Vaccines are one of the most reliable and cost-effective public health interventions ever implemented that are saving millions of lives each year [1-2]. Following the deciphering of the genome sequence of SARS-CoV-2 in early 2020 and the declaration of the pandemic by WHO in March 2020 [3-4],scientists and pharmaceutical companies are racing against time in efforts to develop vaccines. Older adults, persons with certain coexisting morbid conditions (Coronary heart disease, Hypertension, Diabetes mellitus, Obesity, Chronic obstructive airway disorders, Chronic diseases of the lung, liver, heart and kidney) and front-line workers are at highest risk for Covid-19 and its complications. Recent data show increasing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and Covid-19 in other populations, including younger adults [5-6]. As of 4th December 2021, there had been more than 3.4 crore cases and nearly 5 lac reported deaths from COVID-19 in India [7]. In May 2020, the 73rd World Health Assembly issued a resolution recognizing the role of extensive immunization as a global public-health goal for preventing, containing and stopping transmission of SARS-CoV-2.  Global equitable access to a vaccine, particularly protecting health care workers and those most-at-risk is the only way to mitigate the public health and economic impact of the pandemic and is the current priority. The vaccine is to be used in conjunction with other control measures such as use of mask, hand hygeine and social distancing. While countries, including India, have taken strong measures to contain the spread of COVID-19 through better diagnostics and treatment, vaccines will provide a solution by enhancing immunity and containing the disease spread.  Currently, India has three vaccines with fourth about to debut in the country, which has been administered as staggering 41.8 crore doses, fully vaccinating 8.76 crore people that’s approximately 6.5% of the population. Amongst Indian vaccines the first and foremost is India’s indigenous COVAXIN, which works on whole-virion inactivated Vero Cell technology and the second one is COVISHEILD (Indian brand name for Oxford AstrZeneca recombinant vaccine) which is based on replication deficient chimpanzee adenovirus vector encoding for SARS-CoV-2 spike glycoprotein. Both require 2 doses of 0.5 ml and should be stored at 2-8^o   Celsius.  Third   comes  Russia’s   Sputnik  V vaccine which got approval on 14th April 2021 in India and is based on 2 viral vectors which are deficient in E1 replication gene. The 2 doses of this are to be administered 21 days apart. India is on the verge of getting a fourth and the world’s first single dose vaccine by Johnson and Johnson [8]. Although a safe and effective vaccine holds the greatest promise for resolving the COVID-19 pandemic, hesitancy to accept vaccines remains common. Many people including health care workers have doubts about vaccine safety, and this is going to be a major challenge to be resolved by health care providers and policy makers to increase the widespread acceptance of the vaccines [6]. With this background, the present study was undertaken to assess the COVID 19 Vaccination status of patients and hospital staff at a Tertiary care hospital in a district of Maharashtra. 

A Hospital based prospective study was carried out in admitted COVID wards of a tertiary care hospital in a  District of Maharashtra State.The study was carried out for a period of 6  months (1^st June to 30^th November 2021). Before the commencement of data collection, written informed consent was taken from each participant. 

All COVID positive patients in designated COVID wards were interviewed using a pretested, predesigned questionnaire. Each patient was subjected to detailed history regarding COVID vaccination such as type of COVID vaccine received (Covaxin, Covisheild or other type if any), number of doses taken and side effects. Those who had taken single dose of either Covaxin or Covisheild vaccine are labelled as partially vaccinated and those who had received 2 doses of either Covaxin or Covisheild vaccine are labelled as fully vaccinated. Also, all the Covid positive patients were followed up at periodic interval to see the outcome in them. The outcome was noted as Discharged, DAMA (Discharge against medical advice or Death. 

In addition to COVID positive patients, vaccination data of 1501 heath care workers including teaching, non-teaching staff and medical students was also gathered. 125 Medical teachers, 110 Non-teaching staff (Clerical and administrative staff), 306 Nurses, 59 Nursing students, 706 Undergraduate students, 72 Post graduate students pursuing MD/MS in various clinical and non-clinical departments and 123 Interns were enrolled in the study. The study was carried out after obtaining permission from Institutional ethical committee.

Data thus collected was entered in microsoft word excel sheet, compiled and statistically analysed by using proportion and percentages.

Table 1 shows the distribution of admitted hospital patients according to their vaccination status. Surprisingly, almost all admitted COVID positive patients had been vaccinated against COVID 19 either fully (received 2 doses either of Covishield or Covaxin) or partially vaccinated (received single dose either of Covishield or Covaxin). Overall, 72.4% patients were partially vaccinated and 27.6% were fully vaccinated.

It was observed that majority of the admitted COVID positive patients were partially vaccinated (Covishield 50.4%, Covaxin 22%), whereas 15% were fully vaccinated with Covishield and 12.6% with Covaxin. None of the patients gave history of receiving any other Corona vaccine apart from Covishield and Covaxin.

The outcome of admitted Covid positive vaccinated patients has been shown in Table II. It was noted that out of total 119 patients, 109 (91.6%) patients had got cured of Covid 19 disease and had been discharged. Whereas 10 (8.4%) patients succumbed to Covid 19 and its complications despite being partially or fully vaccinated against COVID vaccine.

As far as vaccination status of Hospital staff of tertiary care hospital is concerned, it was observed that out of total 1501 staff and students, 162 (10.8%) were partially vaccinated, 1199 (79.9%) were fully vaccinated and 140 (9.3%) remained unvaccinated.

Among hospital staff and students, majority of medical undergraduate students were fully vaccinated (91.6%) followed   by   medical  teachers   (90.4%),   and  least were nurses (57.5%). Among partially vaccinated staff, majority were nurses (22.2%) followed by nursing students 20.53% and least were Interns (3.3%). 32.5% Interns were found to be unvaccinated. Only 1 (1.4%) postgraduate student did not receive any Covid vaccine.

Table 1: Vaccination Status of Patients Admitted in Hospital

Table 2: Outcome of Vaccinated Patients

Table 3: Covid-19 Vaccination Status in Hospital Staff, Students and Interns

Note: Figures in parentheses indicate percentage

This study sought to assess the vaccination status of COVID 19 Vaccination status of patients and hospital staff at a Tertiary care hospital. Even though safe and effective vaccines are now being administered, vaccination programs still face significant obstacles. Refusal to accept the vaccine may substantially diminish the population impact. Study based on a sample from 19 countries involving 13,426 participants showed that the global acceptance of COVID-19 vaccines ranges between as low as 54.8% from Russia to as high as 88.6% from China [9]. Moreover, most western countries report relatively higher public acceptance (59–75%) [6,9].  Younger participants (Undergraduate and postgraduate students) were more likely to accept COVID-19 vaccines in the current study, contrary to studies reporting higher acceptance among older age groups [9]. This could be due to the different age distribution in different studies. Using a May 2020 survey, Malik et al. [10] found 67% reported they would accept a COVID-19 vaccine but likely acceptance varied by demographic group, with males, older adults, Asians, and college graduates more prone to accept. Hence, understanding why people feel hesitant towards a vaccine against COVID-19 is of paramount importance, as this can help boost vaccine acceptance to limit the spread of the disease. Further research to improve public health policymakingis needed to track changes in factors that influence vaccine acceptance. 

Based on the findings of our study, we conclude that Covid infection cure rate was very high in admitted vaccinated patients (91.6%). Whereas the mortality rate was found to be 8.4% among vaccinees. Thus available vaccines were found to be highly effective in reducing the severity of COVID-19 infection. Moreover, 90.7% hospital staff including students was found to be vaccinated against Covid 19 with preponderance among postgraduate students (98.6%) and undergraduate students (97.7%) followed by teaching staff (96.8%). This reflects greater acceptance of vaccine in younger population.The main reasons for the participants’ vaccination refusal or hesitancy were concerns regarding the use of vaccines, side effects and a lack of trust in them.

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