Date of Award

January 2022

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Carrie A. Redlich


Evaluating the evolution of SARS-CoV-2 infections throughout a population is a very difficult task, but can provide important information about which populations and sub-populations are at a higher risk of disease while also giving actionable data on whether infection control measures are effective in curbing the spread of a virus. This study looked at 1230 voluntary participants from a northeast Connecticut casino and tribal reservation who were sampled for COVID-19 antibodies during summer of 2020, and a further 600 participants who were sampled a year afterwards to evaluate vaccine uptake and characterize the new rate of seroconversion. Our baseline group had a positivity rate of around 8%, comparable to the state’s overall seroprevalence at that time period. We found that the onset of vaccination led to a notable decrease in the infection rate, and that there were no occupational factors (such as job title, mask usage or social distancing) that led to higher or lower rates of infection across this time period. Combined with the lower incidence of cases post-vaccination when compared to the state, this data helps strengthen the argument that a comprehensive vaccination and infection control campaign can result in measurable declines in covid infection rates across the entire workforce, and that environmental (including vaccine availability) factors play a larger role in driving infection rates than occupational factors for the gaming and service industry.


This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.