Occupational determinants of COVID-19 cases and vaccination: an ecological analysis of counties in the United States as of December 2021

Objective We aim to study the relationship between occupation distribution within each county and COVID-19 cumulative incidence and vaccination rate in the United States. Methods We collected county-level data from January 22, 2020 up to December 25, 2021. We fit multivariate linear models to find the relationship of the percentage of people employed by 23 main occupations. Results Counties with more health-related jobs, office support roles, community service, sales, production and material moving occupations had higher COVID-19 cumulative incidence. During the uptick of the “Delta” COVID variant (stratified period July 1-Dec 25), counties with more transportation occupations had significantly more COVID-19 cumulative incidence than before. Significance Understanding the association between occupations and COVID-19 cumulative incidence on an ecological level can provide information for precision public health strategies for prevention and protecting vulnerable workers. Impact Statement We used data from US Census and COVID-19 data to explore the association between occupations and COVID-19 cumulative incidence and vaccination rate on an ecological level, which can provide information for precision public health strategies for prevention of spread of disease and protecting vulnerable workers. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No funding was received for this project. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are gathered from public sources.