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To assess reasons for noncompliance to COVID-19 vaccination among health care workers.
Cohort observational and surveillance study.
Sheba Medical center, a 1600 bed tertiary medical center in Israel
10,888 Health care workers including all employees, students and volunteers.
The BNT162b2 mRNA Covid-19 vaccine was offered to all health care workers of the hospital, non-compliance was assessed and pre-rollout and post-rollout surveys were carried out. Data regarding uptake of the vaccine as well as demographic data and compliance to prior influenza vaccination was collected. Additionally, two surveys were distributed; pre-rollout, regarding intention to receive the vaccine and post-rollout, to all unvaccinated health care workers regarding causes of hesitancy.
In the pre-rollout survey 1673/3563 (47%) declared their intent to receive the vaccine. Eventually 8108 (79%) of health care workers 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 gender, 40-59 age group, Paramedical and Doctors, a high socioeconomic level and compliance with flu vaccine. Among 425 unvaccinated health care workers who answered the second survey, the most common cause for hesitancy was the risk during pregnancy (31%).
Though vaccine uptake among health care workers was higher than expected, still relatively low uptake was observed among young women and those from lower socioeconomic level and educational background. Concerns regarding vaccine safety during pregnancy were common and more data about vaccine safety especially during pregnancy might improve compliance.
The severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2) pandemic of 2020-2021 created unprecedented challenges for clinicians in critical care transport (CCT). These CCT services had to rapidly adjust their clinical approaches to evolving patient demographics, a preponderance of respiratory failure, and transport utilization stratagem. Organizations had to develop and implement new protocols and guidelines in rapid succession, often without the education and training that would have been involved pre-coronavirus disease 2019 (COVID-19). These changes were complicated by the need to protect crew members as well as to optimize patient care. Clinical initiatives included developing an awake proning transport protocol and a protocol to transport intubated proned patients. One service developed a protocol for helmet ventilation to minimize aerosolization risks for patients on noninvasive positive pressure ventilation (NIPPV). While these clinical protocols were developed specifically for COVID-19, the growth in practice will enhance the care of patients with other causes of respiratory failure. Additionally, these processes will apply to future respiratory epidemics and pandemics.
Healthcare workers (HCWs) experience barriers to COVID-19 testing specific to their perceptions of access, and employment factors. A survey was sent to all employees at one Boston hospital to examine their perceived barriers to testing. HCWs who reported difficulty paying their bills were less likely to receive a COVID-19 test.
During the COVID-19 pandemic, access to addiction treatment has plummeted. At the same time, patients with opioid use disorder are at higher risk for COVID-19 infection and experience worse outcomes. The Baltimore Convention Center Field Hospital (BCCFH), a state-run COVID-19 disaster hospital operated by Johns Hopkins Medicine and the University of Maryland Medical System, continues to operate 14 months into the pandemic to serve as an overflow unit for the state’s hospitals. BCCFH staff observed the demand for opioid use disorder care and developed admission criteria, a pharmacy formulary, and case management procedures to meet this need. This article describes generalized lessons from the BCCFH experience treating substance use disorder during a pandemic.
Real world studies have demonstrated impressive effectiveness of the BNT162b2 COVID-19 vaccine in preventing symptomatic and asymptomatic SARS-CoV-2 infection. We describe an outbreak of SARS-CoV-2 infections in a hospital with high vaccine uptake. We found low secondary attack rate(7%), suggesting low infectivity of vaccinated persons with vaccine breakthrough SARS-CoV-2 infections.
To evaluate COVID-19 vaccine hesitancy among health care personnel (HCP) with significant clinical exposure to COVID-19 at two large, academic hospitals in Philadelphia.
Design, Setting and Participants
HCP were surveyed between November-December 2020 about their intention to receive the COVID-19 vaccine.
The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (MD, NP/PA, RN) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines.
Among 5,929 HCP (2,253 MDs/DOs, 582 NPs, 158 PAs, and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs/NPs and 13.1% of MDs/DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (OR∼5) and females were more hesitant than males (OR∼2).
Although a majority of clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race/ethnicity across all positions. These results underline the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.