{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T15:47:06Z","timestamp":1758124026017,"version":"3.40.5"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21004499_as1\"><jats:title>Objective:<\/jats:title><jats:p>To describe the incidence of systemic overlap and typical coronavirus disease 2019 (COVID-19) symptoms in healthcare personnel (HCP) following COVID-19 vaccination and association of reported symptoms with diagnosis of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in the context of public health recommendations regarding work exclusion.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21004499_as2\"><jats:title>Design:<\/jats:title><jats:p>This prospective cohort study was conducted between December 16, 2020, and March 14, 2021, with HCP who had received at least 1 dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21004499_as3\"><jats:title>Setting:<\/jats:title><jats:p>Large healthcare system in New England.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21004499_as4\"><jats:title>Interventions:<\/jats:title><jats:p>HCP were prompted to complete a symptom survey for 3 days after each vaccination. Reported symptoms generated automated guidance regarding symptom management, SARS-CoV-2 testing requirements, and work restrictions. Overlap symptoms (ie, fever, fatigue, myalgias, arthralgias, or headache) were categorized as either lower or higher severity. Typical COVID-19 symptoms included sore throat, cough, nasal congestion or rhinorrhea, shortness of breath, ageusia and anosmia.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21004499_as5\"><jats:title>Results:<\/jats:title><jats:p>Among 64,187 HCP, a postvaccination electronic survey had response rates of 83% after dose 1 and 77% after dose 2. Report of \u22653 lower-severity overlap symptoms, \u22651 higher-severity overlap symptoms, or at least 1 typical COVID-19 symptom after dose 1 was associated with increased likelihood of testing positive. HCP with prior COVID-19 infection were significantly more likely to report severe overlap symptoms after dose 1.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21004499_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Reported overlap symptoms were common; however, only report of \u22653 low-severity overlap symptoms, at least 1 higher-severity overlap symptom, or any typical COVID-19 symptom were associated with infection. Work-related restrictions for overlap symptoms should be reconsidered.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.449","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T09:08:18Z","timestamp":1635844098000},"page":"1439-1446","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Symptom monitoring after coronavirus disease 2019 (COVID-19) vaccination in a large integrated healthcare system: Separating symptoms from severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-1123","authenticated-orcid":false,"given":"Erica S.","family":"Shenoy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paige G.","family":"Wickner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren R.","family":"West","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleena","family":"Banerji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly G.","family":"Blumenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda J.","family":"Centi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Gottlieb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean M.","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvel","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn A.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam B.","family":"Landman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"S0899823X21004499_ref1","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.15585\/mmwr.mm695152e1","article-title":"The Advisory Committee on Immunization Practices\u2019 interim recommendation for use of Moderna COVID-19 vaccine\u2014United States, December 2020","volume":"69","author":"Oliver","year":"2021","journal-title":"Morb Mortal Wkly Rep"},{"key":"S0899823X21004499_ref29","doi-asserted-by":"crossref","first-page":"100914","DOI":"10.1016\/j.eclinm.2021.100914","article-title":"Association between previous infection with SARS CoV-2 and the risk of self-reported symptoms after mRNA BNT162b2 vaccination: data from 3,078 healthcare workers","volume":"36","author":"d\u2019Arminio Monforte","year":"2021","journal-title":"EClinicalMedicine"},{"key":"S0899823X21004499_ref24","unstructured":"24. 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Accessed December 16, 2020."},{"key":"S0899823X21004499_ref2","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.15585\/mmwr.mm6950e2","article-title":"The Advisory Committee on Immunization Practices\u2019 interim recommendation for use of Pfizer-BioNTech COVID-19 vaccine\u2014United States, December 2020","volume":"69","author":"Oliver","year":"2020","journal-title":"Morb Mortal Wkly Rep"},{"key":"S0899823X21004499_ref13","unstructured":"13. Dowle, MS. data.table: extension of data.frame. R package version 1.14.0., 2021. https:\/\/CRAN.R-project.org\/package=data.table."},{"key":"S0899823X21004499_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S0899823X21004499_ref18","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/S0140-6736(21)00790-X","article-title":"Effectiveness of BNT162b2 mRNA vaccine against infection and COVID-19 vaccine coverage in healthcare workers in England, multicentre prospective cohort study (the SIREN Study)","volume":"397","author":"Hall","year":"2021","journal-title":"Lancet"},{"key":"S0899823X21004499_ref28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2101667"},{"key":"S0899823X21004499_ref22","unstructured":"22. Moderna COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee December 17, 2020, meeting briefing document- sponsor, 2020. Food and Drug Administration website. https:\/\/www.fda.gov\/media\/144452\/. Published 2020. Accessed October 13, 2021."},{"key":"S0899823X21004499_ref19","first-page":"979","article-title":"FDA-authorized mRNA COVID-19 vaccines are effective per real-world evidence synthesized across a multistate health system","volume":"2","author":"Pawlowski","year":"2021","journal-title":"Med (N Y)"},{"key":"S0899823X21004499_ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2102131"},{"key":"S0899823X21004499_ref11","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1001\/jama.2021.3976","article-title":"Acute allergic reactions to mRNA COVID-19 vaccines","volume":"325","author":"Blumenthal","year":"2021","journal-title":"JAMA"},{"key":"S0899823X21004499_ref9","unstructured":"9. V-safe after vaccination health checker. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/safety\/vsafe.html. Accessed April 19, 2021."},{"key":"S0899823X21004499_ref17","unstructured":"17. Local reactions, systemic reactions, adverse events, and serious adverse events: Moderna COVID-19 vaccine. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/vaccines\/covid-19\/info-by-product\/moderna\/reactogenicity.html. Accessed April 19, 2021."},{"key":"S0899823X21004499_ref14","unstructured":"14. Sjoberg, DC , Hannum, M , Whiting, M , Zabor, K , EC. gtsummary: presentation-ready data summary and analytic result tables, R package version 1.3.7. 2021. https:\/\/CRAN.R-project.org\/package=gtsummary. Accessed April 19, 2021."},{"key":"S0899823X21004499_ref5","unstructured":"5. Postvaccine considerations for healthcare personnel. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/community\/workplaces-businesses\/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fpost-vaccine-considerations-healthcare-personnel.html. Published 2020. Accessed December 16, 2020."},{"key":"S0899823X21004499_ref31","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.7326\/M21-1213","article-title":"Association between caseload surge and COVID-19 survival in 558 US hospitals, March to August 2020","volume":"174","author":"Kadri","year":"2021","journal-title":"Ann Intern Med"},{"key":"S0899823X21004499_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"S0899823X21004499_ref21","unstructured":"21. Moderna COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee December 17, 2020, meeting briefing document addendum- sponsor. Food and Drug Administration website. https:\/\/www.fda.gov\/media\/144453\/. Published 2020. Accessed October 13, 2021."},{"key":"S0899823X21004499_ref30","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/bmjqs-2020-011512","article-title":"Chronic hospital nurse understaffing meets COVID-19: an observational study","volume":"30","author":"Lasater","year":"2021","journal-title":"BMJ Qual Saf"},{"key":"S0899823X21004499_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00224-3"},{"key":"S0899823X21004499_ref16","unstructured":"16. Local reactions, systemic reactions, adverse events, and serious adverse events: Pfizer-BioNTech COVID-19 vaccine. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/vaccines\/covid-19\/info-by-product\/pfizer\/reactogenicity.html. Accessed April 19, 2021."},{"key":"S0899823X21004499_ref26","unstructured":"26. COVID-19 dashboard. Massachusetts Department of Public Health Bureau of Infectious Diseases and Laboratory Sciences and the Registry of Vital Records and Statistics, Office of Integrated Surveillance and Informatics Services. State of Massachusetts website. https:\/\/www.mass.gov\/info-details\/covid-19-response-reporting#covid-19-interactive-data-dashboard-. Published 2021. Accessed October 13, 2021."},{"key":"S0899823X21004499_ref10","doi-asserted-by":"publisher","DOI":"10.2196\/19533"},{"key":"S0899823X21004499_ref15","unstructured":"15. R Core Team. R: a language and environment for statistical computing. https:\/\/www.R-project.org\/. Accessed April 19, 2021."},{"key":"S0899823X21004499_ref20","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7013e3"},{"key":"S0899823X21004499_ref25","unstructured":"25. Janssen COVID-19 vaccine. Vaccines and Related Biological Products Advisory Committee, February 26, 2021, meeting briefing document addendum \u2013 sponsor. 2021. Food and Drug Administration website. https:\/\/www.fda.gov\/media\/146218\/. Published 2021. 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