Reactogenicity within the first week after Sinopharm, Sputnik V, AZD1222, and COVIran Barekat vaccines: findings from the Iranian active vaccine surveillance system.

BACKGROUND: This study aimed to evaluate the reactogenicity effects of COVID-19 vaccines, used in Iran. METHODS: At least 1000 people were followed up with phone calls or self-report in a mobile application within 7 days after vaccination. Local and systemic reactogenicities were reported overall and by subgroups. RESULTS: The presence of one or more local and systemic adverse effects after the first dose of vaccines was 58.9% [(95% Confidence Intervals): 57.5-60.3)] and 60.5% (59.1-61.9), respectively. These rates were reduced to 53.8% (51.2-55.0) and 50.8% (48.8-52.7) for the second dose. The most common local adverse effect reported for all vaccines was pain in the injection site. During the first week after the first dose of vaccines, the frequency of the pain for Sinopharm, AZD1222, Sputnik V, and Barekat was 35.5%, 86.0%, 77.6%, and 30.9%, respectively. The same rates after the second dose were 27.3%, 66.5%, 63.9%, and 49.0%. The most common systemic adverse effect was fatigue. In the first dose, it was 30.3% for Sinopharm, 67.4% for AZD1222, 47.6% for Sputnik V, and 17.1% for Barekat. These rates were reduced to 24.6%, 37.1%, 36.5%, and 19.5%, in the second dose of vaccines. AZD1222 had the highest local and systemic adverse effects rates. The odds ratio of local adverse effects of the AZD1222 vaccine compared to the Sinopharm vaccine were 8.73 (95% CI 6.93-10.99) in the first dose and 4.14 (95% CI 3.32-5.17) in the second dose. Barekat and Sinopharm had the lowest frequency of local and systemic adverse effects. Compared to Sinopharm, systemic adverse effects were lower after the first dose of Barekat (OR = 0.56; 95% CI 0.46-0.67). Reactogenicity events were higher in women and younger people. Prior COVID-19 infection increased the odds of adverse effects only after the first dose of vaccines. CONCLUSIONS: Pain and fatigue were the most common reactogenicities of COVID-19 vaccination. Reactogenicities were less common after the second dose of the vaccines. The adverse effects of AZD1222 were greater than those of other vaccines.

Barriers to hand hygiene compliance in intensive care units during the COVID-19 pandemic: A qualitative study.

Background: The practice of hand washing is an effective way to prevent contamination and disease transmission. Following the COVID-19 pandemic, hand washing has become increasingly important. Therefore, this qualitative study aimed to understand barriers to hand hygiene compliance among healthcare workers during the COVID-19 pandemic. Materials and methods: Twenty-five healthcare workers from intensive care units were sampled using purposive sampling in a qualitative content analysis study. Data were collected through a semi-structured interview and field notes. Based on the Lundman and Graneheim approach, the data were analyzed. COREQ checklist was used to report the research. Results: According to the findings, there are three main categories of barriers to hand hygiene practice: barriers related to individuals (including two subcategories of lack of knowledge of healthcare workers and healthcare workers' improper attitude), barriers related to management (including two subcategories of wrong behavioral patterns and unsuitable training and planning), and barriers related to organizations (including four subcategories of heavy workloads, improperly designed wards, a lack of equipment, and lack of quality equipment). Conclusions: This research indicates that hand washing practice increased during the COVID-19 pandemic. Nevertheless, some barriers persist, resulting in a decline in hand washing compliance among health care workers. This finding can help managers and policymakers remove barriers to hand washing compliance and improve healthcare workers' adherence to hand washing.

Psychological consequences and the related factors among COVID-19 survivors in southeastern Iran.

Introduction: Coronavirus disease-2019 (COVID-19) is a new viral disease that has spread rapidly worldwide since December 2019 and there is no effective treatment for it. The current study aimed to investigate the psychological consequences and related factors among COVID-19 survivors. Methods: This descriptive analytical study was conducted on 152 patients with COVID-19 referred to referral hospitals in southeastern Iran in 2020. Data collection tools were three questionnaires of demographic and background information, Depression Anxiety stress Scale (DASS-21) and Impact of Events Scale-Revised (IESR). Descriptive and inferential statistics and SPSS25 were used to analyze the data. Results: The mean age of patients was 39.52 ± 13.16 years. The patients were mostly female (63.8%). Seventy-three percent of the patients had severe posttraumatic stress disorder, 26.3% had moderate depression and 26.3% had severe anxiety. The mean scores of posttraumatic stress, depression, and anxiety among patients with COVID-19 were 41.59 ± 17.28, 12.13 ± 9.16, and 12.45 ± 10.71, respectively. Intensive care unit (ICU) admission, divorce, illiteracy, and retirement were all associated with higher psychological load among patients. Discussion and Conclusion: The results showed that patients with COVID-19 had different levels of anxiety, depression, and posttraumatic stress. These results may direct the attention of the medical staff to the mental health of COVID-19 patients, necessitating timely psychological care and intervention during an epidemic.

COVID-19 cases, hospitalizations and deaths after vaccination: a cohort event monitoring study, Islamic Republic of Iran.

Objective: To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated with either AZD1222 Vaxzevria, CovIran® vaccine, SARS-CoV-2 Vaccine (Vero Cell), Inactivated (lnCoV) or Sputnik V. Methods: We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings: Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0-542.7) for contracting COVID-19; 55.8 (95% CI: 51.4-60.5) for hospitalization; and 4.1 (95% CI: 3.0-5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61-0.80) with AZD1222; 0.73 (95% CI: 0.62-0.86) with Sputnik V; and 0.73 (95% CI: 0.63-0.86) with CovIran®. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69-0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion: The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.

COVID-19 cases, hospitalizations and deaths after vaccination: a cohort event monitoring study, Islamic Republic of Iran Cas, hospitalisations et décès liés à la COVID-19 après la vaccination: étude de cohorte portant sur la surveillance des événements en République islamique d'Iran Casos, hospitalizaciones y muertes por la COVID-19 tras la vacunación: un estudio de cohortes sobre el seguimiento de eventos en la República Islámica de Irán حالات كوفيد 19، حالات الاستشفاء والوفيات بعد التطعيم: دراسة رصد إترابي للأحداث، جمهورية إيران الإسلامية 接种疫苗后的新冠肺炎病例、住院率以及死亡率：伊朗伊斯兰共和国的一项事件监测队列研究 Случаи заражения COVID-19, госпитализации и смерти после вакцинации: когортное исследование мониторинга событий, Исламская Республика Иран

Objective To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated with either AZD1222 Vaxzevria, CovIran® vaccine, SARS-CoV-2 Vaccine (Vero Cell), Inactivated (lnCoV) or Sputnik V. Methods We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0–542.7) for contracting COVID-19;55.8 (95% CI: 51.4–60.5) for hospitalization;and 4.1 (95% CI: 3.0–5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61−0.80) with AZD1222;0.73 (95% CI: 0.62–0.86) with Sputnik V;and 0.73 (95% CI: 0.63–0.86) with CovIran®. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76;95% CI: 0.69–0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.

Self-Sacrifice in a Distressful and Threatening Environment: The Consequences of the COVID-19 Crisis in Intensifying Workplace Violence.

Background: The stress and mental pressure resulting from the challenges posed by the COVID-19 crisis exacerbated occupational stressors such as workplace violence against nurses even though nurses were endangering their lives to provide high-quality care and reduce patients' suffering. Therefore, the present study aimed to explain Iranian nurses' experiences of workplace violence during the COVID-19 crisis. Materials and Methods: This study was conducted using a qualitative approach. Twenty-five semi-structured interviews were conducted with nurses who had experienced workplace violence at COVID-19 referral centers in Kerman during the COVID-19 crisis. Conventional content analysis was used to analyze the data, and the research was reported via the COREQ checklist. Results: Analysis of the findings led to one main category, "nurses' self-sacrifice in a distressful and threatening environment," and four subcategories, which included "omitting entertainment and fun activities," "having challenging duties in unsafe conditions," "receiving insufficient support," and "nurses' toleration of disrespect." Conclusion: Crises can exacerbate workplace violence toward nurses. Thus, it is necessary to design educational programs and prevention strategies to manage the destructive psychological and occupational impact of the crises on nurses. Nurses should receive training in crisis management to cope with the intensified aggressive behavior of managers, colleagues, patients, and patient companions during the crisis. Policy-makers must be prepared to deal with crises, and they should take measures to improve nurses' mental health and quality of care.

Study protocol: cohort event monitoring for safety signal detection after vaccination with COVID-19 vaccines in Iran.

BACKGROUND: New vaccines that are initially approved in clinical trials are not completely free of risks. Systematic vaccine safety surveillance is required for ensuring safety of vaccines. This study aimed to provide a protocol for safety monitoring of COVID-19 vaccines, including Sputnik V, Sinopharm (BBIBP-CorV), COVIran Barekat, and AZD1222. METHODS: This is a prospective cohort study in accordance with a template provided by the World Health Organization. The target population includes citizens of seven cities in Iran who have received one of the available COVID-19 vaccines according to the national instruction on vaccination. The participants are followed for three months after they receive the second dose of the vaccine. For each type of vaccine, 30,000 people will be enrolled in the study of whom the first 1,000 participants are in the reactogenicity subgroup. The reactogenicity outcomes will be followed seven days after vaccination. Any hospitalization, COVID-19 disease, or other minor outcomes will be investigated in weekly follow-ups. The data are gathered through self-reporting of participants in a mobile application or phone calls to them. The study outcomes may be investigated for the third and fourth doses of vaccines. Other long-term outcomes may also be investigated after the expansion of the follow-up period. We have planned to complete data collection for the current objectives by the end 2022. DISCUSSION: The results of this study will be published in different articles. A live dashboard is also available for managers and policymakers. All data will be available on reasonable requests from the corresponding author.The use of the good and comprehensive guidelines provided by WHO, along with the accurate implementation of the protocol and continuous monitoring of the staff performance are the main strengths of this study which may be very useful for policymaking about COVID-19 vaccination.

Prevalence and Motives of Social Media Use among the Iranian Population.

Background: Around the world, people are using social media (SM) for different purposes following a wide range of patterns. There is a paucity of studies addressing the issue in the Eastern Mediterranean region. In this population-based study, the frequency and patterns of SM use in Iran were investigated. Materials and Methods: To explore the prevalence and motives of SM use, a sample of 1800 Iranian people aged 10-65 years old (53.5% female) were surveyed. Social media addiction (SMA) was assessed using the Bergen Social Media Addiction Scale. Results: The results revealed that 88.5% (n = 1593) of the participants were SM users, and the average time spent by them in SM was 4.0 ± 3.9 hours. The most common motivations for SM use were communication with others (48.9%), receiving news (40.7%), and surfing the net (40.6%). Besides, burning eyes (31.0%), headache (26.8%), and sleep disturbance (25.1%) were the most common health problems experienced by SM users. The SMA prevalence was 23.1% (95% CI: 21.2, 25.1) (males: 23.8%; females: 22.5%), with a higher rate (26.0%) among adolescents and young people. Conclusion: SM use and SMA appear to be real health challenges in Iran, particularly among youth. Consequently, to decrease the negative impacts of excessive SM use, exploring the motives behind SM use and designing population-based interventions are recommended.

Use of complementary and alternative medicine in general population during COVID-19 outbreak: A survey in Iran.

OBJECTIVE: Some epidemic diseases such as coronavirus disease 2019 (COVID-19) have caused many physical, psychological, and social challenges, despite the existence of treatment strategies. Many people are looking for complementary and alternative medicine (CAM) to prevent such diseases. The present study was performed to determine how some types of CAM were being used during the COVID-19 epidemic in Iran. METHODS: The present study had a cross-sectional descriptive correlational design. All Iranian residents above 17 years old were eligible to participate in the study. A total of 782 participants completed a demographic information questionnaire, a questionnaire about their use of CAMs and a questionnaire about their satisfaction with the CAMs they used. Web-based sampling was conducted from 20 April 2020 to 20 August 2020. RESULTS: Of the participants, 84% used at least one type of CAM during the COVID-19 outbreak. The most used CAMs were dietary supplements (61.3%), prayer (57.9%), and herbal medicines (48.8%). The majority of the participants (50%-66%) have used CAMs to prevent the transmission of COVID-19 or to reduce anxiety caused by the COVID-19 pandemic. CAM use was associated with sex, having children, place of residence, COVID-19 status, and source of gathering information about CAM (P < 0.05). All 32 participants who had been infected with COVID-19 used at least one type of CAM for treatment or alleviation of the disease symptoms. CONCLUSION: During the COVID-19 outbreak, some types of CAM, particularly nutritional supplements, medicinal herbs, and prayer, were commonly used to prevent COVID-19 and reduce pandemic-related anxiety.

Effectiveness of resilience training on social self-efficacy of the elementary school girls during COVID-19 outbreak.

Children, especially girls, are more vulnerable during crises, who need to acquire skills such as social self-efficacy to meet the challenges of the environment. Given that, much progress has been made in e-learning; its capabilities can be used to promote children's health. This study aimed to determine the effect of virtual resilience training on the social self-efficacy of elementary school girls. This experimental study was performed on primary school girls aged 9-10 years in southeastern Iran. Students were selected by convenience sampling and divided into intervention (n = 40) and control (n = 37) groups by using randomized allocation. The Children's Social Self-Efficacy in Peer Interaction Scale was used for data collection before, immediately, and one month after the intervention. No significant difference was found between the two groups of intervention and control in the score of social self-efficacy before the intervention. However, the score of students in the intervention group improved immediately and one month after the intervention, and a significant difference was observed between the two groups (p = .0001). Virtual resilience training has improved the social self-efficacy of elementary school girls and facing challenges is inevitable in today's world, so resilience training seems necessary to prevent social and psychological harm in such children.

Fear and anxiety in girls aged 7 to 11 years old and related factors during the coronavirus pandemic.

Children are one of the most vulnerable groups in crises. The psychological consequences of COVID-19 in children must be considered. This study aimed to assess the fear and anxiety of COVID-19 in primary school girls. It is a descriptive correlational study to investigate schoolgirls' fear and anxiety of covid-19 in southeastern Iran. Data were collected using the fear of coronavirus questionnaire and the Corona Disease Anxiety Scale. The mean score of fear and anxiety of corona disease was 11.49 ± 6.59 and 17.67 ± 10.87, respectively. The bivariate analysis showed a significant association between fear and anxiety of corona disease, a single child (p = .025 and p = .006), and a mother's level of education (p = .01). In other words, girls who were single child had a significantly higher level of fear and anxiety than other girls and the girls whose mothers had diploma had a higher level of fear and anxiety than girls whose mothers had Ph.D. Since fear and anxiety can be affected by factors such as culture, education level, and birth rate, it is recommended that this study be performed in other communities as well.

The Impact of COVID-19 Outbreak on Nosocomial Infection Rate: A Case of Iran.

BACKGROUND: Coronavirus disease-19 (COVID-19) is a new type of coronavirus that has caused a global pandemic. The disease is highly contagious, and all people are susceptible to the disease. Therefore, extensive measures were taken to prevent the spread of the disease at the community and hospitals. This study aimed to investigate the impact of COVID-19 outbreak on nosocomial infection rate. METHODS: This cross-sectional study was conducted in an educational hospital, southeast Iran. The nosocomial infection rates of critical/intensive care units (CCU/ICUs) and medical-surgical units were assessed during and before the COVID-19 outbreak. RESULTS: There was a 19.75-point decrease in the total rate of nosocomial infection during the COVID-19 outbreak (P = 0.02). In addition, there was a 39.12-point decrease in the total rate of CCU/ICUs' nosocomial infection during the COVID-19 outbreak (P < 0.001). A 19.23-point decrease was also observed in the total rate of medical-surgical units' nosocomial infection during the COVID-19 outbreak (P = 0.13). All kinds of CCU/ICUs' nosocomial infections had between 31.22- and 100-point decreases during the COVID-19 outbreak. Among medical-surgical units, 33.33- and 30.70-point decreases were observed only in UTI and SSI, respectively, during the COVID-19 outbreak, while BSI had a 40-point increase during the COVID-19 outbreak. CONCLUSIONS: Proper implementation of infection control protocols during the COVID-19 pandemic seems to reduce nosocomial infections.