Monk, Edward J M Evans, Stephanie Foulkes, Sarah Islam, Jasmin Wellington, Edgar Atti, Ana Hope, Russell Robotham, Julie Hopkins, Susan Brown, Colin S Hall, Victoria J Adebiyi, Omoyeni Adeboyeku, David Aeron-Thomas, Jonnie Aga, Masood Agwuh, K Ahmad, S Akhtar, Talat Akhtar, S Aldridge, N Al-Khafaji, Zehra’a Allsop, Lynne Ambalkar, Shrikant Andrews, Nick Arenas-Pinto, Alejandro Ashby, Helen Ashcroft, John Ashton, Maxine Auckland, Cressida Bagary, Manny Baillon, Sarah Bain, Steve Bakker, Philippa Barbour, Lisa Barnes, T Bateman, Vhairi Beekes, Mandy Berry, L Bhayani, Janki Bishop, Jennifer Bishop, Lisa Black, Karen Board, Sarah Boss, David Boulos, Angel Boyd, G Brake, Simon Brand, Sarah Broadley, Andrew Brookes, Claire Brooks, Tim Brown, Alison Brown, Kerryanne Browne, D Burns, Philippa Burton, Ben Butt, Georgina Calbraith, Davina Cameron, Euan Chand, Meera Chandrasekaran, Badrinathan Charlett, Andre Chaudhuri, Ray Chawla, Anu Chenoweth, H Chitalia, Nihil Cochrane, Alexandra Coke, Louise Cole, Michelle Coles, Holly Colton, James Conneely, Joanna Conneely, Paul Corless, Claire Corrigan, Dianne Court, Kathryn Cowley, Anna Cowling, Peter Cromey, Lisa Crosby-Nwaobi, Roxanne Crowe, Jane D’Arcangelo, Silvia Dave, Ananta Dawson, Joy de Lacy, Ellen de Silva, Thushan Del Rosario, Ismaelette Democratis, Jane Dhasmana, Devesh Diaz, Stephanie Dimmer, Allison Ditchfield, Lisa Dobbie, Laura Doel, Allison Donaghy, Tracy Duff, Christopher Dytmer, David Easom, Nicholas Edgar, Joanne Edmunds, Tracy Elliott, John Ellis, Yvette Elumogo, Ngozi Kirby, Eve Etell Faris, Barzo Favager, Clair Finlayson, Lauren Ford, Christine Fowler, Susan Fowles-Gutierrez, Nabila Fraile, Eva Frieslick, Joan Froude, Susannah Gallagher, Eileen Galliford, Joanne Game, F Geen, John Gibson, Hannah Giles, J Goldberg, David Goodwin, Jayne Gormley, S Gould, Imogen Grant, Alison Graves, Jennifer Gray, Kim Gray, Joanne Gray, Katherine Green, Marie Greenwood, Susan Guha, Simantee Hacon, Christian Halkes, Mathew Hams, Steve Hanison, Esther Hanna, Elinor Harbham, Pratap Harman, Paula Harris, Edward Harris, Penny Harrison, G Harvey, D Harwood, J Hatton, Jonathan Hawkins, April Hettiarachchi, Nipunadi Hewson, Jacqueline Higham, Andrew Hinch, Sarah Ho, Antonia Hoad, Ina Holliday, Kyra Hollinshead, Kathryn Holmes, Christopher Horne, Stacey Horsley, A Houston, Angela Howard, M Howard, Joanne Howcroft, Deborah Howell, Kate Huang, Y Hudson, Karen Hughes, Lauren Insalata, Ferdinando Irvine, Val James, Kate Johnston, Frances Johnstone, Helen Jones, C Jorgenson, Annelysse Jory, Hannah Joseph, Maya Kalakonda, Nagesh Kemsley, Philippa Keogh, Siobhan Kerrison, C Khan, Shivani Khanduri, Sheena Khawam, Jameel Kyffin, Robert Larru, A Latham, Scott Laugharne, Richard Lazarus, Rajeka Lee, Mihye Lester, Yvonne Lewis, Kenisha Lewis, T Lewis, Tracy Linley, Ezra Long, Josie Longfellow, Ruth Loughrey, Clodagh Luckas, Murray Mackay, Shekoo Mahabir, Natasha Mahungu, Tabitha Malcolm, Martin Maseda, Diego Matuluko, Ayo Maxwell, V McAdam, Clare McCracken, Danielle Mcwilliam, S Meda, Manjula Mercer, Pauline Milligan, Iain Mirfenderesky, Mariyam Mistry, Raksha Moody, A Moran, Kelly Jones, Caroline Mulvaney Munro, Katie Murphy, Michael Nash, Maxine Neill, Claire Nimako, K Norman, Chris Norman, Chris O’Connell, Anne-Marie O'Kane, Maurice O'Kelly, A Omar, Zohra Otter, Ashley Paques, Kitty Patel, Manish Payne, B Pegg, C Penn, R Pepper, Stacey Pepperell, Justin Pethick, James Pickard, Graham Piercy, Charlie Planche, Tim Plant, Aiden Pothecary, Carla Pottinger, G Powell, James Price, Lesley Price, Cathy Prince, Stephanie Jones, Rowan Pritchard Protaschik, Yuri Qazzafi, Zaman Rajgopal, A Ramsay, Mary Reeks, Chloe Reynolds, T Richardson, Lisa Ridley, P Roberts, Julia Robinson, L Rodger, Alison Roebuck, Alun Rokakis, Anna Rowe, Cathy Roynon, Anna Russell, J Sach, Lauren Saei, Ayoub Sajedi, Noshin Semper, Amanda Sergenson, Nicola Severn, Abigail Shah, A Shipman, K Shorten, Robert Sierra, R Sinclair, Janet Sinclair, Catherine Sinclair, Aaran Sovriarova, Helena Stafford, Claire Stevens, Guy Stewart, B Strong-Sheldrake, Sophia SubhroOsuji, Banerjee Szewczyk, Mags Tarr, Esther Taylor-Kerr, Andrew Tazzyman, Simon Telfer, Andrew Temple-Purcell, Rebecca Templeton, Kate Thomas, Claire Thompson, Catherine Thompson, Fiona Tilley, R Timeyin, Jean Todd, Anne Tomlinson, Johanne Tonge, Simon Tranquillini, Caio Trinick, Tom Tyson, Linda Vasant, Julia Vilimiene, Neringa Walker, Lynne Ward, Emma Warren, Simon Watson, Ekaterina Watt, A Weir, Jennifer Westwell, Fran Whileman, Amanda White, Nikki Wilkinson, Beverly Williams, Claire Williams, M Willshaw, Stephanie Wilson-Davies, E Winchester, Stephen Wiselka, Martin Wong, N Woolcook, Megan Wycherley, Diane Young, Charlotte Zambon, Maria Zheng, Qi |
author_facet | Pople, Diane Monk, Edward J M Evans, Stephanie Foulkes, Sarah Islam, Jasmin Wellington, Edgar Atti, Ana Hope, Russell Robotham, Julie Hopkins, Susan Brown, Colin S Hall, Victoria J Adebiyi, Omoyeni Adeboyeku, David Aeron-Thomas, Jonnie Aga, Masood Agwuh, K Ahmad, S Akhtar, Talat Akhtar, S Aldridge, N Al-Khafaji, Zehra’a Allsop, Lynne Ambalkar, Shrikant Andrews, Nick Arenas-Pinto, Alejandro Ashby, Helen Ashcroft, John Ashton, Maxine Auckland, Cressida Bagary, Manny Baillon, Sarah Bain, Steve Bakker, Philippa Barbour, Lisa Barnes, T Bateman, Vhairi Beekes, Mandy Berry, L Bhayani, Janki Bishop, Jennifer Bishop, Lisa Black, Karen Board, Sarah Boss, David Boulos, Angel Boyd, G Brake, Simon Brand, Sarah Broadley, Andrew Brookes, Claire Brooks, Tim Brown, Alison Brown, Kerryanne Browne, D Burns, Philippa Burton, Ben Butt, Georgina Calbraith, Davina Cameron, Euan Chand, Meera Chandrasekaran, Badrinathan Charlett, Andre Chaudhuri, Ray Chawla, Anu Chenoweth, H Chitalia, Nihil Cochrane, Alexandra Coke, Louise Cole, Michelle Coles, Holly Colton, James Conneely, Joanna Conneely, Paul Corless, Claire Corrigan, Dianne Court, Kathryn Cowley, Anna Cowling, Peter Cromey, Lisa Crosby-Nwaobi, Roxanne Crowe, Jane D’Arcangelo, Silvia Dave, Ananta Dawson, Joy de Lacy, Ellen de Silva, Thushan Del Rosario, Ismaelette Democratis, Jane Dhasmana, Devesh Diaz, Stephanie Dimmer, Allison Ditchfield, Lisa Dobbie, Laura Doel, Allison Donaghy, Tracy Duff, Christopher Dytmer, David Easom, Nicholas Edgar, Joanne Edmunds, Tracy Elliott, John Ellis, Yvette Elumogo, Ngozi Kirby, Eve Etell Faris, Barzo Favager, Clair Finlayson, Lauren Ford, Christine Fowler, Susan Fowles-Gutierrez, Nabila Fraile, Eva Frieslick, Joan Froude, Susannah Gallagher, Eileen Galliford, Joanne Game, F Geen, John Gibson, Hannah Giles, J Goldberg, David Goodwin, Jayne Gormley, S Gould, Imogen Grant, Alison Graves, Jennifer Gray, Kim Gray, Joanne Gray, Katherine Green, Marie Greenwood, Susan Guha, Simantee Hacon, Christian Halkes, Mathew Hams, Steve Hanison, Esther Hanna, Elinor Harbham, Pratap Harman, Paula Harris, Edward Harris, Penny Harrison, G Harvey, D Harwood, J Hatton, Jonathan Hawkins, April Hettiarachchi, Nipunadi Hewson, Jacqueline Higham, Andrew Hinch, Sarah Ho, Antonia Hoad, Ina Holliday, Kyra Hollinshead, Kathryn Holmes, Christopher Horne, Stacey Horsley, A Houston, Angela Howard, M Howard, Joanne Howcroft, Deborah Howell, Kate Huang, Y Hudson, Karen Hughes, Lauren Insalata, Ferdinando Irvine, Val James, Kate Johnston, Frances Johnstone, Helen Jones, C Jorgenson, Annelysse Jory, Hannah Joseph, Maya Kalakonda, Nagesh Kemsley, Philippa Keogh, Siobhan Kerrison, C Khan, Shivani Khanduri, Sheena Khawam, Jameel Kyffin, Robert Larru, A Latham, Scott Laugharne, Richard Lazarus, Rajeka Lee, Mihye Lester, Yvonne Lewis, Kenisha Lewis, T Lewis, Tracy Linley, Ezra Long, Josie Longfellow, Ruth Loughrey, Clodagh Luckas, Murray Mackay, Shekoo Mahabir, Natasha Mahungu, Tabitha Malcolm, Martin Maseda, Diego Matuluko, Ayo Maxwell, V McAdam, Clare McCracken, Danielle Mcwilliam, S Meda, Manjula Mercer, Pauline Milligan, Iain Mirfenderesky, Mariyam Mistry, Raksha Moody, A Moran, Kelly Jones, Caroline Mulvaney Munro, Katie Murphy, Michael Nash, Maxine Neill, Claire Nimako, K Norman, Chris Norman, Chris O’Connell, Anne-Marie O'Kane, Maurice O'Kelly, A Omar, Zohra Otter, Ashley Paques, Kitty Patel, Manish Payne, B Pegg, C Penn, R Pepper, Stacey Pepperell, Justin Pethick, James Pickard, Graham Piercy, Charlie Planche, Tim Plant, Aiden Pothecary, Carla Pottinger, G Powell, James Price, Lesley Price, Cathy Prince, Stephanie Jones, Rowan Pritchard Protaschik, Yuri Qazzafi, Zaman Rajgopal, A Ramsay, Mary Reeks, Chloe Reynolds, T Richardson, Lisa Ridley, P Roberts, Julia Robinson, L Rodger, Alison Roebuck, Alun Rokakis, Anna Rowe, Cathy Roynon, Anna Russell, J Sach, Lauren Saei, Ayoub Sajedi, Noshin Semper, Amanda Sergenson, Nicola Severn, Abigail Shah, A Shipman, K Shorten, Robert Sierra, R Sinclair, Janet Sinclair, Catherine Sinclair, Aaran Sovriarova, Helena Stafford, Claire Stevens, Guy Stewart, B Strong-Sheldrake, Sophia SubhroOsuji, Banerjee Szewczyk, Mags Tarr, Esther Taylor-Kerr, Andrew Tazzyman, Simon Telfer, Andrew Temple-Purcell, Rebecca Templeton, Kate Thomas, Claire Thompson, Catherine Thompson, Fiona Tilley, R Timeyin, Jean Todd, Anne Tomlinson, Johanne Tonge, Simon Tranquillini, Caio Trinick, Tom Tyson, Linda Vasant, Julia Vilimiene, Neringa Walker, Lynne Ward, Emma Warren, Simon Watson, Ekaterina Watt, A Weir, Jennifer Westwell, Fran Whileman, Amanda White, Nikki Wilkinson, Beverly Williams, Claire Williams, M Willshaw, Stephanie Wilson-Davies, E Winchester, Stephen Wiselka, Martin Wong, N Woolcook, Megan Wycherley, Diane Young, Charlotte Zambon, Maria Zheng, Qi |
author_sort | Pople, Diane |
collection | PubMed |
description | OBJECTIVE: To describe the incidence of, risk factors for, and impact of vaccines on primary SARS-CoV-2 infection during the second wave of the covid-19 pandemic in susceptible hospital healthcare workers in England. DESIGN: Multicentre prospective cohort study. SETTING: National Health Service secondary care health organisations (trusts) in England between 1 September 2020 and 30 April 2021. PARTICIPANTS: Clinical, support, and administrative staff enrolled in the SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) study with no evidence of previous infection. Vaccination status was obtained from national covid-19 vaccination registries and self-reported. MAIN OUTCOME MEASURE: SARS-CoV-2 infection confirmed by polymerase chain reaction. Mixed effects logistic regression was conducted to determine demographic and occupational risk factors for infection, and an individual based mathematical model was used to predict how large the burden could have been if vaccines had not been available from 8 December 2020 . RESULTS: During England’s second wave, 12.9% (2353/18 284) of susceptible SIREN participants became infected with SARS-CoV-2. Infections peaked in late December 2020 and decreased from January 2021, concurrent with the cohort’s rapid vaccination coverage and a national lockdown. In multivariable analysis, factors increasing the likelihood of infection in the second wave were being under 25 years old (20.3% (132/651); adjusted odds ratio 1.35, 95% confidence interval 1.07 to 1.69), living in a large household (15.8% (282/1781); 1.54, 1.23 to 1.94, for participants from households of five or more people), having frequent exposure to patients with covid-19 (19.2% (723/3762); 1.79, 1.56 to 2.06, for participants with exposure every shift), working in an emergency department or inpatient ward setting (20.8% (386/1855); 1.76, 1.45 to 2.14), and being a healthcare assistant (18.1% (267/1479); 1.43, 1.16 to 1.77). Time to first vaccination emerged as being strongly associated with infection (P<0.001), with each additional day multiplying a participant’s adjusted odds ratio by 1.02. Mathematical model simulations indicated that an additional 9.9% of all patient facing hospital healthcare workers would have been infected were it not for the rapid vaccination coverage. CONCLUSIONS: The rapid covid-19 vaccine rollout from December 2020 averted infection in a large proportion of hospital healthcare workers in England: without vaccines, second wave infections could have been 69% higher. With booster vaccinations being needed for adequate protection from the omicron variant, and perhaps the need for further boosters for future variants, ensuring equitable delivery to healthcare workers is essential. The findings also highlight occupational risk factors that persisted in healthcare workers despite vaccine rollout; a greater understanding of the transmission dynamics responsible for these is needed to help to optimise the infection prevention and control policies that protect healthcare workers from infection and therefore to support staffing levels and maintain healthcare provision. TRIAL REGISTRATION: ISRCTN registry ISRCTN11041050. |
format | Online Article Text |
id | pubmed-9295077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92950772022-07-20 Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model Pople, Diane Monk, Edward J M Evans, Stephanie Foulkes, Sarah Islam, Jasmin Wellington, Edgar Atti, Ana Hope, Russell Robotham, Julie Hopkins, Susan Brown, Colin S Hall, Victoria J Adebiyi, Omoyeni Adeboyeku, David Aeron-Thomas, Jonnie Aga, Masood Agwuh, K Ahmad, S Akhtar, Talat Akhtar, S Aldridge, N Al-Khafaji, Zehra’a Allsop, Lynne Ambalkar, Shrikant Andrews, Nick Arenas-Pinto, Alejandro Ashby, Helen Ashcroft, John Ashton, Maxine Auckland, Cressida Bagary, Manny Baillon, Sarah Bain, Steve Bakker, Philippa Barbour, Lisa Barnes, T Bateman, Vhairi Beekes, Mandy Berry, L Bhayani, Janki Bishop, Jennifer Bishop, Lisa Black, Karen Board, Sarah Boss, David Boulos, Angel Boyd, G Brake, Simon Brand, Sarah Broadley, Andrew Brookes, Claire Brooks, Tim Brown, Alison Brown, Kerryanne Browne, D Burns, Philippa Burton, Ben Butt, Georgina Calbraith, Davina Cameron, Euan Chand, Meera Chandrasekaran, Badrinathan Charlett, Andre Chaudhuri, Ray Chawla, Anu Chenoweth, H Chitalia, Nihil Cochrane, Alexandra Coke, Louise Cole, Michelle Coles, Holly Colton, James Conneely, Joanna Conneely, Paul Corless, Claire Corrigan, Dianne Court, Kathryn Cowley, Anna Cowling, Peter Cromey, Lisa Crosby-Nwaobi, Roxanne Crowe, Jane D’Arcangelo, Silvia Dave, Ananta Dawson, Joy de Lacy, Ellen de Silva, Thushan Del Rosario, Ismaelette Democratis, Jane Dhasmana, Devesh Diaz, Stephanie Dimmer, Allison Ditchfield, Lisa Dobbie, Laura Doel, Allison Donaghy, Tracy Duff, Christopher Dytmer, David Easom, Nicholas Edgar, Joanne Edmunds, Tracy Elliott, John Ellis, Yvette Elumogo, Ngozi Kirby, Eve Etell Faris, Barzo Favager, Clair Finlayson, Lauren Ford, Christine Fowler, Susan Fowles-Gutierrez, Nabila Fraile, Eva Frieslick, Joan Froude, Susannah Gallagher, Eileen Galliford, Joanne Game, F Geen, John Gibson, Hannah Giles, J Goldberg, David Goodwin, Jayne Gormley, S Gould, Imogen Grant, Alison Graves, Jennifer Gray, Kim Gray, Joanne Gray, Katherine Green, Marie Greenwood, Susan Guha, Simantee Hacon, Christian Halkes, Mathew Hams, Steve Hanison, Esther Hanna, Elinor Harbham, Pratap Harman, Paula Harris, Edward Harris, Penny Harrison, G Harvey, D Harwood, J Hatton, Jonathan Hawkins, April Hettiarachchi, Nipunadi Hewson, Jacqueline Higham, Andrew Hinch, Sarah Ho, Antonia Hoad, Ina Holliday, Kyra Hollinshead, Kathryn Holmes, Christopher Horne, Stacey Horsley, A Houston, Angela Howard, M Howard, Joanne Howcroft, Deborah Howell, Kate Huang, Y Hudson, Karen Hughes, Lauren Insalata, Ferdinando Irvine, Val James, Kate Johnston, Frances Johnstone, Helen Jones, C Jorgenson, Annelysse Jory, Hannah Joseph, Maya Kalakonda, Nagesh Kemsley, Philippa Keogh, Siobhan Kerrison, C Khan, Shivani Khanduri, Sheena Khawam, Jameel Kyffin, Robert Larru, A Latham, Scott Laugharne, Richard Lazarus, Rajeka Lee, Mihye Lester, Yvonne Lewis, Kenisha Lewis, T Lewis, Tracy Linley, Ezra Long, Josie Longfellow, Ruth Loughrey, Clodagh Luckas, Murray Mackay, Shekoo Mahabir, Natasha Mahungu, Tabitha Malcolm, Martin Maseda, Diego Matuluko, Ayo Maxwell, V McAdam, Clare McCracken, Danielle Mcwilliam, S Meda, Manjula Mercer, Pauline Milligan, Iain Mirfenderesky, Mariyam Mistry, Raksha Moody, A Moran, Kelly Jones, Caroline Mulvaney Munro, Katie Murphy, Michael Nash, Maxine Neill, Claire Nimako, K Norman, Chris Norman, Chris O’Connell, Anne-Marie O'Kane, Maurice O'Kelly, A Omar, Zohra Otter, Ashley Paques, Kitty Patel, Manish Payne, B Pegg, C Penn, R Pepper, Stacey Pepperell, Justin Pethick, James Pickard, Graham Piercy, Charlie Planche, Tim Plant, Aiden Pothecary, Carla Pottinger, G Powell, James Price, Lesley Price, Cathy Prince, Stephanie Jones, Rowan Pritchard Protaschik, Yuri Qazzafi, Zaman Rajgopal, A Ramsay, Mary Reeks, Chloe Reynolds, T Richardson, Lisa Ridley, P Roberts, Julia Robinson, L Rodger, Alison Roebuck, Alun Rokakis, Anna Rowe, Cathy Roynon, Anna Russell, J Sach, Lauren Saei, Ayoub Sajedi, Noshin Semper, Amanda Sergenson, Nicola Severn, Abigail Shah, A Shipman, K Shorten, Robert Sierra, R Sinclair, Janet Sinclair, Catherine Sinclair, Aaran Sovriarova, Helena Stafford, Claire Stevens, Guy Stewart, B Strong-Sheldrake, Sophia SubhroOsuji, Banerjee Szewczyk, Mags Tarr, Esther Taylor-Kerr, Andrew Tazzyman, Simon Telfer, Andrew Temple-Purcell, Rebecca Templeton, Kate Thomas, Claire Thompson, Catherine Thompson, Fiona Tilley, R Timeyin, Jean Todd, Anne Tomlinson, Johanne Tonge, Simon Tranquillini, Caio Trinick, Tom Tyson, Linda Vasant, Julia Vilimiene, Neringa Walker, Lynne Ward, Emma Warren, Simon Watson, Ekaterina Watt, A Weir, Jennifer Westwell, Fran Whileman, Amanda White, Nikki Wilkinson, Beverly Williams, Claire Williams, M Willshaw, Stephanie Wilson-Davies, E Winchester, Stephen Wiselka, Martin Wong, N Woolcook, Megan Wycherley, Diane Young, Charlotte Zambon, Maria Zheng, Qi BMJ Research OBJECTIVE: To describe the incidence of, risk factors for, and impact of vaccines on primary SARS-CoV-2 infection during the second wave of the covid-19 pandemic in susceptible hospital healthcare workers in England. DESIGN: Multicentre prospective cohort study. SETTING: National Health Service secondary care health organisations (trusts) in England between 1 September 2020 and 30 April 2021. PARTICIPANTS: Clinical, support, and administrative staff enrolled in the SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) study with no evidence of previous infection. Vaccination status was obtained from national covid-19 vaccination registries and self-reported. MAIN OUTCOME MEASURE: SARS-CoV-2 infection confirmed by polymerase chain reaction. Mixed effects logistic regression was conducted to determine demographic and occupational risk factors for infection, and an individual based mathematical model was used to predict how large the burden could have been if vaccines had not been available from 8 December 2020 . RESULTS: During England’s second wave, 12.9% (2353/18 284) of susceptible SIREN participants became infected with SARS-CoV-2. Infections peaked in late December 2020 and decreased from January 2021, concurrent with the cohort’s rapid vaccination coverage and a national lockdown. In multivariable analysis, factors increasing the likelihood of infection in the second wave were being under 25 years old (20.3% (132/651); adjusted odds ratio 1.35, 95% confidence interval 1.07 to 1.69), living in a large household (15.8% (282/1781); 1.54, 1.23 to 1.94, for participants from households of five or more people), having frequent exposure to patients with covid-19 (19.2% (723/3762); 1.79, 1.56 to 2.06, for participants with exposure every shift), working in an emergency department or inpatient ward setting (20.8% (386/1855); 1.76, 1.45 to 2.14), and being a healthcare assistant (18.1% (267/1479); 1.43, 1.16 to 1.77). Time to first vaccination emerged as being strongly associated with infection (P<0.001), with each additional day multiplying a participant’s adjusted odds ratio by 1.02. Mathematical model simulations indicated that an additional 9.9% of all patient facing hospital healthcare workers would have been infected were it not for the rapid vaccination coverage. CONCLUSIONS: The rapid covid-19 vaccine rollout from December 2020 averted infection in a large proportion of hospital healthcare workers in England: without vaccines, second wave infections could have been 69% higher. With booster vaccinations being needed for adequate protection from the omicron variant, and perhaps the need for further boosters for future variants, ensuring equitable delivery to healthcare workers is essential. The findings also highlight occupational risk factors that persisted in healthcare workers despite vaccine rollout; a greater understanding of the transmission dynamics responsible for these is needed to help to optimise the infection prevention and control policies that protect healthcare workers from infection and therefore to support staffing levels and maintain healthcare provision. TRIAL REGISTRATION: ISRCTN registry ISRCTN11041050. BMJ Publishing Group Ltd. 2022-07-20 /pmc/articles/PMC9295077/ /pubmed/35858689 http://dx.doi.org/10.1136/bmj-2022-070379 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Pople, Diane Monk, Edward J M Evans, Stephanie Foulkes, Sarah Islam, Jasmin Wellington, Edgar Atti, Ana Hope, Russell Robotham, Julie Hopkins, Susan Brown, Colin S Hall, Victoria J Adebiyi, Omoyeni Adeboyeku, David Aeron-Thomas, Jonnie Aga, Masood Agwuh, K Ahmad, S Akhtar, Talat Akhtar, S Aldridge, N Al-Khafaji, Zehra’a Allsop, Lynne Ambalkar, Shrikant Andrews, Nick Arenas-Pinto, Alejandro Ashby, Helen Ashcroft, John Ashton, Maxine Auckland, Cressida Bagary, Manny Baillon, Sarah Bain, Steve Bakker, Philippa Barbour, Lisa Barnes, T Bateman, Vhairi Beekes, Mandy Berry, L Bhayani, Janki Bishop, Jennifer Bishop, Lisa Black, Karen Board, Sarah Boss, David Boulos, Angel Boyd, G Brake, Simon Brand, Sarah Broadley, Andrew Brookes, Claire Brooks, Tim Brown, Alison Brown, Kerryanne Browne, D Burns, Philippa Burton, Ben Butt, Georgina Calbraith, Davina Cameron, Euan Chand, Meera Chandrasekaran, Badrinathan Charlett, Andre Chaudhuri, Ray Chawla, Anu Chenoweth, H Chitalia, Nihil Cochrane, Alexandra Coke, Louise Cole, Michelle Coles, Holly Colton, James Conneely, Joanna Conneely, Paul Corless, Claire Corrigan, Dianne Court, Kathryn Cowley, Anna Cowling, Peter Cromey, Lisa Crosby-Nwaobi, Roxanne Crowe, Jane D’Arcangelo, Silvia Dave, Ananta Dawson, Joy de Lacy, Ellen de Silva, Thushan Del Rosario, Ismaelette Democratis, Jane Dhasmana, Devesh Diaz, Stephanie Dimmer, Allison Ditchfield, Lisa Dobbie, Laura Doel, Allison Donaghy, Tracy Duff, Christopher Dytmer, David Easom, Nicholas Edgar, Joanne Edmunds, Tracy Elliott, John Ellis, Yvette Elumogo, Ngozi Kirby, Eve Etell Faris, Barzo Favager, Clair Finlayson, Lauren Ford, Christine Fowler, Susan Fowles-Gutierrez, Nabila Fraile, Eva Frieslick, Joan Froude, Susannah Gallagher, Eileen Galliford, Joanne Game, F Geen, John Gibson, Hannah Giles, J Goldberg, David Goodwin, Jayne Gormley, S Gould, Imogen Grant, Alison Graves, Jennifer Gray, Kim Gray, Joanne Gray, Katherine Green, Marie Greenwood, Susan Guha, Simantee Hacon, Christian Halkes, Mathew Hams, Steve Hanison, Esther Hanna, Elinor Harbham, Pratap Harman, Paula Harris, Edward Harris, Penny Harrison, G Harvey, D Harwood, J Hatton, Jonathan Hawkins, April Hettiarachchi, Nipunadi Hewson, Jacqueline Higham, Andrew Hinch, Sarah Ho, Antonia Hoad, Ina Holliday, Kyra Hollinshead, Kathryn Holmes, Christopher Horne, Stacey Horsley, A Houston, Angela Howard, M Howard, Joanne Howcroft, Deborah Howell, Kate Huang, Y Hudson, Karen Hughes, Lauren Insalata, Ferdinando Irvine, Val James, Kate Johnston, Frances Johnstone, Helen Jones, C Jorgenson, Annelysse Jory, Hannah Joseph, Maya Kalakonda, Nagesh Kemsley, Philippa Keogh, Siobhan Kerrison, C Khan, Shivani Khanduri, Sheena Khawam, Jameel Kyffin, Robert Larru, A Latham, Scott Laugharne, Richard Lazarus, Rajeka Lee, Mihye Lester, Yvonne Lewis, Kenisha Lewis, T Lewis, Tracy Linley, Ezra Long, Josie Longfellow, Ruth Loughrey, Clodagh Luckas, Murray Mackay, Shekoo Mahabir, Natasha Mahungu, Tabitha Malcolm, Martin Maseda, Diego Matuluko, Ayo Maxwell, V McAdam, Clare McCracken, Danielle Mcwilliam, S Meda, Manjula Mercer, Pauline Milligan, Iain Mirfenderesky, Mariyam Mistry, Raksha Moody, A Moran, Kelly Jones, Caroline Mulvaney Munro, Katie Murphy, Michael Nash, Maxine Neill, Claire Nimako, K Norman, Chris Norman, Chris O’Connell, Anne-Marie O'Kane, Maurice O'Kelly, A Omar, Zohra Otter, Ashley Paques, Kitty Patel, Manish Payne, B Pegg, C Penn, R Pepper, Stacey Pepperell, Justin Pethick, James Pickard, Graham Piercy, Charlie Planche, Tim Plant, Aiden Pothecary, Carla Pottinger, G Powell, James Price, Lesley Price, Cathy Prince, Stephanie Jones, Rowan Pritchard Protaschik, Yuri Qazzafi, Zaman Rajgopal, A Ramsay, Mary Reeks, Chloe Reynolds, T Richardson, Lisa Ridley, P Roberts, Julia Robinson, L Rodger, Alison Roebuck, Alun Rokakis, Anna Rowe, Cathy Roynon, Anna Russell, J Sach, Lauren Saei, Ayoub Sajedi, Noshin Semper, Amanda Sergenson, Nicola Severn, Abigail Shah, A Shipman, K Shorten, Robert Sierra, R Sinclair, Janet Sinclair, Catherine Sinclair, Aaran Sovriarova, Helena Stafford, Claire Stevens, Guy Stewart, B Strong-Sheldrake, Sophia SubhroOsuji, Banerjee Szewczyk, Mags Tarr, Esther Taylor-Kerr, Andrew Tazzyman, Simon Telfer, Andrew Temple-Purcell, Rebecca Templeton, Kate Thomas, Claire Thompson, Catherine Thompson, Fiona Tilley, R Timeyin, Jean Todd, Anne Tomlinson, Johanne Tonge, Simon Tranquillini, Caio Trinick, Tom Tyson, Linda Vasant, Julia Vilimiene, Neringa Walker, Lynne Ward, Emma Warren, Simon Watson, Ekaterina Watt, A Weir, Jennifer Westwell, Fran Whileman, Amanda White, Nikki Wilkinson, Beverly Williams, Claire Williams, M Willshaw, Stephanie Wilson-Davies, E Winchester, Stephen Wiselka, Martin Wong, N Woolcook, Megan Wycherley, Diane Young, Charlotte Zambon, Maria Zheng, Qi Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title | Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title_full | Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title_fullStr | Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title_full_unstemmed | Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title_short | Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines: prospective multicentre cohort study (SIREN) and mathematical model |
title_sort | burden of sars-cov-2 infection in healthcare workers during second wave in england and impact of vaccines: prospective multicentre cohort study (siren) and mathematical model |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295077/ https://www.ncbi.nlm.nih.gov/pubmed/35858689 http://dx.doi.org/10.1136/bmj-2022-070379 |
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burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harmanpaula burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harrisedward burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harrispenny burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harrisong burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harveyd burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT harwoodj 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burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hoantonia burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hoadina burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hollidaykyra burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hollinsheadkathryn burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT holmeschristopher burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hornestacey 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burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT huangy burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hudsonkaren burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT hugheslauren burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT insalataferdinando burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT irvineval burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT jameskate 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burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT khawamjameel burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT kyffinrobert burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT larrua burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lathamscott burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT laugharnerichard burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lazarusrajeka burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT leemihye burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lesteryvonne burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lewiskenisha burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lewist burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT lewistracy burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT linleyezra burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT longjosie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT longfellowruth burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT loughreyclodagh burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT luckasmurray burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mackayshekoo burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mahabirnatasha burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mahungutabitha burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT malcolmmartin burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT masedadiego burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT matulukoayo burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT maxwellv burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mcadamclare burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mccrackendanielle burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mcwilliams burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT medamanjula burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mercerpauline burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT milliganiain burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mirfendereskymariyam burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT mistryraksha burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT moodya burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT morankelly burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT jonescarolinemulvaney burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT munrokatie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT murphymichael burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT nashmaxine burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT neillclaire burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT nimakok burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT normanchris burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT normanchris burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT oconnellannemarie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT okanemaurice burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT okellya burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT omarzohra burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT otterashley burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT paqueskitty burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT patelmanish burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT payneb burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT peggc burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pennr burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pepperstacey burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pepperelljustin burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pethickjames burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pickardgraham burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT piercycharlie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT planchetim burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT plantaiden burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pothecarycarla burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pottingerg burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT powelljames burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pricelesley burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT pricecathy burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT princestephanie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT jonesrowanpritchard burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT protaschikyuri burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT qazzafizaman burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT rajgopala burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT ramsaymary burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT reekschloe burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT reynoldst burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT richardsonlisa burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT ridleyp burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT robertsjulia burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT robinsonl burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT rodgeralison burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT roebuckalun burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT rokakisanna burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT rowecathy burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT roynonanna burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT russellj burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sachlauren burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT saeiayoub burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sajedinoshin burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT semperamanda burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sergensonnicola burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT severnabigail burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT shaha burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT shipmank burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT shortenrobert burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sierrar burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sinclairjanet burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sinclaircatherine burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sinclairaaran burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT sovriarovahelena burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT staffordclaire burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT stevensguy burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT stewartb burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT strongsheldrakesophia burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT subhroosujibanerjee burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT szewczykmags burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tarresther burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT taylorkerrandrew burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tazzymansimon burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT telferandrew burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT templepurcellrebecca burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT templetonkate burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT thomasclaire burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT thompsoncatherine burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT thompsonfiona burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tilleyr burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT timeyinjean burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT toddanne burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tomlinsonjohanne burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tongesimon burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tranquillinicaio burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT trinicktom burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT tysonlinda burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT vasantjulia burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT vilimieneneringa burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT walkerlynne burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wardemma burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT warrensimon burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT watsonekaterina burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT watta burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT weirjennifer burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT westwellfran burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT whilemanamanda burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT whitenikki burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wilkinsonbeverly burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT williamsclaire burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT williamsm burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT willshawstephanie burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wilsondaviese burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT winchesterstephen burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wiselkamartin burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wongn burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT woolcookmegan burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT wycherleydiane burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT youngcharlotte burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT zambonmaria burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel AT zhengqi burdenofsarscov2infectioninhealthcareworkersduringsecondwaveinenglandandimpactofvaccinesprospectivemulticentrecohortstudysirenandmathematicalmodel |