Outbreak of COVID-19 among vaccinated and unvaccinated homeless shelter residents — Sonoma County, California, July 2021

  1. Aleksandr Bukatko
  2. Mark N. Lobato
  3. Emily Mosites
  4. Cameron Stainken
  5. Katheryn Reihl
  6. Mojgan Deldari
  7. John M. Bell
  8. Mary Kate Morris
  9. Debra A. Wadford
  10. Kathleen Harriman
  11. Sundari Mase

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Abstract

In July 2021, the Sonoma County Health Department was alerted to three cases of COVID-19 among residents of a homeless shelter in Santa Rosa, California. Among 153 shelter residents, 83 (54%) were fully vaccinated; 71 (86%) vaccinated residents had received the Janssen COVID-19 vaccine and 12 (14%) received an mRNA (Pfizer BioNTech or Moderna) COVID-19 vaccine. Within 1 month, 116 shelter residents (76%) received positive SARS-CoV-2 test results, including 66 fully vaccinated residents and 50 not fully vaccinated. 9 fully vaccinated and 1 unvaccinated were hospitalized for COVID-19. All hospitalized cases had at least one underlying medical condition. Two deaths occurred, one in a vaccinated resident and one in a non-vaccinated resident. Specimens from 52 residents underwent whole genome sequencing; all were identified as SARS-CoV-2, Delta Variant AY.13 lineage. Additional mitigation measures are needed in medically vulnerable congregate setting where limited resources make individual quarantine and isolation not feasible.

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  1. ScreenIT

    SciScore for 10.1101/2021.12.07.21267204: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serum samples from eight of 10 hospitalized persons were tested for total anti-SARS-CoV-2 nucleocapsid (N) antibodies immunoglobulin (Ig)M, IgG, and IgA (BioRad Platelia, California, USA), and by SARS-CoV-2 enzyme-linked immunosorbent assay to detect anti-SARS-CoV-2 IgG to viral spike (S), matrix (M), and N proteins, and for neutralizing antibodies (United Biomedical, Inc, New York, USA).
    anti-SARS-CoV-2 nucleocapsid (N) antibodies immunoglobulin (Ig)M, IgG
    suggested: None
    IgA
    suggested: None
    anti-SARS-CoV-2 IgG
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The findings in this report are subject to at least four limitations. First the sample size was small, limiting the power to determine the statistical significance of some differences of interest. Second, almost all residents received the Janssen vaccine, so it was not possible to determine whether vaccine type contributed to the findings here. Third, vaccine status was confirmed through the California Immunization Registry; persons who might have been immunized but not included in the registry could have been misclassified in this analysis. Finally, data on underlying conditions were not available for uninfected residents. In this population at higher risk for severe COVID-19 living in a homeless shelter, SARS-CoV-2 infection, symptomatic disease, hospitalization, and death occurred among residents who were fully vaccinated and those who were not fully vaccinated. These findings reinforce the importance of layered prevention strategies, including appropriate isolation and quarantine, screening testing, physical distancing, and masking in addition to providing vaccination, prevent COVID-19 outbreaks in homeless shelters and similar congregate settings.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.12.07.21267204v1 on medRxiv