ABSTRACT
Background. Introduction: Health care personnel (HCP) are at increased risk for SARS-CoV-2 exposure. However, the exposure sources among HCP are poorly understood. Methods. Design(s): We conducted active surveillance for all employed HCP newly diagnosed with COVID-19 between March 2020 and February 2022. We inquired about their sources of exposure using a standardized health department checklist and CDC guidance for managing healthcare personnel with SARS-CoV-2 infection or exposure. Results. Among all 8,766 HCP, 2,220 (25.3%) tested positive. Among positive cases, 749 (33.7%), 651 (29.3%), and 221 (10%) were among ancillary services HCP, RNs, and allied HCP, respectively (Table 1). The majority of the sources of exposures were unknown (57.8%), followed by household (26.2%), community (10.5%), and health care (5.5%), respectively. The incidence of COVID-19 increased with level of patient contact regardless of source of exposure. The majority of the cases, N=1054 (47.5%), occurred among HCP who were not up-to-date on COVID-19 vaccines and had unknown exposure, and vaccination status varied by source of exposure (Table 2). HCP COVID-19 cases mirrored transmission in the community (Figure). Conclusion. The majority of HCP cases had no known exposure to SARS-CoV-2 and were not up-to-date on COVID-19 vaccines highlighting the importance of vaccination as the single most effective mean to COVID-19 prevention among HCP.
ABSTRACT
Background: All Hospital Trusts in England are expected to offer influenza vaccination to eligible inpatients during Winter 2020-21. There is currently no data on which to model need and uptake of this approach by clinicians and patients. (Figure presented) In 2018 addressing vaccination status was added to the COPD 'Bundle' used in our hospital, electronic influenza vaccine prescription was introduced following NICE guidance recommending offering vaccination to eligible inpatients and checking vaccination status and offering to appropriate patients was included in respiratory ward reviews. Aim: To evaluate the uptake and characteristics of inpatients offered and accepting influenza vaccination over Winter 2018-19 and 2019-20 in one Acute Trust. Methods: Data on inpatient influenza vaccine prescriptions between October-March 2018-19 and 2019-20 was obtained from our electronic prescribing system. Electronic records of each admission were reviewed and analysed for patient demographics, reason for admission, indication for vaccination, ward and mortality at June 2020. Results: See table 1 for results. 159 inpatient vaccinations were administered over 2 years. Mean (range) age was 62 (18-94) years and mortality at 1+ year was 28%. 114 (72%) were on our 23-bed respiratory ward. By year 2, 32% (28/88) vaccines were administered on other wards. 2/3 vaccines were for patients with COPD or asthma. Discussion: Our data suggests that offering influenza vaccination to inpatients is a feasible and sustainable intervention for which there is patient demand. Approximately 2 vaccinations/week were administered on a 23-bed respiratory ward. Inpatients were also vaccinated on other wards;with >60% increase on elderly-care wards in year 2. This was largely due to prescribing by trainees who had completed a respiratory rotation and continued to offer vaccination in subsequent roles. The high snap-shot mortality at June 2020 (28% 1 year+) is a reminder of the high risk of death for inpatients eligible for influenza vaccination. Our findings suggest that clinicians want to offer vaccination and that there are groups of unvaccinated inpatients who take up the offer of influenza vaccination. In the era of COVID-19, it is particularly important this population is vaccinated. Face-to-face contact during admission is an opportunity we should be using to do this.