Abstract:

The COVID-19 pandemic has placed tremendous burdens on healthcare workers (HCWs), accounting for over 1.4 million HCW infections and 10% of global fatalities. HCWs faced elevated infection risk, psychological distress, long working hours, fatigue, stigma, and violence. While vaccines are pivotal in reducing severe illness, HCW vaccine hesitancy, given their role as advocates, jeopardizes vaccination coverage global goals and healthcare systems. Addressing this vaccine uptake is imperative through education, transparent communication, and support to safeguard HCWs’ safety and pandemic containment. This study assessed COVID-19 vaccination uptake among frontline HCWs in Kaduna State, Nigeria, and its impact on morbidity and mortality. Utilizing a descriptive cross-sectional approach, we analyzed secondary data from the Surveillance Outbreak Response Management and Analysis System (SORMAS). The study encompassed HCWs in Kaduna State, excluding pregnant and lactating individuals, following national guidelines. Among 8095 HCWs tested for COVID-19, most were aged 31-40 years (35%), female (60.2%), and urban residents (70.3%). COVID-19 vaccination uptake was low at 17.4%, with 82.6% unvaccinated. COVID-19 infection was significantly associated with vaccination (p = 0.039). Although unvaccinated participants exhibited a higher mortality rate (60%) than vaccinated ones (40%), this difference was not statistically significant (p = 0.209). In conclusion, this study unveiled insufficient vaccination uptake among HCWs, potentially impeding pandemic response. While vaccination seemed to positively impact disease outcomes, it didn’t significantly affect the infection risk. Addressing HCW vaccine hesitancy remains critical for achieving immunization goals and ensuring healthcare system safety.

References:

[1] Poudel K, Subedi P. Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal. Int J Soc Psychiatry. 2020;66(8):748–55.

[2] Rasul G, Nepal AK, Hussain A, Maharjan A, Joshi S, Lama A, et al. Socio-economic implications of COVID-19 pandemic in South Asia: emerging risks and growing challenges. Front Sociol. 2021; 6:629693.

[3] Abdel Wahed WY, Hefzy EM, Ahmed MI, Hamed NS. Assessment of Knowledge, Attitudes, and Perception of Healthcare Workers Regarding COVID-19, A Cross-Sectional Study from Egypt. J Community Health [Internet]. 2020;45(6):1242–51. Available from: https://doi.org/10.1007/s10900-020-00882-0.

[4] Ganesan B, Al-Jumaily A, Fong KNK, Prasad P, Meena SK, Tong RKY. Impact of coronavirus disease 2019 (COVID-19) outbreak quarantine, isolation, and lockdown policies on mental health and suicide. Front psychiatry. 2021;12.

[5] World Health Organization. The impact of COVID-19 on health and care workers: a closer look at deaths. 2021;(September):1–17.

[6] Zhou P, Yang X Lou, Wang XG, Hu B, Zhang L, Zhang W, et al. Changes from the previous version. Nature [Internet]. 2021;31(4):29–30. Available from: https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-interim-guidance.

[7] Perrocheau A, Allegranzi B. Covid-19 infections among health workers declining: WHO. 2020;(October):1–2.

[8] Talbot TR. COVID-19 Vaccination of Healthcare Personnel as a Condition of Employment: A Logical Addition to Institutional Safety Programs. JAMA [Internet]. 2021 Jul 6;326(1):23–4. Available from: https://doi.org/10.1001/jama.2021.8901.

[9] Ortiz-Prado E, Simbaña-Rivera K, Gómez- Barreno L, Rubio-Neira M, Guaman LP, Kyriakidis NC, et al. Clinical, molecular, and epidemiological characterization of the SARS-CoV-2 virus and the Coronavirus Disease 2019 (COVID-19), a comprehensive literature review. Diagn Microbiol Infect Dis [Internet]. 2020;98(1):115094. Available from: https://www.sciencedirect.com/science/article/pii/S0732889320304715.

[10] Zhou P, Yang X Lou, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature [Internet]. 2020;579(7798):270–3. Available from: http://dx.doi.org/10.1038/s41586-020-2012-7.

[11] WHO. Virus origin / Origins of the SARS-CoV-2 virus. World Heal Organ [Internet]. 2020;(February). Available from: https://www.who.int/health-topics/coronavirus/origins-of-the-virus?fbclid=IwAR0Sc4F5RLvbug97Z-pLVQRLltb8JyZfPluMMwsb77i8NchuUoyDPMBdbIo%0Ahttps://www.who.int/health-topics/coronavirus/who-recommendations-to-reduce-risk-of-transmission-of-emerging-pathogen.

[12] Giri R, Bhardwaj T, Shegane M, Gehi BR, Kumar P, Gadhave K, et al. When darkness becomes a ray of light in the dark times: understanding the COVID-19 via the comparative analysis of the dark proteomes of SARS-CoV-2, human SARS and bat SARS-like coronaviruses. BioRxiv. 2020.

[13] Lorusso A, Calistri P, Petrini A, Savini G, Decaro N. Novel coronavirus (SARS-CoV-2) epidemic: a veterinary perspective. Vet Ital. 2020;56(1):5–10.

[14] Harapan H, Itoh N, Yufika A, Winardi W, Keam S, Te H, et al. Coronavirus disease 2019 (COVID-19): A literature review. J Infect Public Health [Internet]. 2020;13(5):667–73. Available from: https://www.sciencedirect.com/science/article/pii/S1876034120304329.

[15] of the International CSG. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536.

[16] Numbers SIN. WHO-Timor-Leste-situation-report-–-119-English-1. 2021;2019(September).

[17] World Health Organization. Guidance on developing a national deployment and vaccination plan for COVID-19 vaccines: interim guidance. World Heal Organ [Internet]. 2020;(V):89. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Vaccine_deployment-2020.1.

[18] WHO. Evaluation Of COVID-19 Vaccine Effectiveness. 2021;70.

[19] Colavizza G. COVID-19 research in Wikipedia. Quant Sci Stud. 2020;1(4):1349–80.

[20] Ogunleye OO, Basu D, Mueller D, Sneddon J, Seaton RA, Yinka-Ogunleye AF, et al. Response to the novel corona virus (COVID-19) pandemic across Africa: successes, challenges, and implications for the future. Front Pharmacol. 2020;1205.

[21] Organization WH. Joint WHO/ILO policy guidelines on improving health worker access to prevention, treatment and care services for HIV and TB. 2010.

[22] Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA - J Am Med Assoc. 2020;323(13):1239–42.

[23] Erdem H, Lucey DR. Healthcare worker infections and deaths due to COVID-19: A survey from 37 nations and a call for WHO to post national data on their website. Int J Infect Dis. 2021; 102:239–41.

[24] Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry Clin Neurosci. 2020;74(4):281.

[25] Mariam Saleh. • Africa: COVID-19 vaccination rate by country [Internet]. 2022 [cited 2022 Jul 2]. p. 1–2. Available from: https://www.statista.com/statistics/1221298/covid-19-vaccination-rate-in-african-countries/.

[26] Bank W. Accelerating Covid -19 Vaccine Deployment. 2022.

[27] Adeniran Adeniyi Ayobami AD. Assessment of front-line health workers’ knowledge and attitude towards Tuberculosis screening and case finding in Oyo State, Nigeria. Int J Adv Res. 2022;10(03):84–7.

[28] Conger K. How misinformation, medical mistrust fuel vaccine hesitancy. Stanford Med News Cent. 2021.

[29] Sallam M. COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates. Vaccines. 2021;9(2):160.

[30] Lang MA, Stahlman S, Wells NY, Fedgo AA, Patel DM, Chauhan A, et al. Disparities in COVID-19 vaccine initiation and completion among active component service members and healthcare personnel, 11 December 2020-12 March 2021. MSMR. 2021;28(4):2–9.

[31] World Health Organization. The impact of COVID-19 on health and care workers: a closer look at deaths. Health Workforce Department - Working Paper 1. Geneva; 2021.

[32] Organization WH. Governing Body matters: Key issues arising out of the Seventy–fourth World Health Assembly and the 148th and 149th sessions of the WHO Executive Board. World Health Organization. Regional Office for South-East Asia; 2021.

[33] NPC. No Title. In 2010. p. 9.

[34] Alajmi J, Jeremijenko AM, Abraham JC, Alishaq M, Concepcion EG, Butt AA, et al. COVID-19 infection among healthcare workers in a national healthcare system: The Qatar experience. Int J Infect Dis. 2020; 100:386–9.

[35] Elimian KO, Ochu CL, Ilori E, Oladejo J, Igumbor E, Steinhardt L, et al. Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February-6 June 2020. Epidemiol Infect. 2020;148(e208):1–16.

[36] Dzinamarira T, Nkambule SJ, Hlongwa M, Mhango M, Iradukunda PG, Chitungo I, et al. Risk Factors for COVID-19 Infection Among Healthcare Workers. A First Report from a Living Systematic Review and meta-Analysis. Saf Health Work. 2022;13(3):263–8.

[37] Elimian K, Musah A, King C, Igumbor E, Myles P, Aderinola O, et al. COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria. PLOS Glob Public Heal. 2022;2(6):e0000169.

[38] Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):1–10.

[39] Elimian KO, Ochu CL, Ebhodaghe B, Myles P, Crawford EE, Igumbor E, et al. Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: Retrospective cohort study. BMJ Open. 2020;10(12):1–16.

[40] Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, Elbaz M, Nesher L, Stein M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021;27(11):1652–7.

[41] Singh AK, Gillies CL, Singh R, Singh A, Chudasama Y, Coles B, et al. Prevalence of co‐morbidities and their association with mortality in patients with COVID‐19: a systematic review and meta‐analysis. Diabetes, Obes Metab. 2020;22(10):1915–24.

[42] Idris U, Moses OA, Muhammad IU, Arinola OM, Muazu AS, Saulawa MA, et al. Socio-Demographic and Clinical Characteristics and Outcomes of COVID-19 Patients in Kaduna State. J Biochem Microbiol Biotechnol. 2023;11(1):7–10.