key: cord-0924516-1jicw9nl
authors: Martin, Martinot; Zadeh, Mahsa Mohseni; Marion, Laurent; Roncalez, Daniel
title: COVID-19 vaccine: missed opportunities and hospital vaccine implementation
date: 2022-04-01
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2022.03.036
sha: d3bf76db46e89cca3de14a2cac72fe2260f4c17e
doc_id: 924516
cord_uid: 1jicw9nl

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Despite national campaigns, vaccination centers implementation, and possible of vaccination by general practitioners (GPs) and pharmacists, the vaccination coverage in France by January 5, 2022 in adults and children aged > 12 years was only 91,9% for vaccination with one dose, 89,9% with two doses and only 45,5% for vaccination with a booster dose [1] . There are multiple and complex reasons for people being unvaccinated [2] Some are primarily related to the patient's perception of safety concerns about the COVID-19 vaccine or, less frequently, unfounded beliefs. More practical reasons have also been pointed out: in our private experience during the 4 th wave of the disease, we found that around 1/3 of unvaccinated patients hospitalized in our departments for COVID-19 reported a lack of proposal by their GPs or lack of access to vaccine centers, especially among very old, non-native Frenchspeaking, or psychiatric patients [3] . Specific outpatient groups, such as those undergoing hemodialysis or graft surgery, with hemopathies, or under certain immunosuppressive treatments, have specific vaccine guidelines not always known by their GPs. Lastly, mRNA vaccination is challenging to perform in small structures, due to the need for maintaining the cold chain, preparing of a ready-to-use syringe (multidose vaccines), providing supervision by a healthcare worker, and necessity to record administration required vaccine pathways.

The Royal Cornwall Hospitals [4] and the New York State Psychiatric Hospital System (NYS) [3] have reported their COVID-19 vaccination program experiences as "hospital vaccine centers" for inpatients. Interestingly, the large-scale efficiency of hospital vaccine programs was validated by the NYS experience [3] . However, despite these reports, hospitals are usually not considered COVID-19 vaccination centers for inpatients, although they are used for handling COVID-19 immunization for at least HCWs, which would allow its quick and efficient implementation for inpatients or specific outpatient cohorts [5] .

Hospitalization is a unique opportunity to track unvaccinated cases, such as in isolated patients or frail patients who did not get access to vaccine campaigns, and to convince hesitant patients to get vaccinated. Specific outpatient cohorts, such as highly immunosuppressed patients, are also regularly followed by hospital specialists who are aware of specific guidelines.

We implemented a flexible organization to facilitate the immunization of inpatients with the 

COVID-19 vaccination acceptability in the UK at the start of the vaccination programme: a nationally representative cross-sectional survey (CoVAccS -wave 2)

COVID-19 Case Rates After Surveillance and Vaccinations in a Statewide Psychiatric Hospital System

Covid-19 Vaccination of Inpatients ans Specific Outpatents Groups Standard Operating Procedure

Covid-19 vaccine management (Comirnaty and mrna-1273 Moderna) in a teaching hospital in Italy: a short report on the vaccination campaign

The authors have no conflicts of interest to declare.

The authors did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

The study was approved by the Local Ethics Committee (Hôpitaux Civils de Colmar N° 1/2022).

All authors have approved the final submitted version and participated in data collection and analysis.MM wrote the manuscript. MM, DR and LM revised the manuscript for content.

The authors thank Loïc Jochault for his help in data collecting.