Vaccination Of Healthcare Workers Research Articles

The Level of Knowledge and Practice of Employees on Infection Control in a Tertiary Level Hospital

Introduction: The one of the main causes of hospital acquired infection (HAI) is the lack of knowledge and improper practice of employees in the hospital. Training programs on the infection control for each employees can reduce the rate of infection acquired from hospital. Aim of the study: The aim of this study was to assess the knowledge and practice of infection control among the employees in DMCH and ShSMCH. Methods: This descriptive type of cross-sectional study was conducted in Dhaka Medical college Hospital and Shaheed suhrawardi Medical college Hospital Dhaka for a period of one year starting from January-2019 to December-2019. Total 139 employees (Physician and Nurses) were included in this study. Result: Among 139 respondents, mean age were 31.97±7.412 (SD). 51.8% (n= 72) were female and 48.2% (n= 67) were male. In this study, 99.3% (n=138) of the respondents were aware of infection control. The current study shows that the 100% (n=139) of respondents know about nosocomial infection. 95.7% (n=114) know infection control technique prevent nosocomial infection and 82% (n=114) of the respondents know infection can occur after discharge from hospital. Maximum 63.3% (n=88) of the respondents know the most effective method to control infection were hand washing properly and the minimum 4.3% (n=6) know prudent use of antibiotics, 38,8% (n=54) know wearing caps, masks and shoe cover and 9.4% (n=13) knows regular vaccination of health care worker. Maximum of the respondents 48.2% (n=67) practice often, 33.8% (n=47) practice always, 17.3% (n=24) practice sometime and minimum .7% (n=1) of the respondent never practice infection control guideline. Conclusion: Physician and nurses in the current study have average knowledge and practice level regarding infection control.

Inactivated COVID-19 vaccines: durability of Covaxin/BBV152 induced immunity against variants of concern.

BackgroundCovaxin/BBV152 is one of the most widely used vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and one of the few vaccines used extensively in low- and middle-income countries (LMIC).MethodsWe investigated the effect of Covaxin on the SARS-CoV-2 specific IgG and IgA and neutralizing antibody (NAb) levels at baseline (M0) and at Months 1 (M1), 2 (M2), 3 (M3), 4 (M4), 6 (M6) and 12 (M12) following vaccination in healthcare workers. In addition, we also examined the NAb levels against variant lineages of B.1.617.2 (Delta, India), B.1.617.2.1 (Delta Plus, India), B.1.351 (Beta, SA), B.1.1.7 (Alpha, UK) and B.1.1.529 (Omicron).ResultsCovaxin induces enhanced SARS-CoV-2 binding antibodies of IgG and IgA responses against both spike (S) and nucleocapsid (N) antigens at M1, M2, M3, M4, M6 and M12 in comparison with M0. Our data also reveal that NAb levels against the ancestral strain (Wuhan, wild type) are elevated and sustained at M1, M2, M3, M4, M6 and M12 in comparison with M0 and against variant lineages of B.1.617.2 (Delta, India), B.1.617.2.1 (Delta Plus, India), B.1.351 (Beta, SA) and B.1.1.7 (Alpha, UK) are elevated at M3, M6 and M12 in comparison with M0. However, NAb levels against B.1.1.529 (Omicron) was consistently below the limit of detection except at M12.ConclusionThus, Covaxin induces an enhanced humoral immune response, with persistence till at least 12 months post-vaccination against most SARS-CoV-2 variants.

Bimodal antibody-titer decline following BNT162b2 mRNA anti-SARS-CoV-2 vaccination in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)

BackgroundBoth SARS-CoV-2 mRNA-based vaccines [BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)] have shown high efficacy, with very modest side effects in limiting transmission of SARS-CoV-2 and in preventing the severe COVID-19 disease, characterized by a worrying high occupation of intensive care units (ICU), high frequency of intubation and ultimately high mortality rate. At the INT, in Naples, only the BNT162b2/Pfizer vaccine has been administered to cancer patients and healthcare professionals aged 16 and over. In the present study, the antibody response levels and their decline were monitored in an interval of 6–9 months after vaccine administration in the two different cohorts of workers of the INT – IRCCS "Fondazione Pascale" Cancer Center (Naples, Italy): the group of individuals previously infected with SARS-CoV-2 and vaccinated with a single dose; and that of individuals negative for previous exposure to SARS-CoV-2 vaccinated with two doses 21 days apart.MethodsSpecific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S ECLIA immunoassay were determined in serum samples of 27 healthcare workers with a previously documented history of SARS-CoV-2 infection and 123 healthcare workers without, during antibody titers’ monitoring. Moreover, geometric mean titers (GMT) and relative fold changes (FC) were calculated.ResultsBimodal titer decline was observed in both previously infected and uninfected SARS-CoV-2 subjects. A first rapid decline was followed by a progressive slow decline in the 6/9 month-period before the further vaccine boost. The trend was explained by 2 different mathematical models, exponential and power function, the latter revealing as predictive of antibody titer decline either in infected or in not previously infected ones. The value of the prolonged lower vaccine titer was about 1 log below in the 6/9-month interval after the single dose for previously infected individuals with SARS-CoV-2 and the two doses for those not previously infected. The titer change, after the boost dose administration, on the other hand, was ≥ 1.5 FC higher than the titers at the 6/9-month time-points in both cohorts. A similar quantitative immune titer was observed in both cohorts 8 days after the last boost dose. The subsequent immunoresponse trend remains to be verified.DiscussionThe results show that a very rapid first decline, from the highest antibody peak, was followed by a very slow decline which ensured immune protection lasting more than 6 months. The apparent absence of adverse effects of the rapid decline on the vaccine's immune protective role has been related to a large majority of low avidity antibodies induced by current vaccines. High avidity antibodies with prolonged anti-transmission efficacy show a longer half-life and are lost over a longer interval period. The cellular immunity, capable of preventing severe clinical diseases, lasts much longer. The unbalanced dual activity (cellular vs humoral) while effective in limiting ICU pressure and overall mortality, does not protect against transmission of SARS-CoV-2, resulting in high circulation of the virus among unvaccinated subjects, including the younger population, and the continuous production of variants characterized by changes in transmissibility and pathogenicity. The high mutation rate, peculiar to the RNA virus, can however lead to a dual opposite results: selection of defective and less efficient viruses up to extinction; risk of more efficiently transmitted variants as the current omicron pandemic.ConclusionsIn conclusion the current bimodal antibody-titer decline, following BNT162b2 mRNA anti-SARS-CoV-2 vaccination, needs a further extended analysis to verify the protective borderline levels of immunity and the optimal administration schedule of vaccine boosters. Our current results can contribute to such goal, besides a direct comparison of other FDA-approved and candidate vaccines.

Immunogenicity evaluation after BNT162b2 booster vaccination in healthcare workers

Waning of the immune response upon vaccination in SARS-CoV-2 infection is an important subject of evaluation in this pandemic, mostly in healthcare workers (HCW) that are constantly in contact with infected samples and patients. Therefore, our study aimed to establish the specific humoral response of specific IgG and IgA antibodies upon vaccination, during the second year of pandemic and evaluating the booster shot with the same vaccine type. A group of 103 HCW with documented exposure to the virus were monitored for specific IgG and IgA levels prior to vaccination, after the first vaccination round, during the following 8 months and after the booster shot with the same vaccine type. After 8 months post-vaccination the humoral response in both IgG and IgA decreased, 2.4 times for IgG, and 2.7 times for IgA. Although the antibodies levels significantly decreased, no documented infection was registered in the group. After the booster shot, the entire group, displayed IgG increased levels, immediately after booster followed by the increase in specific IgA. IgG levels post-second round of vaccination are statistically higher compared to the first round, while IgA is restored at the same levels. Within the vaccination or booster routine for a multiple waves’ pandemic that is generating new virus variants, populational immunity remains an important issue for future implementation of prevention/control measures.

Healthcare workers’ acceptability of influenza vaccination nudges: Evaluation of a real-world intervention

Nudges have been proposed as an effective tool to stimulate influenza vaccination uptake in healthcare workers. However, the success of such nudges in practice is heavily reliant on their acceptance by the intended healthcare worker population, which has not been thoroughly examined to date. This study investigated healthcare workers’ acceptability of diverse influenza vaccination nudges implemented in a real-world vaccination campaign and explored the relationship between nudge acceptability and vaccination uptake. A cross-sectional study was conducted among 244 Dutch hospital employees, following a hospital-wide influenza vaccination nudging intervention. A survey assessed healthcare workers’ perceived acceptability of ten distinct influenza vaccination nudges, along with their vaccination status and relevant covariates (e.g., general perceptions regarding influenza vaccination of healthcare workers). Influenza vaccination nudges in general were deemed acceptable, with reward-based nudges being the least accepted, while digital vaccination forms, a mobile vaccination post, peer vaccination, and digital vaccination reminders were most appreciated. A higher overall acceptance of these nudges was associated with a greater likelihood of being vaccinated, particularly in healthcare workers with favorable perceptions of influenza vaccination usefulness. Our findings suggest that influenza vaccination nudges are an accepted means to systematically promote immunization of healthcare workers, and thus present a viable strategy for public health policies aimed at this group.

Clinical characteristics and outcomes of healthcare workers with COVID-19 pre- and postvaccination.

Vaccines are the most effective strategy to control the spread of coronavirus disease‐2019 (COVID‐19). Data on COVID‐19 among healthcare workers (HCW) pre‐ and postvaccination are limited. This study aims to evaluate the clinical characteristics and outcomes of HCW with COVID‐19 pre‐ and postvaccination. Retrospective cohort study. All HCWs with suspected COVID‐19 were included. Demographic data, occupation, symptoms, work in COVID‐19 area, and vaccination status were collected. There were 22 267 HCW visits for suspected COVID‐19; 7879 (35.4%) tested positive, and 14 388 (64.6%) tested negative. Fever, cough, fatigue, and dyspnea were positive predictors of COVID‐19, and sore throat, headache, coryza, work in a COVID‐19 area, and COVID‐19 vaccination were negative predictors. Of the total number of visits, 41.2% were from vaccinated HCW and 58.8% were from unvaccinated HCW. Among HCWs with COVID‐19, 84 (1.1%) required hospitalization, 11 (0.1%) in an intensive care unit (ICU), with three (0.04%) deaths. Six hospitalizations occurred in vaccinated HCWs, being of short duration, with no need for ICU admission and no deaths. SARS‐CoV‐2 infection prevalence was high among HCW, and vaccinated HCW had fewer hospitalizations, need for ICU, and deaths. Therefore, vaccines may attenuate COVID‐19 severity, and efforts must be concentrated to ensure adequate vaccination for HCW.

Differential Dynamics of Humoral and Cell-Mediated Immunity with Three Doses of BNT162b2 SARS-CoV-2 Vaccine in Healthcare Workers in Japan: A Prospective Cohort Study.

Vaccines against SARS-CoV-2 with good efficacy are now available worldwide. However, gained immunity diminishes over time. Here, we investigate the course of both humoral and cell-mediated immunity in response to three doses of the Pfizer mRNA BNT162b2 SARS-CoV-2 vaccine in healthcare workers in Japan. SARS-CoV-2 anti-receptor-binding domain (RBD) antibodies (total Ig, IgG), neutralizing antibodies (NAb), and ELISpot were measured in serum and whole blood samples collected after each vaccine dose. ELISpot numbers were higher than the cutoff values in most participants at all times. It was suggested that the difference in behavior between humoral immunity and cell-mediated immunity with age is complementary. Anti-RBD total Ig, IgG, and NAb indicated a high correlation at each time point after vaccine doses. Total Ig was retained long-term after the second dose and increased significantly faster by the booster dose than IgG. Nab levels of all subjects were ≤20% six months after the second dose, and the correlation coefficient was greatly reduced. These are due to the avidity of each antibody and differences among commercial kits, which may affect the evaluation of immunokinetics in previous COVID-19 studies. Therefore, it is necessary to harmonize reagents categorized by the same characteristics.

Pharmacovigilance of COVID-19 Vaccine Among Health Care Workers in Chittagong Medical College Hospital

Background: Successive waves of COVID-19, the pandemic of 2020 is still sweeping throughout the world in terms of morbidity and mortality. The speed of development of the vaccines, preclinical trials, clinical trials, all are unprecedented. So there remained a concern about the short- and long-term health effects (Wanted and unwanted) of these vaccines. Bangladesh is fortunate enough to get supply of vaccine (Oxford-AstraZeneca) early in the course. As expected, the vaccination program was phased and the population was stratified according to health risk. Health care workers were among the first groups receiving that vaccine in Bangladesh. A study was conducted with the objectives of assessing and describing the adverse events following vaccination against SARSCoV-2 and also of establishment of a post vaccination support clinic in Chittagong Medical College Hospital (CMCH) Bangladesh from February 2021 to June 2021. Materials and methods: Prospective surveillance was done among the vaccine recipients healthcare workers of CMCH and their family members. Participants were enrolled after the start of first dose vaccination from February in CMCH and also after the second dose vaccination from April 2021. A number of 1334 participants were signed-up after first dose of vaccination and were followed up through second dose. The initiative was taken to address the complications arising from vaccination among the vaccine recipients both over telephone and also in ward 16 of CMCH for those whose complaints warranted a physical examination. Results: A total of 1334 Oxford-AstraZeneca COVID-19 vaccine (AZD1222) (Covishield) vaccinated health care workers and their family members participated in the study, with age range from 18 to 89 years. More than 78% of them were within their 2nd to 6th decade of age. 19.2% of respondents were above 60 years old. Males were predominant in numbers than females (61.3% Vs 38.7%). Among the respondents, the majority were physicians by profession (51.4%). Among the recipients, about 30% had previous comorbid diseases; hypertension and diabetes mellitus being more common (18.6% & 14.4%). An elaborate distribution of ‘Adverse Events Following Immunization’ (AEFI) was furnished. 37.3% participants were identified as suffering from symptoms after receiving the first dose of COVID–19 vaccinations, while only 11.4% were affected after taking the second dose. Common symptoms experienced by the respondents after first and second doses of the vaccination were as follows: mild fever (Temp< 38° C), muscle pain, pain at immunization site, tenderness and soreness at injection site, headache, tiredness, fatigue, chills, dizziness etc. Recipients aged more than 50 years suffered significantly more symptoms. Gender and comorbidities did not influence in developing symptoms. There was no serious or fatal event. Conclusion: According to the findings of this study the used vaccine Oxford-AstraZeneca AZ AZD1222 (Covishield) appear to be reasonably safe in adult population with few physical discomforts which are neither life threatening nor serious. JCMCTA 2022 ; 33 (1) : 4-8

Increased body mass index linked to decreased neutralizing antibody titers of inactivated SARS-CoV-2 vaccine in healthcare workers.

ObjectiveObesity is an important risk factor for COVID‐19. However, whether obesity affects SARS‐CoV‐2 antibody production is unclear. This study aimed to identify the influence of obesity on neutralizing antibody production of an inactivated SARS‐CoV‐2 vaccine to better guide vaccination strategies.MethodsThis cross‐sectional study recruited a total of 239 healthcare workers (age, 21–50 years) from Suining Central Hospital during 22–23 April 2021. An electronic questionnaire on basic characteristics was completed by all participants. A general physical exam and fasting blood sampling by venipuncture were performed. Peripheral leukocyte counts and the ratios of leukocyte subsets, hepatorenal function, and the neutralizing antibody titers against SARS‐CoV‐2 were measured.ResultsAmong 239 healthcare workers, the participants with underweight, normal weight, overweight, and obesity accounted for 10.88%, 64.44%, 23.01%, and 1.67%, respectively. The highest peripheral monocyte counts were observed in the group with obesity, whereas the lowest were observed in the group with normal weight. Similar results were obtained with respect to percentage of peripheral monocytes. Participants with obesity had higher peripheral eosinophil counts and percentages than the other three groups. The median neutralizing antibody titer was 12.70 AU/mL, with 85.36% (n = 204) of participants were sufficiently protected against SARS‐CoV‐2. The lowest neutralizing antibody titers were observed in the group with obesity, whereas the highest were observed in the group that was underweight. Additionally, high BMI was significantly associated with high peripheral monocyte counts [B (95% CI) = 0.008 (0.002, 0.013)] and low neutralizing antibody titers [B (95% CI) = −1.934 (−3.663, −0.206)].ConclusionsObesity could induce chronic inflammation, and associated with lower neutralizing antibody titers against SARS‐CoV‐2 after inactivated SARS‐CoV‐2 vaccination.

Assessment of Antibody levels amongst Health Care Workers vaccinated with two doses of COVID vaccine 6 months ago in a Hospital of Kolkata, West Bengal: Is there any Need for a Third dose (Booster Dose) of COVID Vaccine?

Background: Vaccines can prevent the adverse effects, even if the virus is contracted. The first group to receive the doses included the healthcare workers. While data shows that two vaccine shots are largely effective at protecting against severe Covid-19, data on the benefit of booster shots is currently unclear. To establish whether a booster dose would offer significantly increased protection, experts first need to understand the level of antibodies and other immune defences needed to prevent severe illness and death from Covid-19.
 Objectives: To conduct a study to see the clinical exposure profile of the doctors who had taken both doses of vaccines 6 months and before from COVID vaccination centre of BelleVue Clinic, Kolkata and to analyse the antibody levels of the doctors who had been vaccinated with two doses of vaccine 6 months ago and before.
 Methodology: An observational, descriptive, cross-sectional, hospital based study was conducted in the Bellevue Clinic of Kolkata, West Bengal in the span of 6 months from September 2021 to January 2022 taking the health care workers of the clinic as participants. The persons were called for an antibody testing on prefixed scheduled dates. The persons who gave consent were provided with pre-designed validated questionnaire. A total of 130 health care workers including doctors, nurses, housekeeping and administrators gave consent to participate. Blood was collected from them and antibody test was conducted by COVID specific antibody testing kits (Product V 74339 - Access S variants ARS CoV -2 IgG (1st IS) Reagent Kit (200 tests/kit).
 Results: The study was carried out the Pathology department of Bellevue Clinic, Kolkata. The data was analyzed and results showed 80% of the persons whose titre came below the cutoff mark were males. The health care workers belonging to age group 40-60 years were the maximum having lower antibody titres followed by those above 60 years of age. Doctors were the persons who were mostly having lower levels of antibody titres followed by nurses. This may be due to the maximum exposure to the Covid patients that their antibody titre weaned off early. This shows that those who had direct exposure to patients had much higher antibody titres.
 Conclusion: The study opened up a wide angle to the antibody levels of the covid vaccinated health care workers. The results will help the future researchers to develop different means for a Covid free or a normal healthy life based on this data.

Assessment of the Humoral Immune Response Following COVID-19 Vaccination in Healthcare Workers: A One Year Longitudinal Study.

The continuous variability of SARS-CoV-2 and the rapid waning of specific antibodies threatens the efficacy of COVID-19 vaccines. We aimed to evaluate antibody kinetics one year after SARS-CoV-2 vaccination with an mRNA vaccine in healthcare workers (HCW), with or without a booster. A marked decline in anti-Spike(S)/Receptor Binding Domain (RBD) antibody levels was registered during the first eight months post-vaccination, followed by a transitory increase after the booster. At three months post-booster an increased antibody level was maintained only in HCW vaccinated after a prior infection, who also developed a higher and long-lasting level of anti-S IgA antibodies. Still, IgG anti-nucleocapsid (NCP) fades five months post-SARS-CoV-2 infection. Despite the decline in antibodies one-year post-vaccination, 68.2% of HCW preserved the neutralization capacity against the ancestral variant, with a decrease of only 17.08% in the neutralizing capacity against the Omicron variant. Nevertheless, breakthrough infections were present in 6.65% of all participants, without any correlation with the previous level of anti-S/RBD IgG. Protection against the ancestral and Omicron variants is maintained at least three months after a booster in HCW, possibly reflecting a continuous antigenic stimulation in the professional setting.

Level of screening for and vaccination against hepatitis B among healthcare workers in the Eastern Democratic Republic of the Congo: a public health concern

SummaryBackgroundIn low resource settings in sub-Saharan Africa healthcare workers (HCW) have a high risk of contracting hepatitis B infection. Vaccination of HCWs is to protect them from acquisition of hepatitis B from patients.ObjectiveTo evaluate the hepatitis B virus (HBV) serological and vaccination status of HCWs in the Butembo Antenna in the Eastern Democratic Republic of Congo (DR Congo) and to investigate the factors influencing hepatitis screening and vaccination.MethodsA cross-sectional study using a structured questionnaire was carried out from 1st to 30th April 2021 among consenting HCWs in Butembo (≥18 years of age). Data was analysed using SPSS version 23.ResultsOf 373 participants, 178 (47.7%) had already been screened for HBV. Screening was more likely for HCWs in a rural or publicly owned facility (P<0.05). A total of 25 (6.7%) HCWs were fully vaccinated against HBV; the factors associated with full vaccination were: prior screening for HBV (odds ratio: 9.03 (2.51–38.61), P<0.0001), prior knowledge of the value of post-exposure prophylaxis (odds ratio 12.9 (2.89–80.44), P=0.0004), prior knowledge of hepatitis B vaccine benefits (adjusted odds ratio: 4.54 (1.66–13.05), P=0.002) and prior exposure to hepatitis B infection (adjusted odds ratio: 2.61 (1.08–6.39), P=0.039).ConclusionScreening and vaccination rates of HCWs for HBV are extremely low, and not high enough to prevent the spread of this serious illness and its complications. There is a dire need to increase vaccination rates among HCWs in Eastern DR Congo. The DRC government should issue vaccination against HBV as a recommendation at the national level.

To Boost or Not to Boost Residents and Fellows-That Is the Question.

To Boost or Not to Boost Residents and Fellows-That Is the Question.

Transmission of B.1.617.2 Delta variant between vaccinated healthcare workers

Breakthrough infections with SARS-CoV-2 Delta variant have been reported in doubly-vaccinated recipients and as re-infections. Studies of viral spread within hospital settings have highlighted the potential for transmission between doubly-vaccinated patients and health care workers and have highlighted the benefits of high-grade respiratory protection for health care workers. However the extent to which vaccination is preventative of viral spread in health care settings is less well studied. Here, we analysed data from 118 vaccinated health care workers (HCW) across two hospitals in India, constructing two probable transmission networks involving six HCWs in Hospital A and eight HCWs in Hospital B from epidemiological and virus genome sequence data, using a suite of computational approaches. A maximum likelihood reconstruction of transmission involving known cases of infection suggests a high probability that doubly vaccinated HCWs transmitted SARS-CoV-2 between each other and highlights potential cases of virus transmission between individuals who had received two doses of vaccine. Our findings show firstly that vaccination may reduce rates of transmission, supporting the need for ongoing infection control measures even in highly vaccinated populations, and secondly we have described a novel approach to identifying transmissions that is scalable and rapid, without the need for an infection control infrastructure.

Long-term antibody response following SPUTNIK V primary vaccination in healthcare workers with and without history of SARS-CoV-2 infection: Prospective cohort study from a hospital in Argentina

BackgroundIn December 2020, Sputnik V was incorporated to the National COVID-19 Immunization Plan in Argentina. Studies had shown 98% of antibody response rate. To date, data on immunogenicity and antibody persistence in Argentina are scarce.The objective was to assess humoral immune response after two doses of Sputnik V in Health Care Workers (HCWs) at the Ricardo Gutierrez Children’s Hospital (RGCH). MethodsA prospective, cohort study in HCWs immunized with two doses of Sputnik V between February and March 2021. The following variables were assessed: age, gender, risk factors for severe COVID-19 or mortality, immunosuppressive therapy and history of SARS-CoV-2. Blood samples were drawn on the day of the first dose, 28 days and 180 days after the second. Anti-Spike IgG was measured using an ELISA assay. Differences in immune response were evaluated according to study variables. Comparison analyses between groups with or without history of infection were performed, with T-test and ANOVA or Mann-Whitney tests. For each subject, we compared baseline values with 28 days and 180 days after the second vaccine.STATA version 14 and R Sofware were used for data analyses. ResultsWe included 528 individuals, mean age 41.5 years, 82.9% female, 14.4% (76/528) reported previous SARS-CoV-2 infection.All subjects developed antibodies post-vaccination. At day 28, concentrations were significantly higher in previously infected than naïve subjects (p < 0.001) with no differences according to age, gender and comorbidities.At day 180, 17% (95% CI 13.17–21.53) of naïve subjects were negative. Antibody concentrations decreased significantly in all subjects except in those who reported SARS-CoV-2 infection after vaccination (n = 31). This last group had significantly higher antibody concentrations. ConclusionThis study assessed immune response to a new COVID-19 vaccine in real life in a cohort of subjects. Antibody concentrations varied according to history of SARS-COV-2 infection and decreased over time.

Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines

ABSTRACT Introduction Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs’ hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. Method A short survey was carried out in May–June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. Results In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. Conclusion Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs.

Salivary, serological, and cellular immune response to the CoronaVac vaccine in health care workers with or without previous COVID-19

We investigated the anti-SARS-CoV-2 post-vaccine response through serum and salivary antibodies, serum antibody neutralizing activity and cellular immune response in samples from health care workers who were immunized with two doses of an inactivated virus-based vaccine (CoronaVac) who had or did not have COVID-19 previously. IgA and IgG antibodies directed at the spike protein were analysed in samples of saliva and/or serum by ELISA and/or chemiluminescence assays; the neutralizing activity of serum antibodies against reference strain B, Gamma and Delta SARS-CoV-2 variants were evaluated using a virus neutralization test and SARS-CoV-2 reactive interferon-gamma T-cell were analysed by flow cytometry. CoronaVac was able to induce serum and salivary IgG anti-spike antibodies and IFN-γ producing T cells in most individuals who had recovered from COVID-19 and/or were vaccinated. Virus neutralizing activity was observed against the ancestral strain, with a reduced response against the variants. Vaccinated individuals who had previous COVID-19 presented higher responses than vaccinated individuals for all variables analysed. Our study provides evidence that the CoronaVac vaccine was able to induce the production of specific serum and saliva antibodies, serum virus neutralizing activity and cellular immune response, which were increased in previously COVID-19-infected individuals compared to uninfected individuals.

Pengetahuan, Sikap dan Praktik Analis Kesehatan di Rumah Sakit X Provinsi Riau tentang Vaksinasi Hepatitis B

Hepatitis B is still one of public health problems in the world including in Indonesia. The most vulnerable group to hepatitis B virus exposure is healthcare workers including clinical laboratory technicians. The best way to prevent hepatitis B infection is by getting vaccination. Therefore clinical laboratory technicians are among prioritized subject in getting hepatitis B vaccination. However, hepatitis B vaccination for healthcare workers is not an obligation yet. The purpose of this study was to determine the knowledge, attitude and practice of hepatitis B vaccination among clinical laboratory technicians at X Hospital of Riau Province. This descriptive cross-sectional study was carried out between October 2021 and January 2022. Overall, 38 clinical laboratory technicians were recruited for this study. The Kolmogorov-Smirnov test is used to determine the relationship between knowledge with attitudes and practice. The results showed that 52.6% of respondents had good knowledge, 57.9% had a positive attitude and 68.4% had not been vaccinated against hepatitis B. Based on the results of bivariate analysis, there was no relationship between knowledge and attitude (p&gt;0.05) or practice (p&gt;0.05). Although more than 50% of respondents had good knowledge and attitude, the low number of clinical laboratory technicians in getting the hepatitis B vaccine remains a particular concern.

Multifactorial influences underpinning a decision on COVID-19 vaccination among healthcare workers: a qualitative analysis

ABSTRACT COVID-19 vaccination in healthcare workers (HCW) is essential for improved patient safety and resilience of health systems. Despite growing body of literature on the perceptions of COVID vaccines in HCWs, existing studies tend to focus on reasons for ‘refusing’ the vaccines, using surveys almost exclusively. To gain a more nuanced understanding, we explored multifactorial influences underpinning a decision on vaccination and suggestions for decision support to improve vaccine uptake among HCWs in the early phase of vaccination rollout. Semi-structured interviews were undertaken with thirty-three HCWs in Singapore. Transcribed data was thematically analyzed. Decisions to accept vaccines were underpinned by a desire to protect patients primarily driven by a sense of professional integrity, collective responsibility to protect others, confidence in health authorities and a desire to return to a pre-pandemic way of life. However, there were prevailing concerns with respect to the vaccines, including long-term benefits, safety and efficacy, that hampered a decision. Inadequate information and social media representation of vaccination appeared to add to negative beliefs, impeding a decision to accept while low perceived susceptibility played a moderate role in the decision to delay or decline vaccination. Participants made valuable suggestions to bolster vaccination. Our findings support an approach to improving vaccine uptake in HCWs that features routine tracking and transparent updates on vaccination status, use of institutional platforms for sharing of experience, assuring contingency management plans and tailored communications to emphasize the duty of care and positive outlook associated with vaccination.

SARS-CoV-2 antibody response after BNT162b2 mRNA vaccine in healthcare workers: Nine-month of follow-up

We collected sequential serum samples (0, 4, 12 weeks, 9 months) for the determination of S-RDB IgG levels from 103 vaccinated healthy subjects (age 45 ± 13 years; 60 women), in order to evaluate neutralizing antibody response against SARS-CoV-2 in healthy healthcare workers (HCWs) after the administration of two doses of BNT162b2 SARS-CoV-2 mRNA vaccine. Every subject received two doses of mRNA vaccine BNT162b2 (Pfizer-BioNTech), 21 days apart (January-February 2021). Furthermore, antibody titer of 14 subjects who were hospitalized for symptomatic COVID-19 was evaluated. Antibody response was (median, interquartile range) 35 U/mL (10–104) at baseline, 1960 (1241–3221) at 4 weeks, 791 (388–1179) at 12 weeks and 524 (273–931) at 6 months. Antibody response was inversely correlated with age at all timepoints (p < 0.001) while gender and Body Mass Index had no significant effect. At multivariate analysis, post-baseline values were significantly higher than baseline (p < 0.001) with a reduction at 12 weeks and 9 months (p < 0.001). Antibody response of hospitalized subjects who did not receive vaccination, symptomatic for COVID 19 infection, was 103 (25–557) U/mL, significantly higher than baseline (p = 0.007) of study population but lower than all post-baseline determinations (p < 0.001). Younger subjects showed a stronger response and a lower decrease of antibody titers compared to the classes of older subjects. SARS-CoV2 infection was excluded by performing 1017 nasopharyngeal RT-PCR swabs on the study cohort. The second dose of mRNA vaccine resulted in an antibody response effective in preventing infection in a population of healthcare professionals. The antibody level was stable through week 12, showing a reduction in the following six months.