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Hus’s instructions for vaccinated workers cause confusion – THL: “There is a contradiction and a risk here” – Finland


A Sote worker who has received two doses of coron vaccine is required to come to work even if a coronavirus has been diagnosed in a person living in the same household.

“Some Uncertainty has arisen as to what to do in a situation where a vaccinated Sote worker is exposed to a coronavirus. ‘

This is the beginning of Hus’s instructions regarding the quarantine regulations for coronary vaccinees, which were distributed to employees of Helsinki Malmi Hospital by e-mail last week. And so it goes on:

“If a sote worker who has received two doses of vaccine is exposed to the coronavirus, no quarantine order is made and voluntary quarantine is not recommended. Despite the vaccination, the mouth-nose shield should be used, safety intervals should be observed and good hand and cough hygiene should be ensured. ”

In practice, the guidelines mean that if, for example, a person living in the same household working in on-call, who received two doses of vaccine, were diagnosed with a coronavirus, the worker who received the vaccinated doses would still be obliged to come to on-call. However, the vaccine has not been shown to prevent the spread of the disease.

Hanna Nohynek, Chief Physician of the Department of Health and Welfare, and Markku Mäkijärvi, Chief Physician, Director of the Helsinki and Uusimaa Hospital District.­

Chief Physician of the Helsinki and Uusimaa Hospital District Markku Mäkijärvi and Chief Physician of the Department of Health and Welfare Hanna Nohynek confirm that this can be done.

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– The employee must also be asymptomatic. It has been thought that the worker should have two vaccinations and normal protective equipment in accordance with the instructions. Then, in a way, the risk of being an infectious is estimated to be quite low. Quarantine is always a secondary measure to other more effective protection measures, Mäkijärvi says.

However, is there no contradiction in the guideline, as the vaccine has not been shown to prevent the spread of the disease?

According to THL’s Nohynek, there is a contradiction in the guidelines, but the guidelines are justified. Mäkijärvi does not take a direct position on this.

– After all, there is a contradiction and a risk of 100% virus secretion inhibition has not been demonstrated in vaccinated individuals. However, virus secretion is reduced by up to four times in those who receive two doses of the vaccine. From that perspective, this is justified, Nohynek says.

– If it is two weeks after receiving the second dose of the vaccine, then you can come to work even if your spouse is corona positive at home, he continues.

For example, a person working in the emergency department is dealing with the unvaccinated, even though he or she has protective equipment. Isn’t there a big risk involved if the vaccinee had a household member with coronavirus, for example, at home?

– Yes, it is a risk and it is therefore urged that vaccinated people also use appropriate protective equipment. This is especially important when viral variants are on the rise, when it is not entirely known how much protection a vaccine provides against them. It now appears that, for example, in the case of South African variants, the vaccine prevents the development of mild symptoms worse, but against serious forms of disease, vaccines still seem to be effective. Even in light of this information, it is important to be careful so far, Nohynek says.

– However, some instructions must be given on the basis of incomplete information. If, for example, Sote workers are subject to too strict guidelines and there are therefore not enough workers to work, that is not a good thing either. Not all exposed health professionals can be home for two weeks, he says.

Mäkijärvi emphasizes that the risk of spreading the infection has been considered low.

– It is certainly the case that risks are weighed here. A sote worker who has been vaccinated twice and wears protective equipment has a low risk of spreading the coronavirus to patients and colleagues. However, more and more information is now being gathered that vaccinations reduce the risk of infection. However, the risk of infecting vaccinated people is probably lower compared to non-vaccinated ones, Mäkijärvi says.

The guideline also mentions that “for those who have been vaccinated once, the quarantine instructions are similar to those for those who have not been vaccinated”. Does this therefore mean that a person who has received two doses of a vaccine will distribute less than a person who has received one dose of the vaccine?

– Yes, it is probably based on the fact that after the first dose, both the protection and the reduction in the risk of infection are lower than after the protection provided by two doses of the vaccine. It is a risk assessment. This is the magnitude of the risk assessed for others and the risk assessed for oneself, Mäkijärvi states.

Nohynek, for his part, questions that the first dose would not be effective enough.

– Decreased viral shedding has been seen after a single dose, for example in Pfizer and Biontech’s coronary vaccine three weeks after the first dose, the effect is already really high. Here is the precautionary principle thought that after a single dose, protection is somewhat less, Nohynek believes.

– THL has not yet made any other recommendation on these issues, we will wait and see what the situation will be after a possible closure, and what new information is then available on the effect of vaccines on viral infection, secretion and infectivity.



Source site www.is.fi

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