Background & objectives : COVID-19 pandemic has taken a significant toll on the health of the people across the globe, including India, and is still continuing with its rapidly evolving second wave. Although the COVID-19 vaccines effectively prevent infection, yet some cases of infections have been reported post-vaccination, raising concerns about their efficacy and safety. This study was aimed to investigate the occurrence of SARS-CoV-2 infection among the symptomatic-vaccinated healthcare workers (HCWs) and to analyze the severity of their disease. Methods : This retrospective study was done at a single multispecialty hospital, on the HCWs who have had COVID-19 vaccination, during the initial period of the vaccination drive (January 16 to April 24, 2021). The symptomatic post-vaccination infections in these HCWs were evaluated. Results : Eighty five of 3235 (2.63%) vaccinated HCWs acquired the SARS-CoV-2 infection after vaccination, during the study period. Of these, 65 (76.5%) were fully vaccinated (FV), and 20 (23.5%) were partially vaccinated (PV) and the protection rate of vaccination was 97.4 per cent [95 % confidence interval (CI)=96.8-97.9]. The odds ratio of acquiring infection among females was higher at 1.84 (95% CI=1.17-2.88; P=0.008) mainly because of their greater involvement in the patient care as nursing personnel. The chances of infections were the highest in the medical and nursing personnel, as compared to paramedical, administrative and supporting staff (P<0.001). Among the HCWs studied, only two required hospitalization (0.06%), none needed an intensive care unit (ICU) admission and there were no deaths. Interpretation & conclusions : The COVID-19 infection after vaccination occurred in a smaller subset (2.63%) of HCWs, in both PV and the FV groups. These infections were primarily minor and did not lead to severe disease. Overall, the vaccination with ChAdOx1 nCoV-19 vaccine (recombinant) prevented SARS-CoV-2 severe infection in the HCWs, leading to ICU admission and deaths.

Background and aims During the COVID-19 vaccination program in India, the healthcare workers were given the first priority. There are concerns regarding the occurrence of breakthrough infections after vaccination. We aimed to investigate the effictiveness of COVID-19 vaccines in preventing and reducing the severity of post-vaccination infections. Methods This retrospective test-negative case-control study examined 28342 vaccinated healthcare workers for symptomatic SARS-CoV-2 infections between January 16 to June 15, 2021. They worked at 43 Apollo Group hospitals in 24 Indian cities. These cohorts received either ChAdOx nCOV-19 (Recombinant) or the whole virion inactivated Vero cell vaccines. Various demographic, vaccination related and clinical parameters were evaluated. Results Symptomatic symptomatic post-vaccination infections occurred in a small number of vaccinated cohorts (5.07%, p < 0.001), and these were predominantly mild and did not result in hospitalization (p < 0.0001), or death. Both vaccines provided similar protection, with symptomatic infections in 5.11% and 4.58%, following ChAdOx nCOV-19 (Recombinant) and the whole virion inactivated Vero cell vaccines, respectively (p < 0.001). Nursing and Clinical staff and cohorts >50 years contracted more infections (p < 0.001). Two-dose vaccination has significantly lower odds of developing symptomatic infection (0.83, 95%CI – 0.72 to 0.97). Maximum infections occurred during the peak of the second COVID-19 wave from mid-April to May 2021 (p < 0.001). No significant difference existed in the infection between sex, vaccine type, and the number of vaccine doses received (p ≥ 0.05). Conclusion Symptomatic infections occurred in a small percentage of healthcare workers after COVID vaccination. Vaccination protected them from not only infection but also severe disease.

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Introduction With advances in monitoring, anesthesia, and minimally invasive techniques, same-day surgeries are expected to rise significantly in the coming years. In this group, patients undergo diagnostic and therapeutic procedures and are sent home on the same day. This poses a great responsibility on the doctors involved and the hospital services, in ensuring the absence of delays, unanticipated admissions, and unexpected adverse events. Patient selection criteria are being used effectively by various centers across the world to prevent elective case cancellation and unplanned hospital admission and identify high-risk cases for major complications including morbidity and mortality. In recent year patient selection criteria, based on the latest guidelines, are being used to identify the risk factors and channel patients for ambulatory, day-care, and inpatient categories. Aims and Objectives This article purposes a proper patient selection process for the improvement of quality and safety in patients undergoing day-care and office-based procedures. The patient selection criteria, if understood by all the team players, is instrumental in providing clinical guidance and appropriate patient triaging for caring for an ever-increasing, large volume of same-day surgical population. As the volume and complexity of the patient population grow, it is important to revise the patient selection criteria from time to time. Conclusion Patient selection criteria have to be developed and modified by bodies and institutions to suit local circumstances to channel patients for ambulatory, day-care, and inpatient categories. Processes, administrative, clinical, and technical standards must be in-built into place and the pathway need to be well understood by all the team players in an institution.