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Volume 10
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10.3390/vaccines10081322
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Article

Impact of COVID-19 Vaccination on Healthcare Worker Infection Rate and Outcome during SARS-CoV-2 Omicron Variant Outbreak in Hong Kong

by
Sze-Tsing Zee
1,2,*,
Lam-Fung Kwok
3,
Ka-Man Kee
3,
Ling-Hiu Fung
4,
Wing-Pan Luk
4,
Tsun-Leung Chan
1,
Chin-Pang Leung
1,
Pik-Wa Yu
2,
Jhan Hung
2,
Kit-Ying SzeTo
2,
Wai-Leng Chan
2,3,
Siu-Fai Tang
1,2,
Wai-Chi Lin
5,
Shiu-Kwan Ma
1,
Koon-Hung Lee
5,
Chor-Chiu Lau
5 and
Wai-Hung Yung
1,2,5
1
Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, Hong Kong 999077, China
2
Infection Control Team, Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, Hong Kong 999077, China
3
Quality & Safety Division, Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, Hong Kong 999077, China
4
Research Department, Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, Hong Kong 999077, China
5
Hospital Administration, Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, Hong Kong 999077, China
*
Author to whom correspondence should be addressed.
Vaccines 2022, 10(8), 1322; https://doi.org/10.3390/vaccines10081322
Submission received: 17 July 2022 / Revised: 4 August 2022 / Accepted: 9 August 2022 / Published: 15 August 2022
(This article belongs to the Section COVID-19 Vaccines and Vaccination)
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Abstract

Immune escape is observed with SARS-CoV-2 Omicron (Pango lineage B.1.1.529), the predominant circulating strain worldwide. A booster dose was shown to restore immunity against Omicron infection; however, real-world data comparing mRNA (BNT162b2; Comirnaty) and inactivated vaccines’ (CoronaVac; Sinovac) homologous and heterologous boosting are lacking. A retrospective study was performed to compare the rate and outcome of COVID-19 in healthcare workers (HCWs) with various vaccination regimes during a territory-wide Omicron BA.2.2 outbreak in Hong Kong. During the study period from 1 February to 31 March 2022, 3167 HCWs were recruited, and 871 HCWs reported 746 and 183 episodes of significant household and non-household close contact. A total of 737 HCWs acquired COVID-19, all cases of which were all clinically mild. Time-dependent Cox regression showed that, compared with two-dose vaccination, three-dose vaccination reduced infection risk by 31.7% and 89.3% in household contact and non-household close contact, respectively. Using two-dose BNT162b2 as reference, two-dose CoronaVac recipient had significantly higher risk of being infected (HR 1.69 p < 0.0001). Three-dose BNT162b2 (HR 0.4778 p< 0.0001) and two-dose CoronaVac + BNT162b2 booster (HR 0.4862 p = 0.0157) were associated with a lower risk of infection. Three-dose CoronaVac and two-dose BNT162b2 + CoronaVac booster were not significantly different from two-dose BNT162b2. The mean time to achieve negative RT-PCR or E gene cycle threshold 31 or above was not affected by age, number of vaccine doses taken, vaccine type, and timing of the last dose. In summary, we have demonstrated a lower risk of breakthrough SARS-CoV-2 infection in HCWs given BNT162b2 as a booster after two doses of BNT162b2 or CoronaVac.
Keywords: SARS-CoV-2; Omicron variant of concern; homologous boosting; heterologous boosting; CoronaVac; BNT162b2; healthcare worker; return-to-work SARS-CoV-2; Omicron variant of concern; homologous boosting; heterologous boosting; CoronaVac; BNT162b2; healthcare worker; return-to-work

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MDPI and ACS Style

Zee, S.-T.; Kwok, L.-F.; Kee, K.-M.; Fung, L.-H.; Luk, W.-P.; Chan, T.-L.; Leung, C.-P.; Yu, P.-W.; Hung, J.; SzeTo, K.-Y.; et al. Impact of COVID-19 Vaccination on Healthcare Worker Infection Rate and Outcome during SARS-CoV-2 Omicron Variant Outbreak in Hong Kong. Vaccines 2022, 10, 1322. https://doi.org/10.3390/vaccines10081322

AMA Style

Zee S-T, Kwok L-F, Kee K-M, Fung L-H, Luk W-P, Chan T-L, Leung C-P, Yu P-W, Hung J, SzeTo K-Y, et al. Impact of COVID-19 Vaccination on Healthcare Worker Infection Rate and Outcome during SARS-CoV-2 Omicron Variant Outbreak in Hong Kong. Vaccines. 2022; 10(8):1322. https://doi.org/10.3390/vaccines10081322

Chicago/Turabian Style

Zee, Sze-Tsing, Lam-Fung Kwok, Ka-Man Kee, Ling-Hiu Fung, Wing-Pan Luk, Tsun-Leung Chan, Chin-Pang Leung, Pik-Wa Yu, Jhan Hung, Kit-Ying SzeTo, and et al. 2022. "Impact of COVID-19 Vaccination on Healthcare Worker Infection Rate and Outcome during SARS-CoV-2 Omicron Variant Outbreak in Hong Kong" Vaccines 10, no. 8: 1322. https://doi.org/10.3390/vaccines10081322

APA Style

Zee, S.-T., Kwok, L.-F., Kee, K.-M., Fung, L.-H., Luk, W.-P., Chan, T.-L., Leung, C.-P., Yu, P.-W., Hung, J., SzeTo, K.-Y., Chan, W.-L., Tang, S.-F., Lin, W.-C., Ma, S.-K., Lee, K.-H., Lau, C.-C., & Yung, W.-H. (2022). Impact of COVID-19 Vaccination on Healthcare Worker Infection Rate and Outcome during SARS-CoV-2 Omicron Variant Outbreak in Hong Kong. Vaccines, 10(8), 1322. https://doi.org/10.3390/vaccines10081322

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