Emergency Department Utilization by In-hospital Healthcare Workers after COVID-19 Vaccination

Post COVID-19 vaccination side effects and associated factors among vaccinated health care providers in Oromia region, Ethiopia in 2021

BACKGROUND

Severe Acute Respiratory Syndrome (SARS COV-2) known as COVID-19 since its outbreak in 2019, more than 375 and 5.6 million were infected and dead, respectively. Its influence in all disciplines stimulated different industries to work day to night relentlessly to develop safe and effective vaccines to reduce the catastrophic effect of the disease. With the increasing number of people globally who have been vaccinated, the reports on possible adverse events have grown and gained great public attention. This study aims to determine post-COVID-19 vaccination adverse effects and associated factors among vaccinated Health care providers in the Oromia region, Ethiopia in 2021.

METHODS

A cross-sectional study was conducted among 912 health care workers working in government hospitals in the central Oromia region from November 20 to December 15/2021. Respondents absent from work due to different reasons were excluded during the interview. The outcome variable was COVID-19 side effects (response as Yes/No). A descriptive analysis displayed findings in the form of the frequencies and percentages, and logistic regression was employed to see the association of different variables with side effects experienced.

RESULT

Overall, 92.1% of the participants experienced side effects either in 1st or 2nd doses of post-COVID-19 vaccination; 84.0% and (71.5%) of participants experienced at least one side effect in the 1st and 2nd dose of the vaccines, respectively. COVID-19 infection preventive protocols like keeping distance, hand wash using soap, wearing mask and using sanitizer were decreased post vaccination. About 74.3% of the respondents were worried about the adverse effects of the COVID-19 vaccine they received. The majority (80.2%) of the respondent felt fear while receiving the vaccine and 22.5% of the respondents suspect the effectiveness of the vaccine they took. About 14.8% of the vaccinated Health workers were infected by COVID-19 post-vaccination. Engaging in moderate physical activity and feeling fear when vaccinated were the independent factors associated with reported side effects of post-COVID-19 vaccination using multiple logistic regression. Respondents who did not engage in physical activity were 7.54 fold more likely to develop post-COVID-19 vaccination side effects compared to those who involved at least moderate-intensity physical activity[AOR = 7.54, 95% CI;2.46,23.12]. The odds of experiencing side effects among the respondents who felt fear when vaccinated were 10.73 times compared not felt fear (AOR = 10.73, 95% CI; 2.47,46.64), and similarly, those who felt little fear were 4.28 times more likely to experience side effects(AOR = 4.28, 95% CI; 1.28, 14.39).

CONCLUSION

Significant numbers of the respondents experienced side effects post COVID-19 vaccination. It is recommended to provide pre-awareness about the side effects to reduce observed anxiety related to the vaccine. It is also important to plan monitoring and evaluation of the post-vaccine effect using standard longitudinal study designs to measure the effects directly.

Factors related to the serious adverse events in patients visiting the emergency department after ChAdOx1 and mRNA COVID-19 vaccination

Introduction

We investigated the clinical characteristics, outcomes and factors related to the serious adverse events (AEs) of patients visiting the emergency department (ED) with various AEs after ChAdOx1 and mRNA COVID-19 vaccination.

Methods

Patients with AEs who visited the ED between March 2021 and September 2021 were selected from three EDs. The clinical data of these patients were collected by retrospectively reviewing medical records. Serious adverse events (AEs) were defined as any adverse medical events that led to hospital admission.

Results

A total of 3572 patients visited the ED with AEs; 69.6% were administered mRNA vaccines, and the median (IQR) age was 48 (31–63) years. Regarding chief complaints, chest pain/discomfort (43.7%) was most common in the mRNA vaccines group, while fever (15.8%) was more commonly presented in the ChAdOx1 group. Most patients (93.9%) were discharged from the ED. In multivariate analysis, age ≥70 years, days from vaccination to ED visit ≥8 days, fever and dyspnea as chief complaints were higher independent risk factors for serious AEs (OR 27.94, OR 2.55, OR 1.95 and OR 2.18: p < 0.001, p < 0.001, p = 0.003 and p = 0.003, respectively).

Conclusion

Most patients who visited the ED with AEs after vaccination were discharged from the ED regardless of the type of vaccine. Emergency physicians need to differentiate serious AEs and consider factors that may require admission to the ED.

Impact of COVID-19 vaccine-associated side effects on health care worker absenteeism and future booster vaccination

BACKGROUND

Short-term side effects related to mRNA vaccines against SARS-CoV-2 are frequent and bothersome, with the potential to disrupt work duties and impact future vaccine decision-making.

OBJECTIVE

To identify factors more likely to lead to vaccine-associated work disruption, employee absenteeism, and future vaccine reluctance among healthcare workers (HCWs).

HYPOTHESIS

Side effects related to COVID vaccination: 1- frequently disrupt HCW duties, 2- result in a significant proportion of HCW absenteeism, 3- contribute to uncertainty about future booster vaccination, 4- vary based on certain demographic, socioeconomic, occupational, and vaccine-related factors.

METHODS

Using an anonymous, voluntary electronic survey, we obtained responses from a large, heterogeneous sample of COVID-19-vaccinated HCWs in two healthcare systems in Southern California. Descriptive statistics and regression models were utilized to evaluate the research questions.

RESULTS

Among 2,103 vaccinated HCWs, 579 (27.5%) reported that vaccine-related symptoms disrupted their professional responsibilities, and 380 (18.1%) missed work as a result. Independent predictors for absenteeism included experiencing generalized and work-disruptive symptoms, and receiving the Moderna vaccine [OR = 1.77 (95% CI = 1.33 - 2.36), p < 0.001]. Physicians were less likely to miss work due to side effects (6.7% vs 21.2% for all other HCWs, p < 0.001). Independent predictors of reluctance toward future booster vaccination included lower education level, younger age, having received the Moderna vaccine, and missing work due to vaccine-related symptoms.

CONCLUSION

Symptoms related to mRNA vaccinations against SARS-CoV-2 may frequently disrupt work duties, lead to absenteeism, and impact future vaccine decision-making. This may be more common in Moderna recipients and less likely among physicians. Accordingly, health employers should schedule future booster vaccination cycles to minimize loss of work productivity.

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

Background

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features.

Methods

We searched PubMed and EMBASE covering the period between January 1^st 2020 and August 6^th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset.

Results

Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown.

Conclusions

Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid.

Supplementary Information

The online version contains supplementary material available at 10.1186/s10194-022-01400-4.