Coronavirus disease 2019 (COVID-19) vaccination uptake among healthcare workers

Abstract Objective: To assess reasons for noncompliance with COVID-19 vaccination among healthcare workers (HCWs). Design: Cohort observational and surveillance study. Setting: Sheba Medical Center, a 1,600-bed tertiary-care medical center in Israel. Participants: The study included 10,888 HCWs including all employees, students, and volunteers. Intervention: The BNT162b2 mRNA COVID-19 vaccine was offered to all HCWs of the hospital. Noncompliance was assessed, and pre-rollout and post-rollout surveys were conducted. Data regarding uptake of the vaccine as well as demographic data and compliance with prior influenza vaccination were collected, and 2 surveys were distributed. The survey before the rollout pertained to the intention to receive the vaccine, and the survey after the rollout pertained to all unvaccinated HCWs regarding causes of hesitancy. Results: In the pre-rollout survey, 1,673 (47%) of 3,563 HCWs declared their intent to receive the vaccine. Overall, 8,108 (79%) HCWs received the COVID-19 vaccine within 40 days of rollout. In a multivariate logistic regression model, the factors that were significant predictors of vaccine uptake were male sex, age 40–59 years, occupation (paramedical professionals and doctors), high socioeconomic level, and compliance with flu vaccine. Among 425 unvaccinated HCWs who answered the second survey, the most common cause for hesitancy was the risk during pregnancy (31%). Conclusions: Although vaccine uptake among HCWs was higher than expected, relatively low uptake was observed among young women and those from lower socioeconomic levels and educational backgrounds. Concerns regarding vaccine safety during pregnancy were common and more data about vaccine safety, especially during pregnancy, might improve compliance.

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A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700003520 ◽

1996 ◽

Vol 17 (12) ◽

pp. 798-802 ◽

Cited By ~ 2

Author(s):

Patricia A. Meier ◽

Cheryl D. Carter ◽

Sarah E. Wallace ◽

Richard J. Hollis ◽

Michael A. Pfaller ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Infection Control ◽

Healthcare Workers ◽

Medical Center ◽

Tertiary Care ◽

Chromosomal Dna ◽

Methicillin Resistant ◽

Persistent Problem ◽

Tertiary Care Medical Center ◽

Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

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Impact of Bordetella pertussis Exposures on a Massachusetts Tertiary Care Medical System

Infection Control and Hospital Epidemiology ◽

10.1086/518352 ◽

2007 ◽

Vol 28 (6) ◽

pp. 708-712 ◽

Cited By ~ 20

Author(s):

Iva Zivna ◽

Diana Bergin ◽

Joanne Casavant ◽

Sally Fontecchio ◽

Susan Nelson ◽

...

Keyword(s):

Bordetella Pertussis ◽

Healthcare Workers ◽

Close Contact ◽

Medical Center ◽

Tertiary Care ◽

Medical System ◽

Secondary Case ◽

Tertiary Care Medical Center ◽

Outbreak Investigations ◽

The Impact

Objective.To assess the impact of outbreaks of Bordetella pertussis infection on a tertiary care medical system.Design.Retrospective study.Setting.Academic tertiary care medical center and affiliated ambulatory care settings.Subjects.All patients and healthcare workers (HCWs) who were in close contact with patients with laboratory-confirmed cases of B. pertussis infection from October 1, 2003, through September 30, 2004.Intervention.Direct and indirect medical center costs were determined, including low and high estimates of time expended in the evaluation and management of exposed patients and HCWs during outbreak investigations of laboratory-confirmed cases of B. pertussis infection.Results.During this period, 20 primary and 3 secondary laboratory-confirmed cases of B. pertussis infection occurred, with 2 primary pertussis cases and 1 secondary case occurring in HCWs. Outbreak investigations prompted screening of 353 medical center employees. Probable or definitive exposure was identified for 296 HCWs, and 287 subsequently received treatment or prophylaxis for B. pertussis infection. Direct medical center costs for treatment and prophylaxis were $13,416 and costs for personnel time were $19,500-$31,190. Indirect medical center costs for time lost from work were $51,300-$52,300. The total cost of these investigations was estimated to be $85,066-$98,456.Conclusions.Frequent B. pertussis exposures had a major impact on our facility. Given the impact of exposures on healthcare institutions, routine vaccination for HCWs may be beneficial.

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Healthcare Workers' Knowledge and Attitudes About Pertussis and Pertussis Vaccination

Infection Control and Hospital Epidemiology ◽

10.1086/521654 ◽

2007 ◽

Vol 28 (11) ◽

pp. 1284-1289 ◽

Cited By ~ 29

Author(s):

William P. Goins ◽

William Schaffner ◽

Kathryn M. Edwards ◽

Thomas R. Talbot

Keyword(s):

Pertussis Vaccine ◽

Healthcare Workers ◽

Medical Center ◽

Academic Medical Center ◽

Tertiary Care ◽

Significant Risk ◽

Direct Patient Care ◽

Knowledge And Attitudes ◽

Personal Recommendation ◽

To Receive

Objective.To determine knowledge and attitudes about pertussis and pertussis vaccination among healthcare workers (HCWs).Design.Self-administered, Web-based survey.Setting.Tertiary-care academic medical center.Participants.Medical center employees who participated in direct patient care were recruited to complete the survey through institutional e-mail.Results.Of 14,893 potentially eligible employees, 1,819 (12%) completed the survey. Most respondents (87%) did not plan to receive the pertussis vaccine. Intent to receive vaccination (which included recent history of vaccination) was associated with the following 4 factors: receipt of a physician recommendation for vaccination (odds ratio [OR], 9.01), awareness of Centers for Disease Control and Prevention recommendations for pertussis vaccination for HCWs (OR, 6.89), receipt of encouragement to be vaccinated from a coworker (OR, 4.72), the belief that HCWs may spread pertussis to patients and family (OR, 1.80). Two factors were negatively associated with intent to receive vaccination: the presence of children in the HCW's home (OR, 0.69) and employment as a nurse (OR, 0.59). Reasons cited by those who did not intend to receive vaccination included lack of a personal recommendation for vaccination (78%), receipt of vaccination as a child (51%), and perception that there was no significant risk for contracting pertussis (38%).Conclusions.Of the HCWs surveyed, only 13% intended to receive the pertussis vaccine. A perceived lack of recommendation for vaccination and inaccurate conceptions about pertussis and pertussis vaccination were cited as reasons HCWs did not intend to be vaccinated. Institutional pertussis vaccination campaigns should focus on the risks of healthcare-associated pertussis and new recommendations for pertussis vaccination.

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Factors indicating intention to vaccinate with a COVID-19 vaccine among older U.S. Adults

10.1101/2021.01.10.20248831 ◽

2021 ◽

Author(s):

Janeta Nikolovski ◽

Martin Koldijk ◽

Gerrit Jan Weverling ◽

John Spertus ◽

Mintu Turakhia ◽

...

Keyword(s):

Clinical Study ◽

Demographic Data ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Health Providers ◽

Safety And Efficacy ◽

Random Forest Classification ◽

Factors Associated ◽

Link Type ◽

To Receive

AbstractBACKGROUNDThe success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine.METHODSAdults enrolled in the Heartline™ clinical study were invited to complete a COVID-19 vaccine assessment through the Heartline™ mobile application between November 6-20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm.RESULTSAmong 9,106 study participants, 81.3% (n=7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report.CONCLUSIONSEven among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing.Clinicaltrials.govNCT04276441

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Optimal Bandaging of Smallpox Vaccination Sites to Decrease the Potential for Secondary Vaccinia Transmission Without Impairing Lesion Healing

Infection Control and Hospital Epidemiology ◽

10.1086/508827 ◽

2006 ◽

Vol 27 (11) ◽

pp. 1184-1192 ◽

Cited By ~ 7

Author(s):

Thomas R. Talbot ◽

Jody Peters ◽

Lihan Yan ◽

Peter F. Wright ◽

Kathryn M. Edwards

Keyword(s):

Index Finger ◽

Medical Center ◽

Tertiary Care ◽

Skin Irritation ◽

Smallpox Vaccination ◽

Optimal Method ◽

Vaccination Site ◽

Tertiary Care Medical Center ◽

Study Participants ◽

To Receive

Objective.To assess the optimal method for covering smallpox vaccination sites to prevent transmission of vaccinia.Design.Randomized, nonblinded clinical trial.Setting.Tertiary care medical center.Participants.Vaccinia-naive and vaccinia-experienced volunteers.Interventions.After vaccination, study participants were randomized to receive 1 of 3 types of bandage: gauze, occlusive with gauze lining, or foam. Vaccination sites were assessed every 3 to 5 days until the lesion healed. During each visit, specimens were obtained from the vaccination site, the bandage surface before removal, and the index finger contralateral to the vaccination site and were cultured for vaccinia. Time to lesion healing was assessed.Results.All 48 vaccinia-naive and 47 (87%) of 54 vaccinia-experienced participants developed a vesicle or pustule at the injection site 6-11 days after vaccination. Fourteen (14%) of 102 participants had bandage cultures positive for vaccinia. All but 1 of these vaccinia-positive cultures were of a bandage from participants randomized to the gauze bandage group, and all but 3 were of bandages from vaccinia-naive participants. No finger-specimen cultures were positive for vaccinia. One episode of neck autoinoculation occurred in a vaccinia-naive individual who had vaccinia recovered from his gauze bandage on multiple visits. The foam bandage was associated with more local adverse effects (skin irritation and induration). The time to healing did not differ among the bandage groups.Conclusions.The potential for transmission of vaccinia from a vaccination site is greater if the site is covered by gauze than if it is covered by occlusive or foam bandages. Use of an occlusive bandage with a gauze lining is the best choice for coverage of smallpox vaccination sites because of a reduced potential for vaccinia transmission and a lower reactogenicity rate. Bandage choice did not affect vaccination lesion healing.

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Factors indicating intention to vaccinate with a COVID-19 vaccine among older U.S. adults

PLoS ONE ◽

10.1371/journal.pone.0251963 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251963

Author(s):

Janeta Nikolovski ◽

Martin Koldijk ◽

Gerrit Jan Weverling ◽

John Spertus ◽

Mintu Turakhia ◽

...

Keyword(s):

Clinical Study ◽

Demographic Data ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Health Providers ◽

Safety And Efficacy ◽

Random Forest Classification ◽

Factors Associated ◽

Forest Classification ◽

To Receive

Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.

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Mandatory Influenza Vaccination of Healthcare Workers: A 5-Year Study

Infection Control and Hospital Epidemiology ◽

10.1086/656210 ◽

2010 ◽

Vol 31 (9) ◽

pp. 881-888 ◽

Cited By ~ 169

Author(s):

Robert M. Rakita ◽

Beverly A. Hagar ◽

Patricia Crome ◽

Joyce K. Lammert

Keyword(s):

Influenza Vaccination ◽

Healthcare Workers ◽

Influenza Season ◽

Medical Center ◽

Tertiary Care ◽

Vaccination Program ◽

First Year ◽

Vaccination Rates ◽

Religious Reasons ◽

To Receive

Background.The rate of influenza vaccination among healthcare workers (HCWs) is low, despite a good rationale and strong recommendations for vaccination from many health organizations.Objective.To increase influenza vaccination rates by instituting the first mandatory influenza vaccination program for HCWs.Design and Setting.A 5-year study (from 2005 to 2010) at Virginia Mason Medical Center, a tertiary care, multispecialty medical center in Seattle, Washington, with approximately 5,000 employees.Methods.All HCWs of the medical center were required to receive influenza vaccination. HCWs who were granted an accommodation for medical or religious reasons were required to wear a mask at work during influenza season. The main outcome measure was rate of influenza vaccination among HCWs.Results.In the first year of the program, there were a total of 4,703 HCWs, of whom 4,588 (97.6%) were vaccinated, and influenza vaccination rates of more than 98% were sustained over the subsequent 4 years of our study. Less than 0.7% of HCWs were granted an accommodation for medical or religious reasons and were required to wear a mask at work during influenza season, and less than 0.2% of HCWs refused vaccination and left Virginia Mason Medical Center.Conclusion.A mandatory influenza vaccination program for HCWs is feasible, results in extremely high vaccination rates, and can be sustained over the course of several years.

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Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak

Journal of Health Psychology ◽

10.1177/1359105321991630 ◽

2021 ◽

pp. 135910532199163

Author(s):

Maya Bizri ◽

Ghida Kassir ◽

Hani Tamim ◽

Firas Kobeissy ◽

Samer El Hayek

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Healthcare Workers ◽

Medical Center ◽

Care Center ◽

Tertiary Care ◽

Post Traumatic Stress ◽

Online Questionnaire ◽

Targeted Interventions ◽

Tertiary Care Medical Center

The COVID-19 outbreak has had a significant mental health toll on healthcare workers in Lebanon. We examined pandemic-related psychological distress among healthcare workers in a tertiary care medical center. One hundred and fifty participants completed an online questionnaire. About half showed a high risk of acute distress (58.7%) on the GHQ-28, while most (89.3%) scored low/moderate stress on the PSS-10. The IES-R revealed concern for post-traumatic stress in one-third of participants, significantly in nurses ( p = 0.008) and those living with vulnerable individuals ( p = 0.030). Mental health history did not increase the risk. Our findings highlight the need for early targeted interventions during the pandemic.

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EVALUATION OF FACTORS ASSOCIATED WITH MORTALITY AMONGST PATIENTS ADMITTED TO A TERTIARY CARE MEDICAL CENTER FOR COVID-19 INFECTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)04478-8 ◽

2021 ◽

Vol 77 (18) ◽

pp. 3123

Author(s):

Anish Samuel ◽

Ashesha Mechineni ◽

Robin Craven ◽

Wilbert Aronow ◽

Mourad Ismail ◽

...

Keyword(s):

Medical Center ◽

Tertiary Care ◽

Factors Associated ◽

Tertiary Care Medical Center

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Evaluation of post-ERCP pancreatitis after biliary stenting with self-expandable metal stents vs. plastic stents in benign and malignant obstructions

Endoscopy International Open ◽

10.1055/a-1388-6964 ◽

2021 ◽

Vol 09 (06) ◽

pp. E888-E894

Author(s):

Nichol S. Martinez ◽

Sumant Inamdar ◽

Sheila N. Firoozan ◽

Stephanie Izard ◽

Calvin Lee ◽

...

Keyword(s):

Pancreatic Duct ◽

Medical Center ◽

Tertiary Care ◽

Plastic Stents ◽

Metal Stents ◽

Limited Data ◽

Sems Group ◽

Tertiary Care Medical Center ◽

Stent Type ◽

Pancreatic Duct Stent

Abstract Background and study aims There are conflicting data regarding the risk of post-ERCP pancreatitis (PEP) with self-expandable metallic stents (SEMS) compared to polyethylene stents (PS) in malignant biliary obstructions and limited data related to benign obstructions. Patients and methods A retrospective cohort study was performed of 1136 patients who underwent ERCP for biliary obstruction and received SEMS or PS at a tertiary-care medical center between January 2011 and October 2016. We evaluated the association between stent type (SEMS vs PS) and PEP in malignant and benign biliary obstructions. Results Among the 1136 patients included in our study, 399 had SEMS placed and 737 had PS placed. Patients with PS were more likely to have pancreatic duct cannulation, pancreatic duct stent placement, double guidewire technique, sphincterotomy and sphincteroplasty as compared to the SEMS group. On multivariate analysis, PEP rates were higher in the SEMS group (8.0 %) versus the PS group (4.8 %) (OR 2.27 [CI, 1.22, 4.24]) for all obstructions. For malignant obstructions, PEP rates were 7.8 % and 6.6 % for SEMS and plastic stents, respectively (OR 1.54 [CI, 0.72, 3.30]). For benign obstructions the PEP rate was higher in the SEMS group (8.8 %) compared to the PS group (4.2 %) (OR 3.67 [CI, 1.50, 8.97]). No significant differences between PEP severity were identified based on stent type when stratified based on benign and malignant. Conclusions PEP rates were higher when SEMS were used for benign obstruction as compared to PS. For malignant obstruction, no difference was identified in PEP rates with use of SEMS vs PS.

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