Date of Award

11-13-2022

Degree Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

First Advisor

Dr. Rafat jan

Second Advisor

Dr. Salma Rattani

Third Advisor

Ms. Dilshad Begum

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Although the COVID-19 vaccine has played an important role in controlling COVID-19 infection, but even after the vaccination, cases of COVID-19 vaccine breakthrough infections have been reported. This study investigated the prevalence and severity of the COVID-19 vaccine breakthrough infection. Purpose: The purpose of this study was to determine the prevalence of COVID-19 vaccine breakthrough infection among the vaccinated patients admitted in the critical units of tertiary care hospitals in Peshawar, Pakistan. To determine the severity of the breakthrough infections, the National Clinical Management guidelines for COVID-19 infection were used. This research also determined the mortality and recovery rates of patients who had the COVID-19 breakthrough infection.
Method: A quantitative chart review study design, with consecutive sampling technique, was used for this study. The study was conducted in three tertiary care hospitals, where the data was collected from the medical records of the patients with infections. The data was analyzed through the Statistical Package for Social Sciences (SPSS) 25. In descriptive statistics, percentages and frequencies were calculated for categorical variables, and for inferential statistic, non-parametric tests, that is Chi-square and Fisher’s tests, were applied. P-values were calculated for significant associations between the demographic and outcome variables.
Findings: A total of 5,815 files were reviewed; out of that, 242 patients presented with the COVID[1]19 vaccine breakthrough infections. The prevalence of COVID-19 vaccine breakthrough infections was 4.16%. Most of the infected patients were noted in the age categories 58-67 and 68-77 years. In all the infected patients, 51.2 % of them were females. More than half 52% of the patients were admitted in the public hospital. Most of the patients were severe followed by non-severe patients. The critical patients were mostly found in the males (11.2%), age category 58-67 years (39.6 %), uneducated (15.3%), and with comorbidities (39%). Almost 50% of the patients were vaccinated with Sinovac.Coronavac. Patients with single-dose vaccines had the least number of critical patients. Only 9.5% of the patients were vaccinated with booster dose vaccines and most of them presented with severe symptoms. The highest number of recovered patients presented with non[1]severe symptoms, and the least number of the patients recovered from those who presented with critical symptoms. Pak vac vaccine had a 100% recovery rate, followed by the Pfizer vaccine while AstraZeneca had the lowest recovery rate.
Conclusion: Patients reported a high prevalence rate of COVID-19 vaccine breakthrough infections. Even after vaccination, the possibility of individuals getting the COVID-19 remains. However, based on the type of vaccination and the number of doses/vaccination status the severity varied. Therefore, proper management should be ensured to control the infection. The time between the number of doses, and even the composition of vaccines, needs to be adjusted, so that they offer good efficacy against the variants as well.

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