Back to Top Skip to main content Skip to sub-navigation

USU cohort study investigates COVID-19 impacts on DOD personnel

Military health personnel wearing a mask and a face shield holding up a sign that has the number eighteen on it Navy Hospital Corpsman 3rd Class Charles Cambern holds up a numbered sign as patients circle through to receive the COVID-19 vaccine at Walter Reed National Military Medical Center, in Bethesda, Maryland. WRNMMC is one of 10 DOD sites undertaking the EPICC study to better understand COVID-19 disease. (U.S. Navy photo by Ricardo Reyes)

Recommended Content:

COVID-19 Toolkit | Immunizations | COVID-19 Vaccine Efforts | Coronavirus

The Uniformed Services University of the Health Sciences’ Infectious Disease Clinical Research Program is leading a multi-year study to identify risk factors for COVID-19 in the military population, understand the symptoms and disease course, and investigate clinical outcomes.

Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential – or EPICC – study hopes to inform the Military Health System on ways to improve the patient care and treatment, infection, and disease prevention of those with COVID-19. USU is working in partnership with a network of military commands, treatment facilities, and laboratories across the country for EPICC.

Findings from the study “will support further understanding of the impact of SARS-COV-2 infection on active-duty readiness, acute and chronic clinical outcomes, the effectiveness of new treatments and vaccines, and address questions related to the emergence of new variants and their clinical impact,” said Dr. Brian Agan, deputy science director of IDCRP and principal investigator of the study.

The study is also evaluating how long the immune response to the COVID-19 vaccines lasts, breakthrough infections – which happen when a vaccinated individual becomes sick from the same illness the vaccination is designed to prevent – and how they behave over time, and estimating vaccine effectiveness, said Agan, who is also an employee of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.

Department of Defense service members and MHS beneficiaries of any age with COVID-19-like illness who are admitted to the hospital or treated as outpatients at an EPICC site can join. Likewise, those 18 years or older who have been tested for COVID-19, whether they tested positive or negative, can participate in the online portion of the study, which includes self-collected blood specimens for selected participants.

The protocol was recently updated to also enroll COVID-19 vaccine recipients and will initiate recruitment upon approval, said Navy Capt. (Dr.) Timothy Burgess, program director of IDCRP, who oversees the study. Eligible beneficiaries who are interested in participating in EPICC can submit an online screening form to join.

“In addition, asymptomatic individuals with a high risk of exposure are also eligible for enrollment in EPICC, which includes health care workers and close contacts of cases,” said Burgess. “Particularly, health care workers who have received a COVID-19 vaccination will be an important population for studies to examine vaccine effectiveness and outcomes.”

Data from inpatient, outpatient, and online participants, including their clinical characteristics, comorbidities, the clinical course of their illness, treatment, immunology, and outcomes, is being collected for the study.

“Questionnaires are provided to enrollees to collect information on demographics, symptoms at initial presentation and chronic or persisting symptoms during follow-up, exposure history, and lifestyle factors,” said Burgess. “Clinical and research specimens collected from enrollees are examined using molecular, serological, and other immune assays in collaboration USU and non-USU partner laboratories.”

Initiated in March 2020, EPICC is expected to continue enrolling participants at least through March 2022, or for as long as needed to fill in the knowledge gaps related to this disease, explained Agan.

“Once enrolled, participants are actively followed for one year to fully capture specimens and data including chronic outcomes and sequelae and will be followed for up to four additional years through electronic medical record review,” Agan said.

EPICC is being conducted at 10 military medical treatment facilities throughout the United States:

  • Brooke Army Medical Center in Fort Sam Houston, Texas
  • Carl R. Darnall Army Medical Center in Fort Hood, Texas
  • Fort Belvoir Community Hospital in Fort Belvoir, Virginia
  • Joint Base Lewis-McChord, Washington
  • Naval Medical Center Portsmouth in Portsmouth, Virginia
  • Naval Medical Center San Diego in San Diego, California
  • Tripler Army Medical Center in Honolulu, Hawaii
  • William Beaumont Army Medical Center in El Paso, Texas
  • Womack Army Medical Center in Fort Bragg, North Carolina
  • Walter Reed National Military Medical Center in Bethesda, Maryland

Military health personnel wearing a face mask and shield speaking to a man who is wearing a face mask
Navy Hospital Corpsman 3rd Class Michael A. Torrent conducts a pre-screening questionnaire prior to administering the COVID-19 vaccine as part of Operation Warp Speed at Walter Reed National Military Medical Center. (U.S. Navy photo by Ricardo Reyes)

By the first week of February, more than 1,600 active-duty service members and MHS beneficiaries had enrolled in EPICC, the majority of whom are being treated as outpatients, said Agan. Approximately half of the subjects with confirmed SARS-CoV-2 diagnoses included in EPICC are active-duty service members.

Some interesting observations the researchers found thus far are that the characteristics of hospitalized COVID-19 patients compared to those treated as outpatients has shown a higher proportion of comorbidities, with hypertension, diabetes, and obesity being most prevalent, said Agan. In fact, their findings have begun to identify why obesity is a risk factor for more severe disease.

They were also able to garner valuable insight into the risk of reinfection from a military health care worker enrolled in the study who was reinfected with a symptomatic case of COVID-19. 

“A median time to recovery has been identified as 14 days, with nine lost duty days among active-duty service members,” said Agan. “These findings not only support operational planning, but also provide an important baseline to evaluate the effectiveness of vaccines as uptake widens across the DOD.”

They also found that the antibody levels that cause immunity remain in individuals for more than six months post-infection and that there were no “seroreversions” after six months post-infection. Seroreversion is the loss of serologic reactivity, or the presence of a particular antigen in the blood, whether spontaneous or in response to therapy. 

“With ongoing concerns about the magnitude and duration of immunity post-infection, our findings were both surprising and a relief,” said Burgess.

The researchers hope the information on the effectiveness and safety of the vaccines will alleviate concerns and encourage individuals to be vaccinated. And as the vaccine rollout expands to more recipients, the study will benefit from recruiting participants among the growing population of vaccinated recipients.

“This will enhance our ability to evaluate vaccine effectiveness in the population and if other reports showing high levels of protection are confirmed, our work may help boost confidence among those who are less certain,” said Burgess. “We are excited about the ability of the EPICC study to answer key questions for patients, health care providers, and leadership to guide decisions as we steer through the coming months of this unprecedented and historic pandemic.

You also may be interested in...

MHS Town Hall, May 12, 2021

Video
5/12/2021
MHS and Military OneSource COVID-19 Townhall, Walter Reed Army Institute of Research, Wednesday 12 May

Tune in for another MHS and Military OneSource Town Hall with the Walter Reed Army Institute of Research

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

Join Us!! Sixth Live COVID-19 Town Hall

Article
5/12/2021
Image describing today's Town Hall with Dr. Paul Scott and COL Clinton K. Murray, MD.  They are with the Walter Reed Army Institute of Research, and will discuss COVID-19 Vaccine Advancement and Trials.

Join us for today's Town Hall with Dr. Paul Scott and COL Clinton K. Murray, MD. They are with the Walter Reed Army Institute of Research, and will discuss COVID-19 Vaccine Advancement and Trials.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts | COVID-19 Vaccine Toolkit

Is It Allergies or COVID-19?

Infographic
5/11/2021
Infographic that describes the difference between symptoms of allergies and those related to COVID-19

This Infographic provides a chart that outlines how to tell the difference between COVID-19 and allergy symptoms

Recommended Content:

Symptoms of COVID-19 | Coronavirus | COVID-19 Vaccine Toolkit

DHA-PI 6205.01: Medical Logistics Guidance for the DoD Coronavirus Disease 2019 (COVID-19) Vaccination Program

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (n), establishes the Defense Health Agency's (DHA's) procedures for ordering, receiving, and managing COVID-19 Vaccines inventory and ancillary kits.

Navy nurse steps into Jacksonville community for COVID-19 vaccinations

Article
5/7/2021
Military health personnel wearing face mask discussing the COVID-19 vaccine program

Navy Cmdr. Glenn “Pete” Bradford is aiding the underserved Jacksonville community in COVID-19 vaccination mission

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

Line Leader Presentation (PDF)

Publication
5/7/2021

This document is identical to the PowerPoint presentation for line leader reference and use.

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

Line Leader Presentation PPT

Publication
5/7/2021

Leaders across the Department can leverage this briefing deck to discuss COVID-19 vaccines with their troops. Don't forget to reference speaker notes and to personalize the title slide!

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

Presentation Companion

Publication
5/7/2021

Leaders and public affairs officers may reference this document. It can be shared with commands to support briefings, or distributed independently to share facts about COVID-19 vaccines.

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

Reasons to Choose a COVID-19 Vaccine Fact Sheet

Publication
5/7/2021

Leaders and public affairs officers can share this information across channels to continue the vaccine confidence conversation.

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

DHA, HA leaders discuss MHS Transformation at AHA panel

Article
5/6/2021
Military personnel talking at a podium

Army Lt. Gen. (Dr.) Ronald Place and Dr. Terry Adirim discussed MHS Transformation, MHS GENESIS, and highlighted the DHA’s response to COVID-19 in a virtual roundtable hosted April 12 by the American Hospital Association.

Recommended Content:

MHS GENESIS | MHS Transformation | Genesis of MHS GENESIS | Coronavirus

EACH celebrates National Nurses Week with a reflection on the pandemic

Article
5/6/2021
Military health personnel inputting information into a computer

Evans Army Community Hospital celebrates National Nurses Week 2021.

Recommended Content:

National Nurses Week | Nurses Week | Coronavirus | COVID-19 Vaccine Toolkit

Nurse and Tech Week: Air Force airmen are battle-tested and ready

Article
5/6/2021
12 COVID-19 patients aboard a C-17 Globemaster III aircraft

For the past year, Air Force nurses and medical technicians have found themselves on the front lines in the battle against the COVID-19 disease.

Recommended Content:

COVID-19 Vaccine Toolkit | National Nurses Week | Technology | Nurses Week | May Toolkit | Coronavirus

Got Your 6 - May 6, 2021

Video
5/6/2021
Video screen image for the May 6, 2021 Got Your Six video

"Got Your 6" is TRICARE's COVID-19 vaccine video series that delivers important information and updates, three times a month. It includes the latest information about DoD vaccine distribution, the TRICARE health benefit, and vaccine availability for a DoD-affiliated, and TRICARE beneficiary audience.

Recommended Content:

COVID-19 Toolkit | COVID-19 Vaccine Efforts | COVID-19 Vaccine Toolkit

DHA-IPM 20-004: Department of Defense (DoD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation

Policy

This Defense Health Agency (DHA) Interim Procedures Memorandum (IPM), based on the authority of References (a) through (d), and in accordance with the guidance cited in References (e) through (aa), establishes the DHA’s procedures to implement instructions, assign responsibilities, and prescribe procedures for the COVID-19 Vaccination Program. This DHA-IPM applies to DHA, DHA Components (activities under the authority direction, and control of the DHA), Military Departments (MILDEP), and the United States Coast Guard (CG). This DHA-IPM cancels and replaces DHA-IPM 20-004, “Department of Defense (DoD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation,” December 13, 2020.

Janssen COVID-19 vaccine returns to Military Health System

Article
5/4/2021
Military personnel wearing a face mask and a face shield administering the COVID-19 vaccine

Doses of the Janssen COVID-19 vaccine became available April 29 to those in the Military Health System eligible and authorized to receive COVID-19 vaccinations.

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 35

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.