COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study.
COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study.
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DOI：
10.1016/j.vaccine.2023.01.023
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发表时间：
2023-02-10
期刊：
影响因子：
5.5
通讯作者：
Lyons, Ronan A
中科院分区：
文献类型：
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作者：
Bedston, Stuart;Lowthian, Emily;Jarvis, Christopher I;Akbari, Ashley;Beggs, Jillian;Bradley, Declan;de Lusignan, Simon;Griffiths, Rowena;Herbert, Laura;Hobbs, Richard;Kerr, Steven;Lyons, Jane;Midgley, William;Owen, Rhiannon K;Quint, Jennifer K;Tsang, Ruby;Torabi, Fatemeh;Sheikh, Aziz;Lyons, Ronan A
从2021年9月起，威尔士的卫生保健工作者（HCWs）开始接受COVID-19加强疫苗接种。这是超出初级疫苗接种计划的第一剂。鉴于新变种的出现、疫苗的减弱以及越来越多的疫苗接种犹豫，有必要了解在这一高危人群中加强疫苗的吸收和随后的突破。我们使用SAIL数据库的匿名关联数据，对威尔士的医护人员进行了一项前瞻性、全国性、观察性队列研究。我们分析了2021年9月至2022年2月期间COVID-19加强疫苗接种的情况，并与初始初级疫苗接种计划的情况进行了比较。我们还分析了以pcr确认的SARS-Cov-2感染形式出现的加强剂突破，并与第二次初级剂量进行了比较。Cox比例风险模型用于估计疫苗接种率和突破与工作人员角色、社会人口统计学、家庭组成和其他因素的关联。我们选取了73030名生活在威尔士的卫生保健员（78%为女性，60%为18-49岁）。与18-29岁的患者相比，60岁以上的患者吸收速度最快（aHR 2.54, 95%CI 2.45-2.63）。与白人HCWs相比，亚洲HCWs吸收更快（aHR 1.18, 95%CI 1.14-1.22），而黑人HCWs吸收较慢（aHR 0.67, 95%CI 0.61-0.74）。与生活在最贫困地区的卫生保健人员相比，生活在最贫困地区的卫生保健人员接受加强剂量的速度略快（aHR 1.12, 95%CI 1.09-1.16）。与只有两个成年人的家庭相比，有儿童的家庭与突破性感染的关联最强（aHR为1.52,95%CI为1.41-1.63）。与18-29岁的医护人员相比，60岁以上的医护人员发生突破性感染的可能性较低（aHR 0.42, 95%CI 0.38-0.47）。在黑人卫生保健员以及来自贫困地区的卫生保健员中，疫苗接种率一直较低。而突破性感染在有孩子的家庭中最高。
From September 2021, Health Care Workers (HCWs) in Wales began receiving a COVID-19 booster vaccination. This is the first dose beyond the primary vaccination schedule. Given the emergence of new variants, vaccine waning vaccine, and increasing vaccination hesitancy, there is a need to understand booster vaccine uptake and subsequent breakthrough in this high-risk population. We conducted a prospective, national-scale, observational cohort study of HCWs in Wales using anonymised, linked data from the SAIL Databank. We analysed uptake of COVID-19 booster vaccinations from September 2021 to February 2022, with comparisons against uptake of the initial primary vaccination schedule. We also analysed booster breakthrough, in the form of PCR-confirmed SARS-Cov-2 infection, comparing to the second primary dose. Cox proportional hazard models were used to estimate associations for vaccination uptake and breakthrough regarding staff roles, socio-demographics, household composition, and other factors. We derived a cohort of 73,030 HCWs living in Wales (78% female, 60% 18–49 years old). Uptake was quickest amongst HCWs aged 60 + years old (aHR 2.54, 95%CI 2.45–2.63), compared with those aged 18–29. Asian HCWs had quicker uptake (aHR 1.18, 95%CI 1.14–1.22), whilst Black HCWs had slower uptake (aHR 0.67, 95%CI 0.61–0.74), compared to white HCWs. HCWs residing in the least deprived areas were slightly quicker to have received a booster dose (aHR 1.12, 95%CI 1.09–1.16), compared with those in the most deprived areas. Strongest associations with breakthrough infections were found for those living with children (aHR 1.52, 95%CI 1.41–1.63), compared to two-adult only households. HCWs aged 60 + years old were less likely to get breakthrough infections, compared to those aged 18–29 (aHR 0.42, 95%CI 0.38–0.47). Vaccination uptake was consistently lower among black HCWs, as well as those from deprived areas. Whilst breakthrough infections were highest in households with children.