Health care workers are at greater risk than the general population for COVID-19 infection, and nurses providing direct care to patients have the highest risk of all, according to several studies. For that reason, the results of a recent study in the New England Journal of Medicine should be reassuring for nurses on the front lines who are fully immunized.

Figure. Nurse Elyse Isopo receives the Pfizer vaccine booster at Long Island Jewish Medical Center in New Hyde Park, New York. Photo by Lev Radin / Sipa USA / AP Images.

According to the study, the Moderna (mRNA-1273) and Pfizer-BioNTech (BNT162b2) vaccines are highly effective at protecting health care workers in real-world settings, not just in the controlled conditions of a clinical trial. The study included 4,931 health care workers at 33 acute and long-term care sites across the United States. Effectiveness against symptomatic infection after two doses was 96% for the Moderna vaccine and 90% for Pfizer-BioNTech. After adjusting for possible confounders, such as age, race, and ethnic group; underlying conditions or risk factors for severe disease; and community or workplace behaviors, effectiveness was 90% after two doses for both vaccines and 80% after one dose. Effectiveness was the same regardless of the health care worker's level of patient contact. Yet, according to a study of over 3 million hospital-based health care workers in the American Journal of Infection Control, as of September 2021, only 70% of health care workers were fully vaccinated-defined at the time of the study as two doses.

The percentage has likely increased since that time, as vaccine mandates that went into effect later in 2021 propelled many health care workers to get vaccinated. And, in January, the U.S. Supreme Court upheld the federal vaccination mandate for health care workers who treat Medicare and Medicaid patients, making it harder for people to refuse and still keep their jobs. The study by Pilishvili and colleagues adds to the evidence that vaccination protects against COVID-19 illness, reinforcing the need for continued efforts to improve vaccination rates among nurses and other health care workers.-Karen Roush, PhD, RN, FNP-BC, news director