Category: Virology: Studies of the Epidemiology of Viral Infections

Poster Session: Virology: Studies of the Epidemiology of Viral Infections

1715 - Influenza-like Illness (ILI) Experience Among Healthcare Workers in Military Treatment Facilities: An Offshoot of the Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED) Study

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Presenting Author(s)

RC

Rhonda E. Colombo

Clinical Research Physician
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Madigan Army Medical Center Division of Infectious Diseases
Tacoma, Washington
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

SR

Stephanie A. Richard

Epidemiologist
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CS

Christina Schofield

Infectious Disease Physician
Madigan Army Medical Center Division of Infectious Diseases, Infectious Disease Clinical Research Program
Tacoma, Washington
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LC

Limone Collins

Chief, Vaccine Safety and Evaluation Oversight
Immunization Healthcare Division, Defense Health Agency
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AG

Anuradha Ganesan

Infectious Disease Physician Walter Reed National Military Medical Center
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Walter Reed National Military Medical Center
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CG

Casey Geaney

Research Physician, Site PI
Walter Reed National Military Medical Center
Bethesda, MD
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DH

David Hrncir

Regional Medical Director, Immunization
Carl R. Darnall Army Medical Center/Wilford Hall Ambulatory Surgical Center
Fort Hood, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TL

Tahaniyat Lalani

Research Physician, IDCRP Research Area Director, Associate Professor USU
Naval Medical Center Portsmouth
Portsmouth, Virginia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Ana E. Markelz

Medical Director, Infection Prevention and Control Chief, Infectious Disease Service
Brooke Army Medical Center
San Antonio, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RM

Ryan C. Maves

Fellowship Program Director
Naval Medical Center San Diego, San Diego, CA and Infectious Disease Clinical Research Program, Bethesda, MD
San DIego, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BM

Bruce McClenathan

Regional Medical Director
Womack Army Medical Center
Fort Bragg, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KM

Katrin Mende

Deputy Research Area Director, EIDAR
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
San Antonio, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JM

Jitendrakumar Modi

Director of Health Services
NHC Annapolis
Laurel, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JM

Jay R. Montgomery

Medical Director
Defense Health Agency
Vienna, Virginia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SS

Srihari Seshadri

Team Lead, Regulatory Investigations Office
Immunization Healthcare Division, Defense Health Agency
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CS

Catherine Skerrett

Nurse Practitioner, Immunization
Lackland Air Force Base
San Antonio, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CS

Christina Spooner

Team Lead, Clinical Investigations
Immunization Healthcare Division, Defense Health Agency
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GU

Gregory Utz

Research Physician, Site PI
Naval Medical Center San Diego, Infectious Disease Clinical Research Program, Bethesda, MD, and Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
San Diego, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TW

Tyler Warkentien

Infectious Disease Specialist
Naval Medical Center Portsmouth
Portsmouth, Virginia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Timothy Burgess

Director
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Mark P. Simons

Deputy Program Director
Infectious Disease Clinical Research Program, Bethesda, MD, The Henry M. Jackson Foundation, Bethesda, MD
Bethesda, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Healthcare workers (HCWs) are at heightened risk of exposure to respiratory pathogens. There are limited published data on influenza-like illness (ILI) experience among HCWs, and the few available studies were hampered by incomplete vaccination histories. PAIVED, a multicenter, multiservice study assessing influenza vaccine effectiveness in the Department of Defense, provides a unique opportunity to describe ILI experience among vaccinated HCWs compared to vaccinated non-HCWs.

Methods: PAIVED participants were randomized to receive either egg-based, cell-based, or recombinant-derived influenza vaccine then surveyed weekly for ILI. At enrollment, participants provided key demographic data including whether they were HCWs with direct patient contact. ILI was defined a priori as 1) having cough or sore throat plus 2) feeling feverish/having chills or having body aches/fatigue. Participants with ILI completed a daily symptom diary for seven days and submitted a nasal swab for pathogen detection.

Results: Of 4433 eligible participants enrolled during the 2019-20 influenza season, 1551 (35%) were HCWs. A higher percentage of HCWs experienced an ILI than non-HCWs (34% vs 26%, p< 0.001). Overall, HCWs were more likely to be female (42% vs 32%), age 25-34 years (39% vs 28%), active-duty military (81% vs 62%), non-smokers (88% vs 75%), and physically active (92% vs 85%). Self-reported race differed between HCWs and non-HCWs; a higher proportion of HCWs identified as White (63% vs 56%) or Asian (8% vs 5%). Similar demographic differences existed among HCWs and non-HCWs with ILI. HCWs were more likely to respond to at least 50% of weekly surveillance messages, irrespective of ILI status. HCWs with ILI had less severe lower respiratory symptoms (p< 0.001) and a shorter duration of illness (12.4±8.1 days vs 13.7±9.0, p=0.005) than non-HCWs. Pathogen data is pending.

Conclusion: HCWs in PAIVED were more likely to report ILI than their non-HCW counterparts yet tended to have lower illness severity, possibly reflecting a higher level of baseline health or enhanced awareness of early ILI symptoms. The important epidemiologic position HCWs occupy for ILI has been apparent in the COVID-19 pandemic. Exploring ways to mitigate ILI risk in HCWs beyond influenza vaccination is warranted.Disclaimer