{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:03:29Z","timestamp":1771657409020,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canadian Institutes of Health Research","award":["173212"],"award-info":[{"award-number":["173212"]}]},{"name":"Canadian Institutes of Health Research","award":["181116"],"award-info":[{"award-number":["181116"]}]},{"name":"Canadian Institutes of Health Research","award":["6014200738"],"award-info":[{"award-number":["6014200738"]}]},{"name":"Canadian Institutes of Health Research","award":["2021-HQ-000149"],"award-info":[{"award-number":["2021-HQ-000149"]}]},{"name":"Physician Services Incorporated Foundation","award":["173212"],"award-info":[{"award-number":["173212"]}]},{"name":"Physician Services Incorporated Foundation","award":["181116"],"award-info":[{"award-number":["181116"]}]},{"name":"Physician Services Incorporated Foundation","award":["6014200738"],"award-info":[{"award-number":["6014200738"]}]},{"name":"Physician Services Incorporated Foundation","award":["2021-HQ-000149"],"award-info":[{"award-number":["2021-HQ-000149"]}]},{"name":"Weston Family Foundation","award":["173212"],"award-info":[{"award-number":["173212"]}]},{"name":"Weston Family Foundation","award":["181116"],"award-info":[{"award-number":["181116"]}]},{"name":"Weston Family Foundation","award":["6014200738"],"award-info":[{"award-number":["6014200738"]}]},{"name":"Weston Family Foundation","award":["2021-HQ-000149"],"award-info":[{"award-number":["2021-HQ-000149"]}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["173212"],"award-info":[{"award-number":["173212"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["181116"],"award-info":[{"award-number":["181116"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["6014200738"],"award-info":[{"award-number":["6014200738"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["2021-HQ-000149"],"award-info":[{"award-number":["2021-HQ-000149"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Essential workers, including those working in healthcare and education, are at higher risk of exposure to communicable diseases, including SARS-CoV-2. Reducing the rates of infection is important for their personal health and for the ongoing safe operation of essential services. Methods: Data from participants in two prospective cohort studies who tested positive for SARS-CoV-2 in 2020 through 2023 were used to determine whether vaccination against SARS-CoV-2 is associated with the severity of symptoms in working-age adults. Results: SARS-CoV-2-positive tests (N = 3757) were reported by 3093 participants (mean: 1.2 per person); 1229 (33%) illnesses did not interfere with regular activities, 1926 (51%) made participants too unwell for regular activities, and 602 (16%) required participant bed rest. Compared with vaccine receipt more than 12 months earlier, receipt within six months of an infection was associated with lower risk ratios for more severe illness (too unwell: 0.69 and bed rest: 0.67) compared with being able to conduct regular activities. More recent vaccination was also associated with lower odds reporting of systemic symptoms (fever, myalgia, arthralgia) and fewer solicited symptoms. Conclusion: Staying current with COVID-19 vaccinations should continue to be recommended since receiving a recent immunization lessened the severity of illness. Also, as symptoms of COVID-19 are now largely similar to other respiratory viruses, practitioners need to use this evidence to inform diagnostic testing and return-to-work policies.<\/jats:p>","DOI":"10.3390\/ijerph21111501","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T08:12:39Z","timestamp":1731399159000},"page":"1501","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Recent Vaccination Against SARS-CoV-2 Is Associated with Less Severe Disease in Working-Age Adults"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8984-9177","authenticated-orcid":false,"given":"Kailey","family":"Fischer","sequence":"first","affiliation":[{"name":"Sinai Health, 600 University Ave, Toronto, ON M5G 1X5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3270-7345","authenticated-orcid":false,"given":"Joanne M.","family":"Langley","sequence":"additional","affiliation":[{"name":"Canadian Center for Vaccinology, Dalhousie University, IWK and Nova Scotia Health, 5850 University Ave, Halifax, NS B3K 6R8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8771-0544","authenticated-orcid":false,"given":"Robyn","family":"Harrison","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alberta, 8440 112 St, Edmonton, AB T5J 3E4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samira","family":"Mubareka","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeya","family":"Nadarajah","sequence":"additional","affiliation":[{"name":"Oak Valley Health, 381 Church St, Markham, ON L3P 13P, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Smieja","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Healthcare, 50 Charlton Ave East, Hamilton, ON L8N 4A6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-8416","authenticated-orcid":false,"given":"Louis","family":"Valiquette","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Sherbrooke, 2500 Bd de l\u2019universit\u00e9, Sherbrooke, QC J1K 2R1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3368-3499","authenticated-orcid":false,"given":"Curtis","family":"Cooper","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2053-6083","authenticated-orcid":false,"given":"Jeff","family":"Powis","sequence":"additional","affiliation":[{"name":"Michael Garron Hospital, 825 Coxwell Avenue Toronto, ON M4C 3E7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"CCS Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"McGeer","sequence":"additional","affiliation":[{"name":"Sinai Health, 600 University Ave, Toronto, ON M5G 1X5, Canada"},{"name":"School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Laboratory Medicine and Pathobiology, University of Toronto, 1 King\u2019s College Cir, Toronto, ON M5S 1A8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda L.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Sinai Health, 600 University Ave, Toronto, ON M5G 1X5, Canada"},{"name":"School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"ref_1","unstructured":"Government of Ontario (2022, April 02). Ontario Enacts Declaration of Emergency to Protect the Public, Available online: https:\/\/news.ontario.ca\/en\/release\/56356\/ontario-enacts-declaration-of-emergency-to-protect-the-public."},{"key":"ref_2","unstructured":"Government of Alberta (2024, February 23). COVID-19 Coronavirus Information for Albertans, Available online: https:\/\/web.archive.org\/web\/20200317234940\/https:\/www.alberta.ca\/coronavirus-info-for-albertans.aspx."},{"key":"ref_3","unstructured":"US Centers for Disease Control and Prevention (2024, February 02). Stay up to Date with COVID-19 Vaccines, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/stay-up-to-date.html."},{"key":"ref_4","unstructured":"National Advisory Committee on Immunization (2024, June 06). Guidance on an Additional Dose of COVID-19 Vaccines in the Spring of 2024 for Individuals at High Risk of Severe Illness due to COVID-19, Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/vaccines-immunization\/national-advisory-committee-immunization-guidance-additional-dose-covid-19-vaccines-spring-2024-individuals-high-risk-severe-illness-due-covid-19.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s40121-022-00753-2","article-title":"Durability of Vaccine-Induced and Natural Immunity Against COVID-19: A Narrative Review","volume":"12","author":"Pooley","year":"2023","journal-title":"Infect. Dis. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S2213-2600(23)00015-2","article-title":"Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: Findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022","volume":"11","author":"Wu","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Song, S., Madewell, Z.J., Liu, M., Longini, I.M., and Yang, Y. (2023). Effectiveness of SARS-CoV-2 vaccines against Omicron infection and severe events: A systematic review and meta-analysis of test-negative design studies. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1195908"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1038\/s41467-024-44973-1","article-title":"Risk of SARS-CoV-2 reinfection during multiple Omicron variant waves in the UK general population","volume":"15","author":"Wei","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"B\u00f8\u00e5s, H., Storm, M.L., Tapia, G., Kristoffersen, A.B., L\u00f8vlie, A.L., St\u00f8rdal, K., Lyngstad, T.M., Bragstad, K., Hungnes, O., and Veneti, L. (2024). Frequency and risk of SARS-CoV-2 reinfections in Norway: A nation-wide study, February 2020 to January 2022. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-17695-8"},{"key":"ref_10","unstructured":"COVID-19 Treatment Guidelines Panel (2024, April 02). Coronavirus Disease 2019 (COVID-19) Treatment Guidelines, Available online: https:\/\/files.covid19treatmentguidelines.nih.gov\/guidelines\/section\/section_43.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s41687-022-00528-w","article-title":"Impact of COVID-19 and effects of BNT162b2 on patient-reported outcomes: Quality of life, symptoms, and work productivity among US adult outpatients","volume":"6","author":"Sun","year":"2022","journal-title":"J. Patient Rep. Outcomes"},{"key":"ref_12","first-page":"e41053","article-title":"A Meta-Analysis To Ascertain the Effectiveness of COVID-19 Vaccines on Clinical Outcomes in Patients With COVID-19 Infection in North America","volume":"15","author":"Ikeokwu","year":"2023","journal-title":"Cureus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"126271","DOI":"10.1016\/j.vaccine.2024.126271","article-title":"Canadian health care providers\u2019 and education workers\u2019 hesitance to receive original and bivalent COVID-19 vaccines","volume":"42","author":"Coleman","year":"2024","journal-title":"Vaccine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"185","DOI":"10.17269\/s41997-022-00613-z","article-title":"Study of the epidemiology of COVID-19 in Ontario elementary and secondary school education workers: An interim analysis following the first school year","volume":"113","author":"Coleman","year":"2022","journal-title":"Can. J. Public Health"},{"key":"ref_15","unstructured":"Statistics Canada (2024, June 10). Canadian Community Health Survey (CCHS)\u20142019, Available online: https:\/\/www23.statcan.gc.ca\/imdb\/p3Instr.pl?Function=getInstrumentList&Item_Id=1207185&UL=AV."},{"key":"ref_16","unstructured":"Government of Canada (2024, June 10). COVID-19 Epidemiology Update: Testing and Variants, Available online: https:\/\/health-infobase.canada.ca\/covid-19\/testing-variants.html."},{"key":"ref_17","unstructured":"StataCorp (2023). Stata Statistical Software: Release 18, StataCorp LLC."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S1473-3099(21)00460-6","article-title":"Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: A prospective, community-based, nested, case-control study","volume":"22","author":"Antonelli","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciac772","article-title":"Impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination and Booster on Coronavirus Disease 2019 (COVID-19) Symptom Severity Over Time in the COVID-OUT Trial","volume":"76","author":"Boulware","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"ofac066","DOI":"10.1093\/ofid\/ofac066","article-title":"Vaccination Against SARS-CoV-2 Is Associated With a Lower Viral Load and Likelihood of Systemic Symptoms","volume":"9","author":"Bramante","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/S1473-3099(23)00271-2","article-title":"Associations of COVID-19 symptoms with omicron subvariants BA.2 and BA.5, host status, and clinical outcomes in Japan: A registry-based observational study","volume":"23","author":"Nakakubo","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2324549","DOI":"10.1080\/21645515.2024.2324549","article-title":"COVID-19 vaccines: Immune correlates and clinical outcomes","volume":"20","author":"Mahrokhian","year":"2024","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Townsley, H., Gahir, J., Russell, T.W., Greenwood, D., Carr, E.J., Dyke, M., Adams, L., Miah, M., Clayton, B., and Smith, C. (2024). COVID-19 in non-hospitalised adults caused by either SARS-CoV-2 sub-variants Omicron BA.1, BA.2, BA.4\/5 or Delta associates with similar illness duration, symptom severity and viral kinetics, irrespective of vaccination history. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0294897"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107157","DOI":"10.1016\/j.ijid.2024.107157","article-title":"Variability in COVID-19 symptom presentation during pregnancy and its impact on maternal and infant outcomes across the pandemic","volume":"146","author":"Ziert","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Geismar, C., Nguyen, V., Fragaszy, E., Shrotri, M., Navaratnam, A.M.D., Beale, S., Byrne, T.E., Fong, W.L.E., Yavlinsky, A., and Kovar, J. (2023). Symptom profiles of community cases infected by influenza, RSV, rhinovirus, seasonal coronavirus, and SARS-CoV-2 variants of concern. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-38869-1"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/11\/1501\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:30:51Z","timestamp":1760113851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/11\/1501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,12]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["ijerph21111501"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21111501","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,12]]}}}