ABSTRACT
Background. Healthcare workers have experienced a significant burden of COVID-19 disease. COVID mRNA vaccines have shown great efficacy in prevention of severe disease and hospitalization due to COVID infection, but limited data is available about acquisition of infection and asymptomatic viral shedding. Methods. Fully vaccinated healthcare workers at a tertiary-care academic medical center in Omaha Nebraska who reported a household exposure to COVID-19 infection are eligible for a screening program in which they are serially screened with PCR but allowed to work if negative on initial test and asymptomatic. Serial screening by NP swab was completed every 5-7 days, and workers became excluded from work if testing was positive or became symptomatic. Results. Of the 94 employees who were fully vaccinated at the time of the household exposure to COVID-19 infection, 78 completed serial testing and were negative. Sixteen were positive on initial or subsequent screening. Vaccine failure rate of 17.0% (16/94). Conclusion. High risk household exposures to COVID-19 infection remains a significant potential source of infections in healthcare workers even after workers are fully vaccinated with COVID mRNA vaccines especially those with contact to positive domestic partners.
ABSTRACT
Background: Better data on medicines use can inform better decisions, better health systems, and better patient outcomes. More African studies of medicines use are emerging, especially those using routinely-collected data. Such work is even more pressing given the growing burden of non-communicable diseases (NCD) - where medicines are often the mainstay of treatment - and additional challenges in financing sustainable health systems for universal health coverage and the ongoing COVID-19 pandemic. Objective: To describe how medicines use studies can strengthen health systems (focus on Ghana). Methods: We identified sources of data: national health insurance systems (public and private);district level health information systems (DHIMS2);health service and hospital data;together with commercial local, regional, and global data. Data users need to be mindful of appropriate data governance and privacy of patient's records. Results and Conclusions: 1. Rational use of medicines: adherence with standard treatment guidelines, treatment pathways, potential cost savings, pharmacovigilance 2. Health Technology Assessment: key inputs for cost-effectiveness and budget impact analysis of medicines for inclusion within a benefits package. 3. Patterns of disease: explore prevalence and incidence of disease (especially NCDs) plus comorbidities using medicines use as a proxy for diseases, particularly in the absence of other high-quality epidemiological data. 4. Health Policy + Monitoring and Evaluation: developing essential medicines lists and treatment guidelines;key indicators in M&E of health systems. 5. Building research capacity: promoting researchers in pharmacoepidemiology using identified and accessible data sources. Initial steps in Africa can develop with continued training and support.