COVID-19 accounted for much more absenteeism than influenza among Greek healthcare personnel (HCP) with low vaccine uptake in 2022 and 2023, highlighting the need to stay current with vaccinations against both diseases, according to an observational study led by a National Public Health Organization researcher in Athens.

For the study, published yesterday in the American Journal of Infection Control, the researchers tested symptomatic HCP at four hospitals for COVID-19 and flu from November 2022 to May 2023 to estimate the number of missed workdays by disease type. The SARS-CoV-2 Omicron variant was predominant during the study period.

"To our knowledge, this is the first study to compare the burden of COVID-19 and seasonal influenza among HCP using data from the same season," the authors wrote.

COVID tied to 2 more days of sick time

A total of 9.2% of HCP were fully vaccinated, and 90.8% were partially vaccinated, against COVID-19. Flu vaccination coverage was 23.1%. HCP with flu were less likely to be current with the flu vaccine than unvaccinated workers with COVID-19 (14.0% vs 26.2%).

In total, 4,245 missed workdays were associated with COVID-19, compared with 333 for flu.

Among 5,752 HCP, 734 COVID-19 (incidence, 12.8%) and 93 flu (1.6%) cases were detected. Two COVID-infected HCP were hospitalized for 4 and 5 days, respectively.

The average number of workdays missed was 5.8 for COVID-19 and 3.6 for flu. In total, 4,245 missed workdays were associated with COVID-19, compared with 333 for flu. Analyses estimated that, on average, HCP with COVID-19 were absent for 1.91 more days than those with flu.

"The shorter duration of work absence among HCP with influenza than those with COVID-19 may be attributed to the milder clinical course of influenza, the particular seasonal influenza strain, and to differences in absenteeism policies," the researchers wrote. "Indeed, although post-COVID-19 isolation is not mandatory as in the first pandemic waves, a five-days leave is common practice for HCP in Greece. In contrast, there are no official recommendations for HCP diagnosed with influenza."

The findings underscore the value of COVID-19 and flu vaccination in protecting HCP health and protecting healthcare services from absenteeism, they concluded.

Bavarian Nordic and the Coalition for Epidemic Preparedness Innovations (CEPI) yesterday announced a partnership to advance the development of Bavarian Nordic's mpox vaccine for children in Africa.

CEPI has awarded $6.5 million to support phase 2 clinical trials of the MVA-BN nonreplicating vaccine in children ages 2 to 12 as compared to adults. The study will enroll 460 people in endemic regions who don't have a history of mpox illness or vaccination. Participants will receive two doses of the vaccine.

The study is expected to launch this year in one or more African countries.

Children hit especially hard

CEPI said the new partnership dovetails with a plan by African countries to coordinate efforts in to battle the virus, which was announced in April.

Richard Hatchett, MD, CEPI's chief executive officer, said children suffer disproportionately from mpox, a concerning and neglected disease that has spread rapidly in recent years. 

Multiple countries in East and Central Africa are battling mpox outbreaks, and so far this year the Democratic Republic of the Congo has reported more than 6,500 cases, 345 of them fatal, with children accounting for most infections and deaths.

Centers for Disease Control and Prevention (CDC) investigators report that about one in five US children had parents reporting vaccine hesitancy (VH) from 2019 to 2022, and VH increased after the authorization of the COVID-19 vaccine for children aged 5 to 11 years and declined for children aged 6 months to 4 years. 

The findings are published in Vaccine, and come as the US Food and Drug Administration's VRBPAC (Vaccines and Related Biological Products Advisory Committee) prepares to meet next week to pick COVID and influenza strains to include in updated vaccines.

The study was based on responses to the 2019 through 2022 National Immunization Surveys.

Overall, VH levels in the United States remained fairly consistent, at 19%, from quarter 2 in 2019 to quarter 3 in 2022. But at various points during the pandemic, certain demographic groups saw increases and decreases in VH. 

Hesitancy up in parents living below poverty line

Parents of children ages 5 to 11 had an average quarterly increase in parental VH from the first quarter of 2021 to quarter 3 of 2022. Parents living below the poverty level also had increasing VH throughout the study period. 

Official US approval of COVID-19 vaccines for children had varying effects on VH, depending on child age: For children ages 6 months to 4 years, VH dropped from 21.6% to 19.4%, a decrease of 2.2 percentage points (95% confidence interval, −3.9 to −0.6).

But VH increased among parents of children 5 to 11; after the authorization, 21.0% had a parent that reported VH, compared with 19.8% before. 

Due to concerns about COVID-19 vaccine safety and increased misinformation about vaccines during the COVID-19 pandemic, parental acceptance and confidence in routine childhood vaccines may have been altered.

"Parents of children aged 5–11 had a sharp increase in VH from Q1 2021 to Q3 2022. Similarly, those living below poverty also saw a gradual increase in VH throughout the study period. Due to concerns about COVID-19 vaccine safety and increased misinformation about vaccines during the COVID-19 pandemic, parental acceptance and confidence in routine childhood vaccines may have been altered," the authors concluded.