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美国纽约大都市区医护人员中的 SARS-CoV-2 感染和对 COVID-19 疫苗的态度。

SARS-CoV-2 infections and attitudes towards COVID-19 vaccines among healthcare workers in the New York Metropolitan area, USA.

机构信息

Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA

COVID-19 Test and Trace Corps, New York, New York, USA.

出版信息

Fam Med Community Health. 2022 Jul;10(3). doi: 10.1136/fmch-2022-001692.

Abstract

OBJECTIVE

Because of their increased interaction with patients, healthcare workers (HCWs) face greater vulnerability to COVID-19 exposure than the general population. We examined prevalence and correlates of ever COVID-19 diagnosis and vaccine uncertainty among HCWs.

DESIGN

Cross-sectional data from the Household Pulse Survey (HPS) conducted during July to October 2021.

SETTING

HPS is designed to yield representative estimates of the US population aged ≥18 years nationally, by state and across selected metropolitan areas.

PARTICIPANTS

Our primary analytical sample was adult HCWs in the New York Metropolitan area (n=555), with HCWs defined as individuals who reported working in a 'Hospital'; 'Nursing and residential healthcare facility'; 'Pharmacy' or 'Ambulatory healthcare setting'. In the entire national sample, n=25 909 HCWs completed the survey. Descriptive analyses were performed with HCW data from the New York Metropolitan area, the original epicentre of the pandemic. Multivariable logistic regression analyses were performed on pooled national HCW data to explore how HCW COVID-19-related experiences, perceptions and behaviours varied as a function of broader geographic, clinical and sociodemographic characteristics.

RESULTS

Of HCWs surveyed in the New York Metropolitan area, 92.3% reported being fully vaccinated, and 20.9% had ever been diagnosed of COVID-19. Of the subset of HCWs in the New York Metropolitan area not yet fully vaccinated, 41.8% were vaccine unsure, 4.5% planned to get vaccinated for the first time soon, 1.6% had got their first dose but were not planning to receive the remaining dose, while 52.1% had got their first dose and planned to receive the remaining dose. Within pooled multivariable analysis of the national HCW sample, personnel in nursing/residential facilities were less likely to be fully vaccinated (adjusted OR, AOR 0.79, 95% CI 0.63 to 0.98) and more likely to report ever COVID-19 diagnosis (AOR 1.35, 95% CI 1.13 to 1.62), than those working in hospitals. Of HCWs not yet vaccinated nationally, vaccine-unsure individuals were more likely to be White and work in pharmacies, whereas vaccine-accepting individuals were more likely to be employed by non-profit organisations and work in ambulatory care facilities. Virtually no HCW was outrightly vaccine-averse, only unsure.

CONCLUSIONS

Differences in vaccination coverage existed by individual HCW characteristics and healthcare operational settings. Targeted efforts are needed to increase vaccination coverage.

摘要

目的

由于与患者的互动增加,医疗保健工作者(HCWs)比一般人群更容易接触到 COVID-19。我们研究了 HCWs 中 COVID-19 诊断和疫苗不确定性的发生率和相关因素。

设计

2021 年 7 月至 10 月期间进行的家庭脉搏调查(HPS)的横断面数据。

设置

HPS 的设计目的是在全国范围内按州和选定的大都市区对年龄≥18 岁的美国人口进行代表性估计。

参与者

我们的主要分析样本是纽约大都市地区的成年 HCWs(n=555),将 HCWs 定义为报告在“医院”、“护理和居住医疗保健设施”、“药房”或“流动医疗保健环境”工作的个人。在整个全国性 HCW 样本中,n=25909 名 HCWs 完成了调查。对来自大流行最初震中纽约大都市区的 HCW 数据进行描述性分析。对全国性 HCW 数据进行多变量逻辑回归分析,以探讨 HCW 与 COVID-19 相关的经历、看法和行为如何因更广泛的地理、临床和社会人口统计学特征而有所不同。

结果

在接受调查的纽约大都市地区的 HCWs 中,92.3%报告已完全接种疫苗,20.9%曾被诊断患有 COVID-19。在尚未完全接种疫苗的纽约大都市地区 HCWs 亚组中,41.8%的人对疫苗不确定,4.5%的人计划很快首次接种疫苗,1.6%的人已经接种了第一剂疫苗,但不打算接种第二剂疫苗,而 52.1%的人已经接种了第一剂疫苗,并计划接种第二剂疫苗。在全国性 HCW 样本的多变量分析中,护理/居住设施的人员不太可能完全接种疫苗(调整后的比值比,AOR 0.79,95%置信区间 0.63 至 0.98),并且更有可能报告曾被诊断患有 COVID-19(AOR 1.35,95%置信区间 1.13 至 1.62)。在全国范围内,尚未接种疫苗的 HCWs 中,对疫苗不确定的人更有可能是白人,并且在药房工作,而接受疫苗的人更有可能受雇于非营利组织,并在流动医疗保健设施工作。几乎没有 HCW 对疫苗完全反感,只是不确定。

结论

个人 HCW 特征和医疗保健运营环境的差异导致疫苗接种覆盖率存在差异。需要有针对性地努力提高疫苗接种率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33ff/9334692/2ef3b13c9a32/fmch-2022-001692f01.jpg

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