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COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center.

ABSTRACT: The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to perform a literature review across a total of 44 studies of the serologic response to COVID-19 vaccines in HCWs in Italy and to report the results obtained in a prospective longitudinal study implemented at the Fondazione IRCCS Istituto Nazionale Tumori (INT) of Milan on 1565 HCWs. At INT we found that 99.81% of the HCWs developed an antibody response one month after the second dose. About six months after the first serology evaluation, 100% of the HCWs were still positive to the antibody, although we observed a significant decrease in its levels. Overall, our literature review results highlight a robust antibody response in most of the HCWs after the second vaccination dose. These figures are also confirmed in our institutional setting seven months after the completion of the cycle of second doses of vaccination.

SUBMITTER: Ciniselli CM

PROVIDER: S-EPMC9146113 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center.

Ciniselli Chiara Maura CM Lecchi Mara M Figini Mariangela M Melani Cecilia C CC Daidone Maria Grazia MG Morelli Daniele D Zito Emanuela E Apolone Giovanni G Verderio Paolo P

Vaccines 20220507 5

The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to ...[more]

PMID: 35632490

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Project description:BackgroundHealth and care workers (HCWs) are at the forefront of COVID-19 response, at high risk of infection, and as a result they are a priority group for COVID-19 vaccination. This paper presents the global patterns in COVID-19 vaccination coverage among HCWs in 2021, how HCWs were prioritized, and identifies factors associated with the early vaccination coverage.MethodsUsing monthly data reported to the World Health Organization, the percentages of partially and fully vaccinated HCWs were computed. The rates of vaccination of HCWs for the first and second half of 2021 were compared in a stratified analysis using several factors. A multivariate analysis was used to investigate the independent associations of these factors with the percentage of HCWs fully vaccinated.ResultsBased on data from 139 Member States, as of end of 2021, 82% HCWs were reported as fully vaccinated with important variations by income groups: 33% for low income countries, 83% for lower-middle income countries, 79% for upper-middle income countries and 88% for high income countries. Overall 76% of countries did not achieve 70% vaccination coverage of their HCWs in the first half of 2021, and 38% of countries by end of 2021. Compared with the general population, the rate of HCWs full vaccination was 3.5 times higher, in particular for low income countries (RR = 5.9). Stratified analysis showed that beyond income group, the availability of vaccine doses was a critical factor of HCWs vaccination coverage with medians of 59.1% and 88.6% coverage in the first and second half of 2021, respectively for countries with enough doses to cover 70% of their population, compared with 0.8% and 47.5% coverage, respectively for countries with doses to cover 40% of their population. The multivariate analysis confirmed this observation with a 35.9% overall difference (95%CI 15.1%; 56.9%) between these two groups.ConclusionDespite being considered a priority group, more than a third of countries did not achieve 70% vaccination coverage of their HCWs at the end of 2021. Large inequities were observed with low income countries lagging behind. Additional efforts should be dedicated to ensure full protection of HCWs through vaccination.

Project description:Influenza imposes a significant burden worldwide from the healthcare and socio-economic standpoints. This is also due to suboptimal vaccination coverage among the target population, even though immunization is recommended since many years and still remains the fundamental tool for its prevention. Healthcare workers (HCWs) are at increased risk of exposure to respiratory pathogens compared with the general population, including flu, with potential threat for their health and for patients' safety. Nevertheless, despite recommendation for immunization of this work-category in most of Western Countries, inadequate flu vaccine uptake is reported during the last decade in the European area. According to recent systematic reviews on this topic, the main determinants of vaccine acceptance among HCWs have been largely investigated and include desire for self-protection and to protect family rather than absolute disease risk or desire to protect patients, among the main drivers. On the other hand, concerns regarding safety of the vaccines resulted in decreased vaccine uptake. Moreover, influenza vaccine hesitancy among HCWs was also associated with several issues such as low risk perception, denial of the social benefit of influenza vaccination, low social pressure, lack of perceived behavioral control, negative attitude toward vaccines, not having been previously vaccinated against influenza, not having previously had influenza, lack of adequate influenza-specific knowledge, lack of access to vaccination facilities, and socio-demographic variables. The topic of influenza vaccination among HCWs is challenging, full of ethical issues. Systematic reviews of randomized controlled trials (RCTs) investigating the effectiveness of interventions for improving vaccine uptake among HCWs found that combined strategies were more effective than isolate approaches. Mandatory policies are currently under debate in several countries. High quality studies would help policy-makers and stake-holders to shape evidence-based initiatives and programs to improve the control of influenza.

Project description:Despite the hospital triage system trying to prevent COVID-19 patients from getting admitted to wards other than isolation/quarantine units, COVID-19 patients were accidentally being discovered time to time from non-COVID-19 wards due to atypical or asymptomatic presentations. Consequently, post-exposure risk assessment was carried out for the relevant health care workers (HCW) and the other patients to assess their risk level of acquiring COVID-19, and to quarantine them if concluded as high risk. Hence, the objective of the study was to assess the outcome and the adequacy of COVID-19 post-exposure risk assessment of health care workers which would be useful in future outbreaks. We studied all events of accidental detection of COVID-19 patients happened in non-COVID-19 wards which were leading to subsequent risk assessment using the 5-questions based tool adapted from the WHO recommendations. The 5 questions discussed the protective measures during face to face meetings or in physical contacts, protective measures during aerosol generating procedures, splashes onto the face, and hand hygiene measures. A retrospective cross-sectional study carried out in the Teaching Hospital Karapitiya, Galle, Sri Lanka, for 4 months covering the second wave of the pandemic. Hospital data base of risk assessments was accessed anonymously and the "yes" or "no" responses to the 5-questions assessment tool were analysed. There were 62 events involving 891 health care workers who underwent post-exposure risk assessment. From the responses the highest score of "yes" was recorded against question 3 (25.7% of total "yes" answers for all questions and 5.8% of total answers for the question number 3) revealing inadequate precautions taken by HCWs in aerosol generating procedures. Hundred and sixty two (18.2%) HCWs were quarantined as high risk and only one became positive for COVID-19 during the quarantine period. Though the 5-question based risk assessment tool effectively helps to identify breaches in infection control during an exposure to a positive COVID-19 patient, it may not be adequate at times as the only tool in deciding the assessee's risk level.

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COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center.

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COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center.

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