Incidence and risk factors of COVID-19 in a tertiary hospital and the effectiveness of booster vaccination among health care workers: A retrospective cohort study, January 2020 to June 2022

Am J Infect Control. 2024 Jun;52(6):688-695. doi: 10.1016/j.ajic.2024.01.010. Epub 2024 Jan 19.

Abstract

Background: Health care workers (HCWs) face a higher risk of infection and may transmit pathogens to patients during a pandemic. This study aims to evaluate infection-control measures by analyzing the incidence and risk factors of COVID-19 and estimating vaccine effectiveness (VE) at a tertiary hospital in Seoul, Republic of Korea.

Methods: This study included 2,516 HCWs from January 1, 2020, to June 30, 2022. Data were analyzed to determine the incidence density and cumulative incidence; the results were compared by the age- and gender-specific standardized incidence ratios (SIR). VE was estimated with multivariate Cox proportional-hazard models as 1-adjusted hazard ratio × 100%.

Results: SIR indicated a lower COVID-19 risk in the hospital population than in the general Korean population (SIR, 0.81; 95% confidence interval [CI]: 0.76-0.87). Multivariate Cox analysis indicated that, compared to doctors, nonmedical service supporters and other HCWs (excluding doctors and nurses) were high-risk groups (adjusted hazard ratio [95% CI], 1.72 [1.04-2.83] and 1.76 [1.20-2.58], respectively). Compared to the outpatient unit, the emergency department was a high-risk department (1.70 [1.16-2.50]). The VE of the booster dose was 55.47%, compared to no or incomplete vaccination (95% CI: 22.63-74.37).

Conclusions: Besides encouraging HCWs vaccination, effective infection-control measures should target high-risk groups and departments.

Keywords: Emerging infectious diseases; Infection control; SARS-CoV-2; Vaccine effectiveness.

MeSH terms

  • Adult
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / immunology
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Female
  • Health Personnel* / statistics & numerical data
  • Humans
  • Immunization, Secondary* / statistics & numerical data
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2* / immunology
  • Tertiary Care Centers* / statistics & numerical data
  • Vaccination / statistics & numerical data
  • Vaccine Efficacy / statistics & numerical data
  • Young Adult

Substances

  • COVID-19 Vaccines