The Effectiveness of Vaccine Day and Educational Interventions on Influenza Vaccine Coverage Among Health Care Workers at Long-Term Care Facilities

Background The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities. Objective The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection. Methods COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase–polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described. Results Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%). Conclusions COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

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Effectiveness of BNT162b2 mRNA COVID-19 vaccine against acquisitions of SARS-CoV-2 among health care workers in long-term care facilities: a prospective cohort study

Clinical Infectious Diseases ◽

10.1093/cid/ciab918 ◽

2021 ◽

Author(s):

Khitam Muhsen ◽

Nimrod Maimon ◽

Ami Mizrahi ◽

Omri Bodenneimer ◽

Dani Cohen ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Cumulative Incidence ◽

Long Term Care ◽

Rt Pcr ◽

Term Care ◽

Care Workers ◽

Care Facilities

Abstract Objective We assessed vaccine effectiveness (VE) of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 acquisition among health care workers (HCWs) of long-term care facilities (LTCFs). Methods This prospective study, in the framework of "Senior Shield" program in Israel, included routine, weekly nasopharyngeal SARS-CoV-2 RT-PCR testing from all LTCF HCWs since July 2020. All residents and 75% of HCWs were immunized between December 2020 and January 2021. The analysis was limited to HCWs adhering to routine testing. Fully vaccinated (14+ days after second dose; n=6960) and unvaccinated HCWs (n=2202) were simultaneously followed until SARS-CoV-2 acquisition, or end of follow-up, April 11, 2021. Hazard ratios (HRs) for vaccination vs. no vaccination were calculated (Cox proportional hazards regression models, adjusting for socio-demographics and residential-area COVID-19 incidence). VE was calculated as [(1– HR)×100]. RT-PCR cycle threshold values (Cts) were compared between vaccinated and unvaccinated HCWs. Results At >14 days post second dose, 40 vaccinated HCWs acquired SARS-CoV-2 (median follow-up, 66 days; cumulative incidence 0.6%) vs. 84 unvaccinated HCWs (median follow-up 43 days; cumulative incidence, 5.1%); HR=0.11 (95% CI 0.07, 0.17), unadjusted VE=89% (95% CI 83%, 93%). Adjusted VE beyond seven days and >14 days post second dose were similar. The median PCR Cts targeting ORF1ab gene among 20 vaccinated and 40 unvaccinated HCWs was 32.0 vs. 26.7, respectively, p=0.008. Conclusions VE following two doses of BNT162b2 against SARS-CoV-2 acquisition in LTCF HCWs was high. The lower viral loads among SARS-CoV-2 positive HCWs suggests further reduction in transmission.

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Covid-19 Vaccine Hesitancy in Nursing Home Staff and the Need for Ongoing Education and Vaccine Access

Clinical Medical Reviews and Reports ◽

10.31579/2690-8794/103 ◽

2022 ◽

Vol 4 (1) ◽

pp. 01-05

Author(s):

Ammu Thampi Susheela ◽

Dheeraj Mahajan ◽

Lori Porter

Keyword(s):

Health Care ◽

Health Care Workers ◽

Long Term Care ◽

Care Facility ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Term Care ◽

Care Workers ◽

Care Facilities

Objective: To study vaccine hesitancy among health care workers who provide direct care in nursing homes and long term care facilities which cater to the most vulnerable population of the community. Design: This is a cross sectional cohort study Setting and participants: The study was conducted on the front line healthcare workers who work in long term care facilities. Methods: A nationwide survey was conducted on the certified nurse assistants on November 16th 2020 which reached 7000 survey recipients. Results: Out of 7000 survey recipients, 3119 responded (45% response rate). There was 71.6% (2,233) negative response about taking the covid19 vaccine due to lack of trust and education of information Conclusions and implications: Our study concluded that the vaccine hesitancy is high among the health care workers of long-term care facility and that ongoing education and interactive dialogue with certified nurse assistants and ongoing access to vaccine is critical as the willingness improves.

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