Response In Healthcare Workers Research Articles

Quantitation of antibodies against SARS‐CoV‐2 spike protein after two doses of CoronaVac in healthcare workers

Quantitation of antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was performed for the detection of adaptive immune response in healthcare workers (HCWs) vaccinated with CorovaVac. We prospectively recruited HCWs from a university hospital in Turkey. Serum samples from 1072 HCWs were obtained following 28 days of the first, and 21 days of the second dose. Detection and quantitation of SARS‐CoV‐2 antispike antibodies were performed by the chemiluminescent microparticle immunoassay (SARS‐CoV‐2 IgG II Quant; Abbott). Results greater than or equal to the cutoff value 50.0 AU/ml were reported as positive. After the first dose, antispike antibodies were detected in 834 of 1072 (77.8%) HCWs. Seropositivity was higher among females (84.6%) than males (70.6%) (p < 0.001) and was found to be highest in both women and men between the ages of 18–34. After the second dose, antibodies were detected in 1008 of 1012 (99.6%) HCWs. Antibody titers were significantly higher in those who had coronavirus disease‐2019 before vaccination than those who did not (p < 0.001). Antibody positivity and median antibody titers were significantly less in HCWs with chronic diseases compared to those without (p < 0.05 and p < 0.001, respectively). In conclusion, our findings indicated that a relatively high frequency (99.6%) of humoral immunity was produced in HCWs aged 18–59 after two doses of CoronaVac. Quantitation of antibodies may help facilitate longitudinal monitoring of the antibody response, which will be especially useful in deciding the dose of the vaccine in vulnerable groups such as those over 60 years of age and those with chronic diseases.

Single-dose BNT162b2 mRNA COVID-19 vaccine significantly boosts neutralizing antibody response in health care workers recovering from asymptomatic or mild natural SARS-CoV-2 infection

ObjectivesTo measure SARS-CoV-2 neutralizing antibody (NtAb) titres in previously infected or uninfected health care workers who received one or two doses of BNT162b2 mRNA COVID-19 vaccine. MethodsNtAbs were titrated as dose-inhibiting 50% virus replication (ID50) by live virus microneutralization. We evaluated 41 health care workers recovering from mild or asymptomatic infection at first vaccination dose (T1_inf) and 21 days later (T2_inf). Sixteen uninfected health care workers were evaluated 20 days after first dose (T2_uninf) and 20 days after second vaccine dose (T3_uninf). ResultsAt T2_inf, but not at T1_inf, there was a significant correlation between days from diagnosis (median 313, interquartile range 285–322) and NtAb levels (P = 0.011). NtAb titres increased at T2_inf with respect to T1_inf (1544 (732–2232) vs 26 (10–88), P < 0.001). Similarly, there was a significant increase in NtAb titres at T3_uninf compared with T2_uninf (183 (111–301) vs 5 (5–15), P < 0001). However, NtAb levels at T2_inf were significantly higher than those at T2_uninf and T3_uninf (P < 0.0001 for both analyses). ConclusionsA single vaccination in people with mild or asymptomatic previous infection further boosts SARS-CoV-2 humoral immunity to levels higher than those obtained by complete two-vaccination in uninfected subjects.

Response of Healthcare Workers to COVID-19 Protocols after the Index Case at 37 Military Hospital, Ghana.

The diagnosis and management of COVID-19 are much dependent on the adherence to standardized protocols. Healthcare workers play a crucial role in the case management of COVID-19 in many institutions. Globally, the disease burden is increasing, and the mortality has reached over 2 041 426 compared with 323 000 in May 2020. In West Africa, the pandemic has shown a slow but steady rise in many countries. Existing protocols and their utilization are best assessed after the occurrence of the index case. General aim. The study assessed the health worker's response to COVID-19 protocols at three designated areas of the in-hospital management care triaging, holding area, and treatment centers. Method. A qualitative design was used to assess the response of healthcare workers with regards to early case detection, infection prevention, risk communication to clients and compliance to protocols. The study conducted observational visits and purposively selected healthcare workers comprising of clinicians, nurses, emergency medical technicians, and laboratory technicians who perform routine duties at the triaging, holding, and treatment centers. A total of 41 observations were made over two weeks. Results. Participants comprised 23 males and 18 females. At all observed units, the case definition was being used to screen attendants presenting, and appropriate categorization of patients was ensured. The use of temperature in screening for COVID-19 at the units was generally adhered to. Only 50% of participants used the prescribed PPEs. The physical distancing between healthcare workers and client and between clients and caregivers were not enforced; however, hand hygiene was practiced. Disinfection of working surfaces and equipment with 0.5% chlorine or 70% alcohol-based rubs were used most of the time. It was observed however that no psychological counselling was given to suspected cases or their relatives. Conclusion. Healthcare workers showed discordant response to different parts of the protocols for COVID-19 especially appropriate distancing. There was an enhanced awareness among healthcare workers and improvement in infection prevention protocols. The study also observed that as the risk of infection increased from triaging to holding area and to treatment centers, the response of healthcare workers to COVID-19 protocols also improved. Risk communication is an essential part of the COVID-19 management strategy. At the treatment centers, healthcare workers adhered to this protocol, whereas it was a major gap at the triaging and holding areas.

Serosurveillance of Health Care Workers in a COVID Hospital: Immune Response, and Its Longevity.

Objective: We aimed to study the seroprevalence of coronavirus disease 2019 (COVID-19) and sustainability of the immune response in health care workers (HCWs). A cross-sectional study was conducted between October 7 and November 30, 2020, in a multi-specialty hospital in Eastern India designated as COVID hospital during this pandemic. Study participants included 2,110 HCWs, including those who have recovered from COVID infection.Method: HCWs were required to complete a questionnaire and give written consent to participate in the study. Their venous blood sample was collected for serum analysis of IgG antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by chemiluminescent immunoassay.Results: Positive IgG antibodies were seen in 924 participants with a point prevalence of 43.79%. Slightly higher reactivity was seen in males. History of COVID-19 infection was noted in 10.9%, with the highest antibody response in 81% cases. A maximum of 87.9% reactivity was seen in the first two months, and a significant fall was noted in the fourth month, with reactivity seen in only 50% of the study participants.Conclusion: SARS-CoV-2 infection is associated with a variable immune response in the infected population. The declining trend of the antibodies correlates with short-lived protective immunity and the possibility of re-infection. Further studies are needed to explore the probable reasons for varied seroprevalence.

Persistence of SARS-CoV-2 N-Antibody Response in Healthcare Workers, London, UK.

Prospective serosurveillance of severe acute respiratory syndrome coronavirus 2 in 1,069 healthcare workers in London, UK, demonstrated that nucleocapsid antibody titers were stable and sustained for <12 weeks in 312 seropositive participants. This finding was consistent across demographic and clinical variables and contrasts with reports of short-term antibody waning.

The effect of COVID-19 pandemic on the mental wellbeing and coping strategies of health care providers in Kasr Al-Ainy Hospital

Objective The pandemic of coronavirus 2019 (COVID-19) in Egypt has represented a distinctive threat in terms of psychological distress for health care providers. The first studies on the effect of the COVID pandemic on health care professionals were developed in China, but with the spread of the pandemic, other countries started to conduct studies analyzing the psychological response of health care workers to the pandemic. This study aims to investigate the mental well-being in terms of depression and anxiety, coping strategies, along with quality of life (QoL) among health care providers working in Kasr Al-Ainy Hospital during the COVID-19 outbreak.Patients and methods Self-administered questionnaires were distributed online through Google forms to health care providers (N=108) working in Kasr Al-Ainy Hospital from beginning of June to end of August 2020. The questionnaires measured depression, anxiety, coping strategies, QoL, and COVID-19 exposure among Egyptian health care providers.Results Overall, ∼40% of health care providers in our study were directly involved in the management of patients infected with COVID-19. They showed higher mean Beck Depression and Beck Anxiety Inventories total scores. Participants perceived their current mental health to be worse during the COVID-19 pandemic as compared with before the outbreak.Conclusions Both immediate-term and long-term psychiatric services for health care workers in Kasr Al-Ainy Hospital should be implemented to re-establish psychological well-being and enhance QoL and resilience for them during times of severe distress.

Building a Taxonomy to Understand Health Care Worker's Response to Workplace 'Pressure' in Complex, Volatile and Emergency Situations.

This research aims to better understand performance under pressure as experienced by health and emergency staff in the workplace. Three basic questions underpin the work: (1) how do health and emergency workers experience and make sense of the ‘pressures’ entailed in their jobs? (2) What impacts do these pressures have on their working lives and work performance, both positively and negatively? (3) Can we develop a useful explanatory model for ‘working under pressure’ in complex, volatile and emergency situations? The present article addresses the first question regarding the nature of pressure; a subsequent article will address the question of its impact on performance. Using detailed interviews with workers in a range of roles and from diverse settings across Ecuador, our analysis aims to better understand the genesis of pressure, how people respond to it and to gain insights into managing it more effectively, especially with a view to reducing workplace errors and staff burnout. Rather than imposing preformulated definitions of either ‘pressure’ or ‘performance’, we took an emic approach to gain a fresh understanding of how workers themselves experience, describe and make sense of workplace pressure. This article catalogues a wide range of pressures as experienced by our participants and maps relationships between them. We argue that while individuals are often held responsible for workplace errors, both ‘pressure’ and ‘performance’ are multifactorial, involving individuals, teams, case complexity, expertise and organizational systems and these must be considered in order to gain better understandings of performing under pressure.

Willingness and psychological preparedness to attend to COVID-19 patients among healthcare workers in a tertiary care private hospital in Kerala - A mixed method study

Background: The COVID-19 pandemic has made an unprecedented psychological impact on healthcare workers. The objective of this study was to appraise the willingness, attitudes and psychological preparedness of the frontline healthcare workers to respond to the COVID-19 pandemic. Methodology: This was a mixed-method study combining a web-based cross-sectional survey, focus group discussions and semi-structured interviews. The cross-sectional survey covered 202 healthcare workers, and the qualitative assessment was done on 16 frontline healthcare workers. Results: The willingness to respond to the pandemic was found to be significantly higher among doctors and nurses compared to medical interns. Among demographic factors increasing age and female gender were the key factors in determining willingness and positive emotional response. While anxiety was the most common emotional response, the fear of infecting family members was found to be the most common risk perceived in qualitative analysis. The study highlights the altruistic attitude of frontline health workers to be the most important contributing factor for psychological preparedness. Conclusion: This study outlines the fact that willingness to respond in a pandemic is an innate response in healthcare workers. Considering the risks, workload and socioeconomic stressors, proactive psychosocial support should be given to frontline healthcare workers by the institutions, governments, and society.

Clinical characteristics and humoral immune response in healthcare workers with COVID-19 in a teaching hospital in Belgium

BackgroundHealthcare workers (HCWs) are at high risk of acquiring COVID-19 and could play a role in nosocomial transmission. Since 4th February 2020, Belgian Health authorities reported more than 90,568 cases, of which 8.3% were HCWs. Data on clinical characteristics, sources of infection and humoral immune response of HCWs with COVID-19 remain scarce.AimTo analyse the clinical characteristics, humoral immune response, sources of contamination, and outcomes among HCWs with COVID-19.MethodsThis retrospective study included 176 HCWs with laboratory-confirmed COVID-19 in a teaching hospital in Belgium. Between 1st March and 31st May 2020, all HCWs with symptoms suspected of COVID-19 were tested by reverse transcription polymerase chain reaction on a nasopharyngeal swab. Serological testing was performed between 55 and 137 days after the onset of symptoms.FindingsMedian age was 40.8 years and 75% were female. Median delay between onset of symptoms and diagnosis was 4.39 days. Most frequent symptoms were cough and headache (both 75%). Fever accounted for 68.7%. Most represented professions were nurses (42%). HCWs were mainly infected by patient contact (32.9%); 7.6% required hospitalization and 1.7% were admitted to the intensive care unit. Unfortunately, one HCW died (0.5%). Total antibodies were positive in 109/126 (86.5%).ConclusionsClinical presentation of COVID-19 in HCWs does not differ from the general population. However, outcomes were more favourable with a mortality rate lower than that reported in Belgian COVID-19 patients in general (16%). The main source of infection was the hospital setting. Our positive antibodies rate was high but lower than previously reported.

Immune response to SARS-CoV-2 in health care workers following a COVID-19 outbreak: A prospective longitudinal study.

ObjectiveCurrently, little is known about the progression of an immune response against SARSCoV- 2 upon infection or sub-infection-exposure over time. We examined the serologic response in healthcare workers up to 12 weeks after a well-documented and contained outbreak and compared results with findings from earlier serologic testing in the same population.MethodsThis study followed 166 health care workers of the University Perinatal Care Center, Regensburg, Germany, for up to 12 weeks. 27 of the subjects had previously tested positive for the presence of SARS-CoV-2 by PCR testing and developed COVID-19. Serologic responses were tested with two independent commercially available test kits.Results77.8 % of COVID-19 study subjects developed a specific IgG-response over the course of the 12-week study, while none of the COVID-19 contact groups had a detectable IgG response. Amongst most COVID-19 patients the values of detectable IgG-responses significantly increased over time as confirmed with both tests, while that of positive IgA responses decreased. Between the number of reported symptoms and antibody responses in COVID-19 patients no correlation was found and no new cases of seroconversion were identified in asymptomatic coworkers with negative PCR during the outbreak.ConclusionsImmune response after COVID-19 increases significantly over time but still approximately 22 % of COVID-19 patients did not mount a measurable serologic immune response within 60 days. Exposed co-workers did not develop any relevant antibody levels at all. We conclude that immunity after infection increases over time, but the antibody response does not develop reliably in all infected people.

Awareness of COVID-19 and perception of work satisfaction among healthcare workers at Patan Hospital, Nepal

Introduction: Healthcare workers (HCWs) awareness of disease outbreak, and working efficiently in a changed environment is vital to fight pandemic. How an institution responds to the crisis depends on HCWs response. This study aims to find out awareness of COVID-19 and work satisfaction of HCWs at Patan Hospital (PH), Nepal.&#x0D; Method: A cross-sectional questionnaires base descriptive study was conducted at PH, Patan Academy of Health Sciences, Nepal, in April 2020. The HCWs were grouped in to technical staff, doctors, and support staff. There were 20 questions each in the awareness of COVID-19 and work satisfaction domain. Ethical approval was obtained.&#x0D; Result: Of all the staff, 223 various level staffs responded to the questionnaire. There were 80 (35.9%) technical staff, 77 (34.5%) doctors and 66 (29.6%) support staff in the study. In the technical staff group 1106 (69.2%) responses were in favour of having good awareness and 1337 (83.5%) responses were in favour of satisfaction. In the doctors’ group 1233 (80.1%) responses were in favour of having good awareness and 1000 (65%) responses were in favour of satisfaction. In the support staff group 236 (17.7%) responses were in favour of having good awareness and 347 (26.2%) responses were in favour of satisfaction.&#x0D; Conclusion: Our study showed that technical staff and doctors had higher levels of perception of work satisfaction and awareness for COVID-19.

M. tuberculosis infection and antigen specific cytokine response in healthcare workers frequently exposed to tuberculosis

Tuberculosis (TB) is the leading cause of death due to an infectious agent, but only a small fraction of those infected develop the disease. Cytokines are involved in the mediation and regulation of immunity, and their secretion patterns may reflect the infection status. To increase our understanding of immune response to M. tuberculosis infection, we conducted a cross-sectional study investigating M. tuberculosis infection status and comparing the release profiles of cytokines GM-CSF, IFN-γ, IL-1β, IL-10, IL-12 (p70), IL-2, IL-4, IL-5, IL-6, IL-8, TNF-α, in community controls (CCs) and healthy healthcare workers (HCWs) highly exposed to TB. Among HCWs and CCs, the probability of latent M. tuberculosis (LTB+) infection was respectively 5.4 (p = 0.002) and 3.4 (p = 0.006) times higher in men than women. The odds ratio of LTB infection was 4 times higher among HCWs in direct contact with active TB patients than other HCW (p = 0.01). Whole blood supernatant cytokine responses to M. tuberculosis antigens showed differential pro-inflammatory responses between HCWs and CCs. CCsLTB− had higher IL-1β responses than HCWsLTB− (p = 0.002). HCWsLTB+ had significantly higher IL-8 responses to M. tuberculosis antigens than HCWsLTB− (p = 0.003) and CCsLTB− (p = 0.015). HCWsLTB+/− showed weak but positive TNF-α responses to M. tuberculosis antigen stimulation compared to CCsLTB+/− (p ≤ 0.015). Looking at T-helper (1 and 2) responses, HCWsLTB+ and CCsLTB+ had significantly higher IFN-γ and IL-2 responses compared to HCWsLTB− and CCsLTB− (p < [0.0001–0.003]). Also, TB antigen induced IL-5 secretion was significantly higher in HCWsLTB+ and CCsLTB+ than in non-infected CCsLTB− (p < [0.005–0.04]). M. tuberculosis antigen specific responses in HCWsLTB+ varied based on active TB exposure gradient. HCWsLTB+ who were highly exposed to active TB (≥3 hours per day) had significantly higher IFN-γ and IL-8 responses (p ≤ 0.02) than HCWs LTB+ not in direct contact with active TB patients. HCWsLTB+ working with active TB patients for 5 to 31 years had a significantly enhanced secretion of proinflammatory cytokines (GM-CSF, IFN-γ, IL-1β, IL-2, IL-6, IL-8, IL-12p70, TNF-α) compared to HCWsLTB− (p < [0.0001–0.01]). Secretion of anti-inflammatory/Th2 cytokines IL-5 and IL-10 was also higher in HCWsLTB+ than HCWsLTB−. In conclusion, LTBI individuals controlling the M. tuberculosis infection have an enhanced TB specific Th1-cytokines/proinflammatory response combined with selected Th2 type/anti-inflammatory cytokines induction.

The French Infectious Diseases Society's readiness and response to epidemic or biological risk–the current situation following the Middle East respiratory syndrome coronavirus and Ebola virus disease alerts

ContextIn 2012, the French Infectious Diseases Society (French acronym SPILF) initiated the “Coordination of epidemic and biological risk” (SPILF-COREB - Emergences [SCE]) group to support the readiness and response of healthcare workers (HCWs) to new alerts. ObjectiveTo present the SCE group, its functioning, and the main support it provided for frontline HCWs. MethodsA multidisciplinary group of heads of infectious disease departments from reference hospitals was created to build a network of clinical expertise for care, training, and research in the field of epidemic and biological risk (EBR). The network developed a set of standardized operational procedures (SOPs) to guide interventions to manage EBR-suspect patients. ResultsA working group created the SOP aimed at frontline HCWs taking care of patients. Priority was given to the development of a generic procedure, which was then adapted according to the current alert. Five key steps were identified and hierarchized: detecting, protecting, caring for, alerting, and referring the EBR patient. The interaction between clinicians and those responsible for the protection of the community was crucial. The SOPs validated by the SPILF and its affiliates were disseminated to a wide range of key stakeholders through various media including workshops and the SPILF's website. ConclusionSPILF can easily adapt and timely mobilize the EBR expertise in case of an alert. The present work suggests that sharing and discussing this experience, initiated at the European level, can generate a new collective expertise and needs to be further developed and strengthened.

Prevalence of STI symptoms and high levels of stigma in STI healthcare among men who have sex with men in Dar es Salaam, Tanzania: a respondent-driven sampling study.

Symptoms of sexually transmitted infections (STIs), whether they are presented for treatment or diagnosis, and how they are received by the clinician where they are presented, may be concomitants of stigma associated with homosexuality in homophobic climates. We analyzed respondent-driven sampling data from a study on 200 young men who have sex with men (MSM) in Dar es Salaam, Tanzania to examine sample prevalence, treatment and clinician response to 10 symptoms potentially associated with STIs. Survey measures included 10 self-reported STI symptoms, further specified according to location (genital, anal, oral), further specified according to place of diagnosis, place of, treatment whether there was pharmacy treatment or self-medication, healthcare worker (HCW) inquiries about source of infection and whether the HCW was polite. Most common symptoms reported were genital pain, burning urination, genital itching/burning, penile discharge, and groin swelling. Anal symptoms had the lowest proportion of treatment at public clinics and among the highest proportion of pharmacy treatment; anal sores had the highest proportion of self-medication. HCWs were reported as not being polite in response to 71-90% of the symptoms, (median = 82%). The findings suggest that stigma and negative HCW response are barriers to public clinic treatment for MSM in Tanzania and that these may have implications for both STI treatment and the HIV cascade.

Commentary on 'Dissecting the hemagglutinin head and stalk specific IgG antibody response in healthcare workers following pandemic H1N1 vaccination'.

Commentary on ‘Dissecting the hemagglutinin head and stalk specific IgG antibody response in healthcare workers following pandemic H1N1 vaccination’

Dissecting the hemagglutinin head and stalk-specific IgG antibody response in healthcare workers following pandemic H1N1 vaccination.

Traditionally, neutralising antibodies that are directed to the major surface glycoprotein hemagglutinin (HA) head domain are measured as surrogate correlates of protection against influenza. In addition to neutralization, hemagglutinin-specific antibodies may provide protection by mediating antibody-dependent cellular cytotoxicity (ADCC). During the 2009 pandemic, vaccination induced HA-specific antibodies that were mostly directed to the conserved HA stalk domain. However, the protective role of these antibodies has not been investigated in detail. We quantified the HA head and stalk-specific antibodies, their avidity, ability to neutralise virus and activate natural killer cells in an ADCC assay. We analyzed sera obtained from 14 healthcare workers who had low hemagglutination inhibition (HI) antibody titres at 3 months after pandemic H1N1 vaccination as well as from 22 controls. Vaccination resulted in a HA stalk dominant antibody response in both low responders and controls. Revaccination of low responders, 5 months later, resulted in a boost in antibodies, with HA head-specific antibodies dominating the response. Comparative analysis of head and stalk antibody avidities revealed that stalk-specific antibodies were qualitatively superior. Furthermore, stalk-specific antibodies mediated virus neutralization and had significantly higher ADCC activity than head-specific antibodies. Despite the head and stalk-specific antibodies being lower in low responders, they had comparable antibody avidity, ADCC functionality and neutralising capacity to those of controls who had high HI titres post-vaccination. Thus, our study has demonstrated that HA stalk-specific antibodies may have an important role in protection through neutralization and ADCC in low responders who do not maintain seroprotective HI antibodies.

Well being and immune response in health care workers (strain and health of the sanitary staff)

Well being and immune response in health care workers (strain and health of the sanitary staff)

Evaluation of hepatitis B surface antibody and specific gamma interferon response in health care workers after vaccination.

Background:Health care workers are at high risk of acquiring hepatitis B virus (HBV) infection through occupational exposure to blood or body fluids. Thus, the assessment of anti-HBs status after immunization is very important.Objectives:This study aimed to evaluate the measurement of HBsAb titer and specific gamma interferon response among the vaccinated health care workers in Golestan Hospital, Ahvaz, Iran.Patients and Methods:The blood samples of 39 health care workers, including 13 general surgeons, 10 anesthesiologists, 5 neurosurgeons, 3 general physicians, 1 orthopedist, 2 urologist and 5 nurses were collected during June 2013. All the participants had received HBV vaccine. They had received last vaccine dose from 2 months to 14 years ago. Their sera were tested for anti-hepatitis B antibody and HBc-IgG by the ELISA. Also, the evaluation of specific interferon γ response against HBsAg was carried out using ELISA test. The age of health care workers were between 24 and 58 years with the mean age of 34.3 ± 7.4 y.Results:Out of 39 sera, 22 (56.41%) had HBsAb titer above 100 IU/mL, 17 (43.6%) had titer below 100 IU/mL, 27 (69.2%) had positive specific HBsAg interferon γ, 8 (20.5%) cases had positive antibody response above 100IU, but negative for specific interferon γ and 3 (7.6%) cases were positive for HBc-IgG.Conclusions:Overall, 87.2% of the health care workers had immunity against HBV infection, which showed remarkable immunity response following HBV vaccination. Booster dose of HBV vaccine is recommended for those whose immunity are below 100 IU/mL.

Assessment of the immune response to hepatitis B virus vaccine as a major factor in the prevention of hepatitis B infection

ObjectiveThe aim of the work was to study the effect of hepatitis B virus (HBV) vaccine as a major factor in the prevention of HBV infection.BackgroundMeasuring the level of hepatitis B surface antibodies in different age groups to determine the time of fading of hepatitis B surface antibodies and whether there is a need for a booster dose or not.Patients and methodsNinety random persons selected among those attending Menoufia Fever Hospital, Menoufia governorate, who were previously vaccinated with HBV vaccine, were classified into three groups.ResultsSignificantly, the seroprotection rate among vaccinated children up to 5 years was 70.0%, with a mean concentration of HBsAb of 139 mIU/ml; of them, 40.0% were over-responders (>100 mIU/ml), 30% were adequate responders (10-100 mIU/ml), and 30.0% were nonresponders.In the second group, the mean concentration of HBsAb was 70 mIU/ml, wherein 43.3% were considered responders; of them, 13.3% were over-responders, 30% were adequate responders, and 56.7% were nonresponders (HBsAb <10 mIU/ml). The HCW of the third group shows that the mean concentration of HBsAb was 639 mIU/ml; 20.0% were adequate responders and 80.0% were over-responders.ConclusionThe HBV vaccine has a major effect on the prophylaxis and the prevention of HBV infection. The HBV vaccine efficacy decreased with increasing age up to 18 years. There was 100% response in healthcare workers 5 years after vaccination.

Innovations and lessons learned from the Canterbury earthquakes

Purpose– The purpose of this paper is to identify innovations and lessons learned from interviews with members of the multidisciplinary healthcare team who participated in the response to the 22 February earthquake, affecting the Canterbury region of New Zealand's South Island.Design/methodology/approach– Narratives from individual staff members who were associated with the Christchurch Hospital Emergency Department response were recorded and analysed. This data, together with other contextual documents have been used to identify the responses of healthcare workers to an unexpected natural disaster. Perspectives were sought from a range of individuals, including allied health professionals, social workers, Maori health workers, orderlies, medical and nursing staff.Findings– The individual as well as the organisational responses to the earthquake events are significant, and need to be considered in relation to future planning and responses. In particular, the importance of encouraging and supporting a culture which values innovation and responsiveness was identified. While specific, practical responses to the earthquake disaster are noted, it is also important to acknowledge the implication for individuals of an acute, unanticipated event.Research limitations/implications– The findings from this study have the potential to illuminate possible responses in other crisis situations, and to guide the development of targeted support measures in response to disaster events.Originality/value– Little documentation has occurred to date relating the experiences of health care responders who are not only reacting to a natural disaster, but are also part of it. This is a unique and valuable perspective that has relevance within a number of settings.