scholarly journals Experience of COVID-19 Vaccination of Healthcare Workers in a Hospital Setting

2021 ◽  
Author(s):  
Tariq Azamgarhi ◽  
Michelle Hodgkinson ◽  
Ashik Shah ◽  
John Skinner ◽  
Tim Briggs ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Cox Regression ◽  
Age Groups ◽  
Hospital Setting ◽  
Healthcare Setting ◽  
Vaccine Uptake ◽  
Post Vaccination ◽  
Vaccination Rates ◽  
Job Roles ◽  
Kaplan Meier

Abstract Introduction Several COVID-19 vaccines against SAR-CoV-2 have demonstrated high efficacy in clinical trials. This is the first report describing their use in a healthcare setting.Methods We conduct a single centre observational study assessing vaccine uptake and apparent efficacy of the Pfizer BioNTech vaccine among healthcare workers (HCW). Results Overall uptake was 60.8%, however we saw statistically significant differences in uptake between age groups, ethnic origins, and job roles. In the 42 days after vaccination, 45 new cases of COVID were identified, of which 4 (8.9%) occurred in HCWs who were beyond 10 days of vaccination. Kaplan Meier curves for vaccinated and unvaccinated groups were congruent until day 14 and continued to diverge up to 42 days. Cox regression analysis showed a 79.0% (95%CI 21 – 95; p=0.02) risk reduction for COVID infection in vaccinated HCWs. Conclusions Initial vaccination rates among HCW were generally good, although uptake was lower in certain groups and efforts should focus on increasing uptake in these groups. The Pfizer BioNTech vaccine is effective from 14 days post-vaccination in a frontline clinical setting and protection continues beyond 21 days post 1st dose without a 2nd dose, being given.

scholarly journals BNT162b2 vaccine uptake and effectiveness in UK healthcare workers – a single centre cohort study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tariq Azamgarhi ◽  
Michelle Hodgkinson ◽  
Ashik Shah ◽  
John A. Skinner ◽  
Iva Hauptmannova ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Cox Regression ◽  
Age Groups ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Single Centre ◽  
Cox Regression Analysis ◽  
Vaccination Rates ◽  
Job Roles

AbstractIn this single centre cohort study we assessed BNT162B2 vaccine uptake and effectiveness among UK healthcare workers (HCWs) during a time of high community COVID-19 prevalence. Early uptake among HCWs was 62.3% (1409/2260), however there were significant differences in uptake between age groups, ethnic origins, and job roles. Uptake increased to 72.9% after a vaccine hesitancy working group implemented specific measures. In the 42 days after vaccination, 49 new cases of COVID-19 were identified, of which 7 (14.3%) occurred in HCWs who were beyond 10 days of vaccination. Kaplan–Meier curves for partially vaccinated and unvaccinated groups were congruent until day 14 and continued to diverge up to 42 days. Cox regression analysis showed a 70.0% (95%CI 6.0–91.0; p=0.04) risk reduction for COVID-19 infection in partially vaccinated HCWs. Here we report early vaccination rates among HCWs are generally high although uptake is lower in certain groups. It is possible to improve vaccine uptake and efforts should focus on this, however, significant resource is required. The BNT162B2 vaccine is effective from 14 days post-vaccination in a frontline clinical setting and protection continues beyond 21 days post 1st dose without a 2nd dose, being given.

scholarly journals Survival analysis of time to SARS-CoV-2 PCR negativisation to optimise PCR prescription in health workers: the Henares COVID-19 healthcare workers cohort study

2021 ◽  
pp. oemed-2020-106903
Author(s):  
Julio González Martin-Moro ◽  
Marta Chamorro Gómez ◽  
Galicia Dávila Fernández ◽  
Ana Elices Apellaniz ◽  
Ana Fernández Hortelano ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Cox Regression ◽  
Health Workers ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Kaplan Meier ◽  
Confounding Variables ◽  
The Impact ◽  
Associated Variables

ObjectivesReverse transcriptase PCR (RT-PCR) is considered the gold standard in diagnosing COVID-19. Infected healthcare workers do not go back to work until RT-PCR has demonstrated that the virus is no longer present in the upper respiratory tract. The aim of this study is to determine the most efficient time to perform RT-PCR prior to healthcare workers’ reincorporation.Materials and methodsThis is a cohort study of healthcare workers with RT-PCR-confirmed COVID-19. Data were collected using the medical charts of healthcare workers and completed with a telephone interview. Kaplan-Meier curves were used to determine the influence of several variables on the time to RT-PCR negativisation. The impact of the variables on survival was assessed using the Breslow test. A Cox regression model was developed including the associated variables.Results159 subjects with a positive RT-PCR out of 374 workers with suspected COVID-19 were included. The median time to negativisation was 25 days from symptom onset (IQR 20–35 days). Presence of IgG, dyspnoea, cough and throat pain were associated with significant longer time to negativisation. Cox logistic regression was used to adjust for confounding variables. Only dyspnoea and cough remained in the model as significant determinants of prolonged negativisation time. Adjusted HRs were 0.68 (0.48–096) for dyspnoea and 0.61 (0.42–0.88) for dry cough.ConclusionsRT-PCR during the first 3 weeks leads to a high percentage of positive results. In the presence of respiratory symptoms, negativisation took nearly 1 week more. Those who developed antibodies needed longer time to negativisate.

scholarly journals COVID-19 Vaccination of HCWs in the First Phase of a Large-Scale Mass Vaccination Program within a Healthcare System

2021 ◽  
Vol 1 (S1) ◽  
pp. s11-s11
Author(s):  
Kimberly Korwek ◽  
E. Jackie Blanchard ◽  
Julia Moody ◽  
Katherine Lange ◽  
Ryan Sledge ◽  
...  
Keyword(s):  
Human Resources ◽  
Healthcare Workers ◽  
Large Scale ◽  
Rapid Development ◽  
Vaccination Strategy ◽  
State Level ◽  
Mass Vaccination ◽  
Vaccine Uptake ◽  
Vaccination Program ◽  
Vaccination Rates

Background: The approval of the first SARS-COV-2 vaccines for COVID-19 were accompanied by unprecedented efforts to provide vaccination to healthcare workers and first responders. More information about vaccine uptake in this group is needed to better refine and target educational messaging. Methods: HCA Healthcare used federal guidance and internal experience to create a systemwide mass vaccination strategy. A closed point-of-dispensing (POD) model was developed and implemented. The previously developed enterprise-wide emergency operations strategy was adapted and implemented, which allowed for rapid development of communications and operational processes. A tiering strategy based on recommendations from the National Academies was used in conjunction with human resources data to determine vaccine eligibility for the first phase of vaccination. A comprehensive data and reporting strategy was built to connect human resources and vaccine consent data for tracking vaccination rates across the system. Results: Vaccination of employed and affiliated colleagues began December 15, 2020, and was made available based on state-level release of tiers. Within the first 6 weeks, in total, 203,544 individuals were eligible for vaccine based on these criteria. Of these, 181,282 (89.1%) consented to and received vaccine, 19,788 (9.7%) declined, and 2,474 (1.2%) indicated that they had already been vaccinated. Of those eligible, the highest acceptance of vaccine was among the job codes of specialists and professionals (n = 7,914 total, 100% consent), providers (n = 23,335, 99.6%,), and physicians (n = 3,218, 98.4%). Vaccine was most likely to be declined among job codes of clerical and other administrative (n = 12,889 total, 80.1% consent), clinical specialists and professionals (n = 22,853, 81.0%,) and aides, orderlies and technicians (n = 17,803, 82.6%,). Registered nurses made up the largest eligible population (n = 56,793), and 89.5% of those eligible consented to receive vaccination. Average age among those who consented was slightly older (48.3 years) than those that declined (44.7 years), as was length of employment tenure (6.9 vs 5.0 years). Conclusion: A large-scale, closed POD, mass vaccination program was able to vaccinate nearly 200,000 healthcare workers for SARS-CoV-2 in 6 weeks. This program was implemented in acute-care sites across 20 different US states, and it was able to meet the various state-level requirements for management of processes, product, and required reporting. The development of a standardized strategy and custom, centralized monitoring and reporting facilitated insight into the characteristics of early vaccine adopters versus those who decline vaccination. These data can aid in the refining and targeting of educational materials and messaging about the SARS-CoV-2 vaccine.Funding: NoDisclosures: None

scholarly journals Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro, Brazil

2020 ◽  
Vol 25 (suppl 2) ◽  
pp. 4131-4140
Author(s):  
Alexandre de Fátima Cobre ◽  
Beatriz Böger ◽  
Mariana Millan Fachi ◽  
Raquel de Oliveira Vilhena ◽  
Eric Luiz Domingos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rio De Janeiro ◽  
Cox Regression ◽  
Age Groups ◽  
Mortality Rates ◽  
Male Gender ◽  
Delay In Diagnosis ◽  
Kaplan Meier ◽  
Delays In Diagnosis ◽  
The City

Abstract We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients’ sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.

scholarly journals Unplanned Out-of-Hospital Birth—Short and Long-Term Consequences for the Offspring

2020 ◽  
Vol 9 (2) ◽  
pp. 339
Author(s):  
Gil GUTVIRTZ ◽  
Tamar WAINSTOCK ◽  
Daniella LANDAU ◽  
Eyal SHEINER
Keyword(s):  
Perinatal Mortality ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Hospital Setting ◽  
Survival Curves ◽  
Long Term Outcome ◽  
Hospital Birth ◽  
Kaplan Meier ◽  
Hospital Births

The unpredictable nature of childbirth infrequently results in unplanned out-of-hospital birth, in a pre-hospital setting. We evaluated the perinatal and long-term outcome of children accidentally born out-of-hospital. This was a population-based analysis of singleton deliveries occurring at a single tertiary hospital. The maternal characteristics and pregnancy outcome of unplanned out-of-hospital births were compared with in-hospital attended deliveries. Long-term cumulative incidence of hospitalizations (up to 18 years) involving respiratory, neurological, endocrine or infectious morbidity were evaluated using Kaplan–Meier survival curves and Cox regression models were used to control for confounders. In total, 243,682 deliveries were included, and 1.5% (n = 3580) were unplanned out-of-hospital births. Most occurred in multiparous women, and about a quarter of these women had inadequate prenatal care. Perinatal mortality rate was significantly higher for out-of-hospital births as compared with in-hospital births (OR = 2.9; 95% CI 2.2–3.8, p < 0.001). Kaplan–Meier survival curves demonstrated a significantly lower cumulative incidence of hospitalizations of children born out-of-hospital and the Cox models showed that hospitalization rates involving any of the above morbidities were significantly lower in children born out-of-hospital. While perinatal mortality was higher in unplanned out-of-hospital births, offspring born out-of-hospital showed a lower incidence of hospitalizations involving a variety of morbidities, possibly owing to under-utilization of healthcare services in this population.

Access, Education and Policy Awareness: Predictors of Influenza Vaccine Acceptance Among VHA Healthcare Workers

2017 ◽  
Vol 38 (8) ◽  
pp. 970-975 ◽  
Author(s):  
Jennifer Lipkowitz Eaton ◽  
David C. Mohr ◽  
Kathleen M. McPhaul ◽  
Richard A. Kaslow ◽  
Richard A. Martinello
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccine Uptake ◽  
Veterans Health ◽  
Health Administration ◽  
Vaccine Acceptance ◽  
Vaccination Rates ◽  
Modifiable Factors ◽  
Site Access

OBJECTIVETo identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns.DESIGNSurvey.SETTINGNational single-payer healthcare system with 140 hospitals and 321,000 HCWs.PARTICIPANTSNational voluntary sample of HCWs in the Veterans Health Administration (VHA) system.METHODSWe invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts.RESULTSThe response rate was 17.4%. Of 2,502 initial respondents, 2,406 (96.2%) provided usable data. This sample includes respondents from all 140 VA hospitals. Self-reported influenza vaccination rates were highest among physicians (95.6%) and licensed independent providers (88.3%). Nonclinical staff (80.7%) reported vaccine uptake similar to other certified but nonlicensed providers (81.2%). The strongest predictor of vaccine acceptance among VHA HCWs was individual awareness of organizational policy. Vaccine acceptance was also higher among HCWs who reported more options for access to vaccination and among those in facilities with more education activities.CONCLUSIONSInfluenza vaccine acceptance varied significantly by employee awareness of employer policy and on-site access to vaccine. Employer-sponsored activities to increase access continue to show positive returns across occupations. Local influenza campaign efforts to educate HCWs may have reached saturation in this target group. These results suggest that focused communications to increase HCW awareness and understanding of employer policy can drive further increase in influenza vaccination acceptance.Infect Control Hosp Epidemiol 2017;38:970–975

scholarly journals 91 An audit of COVID-19 Awareness and Public Health Message Effectiveness in the Hospital Setting Over the Course of the Pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Render ◽  
A Truss ◽  
H Waddington ◽  
S John ◽  
C Henderson ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Healthcare Workers ◽  
Hospital Setting ◽  
Hospital Workers ◽  
Post Intervention ◽  
Message Effectiveness ◽  
Job Roles ◽  
Public Health Message ◽  
Means Of Transmission

Abstract Introduction An audit of healthcare workers investigated the effectiveness of Public Health England’s (PHE) information campaign across COVID’s timeline and assess knowledge between job roles. Method Data was collected across 3 cycles in 3 hospitals. A questionnaire assessed four domains: symptoms; spread; risk factors and the means to reduce transmission. PHE materials were shown before cycle 2 and respondents then subjected to the general campaign. Results 253 responses were collected. Symptom recognition was 84%, increasing to 88% post-intervention, longer-term recognition remained high at 81% - including the new symptom of anosmia. Identification of COVID’s means of transmission increased from 76% to 95% post intervention, risk factor recognition increased from 85% to 93% post-intervention. This fell to 74% later in the pandemic when recognised risk factors increased. Recognition of the new risk factors BAME status and BMI was 73% and 79% respectively in the final cycle. Doctors had the highest number of pre-intervention correct answers for 3 domains and nurses gave the most incorrect answers for 3 domains pre-intervention. Conclusions We have shown the PHE message is being transmitted effectively. We have also shown an increase in hospital workers recognition of aspects of COVIDs characteristics that have since been verified in the literature.

scholarly journals Survival in Patients with Acute Lymphoblastic Leukemia and COVID-19 in Mexico

2021 ◽  
pp. 32-39
Author(s):  
Patricia Zagoya Martinez ◽  
Jose Alejandro Limon Flores ◽  
Jose Alfredo Vidal Vidal
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Cox Regression ◽  
Medical Center ◽  
Lymphoblastic Leukemia ◽  
Age Groups ◽  
General Treatment ◽  
Chi Square ◽  
National Medical ◽  
Kaplan Meier ◽  
Statistical Program

Aims: To determine the survival of patients with acute lymphoblastic leukemia and COVID-19. Study Design: Prospective, analytical and relational. Place and Duration of Study: Hematology department, Hospital of Specialties, High Specialty Medical Unit, National Medical Center "Gral. Manuel Avila Camacho", Puebla, Mexico, during the period June 2020-April 2021 Methodology: Patients aged 15 to 64 years, both sexes, with acute lymphoblastic leukemia and a confirmed diagnosis of COVID-19 by PCR. The variables included were; sex, age (groups: 15-20; 21-29; 30-39; 40-49; 50-59; and 60-64), comorbidities, general treatment and hematological treatment response. Survival was determined for the diagnosis of COVID-19 for 11 months, using the Kaplan Meier estimator and the Log-Rak test; Cox regression model (univariate and multivariate); as well as Chi square and V-Cramer with a 95% confidence interval and using the statistical program SPSS Ver. 25. Results: The study consisted of 20 patients, of which 33.3% were women, with an average age of 37.75 ± 11.63 years; The men registered an age of 28.50 ± 18.05 years. Overall survival was 50%, with a lower limit of 101.3 and an upper limit of 242.5 days, with a mean of 171.9 days; and median at 17 days. No significant differences were found in survival regarding sex, comorbidities, general treatment and hematological response. However, mortality in patients with comorbidities was higher (p = 0.051). Conclusion: Survival in patients with acute lymphoblastic leukemia and COVID-19 is low, due to complications that increase mortality, mainly owing to hematological suppression, and even more so with the presence of comorbidities.

scholarly journals "The vaccination is positive; I don't think it's the panacea": A qualitative study on COVID-19 vaccine attitudes among ethnically diverse healthcare workers in the United Kingdom

2021 ◽  
Author(s):  
Mayuri Gogoi ◽  
Fatimah Wobi ◽  
Irtiza Qureshi ◽  
Amani Al-Oraibi ◽  
Osama Hassan ◽  
...  
Keyword(s):  
United Kingdom ◽  
Qualitative Study ◽  
Healthcare Workers ◽  
Vaccine Uptake ◽  
Vaccine Acceptance ◽  
Job Roles ◽  
The United Kingdom ◽  
Accessible Information ◽  
Depth Analysis ◽  
Structural Inequities

Background Globally, healthcare workers (HCWs) are prioritised for receiving vaccinations against the coronavirus disease-2019 (COVID-19). Previous research has shown disparities in COVID-19 vaccination uptake among HCWs based on ethnicity, job role, sex, age, and deprivation. However, vaccine attitudes underpinning these variations are yet to be fully explored. Methods We conducted a qualitative study with 164 HCWs from different ethnicities, sexes, job roles, migration statuses, and regions in the United Kingdom (UK). Interviews and focus groups were conducted using Microsoft Teams or telephone, and recorded with participants' permission. Recordings were transcribed and thematically analysed following an inductive approach. Findings We conducted an in-depth analysis of 53 randomly selected transcripts (involving 82 participants) to generate rapid evidence. Four different vaccine attitudes were identified: Active Acceptance, Passive Acceptance, Passive Decline, and Active Decline. Factors influencing vaccine acceptance include: knowledge of vaccine; risk perception; positive attitude towards other vaccines; social influences; and considerations about the future. Correspondingly, barriers to vaccine acceptance were identified as, low trust in the vaccine and historical (mis)trust, inadequate communication, and inequities in delivery and access. Opinion on mandatory vaccination was divided. Interpretation Our data show that vaccine attitudes are diverse and elements of hesitancy may remain even after vaccine acceptance. This has implications for the sustainability of the vaccine programme, particularly as new components (e.g. boosters) are being added. Based on our findings we recommend trust-building, designing inclusive and accessible information, and addressing structural inequities for improving vaccine uptake among HCWs. Funding UKRI-MRC and NIHR.

scholarly journals Effectiveness of BNT162b2 and ChAdOx1 Vaccines against Symptomatic COVID-19 among Healthcare Workers in Kuwait: A Retrospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1692
Author(s):  
Walid Q. Alali ◽  
Lamiaa A. Ali ◽  
Mohammad AlSeaidan ◽  
Mohammad Al-Rashidi
Keyword(s):  
Healthcare Workers ◽  
Cox Regression ◽  
Vaccine Coverage ◽  
Age Groups ◽  
Vaccine Dose ◽  
Factors Associated ◽  
Executive Staff ◽  
Hazard Ratios ◽  
Younger Age ◽  
Secondary Hospital

Background: Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated VE against SARS-CoV-2 infection in HCWs at a secondary hospital in Kuwait. Methods: We extracted sociodemographic, occupational, SARS-CoV-2 infection, and vaccination data for eligible HCWs from the hospital records. Vaccine coverage percentages were cross-tabulated with the HCW factors. Cox regression was used to estimate hazard ratios in vaccinated versus unvaccinated. Results: 3246 HCWs were included in the analysis, of which 82.1% received at least one vaccine dose (50.4% only one dose of ChAdOx1, 3.3% only one dose of BNT162b2, and 28.3% two doses of BNT162b2). However, 17.9% of HCWs were unvaccinated. A significantly lower vaccination coverage was reported amongst female HCWs, younger age group (20–30 years), and administrative/executive staff. The adjusted VE of fully vaccinated HCWs was 94.5% (95% CI = 89.4–97.2%), while it was 75.4% (95% CI = 67.2–81.6%) and 91.4% (95% CI = 65.1–97.9%) in partially vaccinated for ChAdOx1 and BNT162b2, respectively. Conclusions: BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in HCWs across age groups, nationalities, and occupations.

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