Monitoring the COVID-19 epidemic in the context of widespread local transmission.

Coronavirus disease 2019 (COVID-19) is a novel viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first detected in Wuhan, China, in December, 2019.1 Given the fast spread, the severity of disease, the increasing number of cases outside China, and the number of affected countries, WHO declared the rapid spread of SARS-CoV-2 a pandemic on March 11, 2020.2 The availability of reliable surveillance platforms is crucial to monitor the COVID-19 epidemic in a timely manner and to respond with adequate control measures. Since the beginning of the outbreak, different countries have used different testing approaches and criteria, depending on their resources and capacity

Vaccination behaviour influences self-report of influenza vaccination status: a cross-sectional study among health care workers.

Background Published influenza vaccination coverage in health care workers (HCW) are calculated using two sources: self-report and vaccination records. The objective of this study was to determine whether self-report is a good proxy for recorded vaccination in HCW, as the degree of the relationship is not known, and whether vaccine behaviour influences self-reporting. Methods A cross-sectional study was conducted using a self-administered survey during September 2010. Considering the vaccination record as the gold standard of vaccination, the properties of self-report as a proxy of the record (sensitivity, specificity, positive predictive value, negative predictive value) were calculated. Concordance between the vaccination campaigns studied (2007-2010) was made using the Kappa index, and discordance was analyzed using McNemar's test. Results 248 HCW responded. The 95% confidence intervals of coverage according to the vaccination record and to self-report overlapped, except for 2007, and the Kappa index showed a substantial concordance, except for 2007. McNemar's test suggested that differences between discordant cases were not due to chance and it was found that the proportion of unvaccinated discordant cases was higher than that of vaccinated discordant cases. Conclusions In our study population, self-reported influenza vaccination coverage in HCW in the previous two years is a good proxy of the vaccination record. However, vaccination behaviour influences the self-report and explains a trend to overestimate coverage in self-reporting compared to the vaccination record. The sources of coverage should be taken into account whenever comparisons are made

The social network around influenza vaccination in health care workers: a cross-sectional study

Background: Influenza vaccination coverage remains low among health care workers (HCWs) in many health facilities. This study describes the social network defined by HCWs’ conversations around an influenza vaccination campaign in order to describe the role played by vaccination behavior and other HCW characteristics in the configuration of the links among subjects. Methods: This study used cross-sectional data from 235 HCWs interviewed after the 2010/2011 influenza vaccination campaign at the Hospital Clinic of Barcelona (HCB), Spain. The study asked: “Who did you talk to or share some activity with respect to the seasonal vaccination campaign?” Variables studied included sociodemographic characteristics and reported conversations among HCWs during the influenza campaign. Exponential random graph models (ERGM) were used to assess the role of shared characteristics (homophily) and individual characteristics in the social network around the influenza vaccination campaign. Results: Links were more likely between HCWs who shared the same professional category (OR 3.13, 95% CI = 2.61–3.75), sex (OR 1.34, 95% CI = 1.09–1.62), age (OR 0.7, 95% CI = 0.63–0.78 per decade of difference), and department (OR 11.35, 95% CI = 8.17–15.64), but not between HCWs who shared the same vaccination behavior (OR 1.02, 95% CI = 0.86–1.22). Older (OR 1.26, 95% CI = 1.14–1.39 per extra decade of HCW) and vaccinated (OR 1.32, 95% CI = 1.09–1.62) HCWs were more likely to be named. Conclusions: This study finds that there is no homophily by vaccination status in whom HCWs speak to or interact with about a workplace vaccination promotion campaign. This result highlights the relevance of social network analysis in the planning of health promotion intervention

Perceptions of Covid-19 maternal vaccination among pregnant women and healthcare workers and factors that influence vaccine acceptance: a cross-sectional study in Barcelona, Spain

COVID-19 is associated with poor maternal and pregnancy outcomes. COVID-19 vaccination is recommended in Spain, yet vaccination rates in pregnancy are suboptimal. This study investigates the perceptions of pregnant women and healthcare workers (HCW) regarding COVID-19 vaccination. A web-based cross-sectional quantitative study was conducted in 2021-2022 among 302 pregnant women and 309 HCWs in the Catalan public health system. Most pregnant women (83%) and HCWs (86%) were aware of COVID-19 maternal vaccines. The recommendation of the COVID-19 vaccination by an HCW was identified as the greatest facilitator for maternal vaccine uptake, while the fear of harming the foetus was the most significant barrier reported for rejecting vaccination. HCWs recognised they received limited information and training about COVID-19 vaccination in pregnancy, which hindered them from providing informed recommendations. This study highlights that information and education on COVID-19 vaccines to pregnant women and health professionals are pivotal to ensuring informed decision-making and increasing vaccine uptake

Promoció de la vacunació antigripal en els professionals sanitaris

[cat] Es fa necessari parlar de promoció de la vacunació antigripal entre professionals sanitaris perquè l'adhesió a la recomanació és baixa. L'estratègia de vacunació de la grip vol protegir sobretot les persones més vulnerables a patir complicacions i els professionals sanitaris estan inclosos en aquesta perspectiva. En aquesta tesi presentem dues campanyes de promoció amb la seva avaluació a l'Hospital Clínic de Barcelona i dos treballs de recerca vinculats a les campanyes: l'anàlisi de la validesa de les cobertures declarades respecte les cobertures registrades i l'anàlisi de la xarxa social al voltant de la campanya de promoció. Les campanyes de promoció que presentem es donen en un context on la vacunació és voluntària i gratuïta. En una primera campanya (2008-09) es va voler visualitzar un compromís més gran de la institució i dels càrrecs amb la campanya i la vacunació, millorar en l'accessibilitat pel que fa a la planificació i disponibilitat als professionals i enviar missatges clars sobre la vacunació alhora que atractius de cara a fomentar la conversa entre els professionals sobre la vacunació. Va usar, per això últim, fotos de treballadors vacunats a la intranet, dos sorteigs i l'ús del correu electrònic corporatiu de forma més intensiva. La campanya es va consensuar amb els treballadors a través dels seus representants. La campanya 2008-09 va aconseguir augments significatius en la cobertura respecte l'anterior. Va resultar també una campanya més ràpida pel que fa a la velocitat de vacunació. La campanya de 2010-11 va voler avaluar els objectius estratègics plantejats per aquella temporada, això és, l'augment de la informació sobre la grip i la vacunació, la major percepció de risc sobre la malaltia i la implicació dels professionals com a promotors entre els seus col·legues. L'avaluació, amb una enquesta abans i després de la campanya en una mostra aleatoritzada de treballadors de l'hospital, va mostrar un impacte a l'alça en les tres objectius estratègics i una bona acceptació de la campanya sense impacte en la cobertura, cosa que mostra que l'increment de la informació i de la percepció de risc no augmenta necessàriament l'acceptació de la vacunació. Quan es parla de cobertures es parla de xifres obtingudes manera molt diversa. Es va considerar adient avaluar si les cobertures declarades són un bon succedani («proxy» en anglès) de les cobertures que consten al registre i si el comportament vacunal influeix en la declaració. Els professionals van ser preguntats per el seu comportament vacunal les tres campanyes anteriors i es va creuar amb el registre del centre. La declaració va resultar ser un bon succedani per dues temporades però es va veure un major nombre de casos discordants en no vacunats que en vacunats. Per últim, atès que s'havia recollit en diversos estudis transversals que l'opinió dels col·legues sobre la vacunació és important de cara a l'acceptació de la pròpia vacunació, es va voler fer una anàlisi de la xarxa generada a partir de les converses entre professionals sobre una campanya de vacunació. Es van enquestar dues unitats completes de l'hospital i es va detectar que les converses es donaven en la mateixa categoria laboral, sexe, edat i servei però no entre treballadors que compartien el comportament vacunal. Els professionals de més edat i vacunats eren més citats. Sembla, per tant, que una campanya de promoció és un tema de conversa entre els treballadors sanitaris i que la xarxa social juga un paper actiu en la campanya. Descriure una xarxa social real té interès en la planificació i implementació de campanyes de promoció de la salut, especialment per conèixer el paper de l'estat de salut en qüestió en la xarxa de relacions. Cal ser cautelós a l'hora de dissenyar intervencions basant-se en aquestes troballes, atès que la xarxa social entre professionals és un capital del centre que cal tractar amb cura.[eng] It is necessary to talk about the promotion of influenza vaccination among healthcare workers because the adherence to the recommendation is low. The influenza vaccination strategy aims at protecting, especially, those most vulnerable to complications, and this strategy includes healthcare professionals. The vaccination promotion campaigns presented in this thesis occur in a context where vaccination is voluntary and free. In the first campaign (2008-09) we wanted to improve the visibility and the commitment of the institution and those holding officers with the vaccination campaign, improve accessibility in terms of planning and availability to healthcare workers and send clear messages about vaccination. We wanted these messages to be attractive in order to foster the conversation among professionals about vaccination. We posted photos of vaccinated healthcare workers in the intranet, organized two raffles and used corporate email more intensively. The campaign was agreed with workers through their representatives. The 2008-09 campaign got significant increases in coverage compared to the previous one. The 2010-11 campaign wanted to evaluate the strategic goals set for that season, that is, increased information about influenza and vaccination, a greater perception or risk about the disease and the involvement of professionals as promoters among their colleagues. The evaluation, conducted through a before-after survey of the campaign in a randomized sample of hospital employees, showed an increase on the three strategic objectives and was well accepted without having an impact on coverage. This shows that the increase of information and perception of risk does not necessarily increase the acceptance of vaccination. The ways vaccination coverage are obtained can be very diverse. We considered it relevant to assess whether the declared coverage is a good proxy of the coverage according to the register and if the vaccine status affects the declaration of vaccination. The professionals were asked about their behavior in the previous three vaccination campaigns and matched to the register of the hospital. Self-declaration turned out to be a good proxy for the two previous seasons but the number of discordant non vaccinated professionals was larger than the number of vaccinated and discordant cases

The social network around influenza vaccination in health care workers: a cross-sectional study

Background: Influenza vaccination coverage remains low among health care workers (HCWs) in many health facilities. This study describes the social network defined by HCWs’ conversations around an influenza vaccination campaign in order to describe the role played by vaccination behavior and other HCW characteristics in the configuration of the links among subjects. Methods: This study used cross-sectional data from 235 HCWs interviewed after the 2010/2011 influenza vaccination campaign at the Hospital Clinic of Barcelona (HCB), Spain. The study asked: “Who did you talk to or share some activity with respect to the seasonal vaccination campaign?” Variables studied included sociodemographic characteristics and reported conversations among HCWs during the influenza campaign. Exponential random graph models (ERGM) were used to assess the role of shared characteristics (homophily) and individual characteristics in the social network around the influenza vaccination campaign. Results: Links were more likely between HCWs who shared the same professional category (OR 3.13, 95% CI = 2.61–3.75), sex (OR 1.34, 95% CI = 1.09–1.62), age (OR 0.7, 95% CI = 0.63–0.78 per decade of difference), and department (OR 11.35, 95% CI = 8.17–15.64), but not between HCWs who shared the same vaccination behavior (OR 1.02, 95% CI = 0.86–1.22). Older (OR 1.26, 95% CI = 1.14–1.39 per extra decade of HCW) and vaccinated (OR 1.32, 95% CI = 1.09–1.62) HCWs were more likely to be named. Conclusions: This study finds that there is no homophily by vaccination status in whom HCWs speak to or interact with about a workplace vaccination promotion campaign. This result highlights the relevance of social network analysis in the planning of health promotion intervention

Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital

Health care workers (HCW) are a high-risk population to acquire SARS-CoV-2 infection from patients or other fellow HCW. This study aims at estimating the seroprevalence against SARS-CoV-2 in a random sample of HCW from a large hospital in Spain. Of the 578 participants recruited from 28 March to 9 April 2020, 54 (9.3%, 95% CI: 7.1-12.0) were seropositive for IgM and/or IgG and/or IgA against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) was 11.2% (65/578, 95% CI: 8.8-14.1). Among those with evidence of past or current infection, 40.0% (26/65) had not been previously diagnosed with COVID-19. Here we report a relatively low seroprevalence of antibodies among HCW at the peak of the COVID-19 epidemic in Spain. A large proportion of HCW with past or present infection had not been previously diagnosed with COVID-19, which calls for active periodic rRT-PCR testing in hospital settings