News in brief: Cath labs closed due to unvaccinated staff; Cardiology consent forms are not understandable; Link between COVID-19 vax and menstrual changes needs investigating

Cath labs closed due to unvaccinated staff exposure

Catheter labs have been closed at one of Sydney’s major hospitals and cardiologists ordered into isolation after two unvaccinated nurses worked there while infectious, according to media reports

Cardiologists at St Vincent’s Hospital said procedures including angiograms, pacemakers, stent and valve replacements have been cancelled after the unvaccinated nurses worked shifts across at least four cardiac wards.

“We normally run four cardiac cath labs every day but because of [the exposures] we are now down to running only one theatre, and only for half a day with reduced staff,” they told the Sydney Morning Herald.

NSW Health has set a 30 September deadline for the remaining 12% of healthcare staff who are unvaccinated to receive at least one dose as a condition of being able to work.

Cardiology consent forms are not understandable for many

Hospital consent forms for cardiology procedures cannot be easily read and understood by patients with low health literacy, an Australian study has found.

A review of 37 cardiology-related consent forms found that only one met the standard criteria for being ‘understandable’ for people with low health literacy, and most needed a high level of education to be understood. Most consent form also failed to use images and captions, effectively, according to Sydney University researchers who said the findings had significant implications for informed consent.

They suggested that patient consent forms be designed using tools such as the PEMAT-P which embody health literate design principles. Online readability calculators can be used to get the reading level down to the recommended Grade 8 level, and patient/consumer representative input can also help produce understandable consent forms, they said.

Link between COVID-19 vax and menstrual changes needs investigating

A link between COVID-19 vaccination and menstrual changes is “plausible and should be investigated”, according to Dr Victoria Male, a reproductive specialist at Imperial College London.

In an editorial published in the BMJ, Dr Male said the Medicines and Healthcare products Agency had received 30,000 reports of menstrual and unexpected bleeding post vaccination with both mRNA and adenovirus vectored COVID-19 vaccines.

This number is still considered low given the proportion of people who have received COVID-19 vaccination and the prevalence of menstrual disorders in the general population. Also, in most cases periods have returned to normal by the following cycle, and there is no evidence to suggest that vaccination adversely affects fertility.

However, while menstrual changes and unexpected bleeding are not currently classed as common side effects of COVID-19 vaccination, current data collection methods make it difficult to draw any firm conclusions, Dr Male noted. Instead, she argued that researchers should be using approaches that compare the incidence of menstrual issues across vaccinated and unvaccinated populations.

“Although reported changes to the menstrual cycle after vaccination are short lived, robust research into this possible adverse reaction remains critical to the overall success of the vaccination programme,” she said. “Vaccine hesitancy among young women is largely driven by false claims that COVID-19 vaccines could harm their chances of future pregnancy. Failing to thoroughly investigate reports of menstrual changes after vaccination is likely to fuel these fears.”

While more evidence on a potential link is gathered, clinicians should encourage anybody experiencing menstrual issues post vaccination to report them to the MHRA’s yellow card scheme, Dr Male advised. Any persistent change to periods persisting or new vaginal bleeds post menopause should be managed as per normal clinical guidelines.

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