Table 1.

Coronavirus Disease 2019 Messenger RNA Vaccine Dose 3 Recipient Characteristics According to Severe Acute Respiratory Syndrome Coronavirus 2 Infection Status and Timing

CharacteristicTotal Participants,
No. (%)
Vaccination-Only (ie, Never Infected),
No. (%)
Previous SARS-CoV-2 Infection,
No. (%)
SARS-CoV-2 Breakthrough Infection,
No. (%)
P Value
All participants (row %)388224 (0.6)123 (0.3)41 (0.1)
Cohort location
 Tucson, Arizona113 (29.1)74 (33.0)22 (17.9)17 (41.5)<.001*
 Phoenix and other areas in Arizona82 (21.1)51 (22.8)27 (22.0)4 (9.8)
 Miami, Florida1 (0.3)0 (0.0)1 (0.8)0 (0.0)
 Duluth, Minnesota154 (39.7)97 (43.3)47 (38.2)10 (24.4)
 Portland, Oregon12 (3.1)0 (0.0)7 (5.7)5 (12.2)
 Temple, Texas4 (1.0)0 (0.0)3 (2.4)1 (2.4)
 Salt Lake City, Utah22 (5.7)2 (0.9)16 (13.0)4 (9.8)
Sex
 Female267 (68.8)147 (65.6)92 (74.8)28 (68.3)0.210
 Male121 (31.2)77 (34.4)31 (25.2)13 (31.7)
Age, y
 18–39224 (57.7)48 (21.4)47 (38.2)12 (29.3).002*
 40–64123 (31.7)164 (73.2)70 (56.9)23 (56.1)
 ≥6541 (10.6)12 (5.4)6 (4.9)6 (14.6)
Race and ethnicity
 Non-Hispanic, White336 (86.6)193 (86.2)105 (85.4)38 (92.7)
 Non-Hispanic, Black1 (0.3)0 (0.0)1 (0.8)0 (0.0).826
 Non-Hispanic, Asian5 (1.3)3 (1.3)2 (1.6)0 (0.0)
 Hispanic39 (10.1)23 (10.3)13 (10.6)3 (7.3)
 Other7 (1.8)5 (2.2)2 (1.6)0 (0.0)
Occupationa
 Primary HCP123 (31.7)79 (35.3)34 (27.6)10 (24.4).252
 Nurses and other allied HCP170 (43.8)95 (42.4)59 (48.0)16 (39.0)
 First responders18 (4.6)7 (3.1)8 (6.5)3 (7.3)
 Essential and other frontline workers77 (19.8)43 (19.2)22 (17.9)12 (29.3)
Body mass indexb
 Underweight/Normal weightc142 (36.6)82 (36.6)48 (39.0)12 (29.3).522
 Overweight (25–29.9 kg/m2)129 (33.2)80 (35.7)32 (26.0)17 (41.5)
 Obese111 (28.6)61 (27.2)40 (32.5)10 (24.4)
Chronic conditiond
 None247 (63.7)150 (67.0)72 (58.5)25 (61.0).512
 1 or more138 (35.6)74 (33.0)49 (39.8)15 (36.6)
Daily medications
 0142 (36.6)82 (36.6)46 (37.4)14 (34.1).957
 184 (21.6)51 (22.8)25 (20.3)8 (19.5)
 2 or more158 (40.7)90 (40.2)50 (40.7)18 (43.9)
Smoking
 Not current smoker319 (82.2)184 (82.1)96 (78.0)39 (95.1).702
 Smoke tobacco products66 (17.0)40 (17.9)25 (20.3)1 (2.4)
Influenza vaccination history in past 5 y
 No vaccination history20 (5.2)11 (4.9)8 (6.5)1 (2.4).294
 1–3 y of vaccination19 (4.9)7 (3.1)9 (7.3)3 (7.3)
 ≥4 y of vaccination346 (89.2)206 (92.0)104 (84.6)36 (87.8)
SARS-CoV-2 clinical presentatione
 CLI symptoms31 (81.6)19 (90.5).369
 Non-CLI associated symptomsf2 (5.3)0 (0.0)
 Asymptomatic5 (13.2)2 (9.5)
SARS-CoV-2 detection duration, wk
 18 (21.1)10 (47.6).034*
 ≥230 (78.9)11 (52.4)
Febrile COVID-19
 No15 (39.5)10 (47.6).442
 Yes23 (60.5)10 (47.6)
Medically attended COVID-19
 No medical visit25 (65.8)17 (81.0).120
 1 or more medical visits13 (34.2)3 (14.3)
COVID-19 vaccine products (all 3 doses)
 BNT162b2340 (87.6)202 (90.2)106 (86.2)32 (78.0).222
 mRNA-127340 (10.3)19 (8.5)14 (11.4)7 (17.1)
 Combination8 (2.1)3 (1.3)3 (2.4)2 (4.9)
CharacteristicTotal Participants,
No. (%)
Vaccination-Only (ie, Never Infected),
No. (%)
Previous SARS-CoV-2 Infection,
No. (%)
SARS-CoV-2 Breakthrough Infection,
No. (%)
P Value
All participants (row %)388224 (0.6)123 (0.3)41 (0.1)
Cohort location
 Tucson, Arizona113 (29.1)74 (33.0)22 (17.9)17 (41.5)<.001*
 Phoenix and other areas in Arizona82 (21.1)51 (22.8)27 (22.0)4 (9.8)
 Miami, Florida1 (0.3)0 (0.0)1 (0.8)0 (0.0)
 Duluth, Minnesota154 (39.7)97 (43.3)47 (38.2)10 (24.4)
 Portland, Oregon12 (3.1)0 (0.0)7 (5.7)5 (12.2)
 Temple, Texas4 (1.0)0 (0.0)3 (2.4)1 (2.4)
 Salt Lake City, Utah22 (5.7)2 (0.9)16 (13.0)4 (9.8)
Sex
 Female267 (68.8)147 (65.6)92 (74.8)28 (68.3)0.210
 Male121 (31.2)77 (34.4)31 (25.2)13 (31.7)
Age, y
 18–39224 (57.7)48 (21.4)47 (38.2)12 (29.3).002*
 40–64123 (31.7)164 (73.2)70 (56.9)23 (56.1)
 ≥6541 (10.6)12 (5.4)6 (4.9)6 (14.6)
Race and ethnicity
 Non-Hispanic, White336 (86.6)193 (86.2)105 (85.4)38 (92.7)
 Non-Hispanic, Black1 (0.3)0 (0.0)1 (0.8)0 (0.0).826
 Non-Hispanic, Asian5 (1.3)3 (1.3)2 (1.6)0 (0.0)
 Hispanic39 (10.1)23 (10.3)13 (10.6)3 (7.3)
 Other7 (1.8)5 (2.2)2 (1.6)0 (0.0)
Occupationa
 Primary HCP123 (31.7)79 (35.3)34 (27.6)10 (24.4).252
 Nurses and other allied HCP170 (43.8)95 (42.4)59 (48.0)16 (39.0)
 First responders18 (4.6)7 (3.1)8 (6.5)3 (7.3)
 Essential and other frontline workers77 (19.8)43 (19.2)22 (17.9)12 (29.3)
Body mass indexb
 Underweight/Normal weightc142 (36.6)82 (36.6)48 (39.0)12 (29.3).522
 Overweight (25–29.9 kg/m2)129 (33.2)80 (35.7)32 (26.0)17 (41.5)
 Obese111 (28.6)61 (27.2)40 (32.5)10 (24.4)
Chronic conditiond
 None247 (63.7)150 (67.0)72 (58.5)25 (61.0).512
 1 or more138 (35.6)74 (33.0)49 (39.8)15 (36.6)
Daily medications
 0142 (36.6)82 (36.6)46 (37.4)14 (34.1).957
 184 (21.6)51 (22.8)25 (20.3)8 (19.5)
 2 or more158 (40.7)90 (40.2)50 (40.7)18 (43.9)
Smoking
 Not current smoker319 (82.2)184 (82.1)96 (78.0)39 (95.1).702
 Smoke tobacco products66 (17.0)40 (17.9)25 (20.3)1 (2.4)
Influenza vaccination history in past 5 y
 No vaccination history20 (5.2)11 (4.9)8 (6.5)1 (2.4).294
 1–3 y of vaccination19 (4.9)7 (3.1)9 (7.3)3 (7.3)
 ≥4 y of vaccination346 (89.2)206 (92.0)104 (84.6)36 (87.8)
SARS-CoV-2 clinical presentatione
 CLI symptoms31 (81.6)19 (90.5).369
 Non-CLI associated symptomsf2 (5.3)0 (0.0)
 Asymptomatic5 (13.2)2 (9.5)
SARS-CoV-2 detection duration, wk
 18 (21.1)10 (47.6).034*
 ≥230 (78.9)11 (52.4)
Febrile COVID-19
 No15 (39.5)10 (47.6).442
 Yes23 (60.5)10 (47.6)
Medically attended COVID-19
 No medical visit25 (65.8)17 (81.0).120
 1 or more medical visits13 (34.2)3 (14.3)
COVID-19 vaccine products (all 3 doses)
 BNT162b2340 (87.6)202 (90.2)106 (86.2)32 (78.0).222
 mRNA-127340 (10.3)19 (8.5)14 (11.4)7 (17.1)
 Combination8 (2.1)3 (1.3)3 (2.4)2 (4.9)

Abbreviations: CLI, COVID-19-like illness; COVID-19, coronavirus disease 2019; HCP, healthcare provider; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

*Statistically significant.

Primary HCPs include medical doctor, doctors of osteopathic medicine, nurse practitioners, and physician assistants.

Body mass index, kg/m2: underweight, ≤18.4; normal, 18.5–24.9; overweight, 25–29.9; obese, BMI ≥30.

Only 1 participant was underweight by 0.6 and therefore combined with normal weight.

Chronic conditions include asthma, autoimmune disease, chronic lung disease, cancer, diabetes, heart disease, hypertension, immunosuppression, kidney disease, liver disease, and neurologic or neuromuscular disease.

Includes only 59 infections that occurred during the active surveillance study period. Those with a self-reported infection prior to enrollment are excluded from this section as infection characteristics are unknown.

Non-CLI symptoms included headache, nausea, and fatigue.

Table 1.

Coronavirus Disease 2019 Messenger RNA Vaccine Dose 3 Recipient Characteristics According to Severe Acute Respiratory Syndrome Coronavirus 2 Infection Status and Timing

CharacteristicTotal Participants,
No. (%)
Vaccination-Only (ie, Never Infected),
No. (%)
Previous SARS-CoV-2 Infection,
No. (%)
SARS-CoV-2 Breakthrough Infection,
No. (%)
P Value
All participants (row %)388224 (0.6)123 (0.3)41 (0.1)
Cohort location
 Tucson, Arizona113 (29.1)74 (33.0)22 (17.9)17 (41.5)<.001*
 Phoenix and other areas in Arizona82 (21.1)51 (22.8)27 (22.0)4 (9.8)
 Miami, Florida1 (0.3)0 (0.0)1 (0.8)0 (0.0)
 Duluth, Minnesota154 (39.7)97 (43.3)47 (38.2)10 (24.4)
 Portland, Oregon12 (3.1)0 (0.0)7 (5.7)5 (12.2)
 Temple, Texas4 (1.0)0 (0.0)3 (2.4)1 (2.4)
 Salt Lake City, Utah22 (5.7)2 (0.9)16 (13.0)4 (9.8)
Sex
 Female267 (68.8)147 (65.6)92 (74.8)28 (68.3)0.210
 Male121 (31.2)77 (34.4)31 (25.2)13 (31.7)
Age, y
 18–39224 (57.7)48 (21.4)47 (38.2)12 (29.3).002*
 40–64123 (31.7)164 (73.2)70 (56.9)23 (56.1)
 ≥6541 (10.6)12 (5.4)6 (4.9)6 (14.6)
Race and ethnicity
 Non-Hispanic, White336 (86.6)193 (86.2)105 (85.4)38 (92.7)
 Non-Hispanic, Black1 (0.3)0 (0.0)1 (0.8)0 (0.0).826
 Non-Hispanic, Asian5 (1.3)3 (1.3)2 (1.6)0 (0.0)
 Hispanic39 (10.1)23 (10.3)13 (10.6)3 (7.3)
 Other7 (1.8)5 (2.2)2 (1.6)0 (0.0)
Occupationa
 Primary HCP123 (31.7)79 (35.3)34 (27.6)10 (24.4).252
 Nurses and other allied HCP170 (43.8)95 (42.4)59 (48.0)16 (39.0)
 First responders18 (4.6)7 (3.1)8 (6.5)3 (7.3)
 Essential and other frontline workers77 (19.8)43 (19.2)22 (17.9)12 (29.3)
Body mass indexb
 Underweight/Normal weightc142 (36.6)82 (36.6)48 (39.0)12 (29.3).522
 Overweight (25–29.9 kg/m2)129 (33.2)80 (35.7)32 (26.0)17 (41.5)
 Obese111 (28.6)61 (27.2)40 (32.5)10 (24.4)
Chronic conditiond
 None247 (63.7)150 (67.0)72 (58.5)25 (61.0).512
 1 or more138 (35.6)74 (33.0)49 (39.8)15 (36.6)
Daily medications
 0142 (36.6)82 (36.6)46 (37.4)14 (34.1).957
 184 (21.6)51 (22.8)25 (20.3)8 (19.5)
 2 or more158 (40.7)90 (40.2)50 (40.7)18 (43.9)
Smoking
 Not current smoker319 (82.2)184 (82.1)96 (78.0)39 (95.1).702
 Smoke tobacco products66 (17.0)40 (17.9)25 (20.3)1 (2.4)
Influenza vaccination history in past 5 y
 No vaccination history20 (5.2)11 (4.9)8 (6.5)1 (2.4).294
 1–3 y of vaccination19 (4.9)7 (3.1)9 (7.3)3 (7.3)
 ≥4 y of vaccination346 (89.2)206 (92.0)104 (84.6)36 (87.8)
SARS-CoV-2 clinical presentatione
 CLI symptoms31 (81.6)19 (90.5).369
 Non-CLI associated symptomsf2 (5.3)0 (0.0)
 Asymptomatic5 (13.2)2 (9.5)
SARS-CoV-2 detection duration, wk
 18 (21.1)10 (47.6).034*
 ≥230 (78.9)11 (52.4)
Febrile COVID-19
 No15 (39.5)10 (47.6).442
 Yes23 (60.5)10 (47.6)
Medically attended COVID-19
 No medical visit25 (65.8)17 (81.0).120
 1 or more medical visits13 (34.2)3 (14.3)
COVID-19 vaccine products (all 3 doses)
 BNT162b2340 (87.6)202 (90.2)106 (86.2)32 (78.0).222
 mRNA-127340 (10.3)19 (8.5)14 (11.4)7 (17.1)
 Combination8 (2.1)3 (1.3)3 (2.4)2 (4.9)
CharacteristicTotal Participants,
No. (%)
Vaccination-Only (ie, Never Infected),
No. (%)
Previous SARS-CoV-2 Infection,
No. (%)
SARS-CoV-2 Breakthrough Infection,
No. (%)
P Value
All participants (row %)388224 (0.6)123 (0.3)41 (0.1)
Cohort location
 Tucson, Arizona113 (29.1)74 (33.0)22 (17.9)17 (41.5)<.001*
 Phoenix and other areas in Arizona82 (21.1)51 (22.8)27 (22.0)4 (9.8)
 Miami, Florida1 (0.3)0 (0.0)1 (0.8)0 (0.0)
 Duluth, Minnesota154 (39.7)97 (43.3)47 (38.2)10 (24.4)
 Portland, Oregon12 (3.1)0 (0.0)7 (5.7)5 (12.2)
 Temple, Texas4 (1.0)0 (0.0)3 (2.4)1 (2.4)
 Salt Lake City, Utah22 (5.7)2 (0.9)16 (13.0)4 (9.8)
Sex
 Female267 (68.8)147 (65.6)92 (74.8)28 (68.3)0.210
 Male121 (31.2)77 (34.4)31 (25.2)13 (31.7)
Age, y
 18–39224 (57.7)48 (21.4)47 (38.2)12 (29.3).002*
 40–64123 (31.7)164 (73.2)70 (56.9)23 (56.1)
 ≥6541 (10.6)12 (5.4)6 (4.9)6 (14.6)
Race and ethnicity
 Non-Hispanic, White336 (86.6)193 (86.2)105 (85.4)38 (92.7)
 Non-Hispanic, Black1 (0.3)0 (0.0)1 (0.8)0 (0.0).826
 Non-Hispanic, Asian5 (1.3)3 (1.3)2 (1.6)0 (0.0)
 Hispanic39 (10.1)23 (10.3)13 (10.6)3 (7.3)
 Other7 (1.8)5 (2.2)2 (1.6)0 (0.0)
Occupationa
 Primary HCP123 (31.7)79 (35.3)34 (27.6)10 (24.4).252
 Nurses and other allied HCP170 (43.8)95 (42.4)59 (48.0)16 (39.0)
 First responders18 (4.6)7 (3.1)8 (6.5)3 (7.3)
 Essential and other frontline workers77 (19.8)43 (19.2)22 (17.9)12 (29.3)
Body mass indexb
 Underweight/Normal weightc142 (36.6)82 (36.6)48 (39.0)12 (29.3).522
 Overweight (25–29.9 kg/m2)129 (33.2)80 (35.7)32 (26.0)17 (41.5)
 Obese111 (28.6)61 (27.2)40 (32.5)10 (24.4)
Chronic conditiond
 None247 (63.7)150 (67.0)72 (58.5)25 (61.0).512
 1 or more138 (35.6)74 (33.0)49 (39.8)15 (36.6)
Daily medications
 0142 (36.6)82 (36.6)46 (37.4)14 (34.1).957
 184 (21.6)51 (22.8)25 (20.3)8 (19.5)
 2 or more158 (40.7)90 (40.2)50 (40.7)18 (43.9)
Smoking
 Not current smoker319 (82.2)184 (82.1)96 (78.0)39 (95.1).702
 Smoke tobacco products66 (17.0)40 (17.9)25 (20.3)1 (2.4)
Influenza vaccination history in past 5 y
 No vaccination history20 (5.2)11 (4.9)8 (6.5)1 (2.4).294
 1–3 y of vaccination19 (4.9)7 (3.1)9 (7.3)3 (7.3)
 ≥4 y of vaccination346 (89.2)206 (92.0)104 (84.6)36 (87.8)
SARS-CoV-2 clinical presentatione
 CLI symptoms31 (81.6)19 (90.5).369
 Non-CLI associated symptomsf2 (5.3)0 (0.0)
 Asymptomatic5 (13.2)2 (9.5)
SARS-CoV-2 detection duration, wk
 18 (21.1)10 (47.6).034*
 ≥230 (78.9)11 (52.4)
Febrile COVID-19
 No15 (39.5)10 (47.6).442
 Yes23 (60.5)10 (47.6)
Medically attended COVID-19
 No medical visit25 (65.8)17 (81.0).120
 1 or more medical visits13 (34.2)3 (14.3)
COVID-19 vaccine products (all 3 doses)
 BNT162b2340 (87.6)202 (90.2)106 (86.2)32 (78.0).222
 mRNA-127340 (10.3)19 (8.5)14 (11.4)7 (17.1)
 Combination8 (2.1)3 (1.3)3 (2.4)2 (4.9)

Abbreviations: CLI, COVID-19-like illness; COVID-19, coronavirus disease 2019; HCP, healthcare provider; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

*Statistically significant.

Primary HCPs include medical doctor, doctors of osteopathic medicine, nurse practitioners, and physician assistants.

Body mass index, kg/m2: underweight, ≤18.4; normal, 18.5–24.9; overweight, 25–29.9; obese, BMI ≥30.

Only 1 participant was underweight by 0.6 and therefore combined with normal weight.

Chronic conditions include asthma, autoimmune disease, chronic lung disease, cancer, diabetes, heart disease, hypertension, immunosuppression, kidney disease, liver disease, and neurologic or neuromuscular disease.

Includes only 59 infections that occurred during the active surveillance study period. Those with a self-reported infection prior to enrollment are excluded from this section as infection characteristics are unknown.

Non-CLI symptoms included headache, nausea, and fatigue.

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