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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Mar 18, 2021
Date Accepted: May 26, 2021
Date Submitted to PubMed: May 31, 2021

The final, peer-reviewed published version of this preprint can be found here:

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

Lutrick K, Ellingson KD, Baccam Z, Rivers P, Beitel S, Parker J, Hollister J, Sun X, Gerald JK, Komatsu K, Kim E, LaFleur B, Grant L, Yoo YM, Kumar A, Mayo Lamberte J, Cowling BJ, Cobey S, Thornburg NJ, Meece JK, Kutty P, Nikolich-Zugich J, Thompson MG, Burgess JL

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

JMIR Res Protoc 2021;10(6):e28925

DOI: 10.2196/28925

PMID: 34057904

PMCID: 8386365

COVID-19 Infection, Reinfection, and Vaccine Effectiveness in a Prospective Cohort of Arizona Frontline/Essential Workers: The AZ HEROES Research Protocol

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

ABSTRACT

Background:

Individuals in certain occupations are at increased risk of SARS-CoV-2 infection because of frequent close contact with others, including healthcare personnel (HCP), first responders (FR), and other essential workers (OEW). Recent studies highlight the elevated risk of exposure and infection among HCP, with more severe outcomes experienced by racial and ethnic minority HCP.

Objective:

The Arizona Healthcare, Emergency Response, and Other Essential workers Study (AZ HEROES) aims to examine the epidemiology of SARS-CoV-2 infection and COVID-19 illness among adults with high occupational exposure risk.

Methods:

Eligible participants include Arizona residents aged 18–85 years who work at least 20 hours per week in an occupation involving regular direct contact (within three feet) with others. Recruitment goals are stratified by demographic characteristics (50% aged 40 or older, 50% women, and 50% Hispanic or American Indian), by occupation (40% healthcare personnel, 30% first responders, and 30% other essential workers), and by prior SARS-CoV-2 infection (with up to 50% seropositive at baseline). Information on sociodemographics, health and medical history, vaccination status, exposures to individuals with suspected or confirmed SARS-CoV-2 infection, use of personal protective equipment, and perceived risks are collected at enrollment and updated through quarterly surveys. Every week, participants complete active surveillance for COVID-19–like illness (CLI) and self-collect nasal swabs. Additional self-collected nasal swab and saliva specimens are collected in the event of CLI onset. Respiratory specimens are sent to Marshfield Laboratories and tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) assay. CLI symptoms and impact on work and productivity are followed through illness resolution. Serum specimens are collected every 3 months and additional sera are collected following incident rRT-PCR positivity and after each COVID-19 vaccine dose. Incidence of SARS-CoV-2 infections will be calculated by person-weeks at risk and compared by occupation and demographic characteristics and by seropositivity status and infection and vaccination history.

Results:

To date, 3,033 participants have been enrolled in the statewide cohort.

Conclusions:

AZ HEROES is unique in aiming to recruit a diverse sample of essential workers and prospectively following strata of SARS-CoV-2 seronegative and seropositive adults. Survey results combined with active surveillance data on exposure, CLI, weekly molecular diagnostic testing, and periodic serology will be used to estimate the incidence of symptomatic and asymptomatic SARS-CoV-2 infection, assess the intensity and durability of immune responses to natural infection and COVID-19 vaccination, and contribute to the evaluation of COVID-19 vaccine effectiveness.


 Citation

Please cite as:

Lutrick K, Ellingson KD, Baccam Z, Rivers P, Beitel S, Parker J, Hollister J, Sun X, Gerald JK, Komatsu K, Kim E, LaFleur B, Grant L, Yoo YM, Kumar A, Mayo Lamberte J, Cowling BJ, Cobey S, Thornburg NJ, Meece JK, Kutty P, Nikolich-Zugich J, Thompson MG, Burgess JL

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

JMIR Res Protoc 2021;10(6):e28925

DOI: 10.2196/28925

PMID: 34057904

PMCID: 8386365

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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.