[Psychiatry to support the Covid-19 vaccination campaign]. / La psychiatrie en renfort de la campagne de vaccination anti-Covid-19.

Health professionals have been mobilised to contribute to the emergency vaccination campaign deployed since the end of 2020 to combat the Covid-19 pandemic. In a mental health institution of the Grand-Est region, a vaccination centre has been implemented in emergency to contribute to the collective public health effort. Feedback from a hospital health executive.

Discrete-event simulation study of a COVID-19 mass vaccination centre.

The global spread of COVID-19 and the declaration of the pandemic status made by the World Health Organization (WHO) led to the establishment of mass vaccination campaigns. The challenges posed by the request to immunise the entire population necessitated the set-up of new vaccination sites, named Mass Vaccination Centres (MVCs), capable of handling large numbers of patients rapidly and safely. The present study focused on the evolution of MVC performances, in terms of the maximum number of vaccinated patients and primary resource utilisation ratio, while involving statistics belonging to the patient dimension. The research involved the creation of a digital model of the MVC, using the Discrete-Event Simulation (DES) software (FlexSim Healthcare), and consequent what-if analyses. The results were derived from the study of an existing facility, located within a sports centre in the province of Bergamo (Italy) and operating with an advanced MVC organisational model, in compliance with the national anti-SARS-CoV-2 legislation. The research provided additional evidence on innovative MVC organisational models, identifying an optimal MVC configuration. Besides, the obtained results remain relevant for countries where a significant portion of the population has not yet addressed the emergency, either for upcoming vaccination treatments. Furthermore, the methodology adopted in the present article proved to be a valuable resource in the analysis of the healthcare processes.

Are We Prepared for the Next Pandemic? Management, Systematic Evaluation and Lessons Learned from an In-Hospital COVID-19 Vaccination Centre for Healthcare Workers.

BACKGROUND: the organisation of a COVID-19 vaccination campaign for healthcare workers (HCWs) within a university hospital presents a challenge of a particularly large scale and urgency. Here, we evaluate the in-hospital vaccination process and centre for HCWs at LMU University Hospital in Munich, Germany. METHODS: We executed a mixed-method process evaluation of the vaccination centre at LMU University Hospital during the first COVID-19 vaccination campaign. In a programme monitoring, we continuously assessed the implementation of the centre's operational management including personnel resources. In evaluating the outreach to and satisfaction of the target group with the centre and process, we executed two anonymous surveys aimed at the HCWs vaccinated at the in-hospital centre (1) as well as centre staff members (2). RESULTS: staff numbers and process time per person were reduced several times during the first vaccination campaign. Lessons concerning appointment scheduling were learned. HCWs vaccinated at the in-hospital centre were satisfied with the process. A longer waiting time between admission and inoculation, perceived dissatisfying accessibility as well as an increased frequency of observed adverse events were linked to a reduced satisfaction. Comparatively subpar willingness to adhere to non-pharmaceutical measures was observed. Centre staff reported high satisfaction and a workload relatively equal to that of their regular jobs. Our outcomes provide references for the implementation of an in-hospital vaccination centre in similar settings.

Factors associated with the immune response to hepatitis A vaccination in HIV-infected patients in the era of highly active antiretroviral therapy.

INTRODUCTION: HIV seropositivity is considered a risk factor for complications in hepatitis A virus (HAV) infection. HAV vaccination schedules are widely implemented in HIV-infected patients, but the immune response remains impaired. METHODS: We analysed the response to vaccination (antiHAV titres ≥20IU/l) in 282 HIV-infected patients included in a standard (1440 Elisa Units (EU) at 0, 6 months) or rapidly accelerated schedule (720 EU at 0, 7, 21 days and 6 months) between 1997 and 2009. Factors associated with the response to vaccination were analysed using logistic regression. RESULTS: The overall response rate was 73.4%. Male sex (OR: 0.16, 95% CI 0.05-0.51) and hepatitis C virus co-infection (OR: 0.30, 95% CI 0.14-0.74) were associated with a lower probability of response. Protective antibody response was associated with a higher CD4/CD8 ratio (OR: 3.69, 95% CI 1.3-10.5) and having received two doses of standard schedule (compared with patients receiving only one dose of the same schedule) (OR: 2.51, 95% CI 1.22-5.15). Three doses of the rapidly accelerated schedule were not more effective than a single dose of 1440 EU (OR: 1.32, 95% CI 0.48-3.63). CONCLUSION: The low responses observed in patients receiving a single dose suggest the need to emphasize adhesion to vaccination protocols to avoid failure. The CD4/CD8 ratio may be considered as an immune status marker which could help to better choose the moment of vaccination. Our findings underscore the importance of identifying strategies that optimize the timing and effectiveness of hepatitis A vaccination in HIV-infected patients and of the need for further studies on individual factors such as sex and hepatitis C co-infection that may affect the response to vaccination. Likewise, the sub-optimal effectiveness of three doses of 720 EU in the rapidly accelerated schedule, if confirmed in future studies, might lead to a revision of the current schedule recommended for HIV-infected travellers.