Predictors of VAEs.

BackgroundThere is a paucity of research regarding COVID-19 vaccines administration errors (VAEs) during the COVID-19 pandemic. This study aimed to investigate the prevalence, types, severity, causes and predictors of VAEs in Jordan during the recent pandemic.MethodThis was a 3-day (Sunday, Tuesday and Thursday of the third week of November 2021) prospective, covert observational point prevalence study. It involved direct observation of vaccination administration practices by covert observers who recorded data on a standardized form, documenting the administration process, observed errors, and contextual factors, such as workload, distractions, and interruptions directly after each observation. Univariate and multivariable logistic models were constructed in order to identify predictors of VAEs.ResultsThe point prevalence of VAEs was 2.4% (209 errors / 8743 vaccine doses). These VAEs were categorized into six types: timing (interval) error (69, 33.0%) dosing error (60, 28.7%), incorrect vaccine product (42, 20.1%), site/route error (17, 8.1%), documentation error (15, 7.2%), and other (6, 2.9%). Most errors were minor (133, 63.6%) and moderate (63, 30.1%). There were 174 (54.9%) healthcare provider-related contributing factors and 102 (32.2%) patient-related factors. Receiving the vaccine in the Southern region compared to Capital region (aOR: 1.92; 95% confidence intervals, 95%CI: 1.41–2.49; p = 0.001) and receiving the vaccine during peak hours compared to regular hours (aOR: 2.18; 95%CI: 1.58–3.86; p = 0.002) were significant predictors of VAEs.ConclusionThough infrequent, VAEs had prevalence higher than previously reported in the literature, posing serious public health challenges, which might have compromised immunization efficacy and patient safety. Identifying these errors’ causes and formulating strategies to reduce them is crucial for enhancing vaccination results.研究背景：新冠疫情期间，针对新冠疫苗接种错误（Vaccine Administration Errors, VAEs）的相关研究较为匮乏。本研究旨在探究近期约旦境内新冠疫情期间VAEs的流行率、类型、严重程度、诱发因素及预测因子。 研究方法：本研究为一项为期3天的前瞻性隐蔽观察时点流行率研究，观察时段为2021年11月第三周的周日、周二及周四。研究由隐蔽观察员直接观察疫苗接种操作流程，在每次观察结束后即刻通过标准化表单记录接种过程、观察到的差错及相关情境因素（如工作量、干扰情况与突发中断等）。本研究构建单因素及多因素logistic回归模型，以识别VAEs的预测因子。 研究结果：VAEs的时点流行率为2.4%（8743剂次疫苗中共计209例差错）。本次研究将VAEs分为6类：时间（间隔）错误69例（33.0%）、剂量错误60例（28.7%）、疫苗品种选择错误42例（20.1%）、接种部位/途径错误17例（8.1%）、记录错误15例（7.2%）及其他类型6例（2.9%）。多数差错为轻度（133例，63.6%）与中度（63例，30.1%）。诱发差错的因素中，174例（54.9%）与医护人员相关，102例（32.2%）与患者相关。与首都地区接种相比，在南部地区接种（调整后比值比aOR=1.92；95%置信区间95%CI：1.41~2.49；P=0.001），以及在高峰时段接种而非常规时段接种（aOR=2.18；95%CI：1.58~3.86；P=0.002），均为VAEs发生的显著预测因子。 研究结论：尽管VAEs并不常见，但其流行率高于既往文献报道的结果，这构成了严峻的公共卫生挑战，甚至可能削弱疫苗接种效果并危及患者安全。明确此类差错的诱发因素并制定针对性防控策略，对于提升疫苗接种工作质量至关重要。