Iranian Healthcare Workers Research Articles

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000–2023, a report of National Reference Laboratory

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000–2023, a report of National Reference Laboratory

Neuro-musculoskeletal side effects related to COVID-19 vaccines; A cross sectional study in Iranian healthcare workers

IntroductionThis study aimed to evaluate neuro-musculoskeletal adverse events related to COVID-19 vaccines in Iranian healthcare workers. MethodsIn this cross-sectional survey, a questionnaire was used, including patients’ demographic information, vaccination information, and local, flu-like, and neuro-musculoskeletal side effects of vaccines. All data were extracted and analyzed by SPSS ver.24. ResultsA total of 500 healthcare workers (381 females, and 119 males), with a Mean ± SD age of 38.06 ± 9.22 years old were recruited; 341 subjects (68.2 %) were vaccinated by Sputnik-V vaccine, 95 subjects (19 %) with AstraZeneca, 40 subjects (8 %) with Sinopharm, and 24 (4.8 %) with Baharat COVID-19 vaccine. Out of 500 participants, COVID-19 vaccines' side effects were reported in 428 subjects (85.6 %) including 339 subjects (67.8 %) with local side effects, 342 subjects (68.4 %) subjects with flu-like side effects, 66 subjects (13.2 %) with neurologic, and 291 subjects (58.2 %) with musculoskeletal side effects. Local pain (67.6 %), fatigue (61.2 %), generalized pain (47.8 %), headache (38.8), upper and lower myalgia (44 %, 36 %), and low back pain (26.8 %) were the most common side effects reported by COVID-19 vaccine recipients. There were significant associations between neuro-musculoskeletal side effects with patients’ sex (P = 0.001), categorized age (less and more than 40 years., P = 0.002), and COVID-19 vaccine types (P < 0.001). ConclusionsAmong all the neurological and musculoskeletal side effects, upper limb paresthesia, and upper limb myalgia alongside low back pain were the most frequent respectively. No serious side effects requiring medical attention or hospitalization were reported by participants.

Knowledge, attitude, and practice of Iranian health care workers about infodemic management: a cross-sectional descriptive study

BackgroundMisinformation (infodemics) can hinder effective healthcare delivery. This study assessed Iranian healthcare workers’ (HCWs) knowledge, attitude, and practice (KAP) regarding infodemic management (IM).MethodA cross-sectional survey using a self-reported questionnaire (KAPIM) distributed via convenience sampling to 1890 HCWs across all Iranian Medical Sciences Universities.ResultsThe results showed that healthcare workers demonstrated overall KAP scores with a mean of 3.38 out of 5. Knowledge scores were 63.01%, attitude scores were 74.23%, and practice scores were lower at 55.76%. There were positive correlations between age and work experience with both knowledge and attitude scores.ConclusionThese findings suggest a gap between HCWs’ knowledge/attitude and practice regarding IM. Targeted interventions emphasizing practical skills are needed. Considering demographics and regional variations is crucial when developing training programs for enhanced infodemic preparedness across the Iranian healthcare system.

Prevalence of Burnout Among Health Workers in Iran: A Systematic Review and Meta-analysis

Introduction: Burnout significantly impacts human service professions, reducing the sense of competence and successful performance of duties. This study aimed to investigate the prevalence of job burnout among healthcare workers in Iran. Methods: A systematic search was conducted according to the PRISMA checklist in databases such as PubMed, Scopus, Web of Science, PsycINFO, Magiran, Scientific Information Database (SID), and IranDoc from the inception of each database until December 30, 2023. Studies that used the Maslach burnout inventory to investigate the prevalence of burnout in health workers and had an observational design (including cross-sectional studies) were included. The selection of relevant studies was performed independently by two researchers at all stages of study selection, including screening, full-text review, and qualitative evaluation using the modified version of the HOY tool. Data implementation was done in Excel, and data analysis was conducted using STATA version 12. Results: A total of 63 articles were included. About 62.2% of the studies had a low risk of bias. A meta-analysis was performed using the random-effects method to calculate the prevalence of job burnout, and the average score of burnout was calculated as ES: [95% Conf interval = 0.38 (0.30 - 0.46)]. The degree of heterogeneity was reported as I2 = 99.66%, which is significant (P = 0.000), indicating high heterogeneity among the studies. Subgroup analysis was conducted to reduce heterogeneity. The results showed that the average burnout score increases with the sample size increase in the study, which is statistically significant (P &lt; 0.001). Conclusions: To minimize burnout, it is suggested that supportive approaches, including access to psychosocial support, web-based services, psychological first aid, psychological support hotlines, and self-care techniques, be considered for healthcare workers during their service years.

Substances use among a sample health care workers in Iran: prevalence, pattern of use and gender differences

ABSTRACT Background Substance use (SU) among HCWs leads to reduced productivity and overall health and, moreover, is a negative role to promote SU reduction. Aim This study aimed to estimate the prevalence of SU and assess its determinants among HCWs. Methods The study analyzed data related to the first phase of the SHAHWAR Cohort study which included 1177 university employees. Results The prevalence of current tobacco use is 11.6% (2.7% in women, and 24.5% in men), and the prevalence of lifetime tobacco use was 19.8 (6.3% in women, and 39.3% in men). The ratio of hookah: cigarette use in women is about seven times that of men. The self-reported current tobacco, alcohol and opium use were 11.6% (M: F ratio > 9), 2.6% (M: F ratio > 6) and 1.4% (M: F ratio > 7) of total subjects. There was a significant difference in substance or alcohol users based on gender, job position, working schedule, employment status, marital status and education levels. There was a negative correlation between job security and stability in terms of work status among workers with substance or alcohol use. Conclusion Since implementation of preventive interventions knowing the high-risk groups and occupational risk factors, the results of the present study may meet this need.

Side effects of COVID-19 vaccines among Iranian healthcare workers: a retrospective cohort study.

This study assessed the incidence and severity of side effects associated with coronavirus disease 2019 (COVID-19) vaccination among healthcare workers registered with the Medical Council of the Islamic Republic of Iran. A retrospective cohort study was conducted on the healthcare workers focusing on the side-effects of COVID-19 vaccines from March to June 2021. Data were collected using online questionnaires. Multivariable logistic regression was used to assess the association between side effects of the vaccines and demographic variables, comorbidities, vaccine type, and history of COVID-19. Out of 42,018 people who were included, 55.85% reported at least one side effect after receiving the first vaccine dose. 4.59% of those with side effects sought diagnostic intervention or were referred to treatment centers. Multivariable logistic regression indicated that being a woman, higher education, having a history of COVID-19 infection, and having comorbidities increased the risk of side effects. The AstraZeneca vaccine significantly increased the risk of side effects compared to the Sputnik vaccine, while the Sinopharm vaccine decreased this risk. The risk of developing a side effect decreased with age. The risk of moderate and severe side effects was significantly associated with gender, younger age, comorbidities, and a history of COVID-19 infection. Moderate and severe side effects were less reported by those who received the Sinopharm vaccine. Clinical complications after COVID-19 vaccination, directly or indirectly caused by the vaccines, are common. However, the benefits of COVID-19 vaccines greatly outweigh the risk of reversible side effects, especially among the high-risk population.

COVID-19 Vaccine Intention Among Iranian Health Workers: Application of the HBM Model

ABSTRACT The study aimed to determine the application of the health belief model (HBM) in the acceptance of COVID-19 vaccination among health workers in 2021. The cross-sectional study was conducted on 3600 health workers from February to March 2021. Data was collected using a researcher-made questionnaire that included the intention to receive vaccines based on the health belief model constructs. Data were analyzed using descriptive statistics indicators, Chi-square, ANOVA test, and logistic regression model at a 95% confidence level. More than 62% of the participants intended to receive the vaccine. The odds of intention to receive the vaccine among people who worked in the health center and did not have a history of hospitalization due to COVID-19 disease were 1.50 and 2.10 units more than the others. Intention to receive the vaccine in individuals with high perceived sensitivity was 1.10 units. Furthermore, in terms of perceived benefits, self-efficacy, and cue-to-action constructs were 1.15, 1.34, and 1.65 units respectively. The rate of vaccine acceptance among Iranian health care workers was relatively good and the constructs of HBM in predicting the rate of intention to receive the vaccine had good applicability.

Shift working and risk of dyslipidemia: a cross-sectional study among health care workers in Iran

Shift working and risk of dyslipidemia: a cross-sectional study among health care workers in Iran

Prevalence of Covid-19 infection among healthcare workers in Central Hospitals of Covid-19 vs non-Covid-19 hospitals in Khuzestan Province, Iran.

Healthcare workers (HCWs) are at high risk of contracting Covid-19 due to their frontline roles and close interactions with infected patients. Understanding the prevalence of Covid-19 infection among HCWs and the factors contributing to it is crucial for informing mitigation strategies. However, the available data on Covid-19 infection rates among Iranian HCWs is limited. The primary objective of this study was to compare the prevalence of Covid-19 infection among HCWs working in hospitals dedicated to Covid-19 care versus HCWs in other non-Covid-19 hospitals in Khuzestan province, Iran. Additionally, the study aimed to identify potential risk factors associated with Covid-19 transmission and symptom severity in this population. This cohort study recruited 3,012 HCWs from 35 hospitals in Khuzestan province. Covid-19 diagnosis was made using RT-PCR testing, chest CT scans, and clinical examination. Overall, 96% (n=2,918) of the 3,012 HCWs were infected with Covid-19. The prevalence was significantly higher among HCWs from Covid-19 hospitals (59.83%, n=1,746) compared to those from non-Covid-19 hospitals (5.75%, n=168). The capital city of Ahvaz had the highest proportion of Covid-19 cases at 28%. HCWs, especially those working in hospitals dedicated to Covid-19 care, face a substantial risk of contracting the virus. The high infection rates observed may be attributed to factors like weakened immune systems, non-compliance with precautions, and delayed diagnosis. These findings underscore the critical need to strengthen infection control measures, improve access to personal protective equipment, and enhance surveillance of Covid-19 among frontline HCWs in Iran.

Prevalence of depression, anxiety, and stress and associated reasons among Iranian primary healthcare workers: a mixed method study

BackgroundDifferent mental disorders may be associated with many work-related factors to which primary health care workers (PHCWs) are exposed. The current research aims to measure the rates of depression, anxiety, and stress among PHCWs, and their associated causes in primary health care (PHC) settings.MethodsAn explanatory sequential mixed methods design was employed in this research from January 2021 to January 2022 in Tabriz, Iran’s PHC centers. First, this study followed an online-based cross-sectional survey using a self-reported questionnaire. The Depression, Anxiety and Stress Scale-21 Items (DASS-21) and questions on demographic and work-related characteristics were completed by 303 frontline PHCWs during the quantitative phase. In the qualitative phase, a semi-structured interview was held with 12 PHCWs who had the highest level of depression, anxiety, and stress to identify the reasons and sources of mental health prevalence. Quantitative data were analyzed using descriptive statistics via SPSS-26. A content analysis was performed to analyze qualitative data.ResultsThe results showed that self-reported stress, anxiety, and depression had a prevalence of 40.3%, 42.9%, and 42.6%, respectively. Symptoms of at least one mental disorder were experienced by 54% of respondents, while 28% had all three. Major sources of stress, anxiety, and depression among PHCWs were working environment conditions, organizational policies, job-related reasons, and interpersonal relations.ConclusionsThe results of current study indicated that PHCWs experienced high levels of depression, anxiety, and stress. The main factors and reasons that contributed to these mental health issues among PHCWs were work environment conditions, organizational policies, job-related reasons and interpersonal relations. Therefore, interventions should be implemented to promote mental health of PHCWs. This can include measures such as psychological screening, supportive care, workload management, flexible scheduling, and access to mental health resources. Additionally, training programs can be implemented to enhance resilience and coping skills among healthcare professionals.

Short-term Safety of Covaxin, Sinopharm, Sputnik V, and AstraZeneca COVID-19 Vaccines Among Iranian Healthcare Workers: A Cross-Sectional Study

Background: Several coronavirus disease 2019 (COVID-19) vaccines, utilizing different platforms, have successfully obtained emergency clinical use authorization to prevent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections. Most published data from COVID-19 vaccine trials have frequently observed mild-to-moderate side effects, with varying severity depending on various vaccine types. Objectives: This study aimed to estimate the prevalence of side effects associated with four types of COVID-19 vaccines among vaccinated healthcare workers following the first and second vaccine doses and to identify possible risk factors for COVID-19 vaccine side effects. Methods: This cross-sectional study was conducted from April 2021 to March 2022 by administering a questionnaire and conducting direct interviews with healthcare workers in Kerman, southeastern Iran, who had received 2 or more doses of COVID-19 vaccines. Results: Out of 861 individuals enrolled in the study, 38.7% received Sputnik, 32.4% AstraZeneca, 19.6% Covaxin, and 9.3% Sinopharm vaccines. Overall, the most common side effects after the first and second doses included general symptoms, fever and chills, injection site reactions, neurological symptoms, and gastrointestinal symptoms. Furthermore, the frequency of symptoms significantly reduced after the second dose. Conclusions: General symptoms and injection site reactions were significantly more common after receiving the first dose of vaccines compared to the second dose. No severe vaccine side effects were observed in this study. However, further research is required to evaluate the long-term symptoms and safety profiles of COVID-19 vaccines.

Psychological Symptoms Among Iranian Healthcare Workers During COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic affected working conditions in healthcare systems and caused occupational stress and challenges for the majority of healthcare workers (HCWs). Objectives: This study aimed to examine the prevalence of anxiety, depression, burnout, and career resilience and assess the personal and occupational risk factors contributing to psychological symptoms in Iranian HCWs during the COVID-19 pandemic. Methods: Through a cross-sectional study, HCWs were surveyed within January to February 2022 to evaluate the prevalence of anxiety and depression (using the Hospital Anxiety and Depression Scale [HADS]), burnout (using the Maslach burnout inventory health services survey for medical personnel [MBI-HSS-MP]), and career resilience (using the Career Resilience Questionnaire [CRQ]). The correlation between demographic-occupational factors and psychological symptoms was analyzed. A total of 610 complete responses were received from Iranian HCWs. Results: Approximately 87.9% of HCWs had symptoms of both anxiety and depression (HADS score ≥ 11). The results indicated that most HCWs experienced various signs of burnout (i.e., emotional exhaustion, decreased sense of personal accomplishment, and depersonalization, respectively). The mean score for career resilience reported by the participants was appropriate; however, a fifth of the HCWs had poor career resilience. The highest scores of burnout, anxiety, and depression, in addition to the lowest scores of career resilience, were reported by intensive care unit (ICU) professionals. Conclusions: Marital status, long daily working hours, night shift work, access to personal protective equipment (PPE), and direct exposure to patients with COVID-19 had a significant impact on the anxiety, depression, burnout, and resilience of the HCWs.

Prevalence of needle stick and its related factors in Iranian health worker: an updated systematic review and meta-analysis.

Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries (NSIs). We aimed to investigate the prevalence of needlestick injuries and other related indicators among HCWs in Iran through a systematic review and meta-analysis. We searched various databases until the end of May 2023 for studies reporting the prevalence of NSIs among healthcare workers in Iran. We used a random model with 95% confidence intervals (CIs) to analyse the data and the Joanna Briggs Institute (JBI) tool to evaluate the quality of included studies. We conducted and reported the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We included 87 studies in the analysis and found that 47% (95% CI = 42-52, I2 = 98.9%) of Iranian HCWs experienced NSI. NSIs were most frequently related to syringe needles (58%; 95% CI = 52-65, I2 = 96.8%) and most often caused by recapping (30%; 95% CI = 22-38, I2 = 98.5%). In this study, 56% (95% CI = 45-67, I2 = 98.6%) of HCWs with NSIs did not report their injury. Moreover, the prevalence of NSIs the highest in the morning shift (0.44; 95% CI = 0.36-0.53, I2 = 97.2%), emergency unit (0.20; 95% CI = 0.16-0.24, I2 = 93.7%), and intensive care unit (0.20; 95% CI = 0.16-0.24, I2 = 94.3%). To reduce the high prevalence of NSIs, HCWs, especially those in emergency departments, should use safety equipment. Healthcare managers should provide a calm and stress-free environment for HCWs, educate them on safety principles and standards, and support experienced HCWs with NSIs.

Psychosocial status and risk perception among Iranian healthcare workers during the fifth wave of the COVID-19 pandemic

BackgroundHealthcare workers (HCWs) are essential resources, and their health and wellbeing are key not only for offering constant and useful care facilities to clients, but also for maintaining the safety of the workforce and patients. The risk of severe mental health problems among HCWs may have increased during large outbreaks of COVID-19. To evaluate the psychosocial status and risk perception of HCWs who participated in treating COVID-19 patients in Northern Iran, we performed a web-based cross-sectional study.MethodsThe web-based cross-sectional design was applied between June 27 and September 2, 2021. Using convenience sampling, 637 HCWs were recruited from hospitals in Northern Iran (Mazandaran). The HCWs completed self-report questionnaires that included a sociodemographic information form, the 12-item General Health Questionnaire, Impact of the Event Scale-Revised, Risk Perception Questionnaire, and Anxiety Stress Scale‐21. The data were analyzed via descriptive and inferential statistics and univariate/multivariate logistic regression to assess the risk factors linked to each psychosocial consequence.ResultsThe results reveal that the COVID-19 pandemic had an adverse psychosocial influence on HCWs, which was already apparent 1.5 years after the crisis began. Based on the results, 71.6%, 55.6%, and 32.3% of HCWs reported having anxiety, depression, and stress symptoms, respectively, since the outbreak of this disease. The logistic regression models displayed that marital status, having children, and working hours with patients were all risk factors of psychosocial impairment.ConclusionsThe outbreak of COVID-19 can be considered an important experience of a bio-disaster resulting in a significant rate of psychiatric problems in HCWs. There is a need for designing and promoting supportive programs to help HCWs cope and to improve their psychosocial state, and the present study has detected for whom psychosocial support may be effective and practical 1.5 years after the primary outbreak. Moreover, detecting and managing concerns and reducing infection-related embarrassment/stigma are essential for improving HCWs’ mental health.

The rates and symptoms of natural and breakthrough infection pre- and post- Covid-19 non-mRNA vaccination at various peaks amongst Iranian healthcare workers

Background/AimsThe aim of this study was to determine the rate of natural and breakthrough infection and related symptoms of Covid-19 amongst Iranian healthcare workers (HCWs) who were vaccinated by different non-mRNA-based vaccines at peak points.MethodsIn this cross-sectional study, the RT-PCR test was performed for a total of 10,581 HCWs suspicious of Covid-19 infection. For each HCW, the frequency of SARS-CoV-2 infection and the time of transmission based on vaccination administration time and schedule were examined during different waves of the pandemic. Based on these findings, the study patients were divided into three groups: natural, natural/breakthrough, and breakthrough.ResultsIn total, 53% of the HCWs were exposed to SARS-CoV-2 infection between 1 and 5 times within two years after the current pandemic, while 20.7% and 32.3% experienced natural and breakthrough SARS-CoV-2 infection, respectively. Only 6% of the breakthrough-infected HCWs had naturally contracted SARS-CoV-2 infection during the initial waves. The highest natural peaks of infection occurred during the interval administration of the first and second dose of the first vaccination series, while the single highest peak of breakthrough infection belonged to the Omicron wave. It occurred simultaneously with the administration of the third vaccination dose. On the other hand, the highest rate of reinfection was observed amongst people who had received the Sinopharm and Bharat vaccines full-doses.ConclusionThis study compared the clinical differences between the two peaks of Omicron and Delta. This study indicates the rates of natural and breakthrough SARS-CoV-2 infections according to vaccination schedules and different waves of the pandemic.

Hand anthropometric survey of Iranian healthcare workers

AbstractBackgroundHand anthropometric data can help properly design hand tools and protective equipment for healthcare workers. This study aimed to measure and analyze the hand anthropometric data of Iranian healthcare workers.MethodsIn this cross‐sectional study, 33 hand dimensions were measured among 540 Iranian healthcare workers (270 male and 270 female) in six ethnic groups. Two‐dimensional imaging and traditional measurement methods were used. The data were classified and compared based on gender and ethnicity.ResultsThe results revealed a difference between the dimensions of males' and females' hands, which indicated that the dimensions of males' hands were larger. The results showed significant differences between different regions of Iran and other countries including the United States, Bangladesh, Nigeria, and Colombia.ConclusionDifferences in hand anthropometric dimensions should be considered in the design and manufacture of hand tools and hand protection equipment to prevent reduced productivity, occupational injuries, and diseases.

Headache following vaccination against COVID-19 among healthcare workers with a history of COVID-19 infection: a cross-sectional study in Iran with a meta-analytic review of the literature

BackgroundThere is evidence of the occurrence of headache after vaccination against COVID-19. However, only a few studies have examined the headache characteristics and related determinants, especially among healthcare workers with a history of COVID-19 infection.MethodsWe evaluated the incidence of headaches after injection of different types of COVID-19 vaccine to determine factors relating to the incidence of headache after vaccination among the Iranian healthcare workers who had previously contracted COVID-19. A group of 334 healthcare workers with a history of COVID-19 infection were included and vaccinated (at least one month after recovery without any COVID-19 related symptoms) with different COVID-19 vaccines. The baseline information, headache characteristics and vaccine specifications were recorded.ResultsOverall, 39.2% reported experiencing a post-vaccination headache. Of those with a previous history of headache, 51.1% reported migraine-type, 27.4% tension-type and 21.5% other types. The mean time between vaccination and headache appearance was 26.78 ± 6.93 h, with the headache appearing less than 24 h after vaccination in most patients (83.2%). The headaches reached its peak within 8.62 ± 2.41 h. Most patients reported a compression-type headache. The prevalence of post-vaccination headaches was significantly different according to the type of vaccine used. The highest rates were reported for AstraZeneca, followed by Sputnik V. In regression analysis, the vaccine brand, female gender and initial COVID-19 severity were the main determinants for predicting post-vaccination headache.ConclusionParticipants commonly experienced a headache following vaccination against COVID-19. Our study results indicated that this was slightly more common in females and in those with a history of severe COVID-19 infection.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

Potential Adverse Effects of COVID-19 Vaccines on Iranian Healthcare Workers: Comparison of Four Available Vaccines in Tehran: A Retrospective Cross-sectional Study.

This study aimed to compare four COVID-19 vaccines for their potential extensive side effects and the relationship between the side effects and age, body mass index (BMI), and history of COVID-19 infection. This cross-sectional study was conducted from June to August 2021 among 1474 healthcare workers of seven selected hospitals in Tehran, Iran. All the subjects were vaccinated (91.7% received two doses and 8.3% received one dose) with one of four vaccines, Sputnik, Covaxin, AstraZeneca, and Sinopharm, at least 10 days before the study. The incidence of 47 side effects was measured after vaccination. Over half of the participants (59.4%; n = 876) were 20-29 years of age, with the mean and average BMI being 26.1±9.0 and 23.5±3.4, respectively; 36.0% (n = 530) were previously diagnosed with COVID-19. There was no significant relationship between age and the incidence of side effects for AstraZeneca, Sputnik, and Covaxin; however, the occurrence of side effects of Sinopharm was significantly higher (p < 0.001) among younger healthcare workers. There was no significant relationship between BMI and the incidence of side effects for all four vaccines. However, in the group with a history of COVID-19 disease, health care workers vaccinated with the Sinopharm vaccine showed significantly (p < 0.001) more complications. The occurrence rate of at least one adverse effect and referral to medical centers for AstraZeneca, Sputnik, Covaxin, and Sinopharm vaccines were 24.9-93.9%, 18.2-86.0%, 14.8-77.0%, and 3.5-37.2%, respectively. The highest and lowest rates were found for AstraZeneca and Sinopharm showing a significant (p < 0.001) difference. The most commonly observed side effects for the AstraZeneca vaccine included fever (64.4%), fatigue (62.5%), and muscle pain (59.9%); for Sputnik muscle pain (59.8%), fever (49.5%), and fatigue (49.5%); for Covaxin fever (49.2%), topical reaction (41.0), and fatigue (34.4%); and for Sinopharm fever (18.7%), topical reaction (17.9%), and fatigue (16.6%). Inactivated virus vaccines (Sinopharm and Covaxin) showed a lower (39.7%) occurrence rate of side effects compared to viral vector vaccines (AstraZeneca and Sputnik; 90.6%). The most likely time for the vaccines to exert side effects was the first 24 hours after vaccination. We found no significant relationship between age, BMI, history of COVID-19 disease, and the incidence of side effects in healthcare workers vaccinated with any of the four vaccines. All four vaccines are safe and have controlled side effects.

Factors affecting burnout in Iranian health care workers during COVID-19: a systematic review

Factors affecting burnout in Iranian health care workers during COVID-19: a systematic review