Search

Homeless shelter residents and staff may be at higher risk of SARS-CoV-2 infection. However, SARS-CoV-2 infection estimates in this population have been reliant on cross-sectional or outbreak investigation data. We conducted routine surveillance and outbreak testing in 23 homeless shelters in King County, Washington, to estimate the occurrence of laboratory-confirmed SARS-CoV-2 infection and risk factors during 1 January 2020-31 May 2021. Symptom surveys and nasal swabs were collected for SARS-CoV-2 testing by RT-PCR for residents aged ≥3 months and staff. We collected 12,915 specimens from 2,930 unique participants. We identified 4.74 (95% CI 4.00-5.58) SARS-CoV-2 infections per 100 individuals (residents: 4.96, 95% CI 4.12-5.91; staff: 3.86, 95% CI 2.43-5.79). Most infections were asymptomatic at the time of detection (74%) and detected during routine surveillance (73%). Outbreak testing yielded higher test positivity than routine surveillance (2.7% versus 0.9%). Among those infected, residents were less likely to report symptoms than staff. Participants who were vaccinated against seasonal influenza and were current smokers had lower odds of having an infection detected. Active surveillance that includes SARS-CoV-2 testing of all persons is essential in ascertaining the true burden of SARS-CoV-2 infections among residents and staff of congregate settings.

To determine the epidemiology of human parainfluenza virus in homeless shelters during the COVID-19 pandemic, we analyzed data and sequences from respiratory specimens collected in 23 shelters in Washington, USA, during 2019-2021. Two clusters in children were genetically similar by shelter of origin. Shelter-specific interventions are needed to reduce these infections.

Background: Rhinovirus (RV) is a common cause of respiratory illness in all people, including those experiencing homelessness. RV epidemiology in homeless shelters is unknown., Methods: We analyzed data from a cross-sectional homeless shelter study in King County, Washington, October 2019-May 2021. Shelter residents or guardians aged ≥3 months reporting acute respiratory illness completed questionnaires and submitted nasal swabs. After 1 April 2020, enrollment expanded to residents and staff regardless of symptoms. Samples were tested by multiplex RT-PCR for respiratory viruses. A subset of RV-positive samples was sequenced., Results: There were 1066 RV-positive samples with RV present every month of the study period. RV was the most common virus before and during the coronavirus disease 2019 (COVID-19) pandemic (43% and 77% of virus-positive samples, respectively). Participants from family shelters had the highest prevalence of RV. Among 131 sequenced samples, 33 RV serotypes were identified with each serotype detected for ≤4 months., Conclusions: RV infections persisted through community mitigation measures and were most prevalent in shelters housing families. Sequencing showed a diversity of circulating RV serotypes, each detected over short periods of time. Community-based surveillance in congregate settings is important to characterize respiratory viral infections during and after the COVID-19 pandemic., Clinical Trials Registration: NCT04141917., Competing Interests: Potential conflicts of interest. E. J. C. reports honoraria from Providence Health and Services, Seattle, WA for presentations on COVID-19. S. N. C. reports honoraria from University of California, Berkeley for presentations on COVID-19. P. R. reports honoraria from the Bill and Melinda Gates Foundation for presentations on COVID-19. J A. E. reports consultation for with Sanofi Pasteur, AstraZeneca, and Meissa Vaccines; and has received research funding from AstraZeneca, GlaxoSmithKline, Merck, and Pfizer outside the submitted work. H. Y. C. reports consultation for Ellume, Pfizer, the Bill and Melinda Gates Foundation, Glaxo Smith Kline, and Merck; and has received research funding from Gates Ventures and Sanofi Pasteur, and support and reagents from Ellume and Cepheid outside of the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Little is known about COVID-19 vaccination intent among people experiencing homelessness. This study assesses surveyed COVID-19 vaccination intent among adult homeless shelter residents and staff and identifies factors associated with vaccine deliberation (responded "undecided") and reluctance (responded "no"), including time trends., Methods: From 11/1/2020-2/28/21, we conducted repeated cross-sectional surveys at nine shelters in King County, WA as part of ongoing community-based SARS-CoV-2 surveillance. We used a multinomial model to identify characteristics associated with vaccine deliberation and reluctance., Results: A total of 969 unique staff (n = 297) and residents (n = 672) participated and provided 3966 survey responses. Among residents, 53.7% (n = 361) were vaccine accepting, 28.1% reluctant, 17.6% deliberative, and 0.6% already vaccinated, whereas among staff 56.2% were vaccine accepting, 14.1% were reluctant, 16.5% were deliberative, and 13.1% already vaccinated at their last survey. We observed higher odds of vaccine deliberation or reluctance among Black/African American individuals, those who did not receive a seasonal influenza vaccine, and those with lower educational attainment. There was no significant trend towards vaccine acceptance., Conclusions: Strong disparities in vaccine intent based on race, education, and prior vaccine history were observed. Increased vaccine intent over the study period was not detected. An intersectional, person-centered approach to addressing health inequities by public health authorities planning vaccination campaigns in shelters is recommended. Clinical Trial Registry Number: NCT04141917., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Helen Y. Chu reports financial support was provided by Centers for Disease Control and Prevention. James P. Hughes reports a relationship with National Institutes of Health that includes: funding grants. Michael L. Jackson, Janet A. Englund, Helen Y. Chu reports a relationship with Sanofi Pasteur that includes: consulting or advisory and funding grants. Michael Boeckh reports a relationship with Moderna Therapeutics Inc that includes: consulting or advisory. Michael Boeckh reports a relationship with VirBio that includes: consulting or advisory and funding grants. Michael Boeckh, Janet A. Englund, Helen Y. Chu reports a relationship with Merck & Co Inc that includes: consulting or advisory and funding grants. Michael Boeckh reports a relationship with Regeneron Pharmaceuticals Inc that includes: funding grants. Michael Boeckh reports a relationship with Ridgeback Biotherapeutics L.P. that includes: funding grants. Michael Boeckh, Helen Y. Chu reports a relationship with Bill and Melinda Gates Foundation that includes: consulting or advisory and funding grants. Janet A. Englund reports a relationship with AstraZeneca that includes: consulting or advisory and funding grants. Janet A. Englund, Helen Y. Chu reports a relationship with GlaxoSmithKline that includes: consulting or advisory and funding grants. Janet A. Englund reports a relationship with Novavax Inc that includes: funding grants. Janet A. Englund, Helen Y. Chu reports a relationship with Pfizer Inc that includes: consulting or advisory and funding grants. Janet A. Englund reports a relationship with Meissa Vaccines that includes: consulting or advisory. Helen Y. Chu reports a relationship with Ellumen Inc that includes: consulting or advisory and funding grants. Helen Y. Chu reports a relationship with Gates Ventures that includes: funding grants. Helen Y. Chu reports a relationship with Cepheid that includes: funding grants.]., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)