Presence of Symptoms 6 Weeks After COVID-19 Among Vaccinated and Unvaccinated U.S. Healthcare Personnel

ABSTRACT

AO_SCPLOWBSTRACTC_SCPLOWO_ST_ABSImportanceC_ST_ABSAlthough COVID-19 vaccines protect against infection and severe disease, the role of vaccination in preventing prolonged symptoms in those with subsequent infection is unclear. ObjectiveTo determine differences in symptoms stratified by prior vaccination reported by healthcare personnel (HCP) 6 weeks after onset of COVID-19, and whether there were differences in timing of return to work. DesignNested cohort study within a multicenter vaccine effectiveness study. HCP with COVID-19 between December 2020 and August 2021 were followed up 6 weeks after illness onset. SettingHealth systems in 12 U.S. states. ParticipantsHCP participating in a vaccine effectiveness study were eligible for inclusion if they had confirmed COVID-19 with either verified mRNA vaccination (symptom onset [≥]14 days after two doses) or no prior COVID-19 vaccination. Among 681 eligible participants, 419 (61%) completed a follow-up survey approximately 6 weeks after illness onset. ExposuresTwo doses of a COVID-19 mRNA vaccine compared with no COVID-19 vaccine. Main outcomes and measuresPresence of symptoms 6 weeks after onset of COVID-19 illness and days to return to work after COVID-19 illness. ResultsAmong 419 HCP with confirmed COVID-19, 298 (71%) reported one or more COVID-like symptoms 6 weeks after illness onset, with a lower prevalence among vaccinated participants (60.6%) compared with unvaccinated participants (60.6% vs. 79.1%; aRR 0.70, 95% CI 0.58-0.84). Vaccinated HCP returned to work a median 2.0 days (95% CI 1.0-3.0) sooner than unvaccinated HCP (aHR 1.37; 95% CI, 1.04-1.79). ConclusionsA history of two doses of COVID-19 mRNA vaccine among HCP with COVID-19 illness was associated with decreased risk of COVID-like symptoms at 6 weeks and earlier to return to work. Vaccination is associated with improved recovery from COVID-19, in addition to preventing symptomatic infection. KEY POINTSO_ST_ABSQuestionC_ST_ABSDoes vaccination lead to improved recovery of symptoms and return to work following COVID-19? FindingsIn this nested cohort study of healthcare personnel, participants with COVID-19 who had received two doses of a COVID-19 mRNA vaccine were less likely to report symptoms 6 weeks after illness onset than participants with COVID-19 who were unvaccinated. Return to work was sooner if previously vaccinated. MeaningVaccination is associated with improved recovery from COVID-19, in addition to prevention of infection and disease.