目的:评估实施COVID-19疫苗授权前后卫生保健人员(HCP)的疫苗覆盖率以及与疫苗接种设计相关的人口统计学特征,设置,和参与者:从2020年12月16日至2021年10月31日,在费城的一家大型学术医院,对10,889名医院员工进行了队列研究。
方法:实施COVID-19疫苗任务前后的COVID-19疫苗接种时间和疫苗系列完成率,性别,种族/民族,以及患者接触/职业组的水平。
结果:在任务宣布之前,疫苗系列完成率为86.0%,任务执行后增加到98.7%。任务宣布前的比率在亚洲人中最高(96.2%),白人(94.0%),男性(89.7%),员工≥65岁(95.2%),和直接接受病人护理的员工(医生,99.0%,和护士,93.3%)。医院的教育举措(包括市政厅以及与疫苗接种率最低的黑人和西班牙裔员工的讨论)似乎可以提高接种率。任务宣布后系列完成量最大的增长发生在黑人中,其他/多种族背景的人,和西班牙裔(35.6%,22.4%,10.8%,分别)以及一些或没有直接患者接触的患者(24.5%和18.3%,分别)。为64名(<0.6%)雇员批准了医疗或宗教豁免,38名(<0.4%)离开了他们的职位(8名自愿,30非自愿),特别是由于COVID-19疫苗的授权。年龄没有临床意义的差异,性别,注意到根据任务规定接种疫苗的人与离开岗位的人的种族/族裔。
结论:这些结果表明,尽管授权可能对机构和执法不受欢迎具有挑战性,它们在减少HCP的犹豫和确保高疫苗接种率方面发挥着重要作用,一组COVID-19的高危人群,因为他们的工作和可能是疾病传播给患者的来源。
To assess vaccine coverage rates before and after implementation of a COVID-19 vaccine mandate among Health care Personnel (HCP) and demographic characteristics associated with vaccine uptake Design, Setting, and Participants: Cohort study conducted among 10,889 hospital employees followed from Dec 16, 2020 - October 31, 2021, at a large academic hospital in Philadelphia.
Time to COVID-19 vaccination and vaccine series completion rates before and after implementation of a COVID-19 vaccine mandate based on age, gender, race/ethnicity, and level of patient contact/occupational group.
The vaccination series completion rate was 86.0% prior to mandate announcement, and increased to 98.7% after mandate implementation. Rates before mandate announcement were highest among Asians (96.2%), Whites (94.0%), males (89.7%), employees ≥ 65 years of age (95.2%), and employees with direct patient care (physicians, 99.0%, and nurses, 93.3%). Hospital educational initiatives (including Town Halls and discussions with Black and Hispanic employees with the lowest vaccination rates) appeared to improve uptake. The largest increase in series completion after mandate announcement occurred among Blacks, those of other/multiracial backgrounds, and Hispanics (35.6%, 22.4%, and 10.8%, respectively) as well as those with some or no direct patient contact (24.5% and 18.3%, respectively). Medical or religious exemptions were approved for 64 (<0.6%) employees and 38 (<0.4%) left their positions (8 voluntary, 30 involuntary) specifically due to the COVID-19 vaccine mandate. No clinically meaningful differences by age, gender, or race/ethnicity for those who were vaccinated under the mandate versus those who left their positions were noted.
These results suggest that while mandates may be challenging to institutions and enforcement unpopular, they play an important role in reducing hesitancy and securing high vaccination rates among HCP, a group at high risk of COVID-19 given their employment and who can be a source of disease transmission to patients.