TABLE 1. Characteristics of emergency department and urgent care encounters among immunocompetent adults aged ≥18 years with COVID-19–like illness,* by mRNA COVID-19 vaccination status and SARS-CoV-2 test result — nine states,† September–November 2022.
| Characteristic | Overall, no. (column %) | SARS-CoV-2 test result status,
no. (row %) |
SMD¶ | mRNA COVID-19 vaccination status,§ no. (row %) |
SMD¶ | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Case-patients (positive) | Control patients (negative) | Unvaccinated | Received 2, 3, or 4 MV doses only, interval since last dose (mos) |
Received BV booster dose ≥7 days earlier | |||||||
| 2–4 | 5–7 | 8–10 | ≥11 | ||||||||
|
All ED/UC encounters
|
78,303
|
9,009
(11.5)
|
69,294
(88.5)
|
—
|
24,142
(30.8)
|
5,668
(7.2)
|
6,891
(8.8)
|
14,220
(18.2)
|
23,477
(30.0)
|
3,905
(5.0)
|
—
|
|
Site
| |||||||||||
| Baylor Scott & White Health |
13,516
(17.3)
|
1,390
(10.3) |
12,126
(89.7) |
0.37 |
7,014
(51.9) |
288
(2.1) |
374
(2.8) |
1,244
(9.2) |
4,513
(33.4) |
83
(0.6) |
3.8 |
| Columbia University |
3,243
(4.1)
|
253
(7.8) |
2,990
(92.2) |
1,421
(43.8) |
110
(3.4) |
209
(6.4) |
508
(15.7) |
941
(29.0) |
54
(1.7) |
||
| HealthPartners |
14,214
(18.2)
|
1,637
(11.5) |
12,577
(88.5) |
3,523
(24.8) |
1,236
(8.7) |
1,296
(9.1) |
3,006
(21.1) |
3,683
(25.9) |
1,470
(10.3) |
||
| Intermountain Healthcare |
16,110
(20.6)
|
2,746
(17.0) |
13,364
(83.0) |
5,290
(32.8) |
924
(5.7) |
1,189
(7.4) |
2,933
(18.2) |
5,538
(34.4) |
236
(1.5) |
||
| KPNC |
19,484
(24.9)
|
1,326
(6.8) |
18,158
(93.2) |
2,431
(12.5) |
2,350
(12.1) |
3,052
(15.7) |
4,787
(24.6) |
5,339
(27.4) |
1,525
(7.8) |
||
| KPCHR |
5,840
(7.5)
|
736
(12.6) |
5,104
(87.4) |
1,405
(24.1) |
617
(10.6) |
602
(10.3) |
1,190
(20.4) |
1,611
(27.6) |
415
(7.1) |
||
| University of Colorado |
5,896
(7.5)
|
921
(15.6) |
4,975
(84.4) |
3,058
(51.9) |
143
(2.4) |
169
(2.9) |
552
(9.4) |
1,852
(31.4) |
122
(2.1) |
||
|
Age group, yrs
| |||||||||||
| 18–49 |
39,190
(50.0)
|
4,035
(10.3) |
35,155
(89.7) |
0.14 |
16,470
(42.0) |
870
(2.2) |
1,661
(4.2) |
7,211
(18.4) |
12,048
(30.7) |
930
(2.4) |
3.41 |
| 50–64 |
14,692
(18.8)
|
1,710
(11.6) |
12,982
(88.4) |
3,903
(26.6) |
1,362
(9.3) |
1,328
(9.0) |
3,085
(21.0) |
4,308
(29.3) |
706
(4.8) |
||
| 65–74 |
10,533
(13.5)
|
1,311
(12.4) |
9,222
(87.6) |
1,898
(18.0) |
1,362
(12.9) |
1,478
(14.0) |
1,714
(16.3) |
3,100
(29.4) |
981
(9.3) |
||
| 75–84 |
8,844
(11.3)
|
1,275
(14.4) |
7,569
(85.6) |
1,202
(13.6) |
1,277
(14.4) |
1,536
(17.4) |
1,424
(16.1) |
2,532
(28.6) |
873
(9.9) |
||
| ≥85 |
5,044
(6.4)
|
678
(13.4) |
4,366
(86.6) |
669
(13.3) |
797
(15.8) |
888
(17.6) |
786
(15.6) |
1,489
(29.5) |
415
(8.2) |
||
|
Sex
| |||||||||||
| Female |
48,342
(61.7)
|
5,343
(11.1) |
42,999
(88.9) |
0.06 |
14,554
(30.1) |
3,431
(7.1) |
4,182
(8.7) |
9,033
(18.7) |
14,819
(30.7) |
2,323
(4.8) |
0.15 |
| Male |
29,961
(38.3)
|
3,666
(12.2) |
26,295
(87.8) |
9,588
(32.0) |
2,237
(7.5) |
2,709
(9.0) |
5,187
(17.3) |
8,658
(28.9) |
1,582
(5.3) |
||
|
Race and ethnicity
| |||||||||||
| Black or African American, NH |
9,261
(11.8)
|
823
(8.9) |
8,438
(91.1) |
0.17 |
3,837
(41.4) |
516
(5.6) |
694
(7.5) |
1,421
(15.3) |
2,553
(27.6) |
240
(2.6) |
1.17 |
| Hispanic or Latino |
14,703
(18.8)
|
1,345
(9.1) |
13,358
(90.9) |
5,119
(34.8) |
850
(5.8) |
1,096
(7.5) |
2,767
(18.8) |
4,492
(30.6) |
379
(2.6) |
||
| Other, NH** |
7,417
(9.5)
|
841
(11.3) |
6,576
(88.7) |
1,746
(23.5) |
659
(8.9) |
785
(10.6) |
1,743
(23.5) |
2,031
(27.4) |
453
(6.1) |
||
| Unknown |
1,255
(1.6)
|
154
(12.3) |
1,101
(87.7) |
547
(43.6) |
46
(3.7) |
73
(5.8) |
240
(19.1) |
321
(25.6) |
28
(2.2) |
||
| White, NH |
45,667
(58.3)
|
5,846
(12.8) |
39,821
(87.2) |
12,893
(28.2) |
3,597
(7.9) |
4,243
(9.3) |
8,049
(17.6) |
14,080
(30.8) |
2,805
(6.1) |
||
|
Documented previous SARS-CoV-2 infection††
| |||||||||||
| Yes |
15,750
(20.1)
|
1,247
(7.9) |
14,503
(92.1) |
0.19 |
4,682
(29.7) |
1,036
(6.6) |
1,351
(8.6) |
2,916
(18.5) |
5,136
(32.6) |
629
(4.0) |
0.15 |
| No |
62,553
(79.9)
|
7,762
(12.4) |
54,791
(87.6) |
19,460
(31.1) |
4,632
(7.4) |
5,540
(8.9) |
11,304
(18.1) |
18,341
(29.3) |
3,276
(5.2) |
||
|
SARS-CoV-2 status
| |||||||||||
| Positive test result (case-patient) |
9,009
(11.5)
|
9,009
(100.0) |
0
(—) |
— |
3,040
(33.7) |
537
(6.0) |
725
(8.0) |
1,677
(18.6) |
2,783
(30.9) |
247
(2.7) |
0.24 |
| Negative test result (control patient) |
69,294
(88.5)
|
0
(—) |
69,294
(100.0) |
21,102
(30.5) |
5,131
(7.4) |
6,166
(8.9) |
12,543
(18.1) |
20,694
(29.9) |
3,658
(5.3) |
||
|
No. of MV mRNA vaccine doses received
| |||||||||||
| None |
24,142
(30.8)
|
3,040
(12.6) |
21,102
(87.4) |
0.08 |
24,142
(100.0) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
— |
| 2 |
19,028
(24.3)
|
2,158
(11.3) |
16,870
(88.7) |
0
(—) |
277
(1.5) |
606
(3.2) |
1,391
(7.3) |
16,538
(86.9) |
216
(1.1) |
||
| 3 |
24,721
(31.6)
|
2,752
(11.1) |
21,969
(88.9) |
0
(—) |
1,006
(4.1) |
2,268
(9.2) |
12,829
(51.9) |
6,939
(28.1) |
1,679
(6.8) |
||
| 4 |
10,412
(13.3)
|
1,059
(10.2) |
9,353
(89.8) |
0
(—) |
4,385
(42.1) |
4,017
(38.6) |
0
(—) |
0
(—) |
2,010
(19.3) |
||
|
Most recent dose product manufacturer
| |||||||||||
| Pfizer-BioNTech |
34,596
(44.2)
|
3,821
(11.0) |
30,775
(89.0) |
0.07 |
0
(—) |
3,610
(10.4) |
4,451
(12.9) |
8,441
(24.4) |
15,290
(44.2) |
2,804
(8.1) |
— |
| Moderna |
19,565
(25.0)
|
2,148
(11.0) |
17,417
(89.0) |
0
(—) |
2,058
(10.5) |
2,440
(12.5) |
5,779
(29.5) |
8,187
(41.8) |
1,101
(5.6) |
||
| None |
24,142
(30.8)
|
3,040
(12.6) |
21,102
(87.4) |
24,142
(100.0) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
0
(—) |
||
|
Any chronic condition
| |||||||||||
| Yes |
23,892
(30.5)
|
2,311
(9.7) |
21,581
(90.3) |
0.12 |
6,782
(28.4) |
2,114
(8.8) |
2,466
(10.3) |
4,056
(17.0) |
7,313
(30.6) |
1,161
(4.9) |
0.46 |
| No |
54,411
(69.5)
|
6,698
(12.3) |
47,713
(87.7) |
17,360
(31.9) |
3,554
(6.5) |
4,425
(8.1) |
10,164
(18.7) |
16,164
(29.7) |
2,744
(5.0) |
||
|
≥1 chronic respiratory condition
| |||||||||||
| Yes |
12,316
(15.7)
|
1,060
(8.6) |
11,256
(91.4) |
0.13 |
3,606
(29.3) |
1,014
(8.2) |
1,203
(9.8) |
2,067
(16.8) |
3,863
(31.4) |
563
(4.6) |
0.2 |
| No |
65,987
(84.3)
|
7,949
(12.0) |
58,038
(88.0) |
20,536
(31.1) |
4,654
(7.1) |
5,688
(8.6) |
12,153
(18.4) |
19,614
(29.7) |
3,342
(5.1) |
||
|
≥1 chronic non-respiratory condition
| |||||||||||
| Yes |
17,268
(22.1)
|
1,836
(10.6) |
15,432
(89.4) |
0.05 | 4,869
(28.2) |
1,600
(9.3) |
1,794
(10.4) |
2,853
(16.5) |
5,389
(31.2) |
763
(4.4) |
0.4 |
| No | 61,035 (77.9) | 7,173 (11.8) | 53,862 (88.2) | 19,273 (31.6) | 4,068 (6.7) | 5,097 (8.4) | 11,367 (18.6) | 18,088 (29.6) | 3,142 (5.1) | ||
Abbreviations: BV = bivalent; ED/UC = emergency department/urgent care; KPNC = Kaiser Permanente Northern California; KPCHR = Kaiser Permanente Center for Health Research; MV = monovalent; NH = non-Hispanic; SMD = standardized mean or proportion difference.
* ED/UC encounters with a discharge code consistent with COVID-19–like illness were included. COVID-19–like illness diagnoses included acute respiratory illness, respiratory signs or symptoms, or febrile signs or symptoms using diagnosis codes from the International Classification of Diseases, Tenth Revision. Clinician-ordered molecular assays (e.g., real-time reverse transcription–polymerase chain reaction) for SARS-CoV-2 occurring ≤14 days before to <72 hours after the encounter date were included.
† California (Sep 13–Nov 18, 2022), Colorado (Sep 13–Nov 7, 2022), Minnesota and Wisconsin (Sep 13–Nov 18, 2022), New York (Sep 13–Nov 18, 2022), Oregon and Washington (Sep 13–Nov 14, 2022), Texas (Sep 13–Nov 13, 2022), and Utah (Sep 13–Nov 18, 2022).
§ Vaccination was defined as having received the last monovalent or bivalent dose within the specified range of months or days before the ED/UC encounter date, which was the date of respiratory specimen collection associated with the most recent positive or negative SARS-CoV-2 test result before the encounter start date or the encounter start date if testing only occurred after the admission.
¶ An absolute SMD >0.20 indicates a nonnegligible difference in variable distributions between ED/UC encounters for vaccinated versus unvaccinated patients or for patients with positive SARS-CoV-2 test results versus patients with negative SARS-CoV-2 test results. For mRNA COVID-19 vaccination status, a single SMD was calculated by averaging the absolute SMDs obtained from pairwise comparisons of each vaccinated category versus unvaccinated. Specifically, it was calculated as the average of the absolute value of the SMDs for 1) vaccinated with only monovalent doses, ≥11 months earlier versus unvaccinated, 2) vaccinated with only monovalent doses, 8–10 months earlier versus unvaccinated, 3) vaccinated with only monovalent doses 5–7 months earlier versus unvaccinated, 4) vaccinated with only monovalent doses 2–4 months earlier versus unvaccinated, and 5) vaccinated with bivalent booster ≥7 days earlier versus unvaccinated.
** Other race includes Asian, Hawaiian or other Pacific Islander, American Indian or Alaska Native, other not listed, and multiple races. Because of small numbers, these categories were combined.
†† Previous SARS-CoV-2 infection was defined as having a positive SARS-CoV-2 test result (molecular or antigen) documented in the electronic health record ≥15 days before the hospital admission date. This does not capture previous infections in which testing was not performed or testing was performed but not available in the electronic health record (e.g., at-home testing).