Houston Methodist, Houston Methodist Academic Institute, Houston, Texas, USA
Center for Outcomes Research, Houston Methodist, Houston, Texas, USA.
BMJ Open. 2021 Oct 12;11(10):e054332. doi: 10.1136/bmjopen-2021-054332.
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).
Cross-sectional study.
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.
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.
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.
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.
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。
横断面研究。
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。
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。
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)。
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。