Title : Level of vaccination against COVID-19 and post vaccination breakthrough infection among a cohort of healthcare workers in a tertiary teaching hospital in Ethiopia
Coronavirus disease 19 (COVID-19) pandemic has posed a challenge to the health sector, and frontline healthcare workers (HCWs) are at higher risk of getting the infection. However, there is a scarcity of data on vaccination and post-vaccine breakthrough infections in Ethiopian HCWs. This study aimed at assessing vaccination levels, breakthrough infections, and associated factors among HCWs at a tertiary teaching hospital in Ethiopia.
A prospective observational cohort study was conducted among 469 HCWs at St. Paul’s Hospital Millennium Medical College from February to July 2022. We used a standard questionnaire for enrollment, sociodemographic and clinical data collection, and biweekly follow-up using the Secure Data Kit, as well as real-time reverse transcription polymerase chain reaction for the COVID-19 test. SPSS v. 25.0 was used for data analysis, chi-square test to determine the association between vaccination and breakthrough infections, and bivariable and multivariable analyses to assess factors associated with vaccine uptake. A p-value of <0.05 was considered statistically significant.
A total of 469 HCWs were enrolled, with a response rate of 98%. The majority of the participants were females (58.4%), and the mean age was 29.2 ± 6.5 years. Physicians have the highest proportion of ever COVID-19-testing status (86.6%), followed by midwives (74.9%), and nurses (71.9%), with patient transporters having the lowest (34.5%). Overall, 64.4% of HCWs were vaccinated against COVID-19, of whom 85.1% were fully vaccinated. Physicians (AOR = 7.94; 95% CI: 3.27–19.26) and having ever been tested for COVID-19 (AOR = 2.34; 95% CI: 1.46-3.75) were determinant factors for vaccine uptake. SARS-CoV-2 infection occurred in 34 (11.3%) of 302 vaccinated HCWs postvaccination, with 32 infections in fully vaccinated HCWs, implying a 10.6% incidence of breakthrough infection. There was no significant difference in the risk of infection between vaccinated and unvaccinated HCWs (p = 0.969).
COVID-19 vaccine uptake among HCWs was low and showed a significant occupational difference, with physicians having the highest level of vaccination. The high incidence of breakthrough infection in the study underscores the benefit of vaccination to reduce but not eliminate transmission.
Audience takes away:
- COVID-19 pandemic is a global health challenge and frontline healthcare workers are at higher risk of getting the infection
- Vaccine uptake among HCWs has a significant occupational difference and implies a need of raising awareness
- Vaccine breakthrough infection is a common phenomenon but with mild and asymptomatic outcomes