ABSTRACT
Background Vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs and maintain essential healthcare services during influenza epidemics. With the present study we aimed to evaluate the efficacy of measures implemented during the three flu campaigns of 2018/19, 2019/20 and 2020/21 in a university hospital in Pisa, Italy, through the assessment of vaccination coverage (VC) in HCWs and to assess attitudes toward flu vaccination. Methods Flu VC was stratified according to sex, age, job and vaccination status for each season and the association between each variable and vaccination status was explored. In 2020, a survey collecting data on knowledge and attitudes on flu vaccination was distributed. Results Starting from the 2018/19 campaign, an increasing flu VC rate was registered: contained in 2019/20 (from 11.6% to 14.3%, Δ%=23.1) and significant (VC = 39.6%, Δ%=177.6) in 2020/21 as compared with the previous year. Physicians were the professionals most willing to get vaccinated during all seasons. Considering age the situation changed greatly over the study period, with VC rising in 2020/21 in those age groups marked by low VC in previous years (<30 and 41-50 years old, Δ%=293). Having been vaccinated in the previous year represented the most important variable to predict likelihood of accepting flu jab. However, while previously vaccinated HCWs were 13 times more likely to get the flu jab in 2019/20 compared with the others;in 2020/21 they were only 3 times. Only half of HCWS considered themselves at higher risk of contracting influenza compared to the general population, while 71% totally agreed that receiving the flu jab in 2020/21 was more important than the previous years due to COVID. Conclusions A significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years, due to the COVID pandemic that positively influenced vaccination uptake. Key messages • This study evaluates the impact of subsequent flu vaccination campaigns implemented in a large university hospital in Italy through the assessment of flu VC among HCWs. • A significant increase in flu VC among HCWs was observed in 2020/21, especially in those categories characterized by lower VC rates in the previous years, more likely due to the COVID-19 pandemic.
ABSTRACT
Background and aim: During coronavirus disease 2019 (COVID-19) pandemic, immumodulatory therapies as well as the access to high-risk places (i.e. hospitals, infusion centers) were associated to an increased risk of infection. Nevertheless, patients with inflammatory bowel diseases (IBD) treated with intravenous (i.v.) biologics had to move to hospital for drug infusion, in contrast to patients treated with subcutaneous (s.c.) therapies who could remain at home, monitored through telemedicine. We investigated whether patients hospitalized or treated at home showed similar COVID-19 risk, as well as the levels of anxiety in both groups Materials and methods: We conducted a survey including consecutive IBD patients in clinical and biochemical remission treated with biologics referring to the lockdown period. Patients underwent the normally scheduled clinical visits, performed at home by means of telemedicine for patients treated with s.c. drugs and only in specific cases for patients treated with i.v. therapies. We administered to all patients the Hospital Anxiety and Depression Scale (HADS) questionnaire and other 12 questions, specifically related to COVID and its implications. Group differences in continuous and nominal variables were tested by Kruskal–Wallis test and Fisher exact test, respectively Results: A total of 189 IBD patients were recruited, 112 (59.3%) treated with i.v. drugs and 77 (40.7%) with s.c. ones. No augmented risk of COVID infection were recorded in both groups (hospitalized vs. non-hospitalized, p=ns). The two groups of patients had similar scores in the 14 single items of the HADS questionnaire (p>0.10 for all). The total HADS score obtained by the sum of all items was also almost identical between groups (37.1±2.8 vs 37.2±2.8;p=0.98). In patients treated with i.v. drugs receiving a televisit (n=17), the rates of satisfaction about telemedicine (58.8%) and the lack of in-person care (33.3%) were significantly lower compared with those treated with s.c. drugs (94.8% and 92.2%, respectively;both p<0.0005). Conclusions: Our results suggest that there is no need to convert patients from i.v. to s.c. therapy during COVID-19 outbreaks, since the risk of infection and its transmission is not increased. Moreover, anxiety levels are similar in both groups, emphasizing that hospitalization seems not affecting the psychological status of the patients and therefore not increasing the relapse rate.
ABSTRACT
Anthony Fauci, an infectious disease expert in the White House's coronavirus task force, is challenged to offer responsible public communication of science despite working under a habitual liar who has no tolerance for criticism or dissent. Fauci manages this rhetorical exigence by using strategic ambiguity, the topos of the hon-est broker, dissociation, and a narrative that constrains executive decision making. © 2020 Penn State University Press. All rights reserved.