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Background: Covid-19 is still pandemic with population vaccination, including among children, remaining the mainstay for hastening the exit from the pandemic. The article provides an insight in Malta's national paediatric vaccination modus operandi, vaccination uptake, and epidemiological trends while exploring geographical social inequalities among the ≤ 15 years cohort up till end of August 2022. Methods: The Vaccination Coordination Unit in Malta's only regional hospital provided an account of the strategic roll-out along with anonymised cumulative vaccination doses by age band and district. Descriptive and multivariant logistic regression analyses were performed. Results: By mid-August 2022, 44.18% of the under 15's population had received at least 1 vaccine dose. A bi-directional relationship was observed between increased cumulative vaccination and reported Covid-19 cases until early 2022. Central vaccination hubs were set up with invitation letters and SMSs sent to parents. Children residing in the Southern Harbour district (OR: 0.42, P < 0.01) had the highest full vaccination uptake (46.66%) as opposed to the Gozo district (lowest at 27.23%; OR: 0.3, P = 0.01). Conclusion: Successful paediatric vaccination is not only dependent on easily accessible vaccination but also on vaccine effectiveness against variants, as well as population characteristics, with potential geographical social inequalities hindering uptake.
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INTRODUCTION Vaccine hesitancy is a chronic public health threat. This study was carried out to ascertain Maltese healthcare workers’ hesitancy to COVID-19 vaccination and correlate this with influenza vaccine uptake. METHODS A short, anonymous questionnaire was sent out to all of Malta’s government sector healthcare workers via the service’s standard email services (11-19/09/2020). A total of 9,681 questionnaires were posted electronically, with 10.4% response. RESULTS The proportion of Maltese healthcare workers who “will take” the influenza vaccine increased significantly. Doctors had the highest baseline uptake and highest likely influenza vaccine uptake next winter. The likely/undecided/unlikely to take a COVID-19 vaccine were 52/22/26% respectively. Males were likelier to take the vaccine. Doctors had the highest projected likelihood to take vaccines. Likelihood of taking COVID-19 vaccine was directly related to the likelihood of influenza vaccination. Concerns raised were related to insufficient knowledge about such a novel vaccine, especially unknown long term side effects. DISCUSSION The anticipated increased uptake of influenza vaccine is probably due to increased awareness of respiratory viral illness. Doctors may have higher vaccine uptakes due to greater awareness and knowledge of vaccine safety. The proportions of who are likely/undecided/unlikely (half, quarter, quarter respectively) to take a COVID-19 are similar to rates reported in other countries. The higher male inclination to take the vaccine may be due the innate male propensity for perceived risk taking. Shared COVID-19 with influenza vaccine hesitancy implies an innate degree of vaccine reluctance/hesitancy and not merely reluctance based on novel vaccine knowledge gap.
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BACKGROUND COVID-19 was a global shock, causing challenges to many countries’ healthcare services. This paper provides a summary of Malta’s healthcare system journey during the COVID-19 pandemic with its initial preparedness for COVID-19 pandemic and the impact of COVID-19 on the service during the first 12 months of the pandemic. METHODS A literature search was conducted using Google and reviewing Maltese online newspapers. A comprehensive summary of internal operations conducted at Mater Dei Hospital, the country’s only acute general hospital, was provided by the Chief Operating Officer. RESULTS Several infrastructural changes including the increase in bed capacity and ITU areas were instituted in preparation for the pandemic. The health system showed resilience during the first wave. However, the situation was more precarious during the second wave. The end of December 2020 saw the start of the Covid-19 vaccination rollout, with over 30 health system hubs offering this service across the islands. Simultaneously health professional’s burnout is on the rise as resources and workforce are overstretched. CONCLUSION The collaborative effort between the guidance provided by the Public Health Authorities and the hospital’s multi-disciplinary team have been pinnacle during the pandemic. However, the future of the healthcare system is heavily dependent on the population’s behaviour, timely measures, the vaccination rollout and the type of immunity acquired through vaccination or infection.
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Background COVID-19 vaccination is critical to protect healthcare workers (HCWs) from serious infection. The first vaccine approved for emergency use was the Pfizer-BioNtech vaccine. European countries received their first supplies at the end of December 2020. The European country of Malta started its vaccination roll-out immediately targeting HCWs. The aim of this study was to evaluate side effects. Methods An anonymous online Google Forms survey was disseminated to all HCWs via work e-mail addresses (29th March to 9th April 2021). This gathered demographic data and side-effects regarding pain, redness, and swelling at the injection site, fever, chills, fatigue, muscle/joint pains, headache, vomiting, and diarrhea severity following each dose (Likert scale). Descriptive, comparative, and multiple binary regression analyses were performed. Results There were 1480 responses (response rate 30.30%). The commonest side-effect (SE) was pain at the injection site (88.92% CI95%:87.21-90.42), with the majority reporting it as mild (51%) and moderate (43%). Fatigue reported by 72.97% (CI95%:70.65-75.17), with 42% reporting it as mild and 41% as moderate. Headaches reported by 44.28% (CI95%:41.74-46.80), with 51% claiming to be mild and 34% as moderate. Females had significantly (p = <0.01 respectively) more pain (OR:1.90), redness (OR:2.49), swelling at the injection site (OR:1.33), fever (OR:1.74), chills (OR:2.32), fatigue (OR:2.43), muscle (OR:1.54) and joint pains (OR:2.01), headache (OR:2.07) and vomiting (OR:3.43) when adjusted for age and HCW role. Younger individuals (18-34 years) reported higher SE rates than older adults. Localised SE was reported following both vaccine doses, unlike systemic SE that was mostly reported following second doses. Conclusions Females and young adults appeared to be more susceptible to SE among this study's cohort, however the nature of these SE was mostly mild or moderate. This is encouraging and should allay vaccine apprehension/hesitancy. Key messages Vaccination benefits outweigh the minor side effects experienced. Caring physicians should be notified of the female higher susceptibility to side effects. Vaccination should be encouraged among all eligible population.