ENG: comparative evaluation of side effects and the factors affecting vaccıne preferences of healthcare workers within the booster Covid-19 vaccınation in turkey

Abstract

Aim: The study’s primary aim is to evaluate the frequency and distribution of 3rd dose vaccines’ side effects, especially for the rare heterologous vaccine scheme. The secondary objective is to determine the factors affecting the booster COVID-19 vaccination preferences of HCWs. Material and Methods: This single-center, retrospective descriptive study was conducted on 1058 HCWs, through an online survey. In this study, 3rd dose COVID-19 vaccine preferences, the affecting factors, and the side effects were questioned and analyzed. Results: 87% of the participants (n=921) had the 3rd booster COVID-19 vaccine. Of those vaccinated, 82.4% (n=759) had Pfizer/BioNTech, and 17.6% (n=162) had CoronaVac/Sinovac. The most common factors that affect the 3rd dose vaccine choice are physicians’/HCWs’ recommendations (53.4%; n=492), scientific publications (42.7%; n=393), and recommendations of the Ministry of Health (41.6 %, n=383). 83% (n=630) of 759 who were vaccinated with Pfizer/BioNTech developed post-vaccine side effects, while 59% (n=96) of 162 HCWs who were vaccinated with CoronaVac/Sinovac developed (p<0.001). The most common side effect observed was muscle-joint pain (49.2%), and it occurred most frequently in the first 48 hours after vaccination (36%). The most commonly reported side effects in the 2-7 days and 7-28 days post-vaccination were muscle-joint pain (11.6%) and fatigue (1.6%), respectively. It was observed that fatigue, headache, muscle-joint pain, local reaction at the injection site, fever, and lymphadenopathy side effects were more common in those who administered the Pfizer/BioNTech vaccine. Conclusion: Although it is associated with developing more frequent side effects, mRNA vaccines are preferred by HCWs. Physician/HCWs recommendations and scientific publications were found to be the most valuable sources on the decision of vaccine preference.

Keywords

• Coronavac/Sinovac
• healthcare worker
• Pfizer/BioNTech
• side effects
• vaccine preferences

TR: Türkiye'de güçlendirici Covid-19 aşılaması kapsamında sağlık çalışanlarının aşı yan etkilerinin ve aşı tercihini etkileyen faktörlerin karşılaştırmalı değerlendirilmesi

Abstract

Amaç: Çalışmanın birincil amacı, özellikle nadir görülen heterolog aşı şeması için 3. doz aşıların yan etkilerinin sıklığını ve dağılımını değerlendirmektir. İkincil amaç ise sağlık çalışanlarının rapel COVID-19 aşılama tercihlerini etkileyen faktörlerin belirlenmesidir. Gereç ve Yöntemler: Bu tek merkezli, retrospektif tanımlayıcı çalışma, çevrimiçi anket aracılığıyla, 1058 sağlık çalışanı ile yürütülmüştür. Bu çalışmada 3. doz COVID-19 aşısı tercihleri, tercihi etkileyen faktörler ve 3. COVID-19 aşısı ile gelişen yan etkiler sorgulanmış analiz edilmiştir. Bulgular: Katılımcıların %87'si (n=921) 3. rapel COVID-19 aşısı oldu. Bunların %82,4'ü (n=759) Pfizer/BioNTech ve %17,6'sı (n=162) CoronaVac/Sinovac ile aşılandı. 3. doz aşı seçimini etkileyen en yaygın faktörler hekim/sağlık çalışanlarının önerileri (%53,4; n=492), bilimsel yayınlar (%42,7; n=393) ve Sağlık Bakanlığı tavsiyeleridir (%41,6; n=383). Pfizer/BioNTech ile aşılanan 759 kişiden %83'ünde (n=630), CoronaVac/Sinovac ile aşılanan 162 sağlık çalışanının %59'unda (n=96) aşı sonrası yan etki gelişti (p<0.001). En sık görülen yan etki kas-eklem ağrısı (%49,2) olup, en sık aşılamadan sonraki ilk 48 saatte (%36) ortaya çıktı. Aşılamadan sonraki 2-7. gün ve 7-28. gün en sık bildirilen yan etkiler sırasıyla kas-eklem ağrısı (%11,6) ve yorgunluktu (%1,6). Pfizer/BioNTech aşısı yaptıranlarda CoronaVac/Sinovac aşısı yaptıranlara göre yorgunluk, baş ağrısı, kas-eklem ağrısı, enjeksiyon yerinde lokal reaksiyon, ateş ve lenfadenopati yan etkileri daha sık görüldü. Sonuç: Sonuçta, daha sık yan etki gelişimi ile ilişkili olmakla birlikte, mRNA aşıları sağlık çalışanları tarafından daha fazla tercih edilmektedir. Aşı olma kararı ve aşı tercihleri konusunda en değerli kaynakların doktor/sağlık çalışanı tavsiyeleri ve bilimsel yayınlar olduğu görülmüştür.

Keywords

• aşı tercihleri
• Coronavac/Sinovac
• Pfizer/BioNTech
• sağlık çalışanı
• yan etkiler

References

1. CDC COVID-19 End of Public Health Emergency https://www.cdc.gov/coronavirus/2019-ncov/your-health/end-of-phe.html
2. World Health Organization (WHO) COVID-19 Vaccines with WHO Emergency Use Listing https://extranet.who.int/pqweb/vaccines/vaccinescovid-19-vaccine-eul-issued
3. Mascellino MT, Di Timoteo F, De Angelis M, Oliva A. Overview of the Main Anti-SARS-CoV-2 Vaccines: Mechanism of Action, Efficacy and Safety. Infect Drug Resist. 2021 Aug 31;14:3459-3476. doi: 10.2147/IDR.S315727.
4. CDC Use of COVID-19 Vaccines in the U.S. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
5. https://www.aa.com.tr/tr/koronavirus/turkiye-ilac-ve-tibbi-cihaz-kurumu-coronavac-asisi-icin-acil-kullanim-onayi-verdi/2108869
6. https://www.sozcu.com.tr/2021/saglik/turkiyede-biontech-asilamasi-basladi-6349241
7. Yildiz Y, Ozger HS, Senol E, Karakus R, Buyukkoruk M, Altin FB, et al. Evaluation of long-term antibody kinetics in healthcare workers vaccinated with inactivated COVID-19 Vero cell vaccine (CoronaVac), a propensity score-matched observational study. Int J Infect Dis. 2022 Sep;122:99-106. doi: 10.1016/j.ijid.2022.05.007.
8. https://www.bbc.com/turkce/haberler-turkiye-57684323

9. Dal Poz MR KY, Dräger S, Kunjumen T. Counting health workers: definitions, data, methods and global results. World Health Organization. 2007.
10. Shimabukuro TT, Nguyen M, Martin D, DeStefano F. Safety monitoring in the Vaccine Adverse Event Reporting System (VAERS). Vaccine. 2015;33(36):4398-405.
11. Tanriover MD, Doğanay HL, Akova M, Güner HR, Azap A, Akhan S,et al; CoronaVac Study Group. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): interim results of a double-blind, randomized, placebo-controlled, phase 3 trial in Turkey. Lancet. 2021 Jul 17;398(10296):213-222. doi: 10.1016/S0140-6736(21)01429-X.
12. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al; C4591001 Clinical Trial Group. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020 Dec 31;383(27):2603-2615. doi: 10.1056/NEJMoa2034577.
13. Possible Side Effects After Getting a COVID-19 Vaccine [Internet]. September 14, 2022. Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html. Accessed on May 2023
14. Koh SWC, Tan HM, Lee WH, Mathews J, Young D. COVID-19 Vaccine Booster Hesitancy among Healthcare Workers: A Retrospective Observational Study in Singapore. Vaccines (Basel). 2022 Mar 17;10(3):464. doi: 10.3390/vaccines10030464.
15. Alobaidi S, Hashim A. Predictors of the Third (Booster) Dose of COVID-19 Vaccine Intention among the Healthcare Workers in Saudi Arabia: An Online Cross-Sectional Survey. Vaccines (Basel). 2022 Jun 21;10(7):987. doi: 10.3390/vaccines10070987.
16. Rehman S, Rehman E, Jianglin Z. Uptake of COVID-19 booster shot among healthcare workers: A mediation analysis approach. Front Public Health. 2022 Oct 5;10:1033473. doi: 10.3389/fpubh.2022.1033473.
17. Kassianos G, Puig-Barberà J, Dinse H, Teufel M, Türeci Ö, Pather S. Addressing COVID-19 vaccine hesitancy. Drugs Context. 2022 Jun 20;11:2021-12-3. Doi: 10.7573/dic.2021-12-3.
18. Alhasan K, Aljamaan F, Temsah MH, Alshahrani F, Bassrawi R, Alhaboob A, et al. COVID-19 Delta Variant: Perceptions, Worries, and Vaccine-Booster Acceptability among Healthcare Workers. Healthcare (Basel). 2021 Nov 17;9(11):1566. doi: 10.3390/healthcare9111566.
19. Deng J, Ma Y, Liu Q, Du M, Liu M, Liu J. Comparison of the Effectiveness and Safety of Heterologous Booster Doses with Homologous Booster Doses for SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Aug 29;19(17):10752. doi: 10.3390/ijerph191710752.
20. Chen M, Yuan Y, Zhou Y, Deng Z, Zhao J, Feng F, et al. Safety of SARS-CoV-2 vaccines: a systematic review and meta-analysis of randomized controlled trials. Infect Dis Poverty. 2021 Jul 5;10(1):94. doi: 10.1186/s40249-021-00878-5.
21. Toubasi AA, Al-Sayegh TN, Obaid YY, Al-Harasis SM, AlRyalat SAS. Efficacy and safety of COVID-19 vaccines: A network meta-analysis. J Evid Based Med. 2022 Sep;15(3):245-262. doi: 10.1111/jebm.12492.
22. Cheng H, Peng Z, Luo W, Si S, Mo M, Zhou H, et al. Efficacy and Safety of COVID-19 Vaccines in Phase III Trials: A Meta-Analysis. Vaccines (Basel). 2021 Jun 1;9(6):582. doi: 10.3390/vaccines9060582.
23. Sharif N, Alzahrani KJ, Ahmed SN, Dey SK. Efficacy, Immunogenicity and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis. Front Immunol. 2021 Oct 11;12:714170. Doi: 10.3389/fimmu.2021.714170.
24. Costa Clemens SA, Weckx L et al. Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac/Sinovac COVID-19 vaccine in Brazil (RHH-001): a phase 4, non-inferiority, single-blind, randomized study. Lancet. 2022 Feb 5;399(10324):521-529. doi: 10.1016/S0140-6736(22)00094-0.
25. Hadiye Demirbakan, İpek Koçer, İhsan Berk, Ayşen Bayram. Evaluation of Side Effects After Heterologous Vaccination with BNT162b2 Vaccine in Healthcare Workers Vaccinated with Two Doses of Inactive COVID-19 Vaccine. Klimik Dergisi 2022; 35(4): 238-43.
26. Co M, Wong PCP, Kwong A. COVID-19 vaccine-associated axillary lymphadenopathy - A systematic review. Cancer Treat Res Commun. 2022;31:100546. doi: 10.1016/j.ctarc.2022.100546.
27. Garreffa E, Hamad A, O'Sullivan CC, Hazim AZ, York J, Puri S, et al. Regional lymphadenopathy following COVID-19 vaccination: Literature review and considerations for patient management in breast cancer care. Eur J Cancer. 2021 Dec;159:38-51. doi: 10.1016/j.ejca.2021.09.033.
28. Shimabukuro T, Nair N. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine. JAMA. 2021 Feb 23;325(8):780-781. doi: 10.1001/jama.2021.0600.
29. Chen JH, Ikwuanusi IA, Bommu VJL, Patel V, Aujla H, Kaushik V, et al. COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports. Cureus. 2022 Jan 30;14(1):e21740. doi: 10.7759/cureus.21740.