Norwegian Institute of Public Health, Cluster for Health Services Research, Postboks 222, Skøyen, N-0213, Oslo, Norway.
Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Faculty of Medicine, Lund, Sweden.
BMC Health Serv Res. 2021 Nov 13;21(1):1229. doi: 10.1186/s12913-021-07233-2.
Survey studies have found that vaccinated persons tend to report more side effects after being given information about side effects rather than benefits. However, the impact of high media attention about vaccine-related side effects on the utilization of health care is unknown. We aimed to assess whether utilization of health care services for newly vaccinated health care workers changed after media attention about fatal side effects of the AstraZeneca vaccine on March 11th, 2021, and whether changes differed by age, sex, or occupation.
We utilized individual-level data on health care use, vaccination, employment, and demographics available in the Norwegian emergency preparedness register Beredt C19. In all 99,899 health care workers in Norway who were vaccinated with AstraZeneca between February 11th and March 11th, we used an event-study design with a matched comparison group to compare the change in primary and inpatient specialist care use from 14 days before to 14 days after the information shock on March 11th, 2021.
Primary health care use increased with 8.2 daily consultations per 1000 health care workers (95% CI 7.51 to 8.89) the week following March 11th for those vaccinated with AstraZeneca (n = 99,899), compared with no increase for the unvaccinated comparison group (n = 186,885). Utilization of inpatient care also increased with 0.8 daily hospitalizations per 1000 health care workers (95% CI 0.37 to 1.23) in week two after March 11th. The sharpest increase in daily primary health care use in the first week after March 11th was found for women aged 18-44 (10.6 consultations per 1000, 95% CI 9.52 to 11.68) and for cleaners working in the health care sector (9.8 consultations per 1000, 95% CI 3.41 to 16.19).
Health care use was higher after the media reports of a few cases of fatal or severe side effects of the AstraZeneca vaccine. Our results suggest that the reports did not only lead vaccinated individuals to contact primary health care more, but also that physicians referred and treated more cases to specialist care after the new information.
调查研究发现，在接种者获得有关副作用的信息后，他们往往会报告更多的副作用。然而，关于媒体对与疫苗相关的副作用的高度关注对医疗保健的利用的影响尚不清楚。我们旨在评估在 2021 年 3 月 11 日媒体报道阿斯利康疫苗致命副作用后，新接种疫苗的卫生保健工作者对医疗服务的利用是否发生变化，以及这种变化是否因年龄、性别或职业而异。
我们利用挪威应急准备登记处 Beredt C19 中可获得的关于医疗保健使用、疫苗接种、就业和人口统计学的个人水平数据。在挪威所有于 2021 年 2 月 11 日至 3 月 11 日之间接种阿斯利康疫苗的 99899 名卫生保健工作者中，我们使用事件研究设计，使用匹配的对照组，比较了 3 月 11 日信息冲击前 14 天和后 14 天的初级和住院专科医疗保健使用变化。
与未接种疫苗的对照组（n=186885）相比，对于接种阿斯利康疫苗的人（n=99899），在 3 月 11 日之后的一周内，初级保健的使用增加了 8.2 次/每 1000 名卫生保健工作者的每日就诊（95%CI 7.51 至 8.89），而未接种疫苗的对照组则没有增加。在 3 月 11 日后的第二周，住院治疗的利用率也增加了 0.8 次/每 1000 名卫生保健工作者的每日住院治疗（95%CI 0.37 至 1.23）。在 3 月 11 日后的第一周内，每日初级保健使用率的急剧上升发生在 18-44 岁的女性（10.6 次就诊/每 1000 人，95%CI 9.52 至 11.68）和在医疗保健部门工作的清洁工（9.8 次就诊/每 1000 人，95%CI 3.41 至 16.19）。
在媒体报道阿斯利康疫苗少数几例致命或严重副作用后，医疗保健的使用增加了。我们的结果表明，这些报道不仅导致接种者更多地接触初级保健，而且还导致医生在获得新信息后将更多病例转诊和治疗至专科保健。
