Management of vaccine-related issues during a pandemic emergency: activation of a referral center

Abstract Issue Vaccine hesitancy (VH) and the challenges faced by healthcare workers (HWs) in evaluating the complex risk-benefit ratio of vaccines’ threaten the effectiveness of vaccination policy. The threat is enhanced when new vaccines are adopted during a pandemic emergency. In Italy, the Emilia-Romagna Region (ERR) created a specialized referral board called Vax-Consilium (VC) to support and guide HWs. Description of the problem During a pandemic emergency, rapid and appropriate vaccine implementation is necessary to protect fragile individuals and to encourage vaccine adherence among exposed groups. Challenges in the realm of vaccination emerge, especially when dealing with patients with a complex medical history or previous vaccine adverse events. HWs were able to consult VC via a standardized digital form after obtaining the patient’s informed consent. After a multidisciplinary and evidence-based evaluation, VC provided a conclusive report on the individual vaccine risk-benefit analysis. No cost is charged to the patient. Results During the anti-COVID-19 vaccination campaign in 2021, 148 interrogations were submitted to VC: 121 were evaluated, whereas 27 were withdrawn by the HWs or rejected because of insufficient documentation. Mean patient age was 44 years. No absolute contraindication was found, whereas in 23 cases VC recommended immunization with a different vaccine. The disciplines most frequently involved were neurology, angiology and cardiology. Lessons VC implementation in EER proved highly effective. Indeed, during the pandemic, anti-COVID-19 vaccination coverage reached >90%. In addition, DTaP-polio-HBV-HIb and MMR vaccination coverage reached >95%. VC proved to be a high-quality public health service. Not only was citizens’ trust in the healthcare system enhanced and was VH reduced, but HWs knowledge improved even in cases not considered in national and international guidelines. Key messages • A specialized referral board (Vax-Consilium) could be an effective tool for enhancing citizens’ trust in vaccines. • A specialized referral board (Vax-Consilium) contributes to lowering VH and supporting HWs decision-making process.

Background: COVID-19 pandemic has had significant effects on physical and mental health of health professionals. It is thought that resilience protects individuals against mental illness and helps individuals cope with difficulties and stress more effectively. In this study, it was aimed to evaluate resilience, life quality and related factors of health professionals during COVID-19 pandemic.

Methods:
A cross-sectional study was performed among health professionals working at a tertiary hospital in Turkey's capital Ankara. An occupation based stratified sampling was done with taking alpha 0.05 and 1-beta 0.80. A questionnaire that consists of sociodemographic information, COVID-19 Impact on Quality of Life Scale and Connor Davidson Resilience Scale was used to collect data. The results of scales were divided into two parts by taking the median values as cut off points. Descriptive/inferential statistics and logistic regression were performed on IBM's SPSS 27.0 program.

Conclusions:
Physicians and nurses who take care of patients one-on-one have lower resilience and higher decrease in life quality due to COVID-19 impacts. This result indicates a significant quality drop in health services is inevitable during pandemics and should be considered by the policy makers.

Key messages:
Policies should be developed to increase the resilience of healthcare professionals so that they can effectively combat public health emergencies such as COVID-19 and not affect their quality of life. It is necessary to determine risk groups among health workers and plan training programs to increase resilience.

Issue:
Vaccine hesitancy (VH) and the challenges faced by healthcare workers (HWs) in evaluating the complex risk-benefit ratio of vaccines' threaten the effectiveness of vaccination policy. The threat is enhanced when new vaccines are adopted during a pandemic emergency. In Italy, the Emilia-Romagna Region (ERR) created a specialized referral board called Vax-Consilium (VC) to support and guide HWs. Description of the problem: During a pandemic emergency, rapid and appropriate vaccine implementation is necessary to protect fragile individuals and to encourage vaccine adherence among exposed groups. Challenges in the realm of vaccination emerge, especially when dealing with patients with a complex medical history or previous vaccine adverse events. HWs were able to consult VC via a standardized digital form after obtaining the patient's informed consent. After a multidisciplinary and 15th European Public Health Conference 2022 evidence-based evaluation, VC provided a conclusive report on the individual vaccine risk-benefit analysis. No cost is charged to the patient.

Results:
During the anti-COVID-19 vaccination campaign in 2021, 148 interrogations were submitted to VC: 121 were evaluated, whereas 27 were withdrawn by the HWs or rejected because of insufficient documentation. Mean patient age was 44 years. No absolute contraindication was found, whereas in 23 cases VC recommended immunization with a different vaccine. The disciplines most frequently involved were neurology, angiology and cardiology. Lessons: VC implementation in EER proved highly effective. Indeed, during the pandemic, anti-COVID-19 vaccination coverage reached >90%. In addition, DTaP-polio-HBV-HIb and MMR vaccination coverage reached >95%. VC proved to be a highquality public health service. Not only was citizens' trust in the healthcare system enhanced and was VH reduced, but HWs knowledge improved even in cases not considered in national and international guidelines.

Background:
Disinfection of contact surfaces has become common practice since the two-year Covid-19 pandemic. The transmission of microbial agents has long been the focus of public health and hygiene awareness campaigns. Indeed, the development of new disinfection technologies and approaches is attracting considerable interest in the scientific community. Mixed plastic powders with antimicrobial properties and silver ions that compromise the metabolism of microorganisms could reduce the contamination of the contact surfaces. We aimed to evaluate an inorganic antimicrobial agent (IAA) based on Ag ions and zeolite mixed in a resin.

Methods:
This experimental study was carried out at the University of Siena, Italy. Different objects were produced in two versions: i) with an IAA mixed in plastic resin; ii) with a standard plastic mixture. To the eye, the two versions were indistinguishable and were randomly contaminated with the hands of several operators. After the hand contamination, T0, we sampled the objects using RODAC plates at T1 (1h) and T2 (6h), incubating at 36 C for 48 hours. Comparisons of the biocidal effect were made at T1 and T2. Statistical analysis was carried out with Stata.

Results:
The mean level of contamination of the objects made with standard plastic were, respectively 50 CFU (SD 36.5) at T1 and 20 CFU (SD 13.6) at T2. In comparison, the objects made with IAA resin showed a mean level of contamination of 10 CFU (SD 5.9) at T1 and 6 CFU (SD3.6) at T2. The objects made with IAA resin have shown a mean percentage reduction of contamination of 79.5% at T1 and 78.3% at T2. Conclusions: IAA resin reduced contamination on objects that came into contact with hands. Antimicrobial plastic blends, are a valuable aid in counteracting the spread of infection related to contact with surfaces and fomites. The public health system could support and raise awareness for using these innovative materials for everyday applications and in healthcare facilities.

Key messages:
Inorganic antimicrobial agent based on Ag ions and Zeolite mixed in a resin are efficient in reducing the contamination on different items in a real-life context. Public health system have to support and sensitize to production with inorganic materials with proven antimicrobial properties.