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1.
Ethics Med Public Health ; 28: 100901, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-2293771

ABSTRACT

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.

2.
Malta Medical Journal ; 34(3):12-18, 2022.
Article in English | EMBASE | ID: covidwho-2003145

ABSTRACT

BACKGROUND Vaccination against COVID-19 is crucial for controlling this scourge. COVID/vaccination deniers often rationalise their unfounded fears by citing rare vaccination side-effects. One of the most frequently cited side effects is myocarditis, especially in younger persons. Malta has very high vaccination rates. This study was carried out to ascertain whether admissions to hospital for myocarditis changed during the vaccination rollout, up to October 2021, when 83.4% of Malta’s population of circa half a million had had their first 1st dose. METHODS Malta is served by one large regional hospital (Mater Dei Hospital). Anonymous data for admissions with a diagnosis of myocarditis (ICD I40, I41, I51.4) were obtained for 01/2016-10/2021. Myocarditis discharges and 95% confidence intervals were plotted for 2016-2020. Myocarditis discharges for Jan-Oct 2021 were plotted separately. RESULTS There were no outlier values for myocarditis discharges in either direction for any age for either sex. CONCLUSION Myocarditis, independent of vaccination, is commonest in young males, half resolving and some developing dilated cardiomyopathy, possibly leading to transplantation or death. The ongoing mass vaccination with novel messenger RNA vaccines resulted in reports of myocarditis in male teens, this being a rare side effect. The lack of significantly increased rates of myocarditis admission in any age age/sex group in Malta confirms that only rarely, myocarditis may be temporally associated with COVID vaccination which almost invariably runs a benign course and that this risk is very low, far lower than myocarditis due to actual COVID infection.

3.
Malta Medical Journal ; 34(3):39-49, 2022.
Article in English | EMBASE | ID: covidwho-2003071

ABSTRACT

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.

4.
Malta Medical Journal ; 34(1):35-42, 2022.
Article in English | EMBASE | ID: covidwho-1812692

ABSTRACT

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.

5.
Malta Medical Journal ; 34(1):17-26, 2022.
Article in English | GIM | ID: covidwho-1717045

ABSTRACT

Introduction: COVID-19 remains pandemic and public health measures included school closures following a precautionary principle in that many previous epidemics (e.g. influenza) were mainly transmitted by children. This paper reviews school outbreaks to date, including in Malta.

6.
Malta Medical Journal ; 34(1):69-75, 2022.
Article in English | GIM | ID: covidwho-1716844

ABSTRACT

Introduction: An effective vaccine may help us to exit the COVID-19 pandemic. General Practitioners/Family Doctors (GPs/FDs) play a vital role in public vaccination in most countries and they also serve as role models. However, they may not always follow national vaccination policies. This study was carried out in order to ascertain the degree of vaccine hesitancy of GPs and GP trainees in Malta vis-..-vis influenza vaccination and a putative novel COVID-19 vaccine.

7.
Malta Medical Journal ; 34(1):5-16, 2022.
Article in English | GIM | ID: covidwho-1716809

ABSTRACT

Introduction: Social distancing mandated by COVID-19 so as to slow viral spread resulted in school closures in 2020. Reopening schools could be safe if accompanied by precautionary measures. This paper describes the events leading up to school closures in Malta with reference to San Andrea independent school, and the measures and contingency plans created by the school during Malta's soft lockdown and summer holidays for safe school reopening.

8.
Malta Medical Journal ; 34(1):58-68, 2022.
Article in English | GIM | ID: covidwho-1716808

ABSTRACT

Background: In the COVID-19 pandemic, vaccination was identified as being of significant importance to prevent virus spread and to move towards re-introducing normality in everyday life. As the influenza season approached in autumn 2020, the importance of the influenza vaccine was highlighted as a mitigation strategy to limit the consequences and risk of co-infection with the influenza virus and COVID-19. The aim of the study was to evaluate the degree of hesitancy of pharmacists and pharmacy students towards influenza and COVID-19 vaccines in autumn 2020.

9.
Dubai Medical Journal ; : 7, 2021.
Article in English | Web of Science | ID: covidwho-1551100

ABSTRACT

Introduction: Non-communicable diseases (NCDs) have been a global epidemic long before the advent of COVID-19. Understandably, with the onset of COVID-19, health priorities shifted. The aim of this study was to explore the impact of COVID-19 through attitudes and experiences on the health and well-being of the Malta adult population suffering from NCDs, a year into COVID-19. Methods: An anonymous survey was distributed online between February 1 and 26, 2021 using Google Forms(R). This assessed the impact of COVID-19 on medical care, intention to take a COVID-19 vaccine, and whether COVID-19 was acquired. Quantitative and qualitative analyses were performed. Results: Out of the 1,034 participants, 34.82% (95% CI, 31.97-37.77;n = 360) reported to suffer from NCDs (single NCD, n = 276;2 NCDs, n = 56;3 NCDs, n = 28) with 6.94% (95% CI, 4.71-10.09) of these reported acquiring COVID-19. Since COVID-19, the NCD population visited the general practitioners less (47%) than those without NCDs (32%) (p <= 0.001). With a consensus of concern and fear, "I rather skip check-ups than risk getting COVID-19 in waiting room or clinic." Postponement and cancellations of medical appointments were reported: "had to do blood tests privately as health centre was not doing them" and "delayed treatment and still awaiting further appointments that were postponed more than once." The majority intended to take COVID-19 vaccine. Conclusions: It is clear that individuals with NCDs have experienced a general negative effect on their medical care. It's recommended that a dual action strategy is embraced to ensure that both NCDs and COVID-19 are treated simultaneously, leaving no one behind.

10.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514547

ABSTRACT

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.

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