Relative Effectiveness of COVID-19 Vaccination in Healthcare Workers: 3-Dose Versus 2-Dose Vaccination.

The omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to have high infectivity and is more likely to evade vaccine immunity. However, booster vaccination is expected to strengthen cross-reactive immunity, thereby increasing the vaccine effectiveness (VE). This study aimed to evaluate the relative VE of the 3-dose (booster) vaccination compared with the 2-dose primary series vaccination in healthcare workers during omicron variant-dominant periods. During the omicron-dominant period from February 1, 2022 to February 28, 2022, a 1:1 matched case-control study was conducted. Healthcare workers with positive SARS-CoV-2 test results were classified as positive cases, whereas those with negative results served as controls. Compared with the 2-dose primary series vaccination, booster vaccination with mRNA vaccine showed moderate VE (53.1%). However, in multivariate analysis including the time elapsed after vaccination, the significant VE disappeared, reflecting the impact of recent vaccination rather than the third dose itself.

Early Safety Monitoring of COVID-19 Vaccines in Healthcare Workers.

Hospital-based surveillance for adverse events was conducted on healthcare workers after they received the first dose of coronavirus disease 2019 (COVID-19) vaccine. Among the two new platform vaccines (messenger RNA- and adenoviral vector-based vaccines), the rates of systemic adverse events were significantly higher among adenovirus-vectored vaccine recipients. Fatigue (87.6% vs. 53.8%), myalgia (80.8% vs. 50.0%), headache (72.0% vs. 28.8%), and fever (≥ 38.0°C, 38.7% vs. 0%) were the most common adverse events among adenovirus-vectored vaccine recipients, but most symptoms resolved within 2 days. Both types of COVID-19 vaccines were generally safe, and serious adverse events rarely occurred.

Infection Control during Surgery for Patients with Confirmed or Suspected Coronavirus Disease-19

The prevalence of coronavirus disease (COVID-19) has led to an increase in the number of patients being treated at medical institutions, including the number of patients requiring surgical treatments. Although the operating room infection control has focused on preventing surgical site infections in patients, a high interest has been shown in preventing infections in the medical staff because of a high risk of exposure of the medical staff to body fluids and respiratory system secretions during surgery when operating on suggested or confirmed patients with COVID-19. A thorough surgical preparation by the medical institution is warranted to protect both the patient and medical staff from contracting infections. The medical institution should closely examine the operation process to maintain the facilities related to the operation and plan the placement of human resources and patient movement. Further, specific guidelines for commodity, environmental, and waste management should be established in accordance with the agency’s situation, and medical workers should be continuously trained using the related guidelines.

Infection Control of Dialysis Patients for Coronavirus Infectious Disease-19 Response

The effects of coronavirus disease 19 (COVID-19) on patients with chronic kidney disease have not yet been fully studied, but acute kidney damage has been reported in some COVID- 19 patients. Hemodialysis is an essential treatment for patients with chronic kidney disease and they receive treatment for extended periods of time in congested spaces such as artificial kidney rooms. Because suspected or confirmed COVID-19 patients must visit medical institutions regularly for dialysis treatment, it is necessary to take efficient and safe infection control measures to prevent infections from spreading to medical staff or other patients during hemodialysis. Due to artificial kidney rooms receiving a high number of patients for outpatient treatment, it is important to assess the patients before admission. Therefore, a monitoring system is needed to check the epidemiological relevance and possible symptoms of COVID-19. Even if they are not epidemiologically related to COVID-19, patients with fever or respiratory symptoms should receive treatment in isolation rooms, while patients with suspected or confirmed COVID-19 infection should use negative-pressure isolation rooms. The medical staff participating in dialysis treatment for COVID-19 patients should wear appropriate personal protective equipment and provide specific guidelines for equipment, environmental, and waste management according to institutional circumstances.