Introduction The COVID-19 pandemic resulted in the need for antibody testing to determine the impact of the disease. This study quantified the COVID-19 infection risk of healthcare workers (HCW) compared to other community essential workers (CEW) through positive COVID-19 antibody rates. Methods This prospective observational study was conducted September through December 2020 in Charleston, West Virginia. A total of 1,081 essential workers were recruited. Blood samples were tested for SARS-CoV-2 IgG antibodies and questionnaires were obtained describing symptom history, exposure, prior testing, and employment. Results COVID-19 antibodies were found in 7.8% of participants. There were no significant differences in terms of gender, living alone or with children, month of lab collection, or working on a COVID-19 unit. Risk factors included having a known exposure (p<0.001), living with someone with COVID-19 (p<0.001), being previously tested (p<0.001), and positive polymerase chain reaction tests (p<0.001). Additional risks were county of residence (p=0.02) and working in healthcare (p=0.004). Discussion Essential workers had a nearly 60% increased risk of COVID-19 compared with the public. HCW had a higher risk than other CEW with rates 1.8 times that of CEW. Living in Kanawha County was a risk factor, but the difference was driven by the HCW population with 12.1% positivity. HCW in a COVID-19 unit had similar positive rates versus non-COVID-19 units. Conclusion This study confirms that healthcare workers had a much higher risk of contracting COVID-19 near Charleston, WV. With these findings, despite the use of safety guidelines and use of personal protective equipment, healthcare workers in Kanawha County had higher positivity rates for SARS-CoV-2 IgG antibodies. Further evaluation of PPE compliance, hand hygiene habits, sharing work culture, and roles within the hospital would be of value.