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mRNA 疫苗对遏制 COVID-19 大流行期间医护人员 SARS-CoV-2 感染和病假利用的影响:休斯顿大都市区三级医疗系统的横断面分析。

Impact of mRNA vaccines in curtailing SARS-CoV-2 infection and disability leave utilisation among healthcare workers during the COVID-19 pandemic: cross-sectional analysis from a tertiary healthcare system in the Greater Houston metropolitan area.

机构信息

Houston Methodist, Houston Methodist Academic Institute, Houston, Texas, USA

Center for Outcomes Research, Houston Methodist, Houston, Texas, USA.

出版信息

BMJ Open. 2021 Oct 12;11(10):e054332. doi: 10.1136/bmjopen-2021-054332.

Abstract

OBJECTIVES

We provide an account of real-world effectiveness of COVID-19 vaccines among healthcare workers (HCWs) at a tertiary healthcare system and report trends in SARS-CoV-2 infections and subsequent utilisation of COVID-19-specific short-term disability leave (STDL).

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Summary data on 27 291 employees at a tertiary healthcare system in the Greater Houston metropolitan area between 15 December 2020 and 5 June 2021. The initial 12-week vaccination programme period (15 December 2020 to 6 March 2021) was defined as a rapid roll-out phase.

MAIN OUTCOMES AND MEASURES

At the pandemic onset, HCW testing and surveillance was conducted where SARS-CoV-2-positive HCWs were offered STDL. Deidentified summary data of SARS-CoV-2 infections and STDL utilisation among HCWs were analysed. Prevaccination and postvaccination trends in SARS-CoV-2 positivity and STDL utilisation rates were evaluated.

RESULTS

Updated for 5 June 2021, 98.2% (n=26 791) of employees received a full or partial dose of one of the approved mRNA COVID-19 vaccines. The vaccination rate during the rapid roll-out phase was approximately 3700 doses/7 days. The overall mean weekly SARS-CoV-2 positivity rates among HCWs were significantly lower following vaccine roll-out (2.4%), compared with prevaccination period (11.8%, p<0.001). An accompanying 69.8% decline in STDL utilisation was also observed (315 to 95 weekly leaves). During the rapid roll-out phase, SARS-CoV-2 positivity rate among Houston Methodist HCWs declined by 84.3% (8.9% to 1.4% positivity rate), compared with a 54.7% (12.8% to 5.8% positivity rate) decline in the Houston metropolitan area.

CONCLUSION

Despite limited generalisability of regional hospital-based studies-where factors such as the emergence of viral variants and population-level vaccine penetrance may differ-accounts of robust HCW vaccination programmes provide important guidance for sustaining a critical resource to provide safe and effective care for patients with and without COVID-19 across healthcare systems.

摘要

目的

我们提供了在三级医疗保健系统中医疗保健工作者(HCWs)中 COVID-19 疫苗真实有效性的描述,并报告了 SARS-CoV-2 感染的趋势以及随后 COVID-19 特定短期残疾休假(STDL)的利用情况。

设计

横断面研究。

地点和参与者

2020 年 12 月 15 日至 2021 年 6 月 5 日期间,休斯顿大都市区一家三级医疗保健系统的 27291 名员工的汇总数据。最初的 12 周疫苗接种计划期(2020 年 12 月 15 日至 2021 年 3 月 6 日)被定义为快速推出阶段。

主要结果和措施

在大流行开始时,对 SARS-CoV-2 呈阳性的 HCW 进行了检测和监测,为他们提供了 STDL。分析了 HCW 中 SARS-CoV-2 感染和 STDL 利用率的无标识符汇总数据。评估了疫苗接种前后 SARS-CoV-2 阳性率和 STDL 利用率的趋势。

结果

截至 2021 年 6 月 5 日更新,98.2%(n=26791)的员工接受了一种或多种批准的 mRNA COVID-19 疫苗的全剂量或部分剂量。在快速推出阶段,疫苗接种率约为 3700 剂/7 天。与疫苗接种前相比,疫苗接种后 HCW 的总体平均每周 SARS-CoV-2 阳性率(2.4%)明显较低(p<0.001)。同时,也观察到 STDL 利用率下降了 69.8%(每周休假从 315 次减少到 95 次)。在快速推出阶段,休斯顿卫理公会 HCW 的 SARS-CoV-2 阳性率下降了 84.3%(从 8.9%降至 1.4%阳性率),而休斯顿大都市区的阳性率下降了 54.7%(从 12.8%降至 5.8%阳性率)。

结论

尽管基于区域医院的研究的推广性有限,因为病毒变异和人群疫苗接种率等因素可能有所不同,但对强有力的 HCW 疫苗接种计划的描述为维持医疗保健系统中为患有和不患有 COVID-19 的患者提供安全有效的护理的关键资源提供了重要指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a2b/8520585/b24175d2abec/bmjopen-2021-054332f01.jpg

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