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Minardi V, Gallo R, Possenti V, Contoli B, Di Fonzo D, D'Andrea E, Masocco M. Influenza Vaccination Uptake and Prognostic Factors among Health Professionals in Italy: Results from the Nationwide Surveillance PASSI 2015-2018. Vaccines (Basel) 2023; 11:1223. [PMID: 37515039 PMCID: PMC10386716 DOI: 10.3390/vaccines11071223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than the general population. (2) The study's purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs. Non-HP (NHP). We analyzed 2014-2018 data (n = 105,608) from the Italian Behavioral Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8-26.1%) of MDs and 8.5% (CI 7.5-9.5%) of NMHP reported to have been vaccinated vs. 6.3% (CI 6.1-6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34 yy, respectively, 9.9%, 4.4%, 3.4% vs. 28.4%, 13.9%, 10.6% in 50-64 yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs. 30.5% in 2018). (4) Despite such an increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.
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Affiliation(s)
- Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Rosaria Gallo
- Primary Healthcare Unit, Health District 9, Local Health Unit Roma 2, 00159 Rome, Italy
- PhD Course Advances in Infectious Diseases, Microbiology, Legal Medicine and Public Health Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Possenti
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Benedetta Contoli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | | | - Elvira D'Andrea
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
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Ali I, Ijaz M, Rehman IU, Rahim A, Ata H. Knowledge, Attitude, Awareness, and Barriers Toward Influenza Vaccination Among Medical Doctors at Tertiary Care Health Settings in Peshawar, Pakistan-A Cross-Sectional Study. Front Public Health 2018; 6:173. [PMID: 29998091 PMCID: PMC6030373 DOI: 10.3389/fpubh.2018.00173] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 05/25/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: This study intends to evaluate the knowledge, attitude and awareness of medical doctors toward influenza vaccination and the reasons for not getting vaccinated. Methods: A cross-sectional study was carried out among medical doctors in three major tertiary care health settings in Peshawar, Khyber Pakhtunkhwa (KP), Pakistan. A web-based, pre-tested questionnaire was used for data collection. Results: A total of (n = 300) medical doctors were invited, however only (n = 215) participated in the study with a response rate of 71.7%. Among the participants, 95.3% (n = 205) were males with a mean age of 28.67 ± 3.89 years. By designation, 121(56.3%) were trainee medical officers and 40 (18.6%) were house officers. The majority 102(47.4%) had a job experience of 1-2 years. Of the total sample, 38 (17.7%) doctors reported having received some kind of vaccination, whereas only 19 (8.84%) were vaccinated against influenza. The results identified that the major barriers toward influenza vaccinations included (1) Unfamiliarity with Influenza vaccination availability (Relative Importance Index RII = 0.830), (2) Unavailability of Influenza vaccines due to lack of proper storage area in the institution (RII = 0.634), (3) Cost of vaccine (RII = 0.608), and (4) insufficient staff to administer vaccine (RII = 0.589). Additionally, 156 (72.6%) of doctors were not aware of the influenza immunization recommendation and guidelines published by the Advisory Committee on Immunization Practices (ACIP) and Centre for Disease Control and Prevention (CDC). Physicians obtained a high score (8.27 ± 1.61) of knowledge and understanding regarding influenza and its vaccination followed by medical officers (8.06 ± 1.37). Linear Regression analysis revealed that gender was significantly associated with the knowledge score with males having a higher score (8.0± 1.39) than females (6.80 ± 1.61 β = -1.254 and CI [-2.152 to -0.355], p = 0.006). Conclusion: A very low proportion of doctors were vaccinated against influenza, despite the published guidelines and recommendations. Strategies that address multiple aspects like increasing awareness and the importance of the influenza vaccine, the international recommendations and enhancing access and availability of the vaccine are needed to improve its coverage and health outcomes.
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Affiliation(s)
- Iftikhar Ali
- Department of Pharmacy, University of Swabi, Swabi, Pakistan
- Department of Pharmacy Services, Northwest General Hospital and Research Center, Peshawar, Pakistan
- Paraplegic Center, Peshawar, Pakistan
| | - Muhammad Ijaz
- Department of Medicine, Gajju Khan Medical College, Swabi, Pakistan
| | - Inayat U. Rehman
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Afaq Rahim
- Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Humera Ata
- Department of International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2018; 5:CD005188. [PMID: 29845606 PMCID: PMC6494593 DOI: 10.1002/14651858.cd005188.pub4] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effectiveness of interventions to increase influenza vaccination uptake in people aged 60 years and older varies by country and participant characteristics. This review updates versions published in 2010 and 2014. OBJECTIVES To assess access, provider, system, and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community. SEARCH METHODS We searched CENTRAL, which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE, Embase, CINAHL, and ERIC for this update, as well as WHO ICTRP and ClinicalTrials.gov for ongoing studies to 7 December 2017. We also searched the reference lists of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster-randomised trials of interventions to increase influenza vaccination in people aged 60 years or older in the community. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as specified by Cochrane. MAIN RESULTS We included three new RCTs for this update (total 61 RCTs; 1,055,337 participants). Trials involved people aged 60 years and older living in the community in high-income countries. Heterogeneity limited some meta-analyses. We assessed studies as at low risk of bias for randomisation (38%), allocation concealment (11%), blinding (44%), and selective reporting (100%). Half (51%) had missing data. We assessed the evidence as low-quality. We identified three levels of intervention intensity: low (e.g. postcards), medium (e.g. personalised phone calls), and high (e.g. home visits, facilitators).Increasing community demand (12 strategies, 41 trials, 53 study arms, 767,460 participants)One successful intervention that could be meta-analysed was client reminders or recalls by letter plus leaflet or postcard compared to reminder (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.15; 3 studies; 64,200 participants). Successful interventions tested by single studies were patient outreach by retired teachers (OR 3.33, 95% CI 1.79 to 6.22); invitations by clinic receptionists (OR 2.72, 95% CI 1.55 to 4.76); nurses or pharmacists educating and nurses vaccinating patients (OR 152.95, 95% CI 9.39 to 2490.67); medical students counselling patients (OR 1.62, 95% CI 1.11 to 2.35); and multiple recall questionnaires (OR 1.13, 95% CI 1.03 to 1.24).Some interventions could not be meta-analysed due to significant heterogeneity: 17 studies tested simple reminders (11 with 95% CI entirely above unity); 16 tested personalised reminders (12 with 95% CI entirely above unity); two investigated customised compared to form letters (both 95% CI above unity); and four studies examined the impact of health risk appraisals (all had 95% CI above unity). One study of a lottery for free groceries was not effective.Enhancing vaccination access (6 strategies, 8 trials, 10 arms, 9353 participants)We meta-analysed results from two studies of home visits (OR 1.30, 95% CI 1.05 to 1.61) and two studies that tested free vaccine compared to patient payment for vaccine (OR 2.36, 95% CI 1.98 to 2.82). We were unable to conduct meta-analyses of two studies of home visits by nurses plus a physician care plan (both with 95% CI above unity) and two studies of free vaccine compared to no intervention (both with 95% CI above unity). One study of group visits (OR 27.2, 95% CI 1.60 to 463.3) was effective, and one study of home visits compared to safety interventions was not.Provider- or system-based interventions (11 strategies, 15 trials, 17 arms, 278,524 participants)One successful intervention that could be meta-analysed focused on payments to physicians (OR 2.22, 95% CI 1.77 to 2.77). Successful interventions tested by individual studies were: reminding physicians to vaccinate all patients (OR 2.47, 95% CI 1.53 to 3.99); posters in clinics presenting vaccination rates and encouraging competition between doctors (OR 2.03, 95% CI 1.86 to 2.22); and chart reviews and benchmarking to the rates achieved by the top 10% of physicians (OR 3.43, 95% CI 2.37 to 4.97).We were unable to meta-analyse four studies that looked at physician reminders (three studies with 95% CI above unity) and three studies of facilitator encouragement of vaccination (two studies with 95% CI above unity). Interventions that were not effective were: comparing letters on discharge from hospital to letters to general practitioners; posters plus postcards versus posters alone; educational reminders, academic detailing, and peer comparisons compared to mailed educational materials; educational outreach plus feedback to teams versus written feedback; and an intervention to increase staff vaccination rates.Interventions at the societal levelNo studies reported on societal-level interventions.Study funding sourcesStudies were funded by government health organisations (n = 33), foundations (n = 9), organisations that provided healthcare services in the studies (n = 3), and a pharmaceutical company offering free vaccines (n = 1). Fifteen studies did not report study funding sources. AUTHORS' CONCLUSIONS We identified interventions that demonstrated significant positive effects of low (postcards), medium (personalised phone calls), and high (home visits, facilitators) intensity that increase community demand for vaccination, enhance access, and improve provider/system response. The overall GRADE assessment of the evidence was moderate quality. Conclusions are unchanged from the 2014 review.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineHealth Sciences Centre3330 Hospital Drive NWCalgaryABCanadaT2N 4N1
| | - Diane L Lorenzetti
- Faculty of Medicine, University of CalgaryDepartment of Community Health Sciences3rd Floor TRW3280 Hospital Drive NWCalgaryABCanadaT2N 4Z6
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Chérif D, N Guessan KEN, Coulibaly D, Zengbé-Acray P, Ekra KD, Traoré A, Tiembré I. [Evaluation of epidemiological monitoring of post-vaccination adverse reactions in Abidjan]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2018; 30:411-417. [PMID: 30541271 DOI: 10.3917/spub.183.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This study was designed to evaluate the adverse events following immunization (AEFI) monitoring system in Abidjan health districts. METHODS This cross-sectional study focused on activities conducted between 1st January and 31st December 2015 in the nine health districts of Abidjan. Data were collected by means of a questionnaire based on the model of World Health Organization evaluation forms. These questionnaires were administered to personnel in charge of epidemiological surveillance in the health districts and the personnel of district hospitals and health centres. RESULTS The AEFI monitoring system, apart from its simplicity and flexibility, remains fairly ineffective due to the relatively low acceptability by all health workers involved. Only 4% of healthcare personnel respondents participate in this activity; 55% of health districts reported cases of AEFI and 25% of health centres reported cases of adverse events. The low acceptability makes this system less sensitive and ineffective for health policy decision-making designed to reduce adverse events following immunization. CONCLUSION Improved performance of the AEFI monitoring system requires better training of health workers, better data processing equipment and improved community participation.
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Talbot TR, Bradley SE, Cosgrove SE, Ruef C, Siegel JD, Weber DJ. Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages. Infect Control Hosp Epidemiol 2016; 26:882-90. [PMID: 16320984 DOI: 10.1086/502512] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractInfluenza causes substantial morbidity and mortality annually, particularly in high-risk groups such as the elderly, young children, immunosuppressed individuals, and individuals with chronic illnesses. Healthcare-associated transmission of influenza contributes to this burden but is often under-recognized except in the setting of large outbreaks. The Centers for Disease Control and Prevention has recommended annual influenza vaccination for healthcare workers (HCWs) with direct patient contact since 1984 and for all HCWs since 1993. The rationale for these recommendations is to reduce the chance that HCWs serve as vectors for healthcare-associated influenza due to their close contact with high-risk patients and to enhance both HCW and patient safety. Despite these recommendations as well as the effectiveness of interventions designed to increase HCW vaccination rates, the percentage of HCWs vaccinated annually remains unacceptably low. Ironically, at the same time that campaigns have sought to increase HCW vaccination rates, vaccine shortages, such as the shortage during the 2004-2005 influenza season, present challenges regarding allocation of available vaccine supplies to both patients and HCWs. This two-part document outlines the position of the Society for Healthcare Epidemiology of America on influenza vaccination for HCWs and provides guidance for the allocation of influenza vaccine to HCWs during a vaccine shortage based on influenza transmission routes and the essential need for a practical and adaptive strategy for allocation. These recommendations apply to all types of healthcare facilities, including acute care hospitals, long-term-care facilities, and ambulatory care settings.
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Affiliation(s)
- Thomas R Talbot
- Department of Medicine, Vanderbilt University School of Medicine, A-2200 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232, USA.
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Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Database Syst Rev 2016; 2016:CD005187. [PMID: 27251461 PMCID: PMC8504984 DOI: 10.1002/14651858.cd005187.pub5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A systematic review found that 3% of working adults who had received influenza vaccine and 5% of those who were unvaccinated had laboratory-proven influenza per season; in healthcare workers (HCWs) these percentages were 5% and 8% respectively. Healthcare workers may transmit influenza to patients. OBJECTIVES To identify all randomised controlled trials (RCTs) and non-RCTs assessing the effects of vaccinating healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs). SEARCH METHODS We searched CENTRAL (2015, Issue 9), MEDLINE (1966 to October week 3, 2015), EMBASE (1974 to October 2015) and Web of Science (2006 to October 2015), but Biological Abstracts only from 1969 to March 2013 and Science Citation Index-Expanded from 1974 to March 2013 due to lack of institutional access in 2015. SELECTION CRITERIA Randomised controlled trials (RCTs) and non-RCTs of influenza vaccination of healthcare workers caring for individuals aged 60 years or older in LTCIs and the incidence of laboratory-proven influenza and its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 years or older in LTCIs. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed risk of bias. Effects on dichotomous outcomes were measured as risk differences (RDs) with 95% confidence intervals (CIs). We assessed the quality of evidence with GRADE. MAIN RESULTS We identified four cluster-RCTs and one cohort study (n = 12,742) of influenza vaccination for HCWs caring for individuals ≥ 60 years in LTCIs. Four cluster RCTs (5896 residents) provided outcome data that addressed the objectives of our review. The studies were comparable in their study populations, intervention and outcome measures. The studies did not report adverse events. The principal sources of bias in the studies related to attrition, lack of blinding, contamination in the control groups and low rates of vaccination coverage in the intervention arms, leading us to downgrade the quality of evidence for all outcomes due to serious risk of bias.Offering influenza vaccination to HCWs based in long term care homes may have little or no effect on the number of residents who develop laboratory-proven influenza compared with those living in care homes where no vaccination is offered (RD 0 (95% CI -0.03 to 0.03), two studies with samples taken from 752 participants; low quality evidence). HCW vaccination probably leads to a reduction in lower respiratory tract infection in residents from 6% to 4% (RD -0.02 (95% CI -0.04 to 0.01), one study of 3400 people; moderate quality evidence). HCW vaccination programmes may have little or no effect on the number of residents admitted to hospital for respiratory illness (RD 0 (95% CI -0.02 to 0.02, one study of 1059 people; low quality evidence). We decided not to combine data on deaths from lower respiratory tract infection (two studies of 4459 people) or all cause deaths (four studies of 8468 people). The direction and size of difference in risk varied between the studies. We are uncertain as to the effect of vaccination on these outcomes due to the very low quality of evidence. Adjusted analyses, which took into account the cluster design, did not differ substantively from the pooled analysis with unadjusted data. AUTHORS' CONCLUSIONS Our review findings have not identified conclusive evidence of benefit of HCW vaccination programmes on specific outcomes of laboratory-proven influenza, its complications (lower respiratory tract infection, hospitalisation or death due to lower respiratory tract illness), or all cause mortality in people over the age of 60 who live in care institutions. This review did not find information on co-interventions with healthcare worker vaccination: hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding admissions, antivirals and asking healthcare workers with influenza or influenza-like illness (ILI) not to work. This review does not provide reasonable evidence to support the vaccination of healthcare workers to prevent influenza in those aged 60 years or older resident in LTCIs. High quality RCTs are required to avoid the risks of bias in methodology and conduct identified by this review and to test further these interventions in combination.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineHealth Sciences Centre3330 Hospital Drive NWCalgaryABCanadaT2N 4N1
| | | | - Toby J Lasserson
- Cochrane Central ExecutiveCochrane Editorial UnitSt Albans House57‐59 HaymarketLondonUKSW1Y 4QX
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Knowledge, attitude and awareness among healthcare professionals about influenza vaccination in Peshawar, Pakistan. Vaccine 2016; 34:1393-8. [PMID: 26845740 DOI: 10.1016/j.vaccine.2016.01.045] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 12/15/2015] [Accepted: 01/20/2016] [Indexed: 11/22/2022]
Abstract
A cross-sectional study was carried out among HCPs in Northwest General Hospital & Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N=170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n=165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24-30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF)=0.71), due to needle fear I do not like to get vaccinated (RIWF=0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF=0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (-0.215 [-0.389 to 0.040]; p=0.016) and job experience (0.823 [0.521-1.125]; p<0.001) HCPs age (-0.409 [-0.755 to -0.064]; p=0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5 ± 0.8, p<0.001*), followed by pharmacists (6.3 ± 1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.
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MacDougall DM, Halperin BA, MacKinnon-Cameron D, Li L, McNeil SA, Langley JM, Halperin SA. The challenge of vaccinating adults: attitudes and beliefs of the Canadian public and healthcare providers. BMJ Open 2015; 5:e009062. [PMID: 26419683 PMCID: PMC4593142 DOI: 10.1136/bmjopen-2015-009062] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Vaccine coverage for recommended vaccines is low among adults. The objective of this study was to assess the knowledge, attitudes, beliefs and behaviours of adults and healthcare providers related to four vaccine-preventable diseases and vaccines (diphtheria-tetanus-pertussis, zoster, pneumococcus and influenza). DESIGN We undertook a survey and focus groups of Canadian adults and healthcare providers (doctors, nurses, pharmacists). A total of 4023 adults completed the survey and 62 participated in the focus groups; 1167 providers completed the survey and 45 participated in the focus groups. RESULTS Only 46.3% of adults thought they were up-to-date on their vaccines; 30% did not know. In contrast, 75.6% of providers reported being up-to-date. Only 57.5% of adults thought it was important to receive all recommended vaccines (compared to 87.1-91.5% of providers). Positive attitudes towards vaccines paralleled concern about the burden of illness and confidence in the vaccines, with providers being more aware of disease burden and confident in vaccine effectiveness than the public. Between 55.0% and 59.7% of adults reported willingness to be vaccinated if recommended by their healthcare provider. However, such recommendations were variable; while 77.4% of the public reported being offered and 52.8% reported being recommended the influenza vaccine by their provider, only 10.8% were offered and 5.6% recommended pertussis vaccine. Barriers and facilitators to improved vaccine coverage in adults, such as trust-mistrust of health authorities, pharmaceutical companies and national recommendations, autonomy versus the public good and logistical issues (such as insufficient time and lack of vaccination status tracking), were identified by both the public and providers. CONCLUSIONS Despite guidelines for adult vaccination, there are substantial gaps in knowledge and attitudes and beliefs among both the public and healthcare providers that lead to low vaccine coverage. A systematic approach that involves education, elimination of barriers and establishing and improving infrastructure for adult immunisation is required.
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Affiliation(s)
- D M MacDougall
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada School of Nursing, St. Francis Xavier University, Nova Scotia, Canada
| | - B A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada School of Nursing, Dalhousie University, Nova Scotia, Canada Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
| | - D MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada
| | - Li Li
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada
| | - S A McNeil
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada Department of Medicine, Dalhousie University, Nova Scotia, Canada
| | - J M Langley
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada Department of Pediatrics, Dalhousie University, Nova Scotia, Canada Department of Community Health and Epidemiology, Dalhousie University, Nova Scotia, Canada
| | - S A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Nova Scotia, Canada Department of Pediatrics, Dalhousie University, Nova Scotia, Canada Department of Microbiology & Immunology, Dalhousie University, Nova Scotia, Canada
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Little K, Goodridge S, Lewis H, Lingard S, Din S, Tidley M, Roberts R, Williams N, Hayes S. Occupational vaccination of health care workers: uptake, attitudes and potential solutions. Public Health 2015; 129:755-62. [DOI: 10.1016/j.puhe.2015.02.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 12/31/2014] [Accepted: 02/22/2015] [Indexed: 01/05/2023]
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Goins WP, Schaffner W, Edwards KM, Talbot TR. Healthcare Workers' Knowledge and Attitudes About Pertussis and Pertussis Vaccination. Infect Control Hosp Epidemiol 2015; 28:1284-9. [DOI: 10.1086/521654] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 06/11/2007] [Indexed: 11/03/2022]
Abstract
Objective.To determine knowledge and attitudes about pertussis and pertussis vaccination among healthcare workers (HCWs).Design.Self-administered, Web-based survey.Setting.Tertiary-care academic medical center.Participants.Medical center employees who participated in direct patient care were recruited to complete the survey through institutional e-mail.Results.Of 14,893 potentially eligible employees, 1,819 (12%) completed the survey. Most respondents (87%) did not plan to receive the pertussis vaccine. Intent to receive vaccination (which included recent history of vaccination) was associated with the following 4 factors: receipt of a physician recommendation for vaccination (odds ratio [OR], 9.01), awareness of Centers for Disease Control and Prevention recommendations for pertussis vaccination for HCWs (OR, 6.89), receipt of encouragement to be vaccinated from a coworker (OR, 4.72), the belief that HCWs may spread pertussis to patients and family (OR, 1.80). Two factors were negatively associated with intent to receive vaccination: the presence of children in the HCW's home (OR, 0.69) and employment as a nurse (OR, 0.59). Reasons cited by those who did not intend to receive vaccination included lack of a personal recommendation for vaccination (78%), receipt of vaccination as a child (51%), and perception that there was no significant risk for contracting pertussis (38%).Conclusions.Of the HCWs surveyed, only 13% intended to receive the pertussis vaccine. A perceived lack of recommendation for vaccination and inaccurate conceptions about pertussis and pertussis vaccination were cited as reasons HCWs did not intend to be vaccinated. Institutional pertussis vaccination campaigns should focus on the risks of healthcare-associated pertussis and new recommendations for pertussis vaccination.
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LaVela SL, Smith B, Weaver FM, Legro MW, Goldstein B, Nichol K. Attitudes and Practices Regarding Influenza Vaccination Among Healthcare Workers Providing Services to Individuals With Spinal Cord Injuries and Disorders. Infect Control Hosp Epidemiol 2015; 25:933-40. [PMID: 15566027 DOI: 10.1086/502323] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractObjective:To examine influenza vaccination status and predictors for vaccine receipt among healthcare workers (HCWs)
caring for patients with spinal cord injuries and disorders.Design:Cross-sectional, nationwide anonymous survey.Setting:Twenty-three Veterans Affairs spinal cord injury centers.Participants:One thousand five hundred fifty-six HCWs.Methods:The primary outcome was staff vaccination status. Independent variables included staff demographic and employment characteristics, health status, attitudes and beliefs about the vaccine, and implications for its use.Results:The staff vaccination rate was 51%. Leading motivators of vaccine receipt were self-protection (77%) and patient protection (49%). The most common reasons for nonreceipt were concerns about side effects (49%), preventive quality (20%), and inconvenience (14%). Logistic regression results suggested that age of 50 years or older (OR, 1.47; P = .021), male gender (OR, 2.50; P < .001), strong belief in vaccine effectiveness (OR, 19.03; P = .008), and importance of HCW vaccination (OR, 20.50; P = .005) significantly increased the probability of vaccination. Recommending the vaccine to coworkers, patients, or patients' families was also associated with HCW vaccination (OR, 3.20; P < .001). Providers who did not believe the vaccine was protective (P < .001) or effective P < .001) were less likely to recommend it to patients.Conclusions:Strategies to increase vaccination rates among HCWs should address concerns about side effects, effectiveness, and protective value of the vaccine and access to it. The impact of provider recommendations should be stressed. Vaccination and subsequent prevention of illness may limit morbidity and mortality, thus benefiting HCWs, healthcare facilities, and patients.
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Affiliation(s)
- Sherri L LaVela
- Spinal Cord Injury Quality Enhancement Research Initiative, Midwest Center for Health Services and Policy Research, Department of Veterans Affairs, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois 60141, USA
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Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2014; 2014:CD005188. [PMID: 24999919 PMCID: PMC6464876 DOI: 10.1002/14651858.cd005188.pub3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effectiveness of interventions to increase the uptake of influenza vaccination in people aged 60 and older is uncertain. OBJECTIVES To assess access, provider, system and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community. SEARCH METHODS We searched CENTRAL (2014, Issue 5), MEDLINE (January 1950 to May week 3 2014), EMBASE (1980 to June 2014), AgeLine (1978 to 4 June 2014), ERIC (1965 to June 2014) and CINAHL (1982 to June 2014). SELECTION CRITERIA Randomised controlled trials (RCTs) of interventions to increase influenza vaccination uptake in people aged 60 and older. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study quality and extracted influenza vaccine uptake data. MAIN RESULTS This update identified 13 new RCTs; the review now includes a total of 57 RCTs with 896,531 participants. The trials included community-dwelling seniors in high-income countries. Heterogeneity limited meta-analysis. The percentage of trials with low risk of bias for each domain was as follows: randomisation (33%); allocation concealment (11%); blinding (44%); missing data (49%) and selective reporting (100%). Increasing community demand (32 trials, 10 strategies)The interventions with a statistically significant result were: three trials (n = 64,200) of letter plus leaflet/postcard compared to letter (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.15); two trials (n = 614) of nurses/pharmacists educating plus vaccinating patients (OR 3.29, 95% CI 1.91 to 5.66); single trials of a phone call from a senior (n = 193) (OR 3.33, 95% CI 1.79 to 6.22), a telephone invitation versus clinic drop-in (n = 243) (OR 2.72, 95% CI 1.55 to 4.76), a free groceries lottery (n = 291) (OR 1.04, 95% CI 0.62 to 1.76) and nurses educating and vaccinating patients (n = 485) (OR 152.95, 95% CI 9.39 to 2490.67).We did not pool the following trials due to considerable heterogeneity: postcard/letter/pamphlets (16 trials, n = 592,165); tailored communications (16 trials, n = 388,164); customised letter/phone-call (four trials, n = 82,465) and client-based appraisals (three trials, n = 4016), although several trials showed the interventions were effective. Enhancing vaccination access (10 trials, six strategies)The interventions with a statistically significant result were: two trials (n = 2112) of home visits compared to clinic invitation (OR 1.30, 95% CI 1.05 to 1.61); two trials (n = 2251) of free vaccine (OR 2.36, 95% CI 1.98 to 2.82) and one trial (n = 321) of patient group visits (OR 24.85, 95% CI 1.45 to 425.32). One trial (n = 350) of a home visit plus vaccine encouragement compared to a home visit plus safety advice was non-significant.We did not pool the following trials due to considerable heterogeneity: nurse home visits (two trials, n = 2069) and free vaccine compared to no intervention (two trials, n = 2250). Provider- or system-based interventions (17 trials, 11 strategies)The interventions with a statistically significant result were: two trials (n = 2815) of paying physicians (OR 2.22, 95% CI 1.77 to 2.77); one trial (n = 316) of reminding physicians about all their patients (OR 2.47, 95% CI 1.53 to 3.99); one trial (n = 8376) of posters plus postcards (OR 2.03, 95% CI 1.86 to 2.22); one trial (n = 1360) of chart review/feedback (OR 3.43, 95% CI 2.37 to 4.97) and one trial (n = 27,580) of educational outreach/feedback (OR 0.77, 95% CI 0.72 to 0.81).Trials of posters plus postcards versus posters (n = 5753), academic detailing (n = 1400) and increasing staff vaccination rates (n = 26,432) were non-significant.We did not pool the following trials due to considerable heterogeneity: reminding physicians (four trials, n = 202,264) and practice facilitators (three trials, n = 2183), although several trials showed the interventions were effective. Interventions at the societal level We identified no RCTs of interventions at the societal level. AUTHORS' CONCLUSIONS There are interventions that are effective for increasing community demand for vaccination, enhancing access and improving provider/system response. Heterogeneity limited pooling of trials.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineUCMC#1707‐1632 14th AvenueCalgaryCanadaT2M 1N7
| | - Diane L Lorenzetti
- Faculty of Medicine, University of CalgaryDepartment of Community Health Sciences3rd Floor TRW3280 Hospital Drive NWCalgaryCanadaT2N 4Z6
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Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Database Syst Rev 2013:CD005187. [PMID: 23881655 DOI: 10.1002/14651858.cd005187.pub4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Healthcare workers' influenza rates are unknown but may be similar to those of the general public. Healthcare workers may transmit influenza to patients. OBJECTIVES To identify all randomised controlled trials (RCTs) and non-RCTs assessing the effects of vaccinating healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs). SEARCH METHODS We searched CENTRAL 2013, Issue 2, MEDLINE (1966 to March week 3, 2013), EMBASE (1974 to March 2013), Biological Abstracts (1969 to March 2013), Science Citation Index-Expanded (1974 to March 2013) and Web of Science (2006 to March 2013). SELECTION CRITERIA Randomised controlled trials (RCTs) and non-RCTs of influenza vaccination of healthcare workers caring for individuals aged 60 years or older in LTCIs and the incidence of laboratory-proven influenza and its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 years or older in LTCIs. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed risk of bias. MAIN RESULTS We identified four cluster-RCTs (C-RCTs) (n = 7558) and one cohort study (n = 12,742) of influenza vaccination for HCWs caring for individuals ≥ 60 years in LTCFs. Three RCTs (5896 participants) provided outcome data that met our criteria. These three studies were comparable in study populations, intervention and outcome measures. The studies did not report adverse events. The principal sources of bias in the studies related to attrition and blinding. The pooled risk difference (RD) from the three cluster-RCTs for laboratory-proven influenza was 0 (95% confidence interval (CI) -0.03 to 0.03) and for hospitalisation was RD 0 (95% CI -0.02 to 0.02). The estimated risk of death due to lower respiratory tract infection was also imprecise (RD -0.02, 95% CI -0.06 to 0.02) in individuals aged 60 years or older in LTCIs. Adjusted analyses which took into account the cluster design did not differ substantively from the pooled analysis with unadjusted data. AUTHORS' CONCLUSIONS The results for specific outcomes: laboratory-proven influenza or its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract illness) did not identify a benefit of healthcare worker vaccination on these key outcomes. This review did not find information on co-interventions with healthcare worker vaccination: hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding admissions, antivirals and asking healthcare workers with influenza or influenza-like-illness (ILI) not to work. This review does not provide reasonable evidence to support the vaccination of healthcare workers to prevent influenza in those aged 60 years or older resident in LTCIs. High-quality RCTs are required to avoid the risks of bias in methodology and conduct identified by this review and to test further these interventions in combination.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty ofMedicine, University of Calgary, Calgary, Canada.
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Factors Affecting Acceptance and Intention to Receive Pandemic Influenza A H1N1 Vaccine among Primary School Children: A Cross-Sectional Study in Birmingham, UK. INFLUENZA RESEARCH AND TREATMENT 2012; 2012:182565. [PMID: 23150815 PMCID: PMC3485484 DOI: 10.1155/2012/182565] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 06/19/2012] [Indexed: 01/07/2023]
Abstract
UK pandemic influenza strategy focused on vaccination of high risk groups, although evidence shows that school-age children have the highest infection rates. Vaccination of children might be an additional strategy. We undertook a cross-sectional study amongst 149 parents of primary school children aged 4–7 years in Birmingham, UK to quantify intention to accept pandemic influenza vaccine and identify factors affecting uptake. Ninety-one (61.1%, 95% CI 52.8, 68.9) had or would accept vaccine for their child. The most common reasons for declining vaccine were concerns about safety (58.6% reported this), side effects (55.2%), or believing their child had already had swine flu (12.1%). Parents of nonwhite ethnicity (OR 2.4 (1.1, 5.0)) and with asthmatic children (OR 6.6 (1.4, 32.1)) were significantly more likely to accept pandemic vaccine, as were those whose children had ever received seasonal vaccine and those who believed swine flu to be a serious threat (OR 4.2 (1.9, 9.1)). Parents would be more likely to accept vaccination if they received a letter of invite, if the government strongly encouraged them, if it were administered at school, and if it were more thoroughly tested. Accurate media portrayal of safety of the vaccine during future pandemics will be essential.
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Torre GLA, Semyonov L, Mannocci A, Boccia A. Knowledge, attitude, and behaviour of public health doctors towards pandemic influenza compared to the general population in Italy. Scand J Public Health 2011; 40:69-75. [DOI: 10.1177/1403494811424612] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To study differences between public health physicians’ and general population’s knowledge, attitude, and behaviours towards an influenza pandemic. Methods: During winter 2009, an anonymous questionnaire online ( www.ijph.it ) of 34 questions was available for participants, structured into three parts: socio-demographic information, people’s knowledge, and behaviours about influenza H1N1. Results: 836 persons were interviewed (335 physicians and 501 not physicians). Of these, 50.8% of physicians and 78.1% of not physicians were aged less than 50 years and 57.6% of physicians and 31.7% of not physicians were male. Physicians were more interested to be updated about the pandemic (90.6% versus 88.4% of not physicians; p = 0.003); not physicians were more inclined to avoid crowded places (29.7% versus 17.6% of physicians; p < 0.001); and physicians were more prone to get vaccinated (56.4% versus 23.6% of not physicians; p < 0.001). Broadly, physicians had a better ability to deal the pandemic, both for knowledge and behaviours. Particularly, a significant difference ( p < 0.001) was found concerning the principle source of information on the pandemic, for physicians being the internet (41.5%), followed by the health facilities’ internal communication (33.1%), while for not physicians being watching the national television news (34.1%) and surfing the internet (30.9%). Conclusions: During the spread of the pandemic flu, a lot of information was propagated chaotically. The information given were not always truthful and often they were interpreted incorrectly or sometimes only partially understood by the population, and this needs to be taken into account for future successful communication in cases of emergency.
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Affiliation(s)
- Giuseppe LA Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Leda Semyonov
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Antonio Boccia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Johansen LJ, Stenvig T, Wey H. The decision to receive influenza vaccination among nurses in North and South Dakota. Public Health Nurs 2011; 29:116-25. [PMID: 22372448 DOI: 10.1111/j.1525-1446.2011.00966.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We examined the relationships between factors (intention, habit, facilitating conditions, and social, cognitive, and affective factors) and nurses' decisions about influenza vaccinations to understand why some get vaccinated while others do not. DESIGN AND SAMPLE In a descriptive correlational design, the Triandis model of interpersonal behavior was used to examine the decision of nurses to receive influenza vaccinations. Participants were a random sample (N=193) of registered nurses in North and South Dakota drawn from the respective state nursing licensing board lists. MEASURES Instrument construction and mail survey procedures followed Dillman's tailored design method. RESULTS The response rate exceeded 80%. The findings revealed significant, positive correlations among all model variables. Item analysis showed that false beliefs about influenza disease and vaccinations were prevalent and that there was a wide variation in employer support for nurses getting vaccinated. CONCLUSIONS Educational and social marketing strategies may improve nurse's knowledge about influenza disease and vaccine and increase vaccine uptake. Employers should be encouraged to promote and improve influenza vaccine accessibility in the workplace. Additional study is needed to understand how best to strengthen the influence of intention and habit on the decision of nurses to receive influenza vaccinations.
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Affiliation(s)
- Laurie Jo Johansen
- College of Nursing, South Dakota State University, Brookings, South Dakota 57007, USA.
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Boyeau C, Tanguy M, Pean S, Delhumeau A, Fanello S. Couverture vaccinale antigrippale saisonnière et pandémique (H1N1) 2009 : étude auprès du personnel du chu d'Angers. SANTE PUBLIQUE 2011. [DOI: 10.3917/spub.111.0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Influenza vaccination for healthcare workers who work with the elderly: Systematic review. Vaccine 2010; 29:344-56. [DOI: 10.1016/j.vaccine.2010.09.085] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 09/01/2010] [Accepted: 09/24/2010] [Indexed: 11/20/2022]
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Godin G, Vézina-Im LA, Naccache H. Determinants of influenza vaccination among healthcare workers. Infect Control Hosp Epidemiol 2010; 31:689-93. [PMID: 20482373 DOI: 10.1086/653614] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To identify the determinants of influenza vaccination and the moderators of the intention-behavior relationship among healthcare workers (HCWs). DESIGN Prospective survey with 2-month follow-up. SETTING Three university-affiliated public hospitals. PARTICIPANTS Random sample of 424 HCWs. METHODS The intention of an HCW to get vaccinated against influenza was measured by means of a self-administered questionnaire based on an extended version of the theory of planned behavior. An objective measure of behavior was extracted 2 months later from the vaccination database of the hospitals. RESULTS Controlling for past behavior, we found that the determinants of influenza vaccination were intention (odds ratio [OR], 8.32 [95% confidence interval {CI}, 2.82-24.50]), moral norm (OR, 3.01 [95% CI, 1.17-7.76]), anticipated regret (OR, 2.33 [95% CI, 1.23-4.41]), and work status (ie, full time vs part time; OR, 1.99 [95% CI, 1.92-3.29]). Moral norm also interacted with intention as a significant moderator of the intention-behavior relationship (OR, 0.09 [95% CI, 0.03-0.30]). Again, apart from the influence of past behavior, intention to get vaccinated was predicted by use of the following variables: attitude (beta=.32; P<.001), professional norm (beta=.18; P<.001), moral norm (beta=.18; P<.001), subjective norm (beta=.09; P<.001), and self-efficacy (beta=.08; P<.001). This latter model explained 89% of the variance in HCWs' intentions to get vaccinated against influenza during the next vaccination campaign. CONCLUSIONS Our study suggests that influenza vaccination among HCWs is mainly a motivational issue. In this regard, it can be suggested to reinforce the idea that getting vaccinated can reduce worry and protect family members.
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Affiliation(s)
- Gaston Godin
- Faculty of Nursing, Laval University, Quebec City, Quebec, Canada.
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Thomas RE, Russell M, Lorenzetti D. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2010:CD005188. [PMID: 20824843 DOI: 10.1002/14651858.cd005188.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although the evidence to support influenza vaccination is poor, it is promoted by many health authorities. There is uncertainty about the effectiveness of interventions to increase influenza vaccination rates in those 60 years or older. OBJECTIVES To assess effects of interventions to increase influenza vaccination rates in those 60 or older. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010, issue 3), containing the Cochrane Acute Respiratory Infections Group's Specialized Register, MEDLINE (January 1950 to July 2010), PubMed (January 1950 to July 2010), EMBASE (1980 to 2010 Week 28), AgeLine (1978 to July 2010), ERIC (1965 to July 2010) and CINAHL (1982 to July 2010). SELECTION CRITERIA Randomized controlled trials (RCTs) to increase influenza vaccination rates in those aged 60 years and older, recording influenza vaccination status either through clinic records, billing data or local/national vaccination registers. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study quality and extracted data. MAIN RESULTS Forty-four RCTs were included. All included RCTs studied seniors in the community and in high-income countries. No RCTs of society-level interventions were included. Heterogeneity was marked and meta-analysis was limited. Only five RCTs were graded at low and six at moderate risk of bias. They included three of 13 personalized postcard interventions (all three with the 95% confidence interval (CI) above unity), two of the four home visit interventions (both with 95% CI above unity, but one a small study), three of the four reminder to physicians interventions (none with 95% CI above unity) and three of the four facilitator interventions (one with 95% CI above unity, and one P < 0.01). The other 33 RCTs were at high risk of bias and no recommendations for practice can be drawn. AUTHORS' CONCLUSIONS Personalized postcards or phone calls are effective, and home visits, and facilitators, may be effective. Reminders to physicians are not. There is insufficient good evidence for other interventions.
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Affiliation(s)
- Roger E Thomas
- Department of Medicine, University of Calgary, UCMC, #1707-1632 14th Avenue, Calgary, Alberta, Canada, T2M 1N7
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Vaccination of health care workers for influenza: promote safety culture, not coercion. Canadian Journal of Public Health 2010. [PMID: 20629446 DOI: 10.1007/bf03403845] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES In British Columbia (BC), Canada, all health care facilities must have a written staff policy on influenza immunization that includes notice that non-immunized staff can be excluded from work without pay during an influenza outbreak in the facility. In light of this policy, our objectives were to explore the views of BC health care workers (HCWs) regarding how best to promote vaccine uptake. METHODS Long-term care, and acute and community health sites in three of six health regions were divided into thirds, according to their previous season's vaccine uptake rates, and the upper and lower thirds targeted. Ten focus groups were held. NVivo software (QSR International) and a separate editing style were used for analysis. RESULTS Four dominant themes emerged: knowledge, communication, perceived punitive nature of workplace policy, and safety climate. HCWs across all focus groups noted that influenza campaign communications should include reinforcement of basic infection control, workplace health and healthy lifestyle choices that affect overall health. HCWs indicated that they wanted a workplace policy that is easy to understand, respectful of individual choice and not punitive. CONCLUSIONS Our findings highlight the importance of comprehensive approaches, a message that has not appeared as strongly in previous literature. Focus group participants pointed out the importance of health and safety at work generally and felt that creating a healthy workplace culture is necessary to promoting vaccine uptake. Future vaccine promotion initiatives should be integrated into facility-wide workplace health campaigns and care taken to ensure that vaccination campaigns do not appear coercive to HCWs.
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Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database Syst Rev 2010:CD005187. [PMID: 20166073 DOI: 10.1002/14651858.cd005187.pub3] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Healthcare workers' (HCWs) influenza rates are unknown, but may be similar to the general public and they may transmit influenza to patients. OBJECTIVES To identify studies of vaccinating HCWs and the incidence of influenza, its complications and influenza-like illness (ILI) in individuals >/= 60 in long-term care facilities (LTCFs). SEARCH STRATEGY We searched CENTRAL (The Cochrane Library 2009, issue 3), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2009), EMBASE (1974 to 2009) and Biological Abstracts and Science Citation Index-Expanded. SELECTION CRITERIA Randomised controlled trials (RCTs) and non-RCTs of influenza vaccination of HCWs caring for individuals >/= 60 in LTCFs and the incidence of laboratory-proven influenza, its complications or ILI. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed risk of bias. MAIN RESULTS We identified four cluster-RCTs (C-RCTs) (n = 7558) and one cohort (n = 12742) of influenza vaccination for HCWs caring for individuals >/= 60 in LTCFs. Pooled data from three C-RCTs showed no effect on specific outcomes: laboratory-proven influenza, pneumonia or deaths from pneumonia. For non-specific outcomes pooled data from three C-RCTs showed HCW vaccination reduced ILI; data from one C-RCT that HCW vaccination reduced GP consultations for ILI; and pooled data from three C-RCTs showed reduced all-cause mortality in individuals >/= 60. AUTHORS' CONCLUSIONS No effect was shown for specific outcomes: laboratory-proven influenza, pneumonia and death from pneumonia. An effect was shown for the non-specific outcomes of ILI, GP consultations for ILI and all-cause mortality in individuals >/= 60. These non-specific outcomes are difficult to interpret because ILI includes many pathogens, and winter influenza contributes < 10% to all-cause mortality in individuals >/= 60. The key interest is preventing laboratory-proven influenza in individuals >/= 60, pneumonia and deaths from pneumonia, and we cannot draw such conclusions.The identified studies are at high risk of bias.Some HCWs remain unvaccinated because they do not perceive risk, doubt vaccine efficacy and are concerned about side effects. This review did not find information on co-interventions with HCW vaccination: hand washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding admissions, anti-virals, and asking HCWs with ILI not to work. We conclude there is no evidence that vaccinating HCWs prevents influenza in elderly residents in LTCFs. High quality RCTs are required to avoid risks of bias in methodology and conduct, and to test these interventions in combination.
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Affiliation(s)
- Roger E Thomas
- Department of Medicine, University of Calgary, UCMC, #1707-1632 14th Avenue, Calgary, Alberta, Canada, T2M 1N7
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Systematic review of interventions to increase influenza vaccination rates of those 60 years and older. Vaccine 2010; 28:1684-701. [DOI: 10.1016/j.vaccine.2009.11.067] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 11/09/2009] [Accepted: 11/20/2009] [Indexed: 11/22/2022]
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Al-Tawfiq JA, Antony A, Abed MS. Attitudes towards influenza vaccination of multi-nationality health-care workers in Saudi Arabia. Vaccine 2009; 27:5538-41. [PMID: 19651170 DOI: 10.1016/j.vaccine.2009.06.108] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Revised: 05/28/2009] [Accepted: 06/10/2009] [Indexed: 12/15/2022]
Abstract
BACKGROUND The compliance with influenza vaccination among health-care workers (HCWs) is known to be low. A multi-nationality survey to explore the reasons for such poor compliance has not been studied in depth. MATERIALS AND METHODS An epidemiologic survey to evaluate the compliance rates with influenza vaccination and possible associated reasons for compliance. RESULTS A total of 450 survey sheets were distributed and 244 (54.2%) were completed. Of the total respondents, 51 (20.9%) were Saudi, 114 (46.7%) were other Arabs, 21 (4%) were North American, 21 (8.6%) were from UK or South Africa and 48 (19.7%) did not indicate their nationalities. There were 32 (13.1%) physicians, and 132 (54.1%) nurses. The overall influenza vaccination rate was 41% in the preceding year and 69% in the preceding 5 years, and 49.2% (n=110) of the latter group received one to three vaccines. Of the total respondents, 156 (63.9%) report that the influenza vaccine was important, 86 (35%) report that they were not at risk of influenza, 163 (66.8%) report that the influenza vaccine was not safe and 152 (62.3%) report that influenza was not a serious illness. In a multivariate analysis, the following factors were important in choosing vaccinations: being a male, other Arab nationality, and knowing that influenza vaccine is important (P<or=0.01). Feeling at risk of influenza, and not using any vaccine alternatives, and that the vaccine is important for self and the patient's protection, were statistically important factors as well (P<or=0.05). CONCLUSION Important factors associated with increasing influenza vaccine acceptance include being a male, other Arab nationality, and knowing that influenza vaccine is important. In addition, feeling at risk of influenza, and not using any vaccine alternatives, and that the vaccine is important for self and the patient's protection, were statistically important factors as well. Thus, efforts to increase the acceptance rates should take these factors in consideration.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Internal Medicine Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran, Saudi Arabia.
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Duclos A, Bouhour D, Baptiste C, Launay O, Guiso N. Assessment of individual vaccine status in a vaccinology experts' group. J Eval Clin Pract 2008; 14:610-4. [PMID: 19126179 DOI: 10.1111/j.1365-2753.2008.00946.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE Worldwide, experts in vaccinology have promoted the broad annual coverage of health care workers with the influenza vaccine. Furthermore, pertussis vaccination is now recommended for young adults and health care workers working with newborns. AIM To analyse the compliance with these guidelines among experts responsible for the development or dissemination of national immunization schedules. METHOD A cross-sectional survey was conducted in a vaccinology workshop group of French experts, using a self-administered questionnaire. RESULTS Among 44 experts, the average rate of influenza vaccination was 69.5% (95% confidence interval, 61.6% to 77.3%) between the 2003/04 and 2005/06 flu seasons, whereas the rate of pertussis vaccination during this period was only 30%. The main reasons that the experts gave for not being vaccinated were a lack of time or simply not remembering to do so. CONCLUSION Experts had low coverage rates for influenza and pertussis vaccination. To improve these rates, a multifaceted intervention combining audit and feedback strategy with a vaccine day is planned.
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Affiliation(s)
- Antoine Duclos
- Département d'Information Médicale des Hospices Civils de Lyon, Pôle IMER, Lyon, France.
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Norton SP, Scheifele DW, Bettinger JA, West RM. Influenza vaccination in paediatric nurses: Cross-sectional study of coverage, refusal, and factors in acceptance. Vaccine 2008; 26:2942-8. [DOI: 10.1016/j.vaccine.2008.03.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 03/17/2008] [Accepted: 03/17/2008] [Indexed: 11/24/2022]
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Siriwardena AN. Healthcare workers and influenza vaccination Commentary on Canning HS, Phillips J & Allsup S (2005) Healthcare workers beliefs about influenza vaccine and the reasons for non-vaccination ? a cross-sectional survey. Journal of Clinical Nursing 14, 922?925. J Clin Nurs 2007; 16:1186-8. [PMID: 17518894 DOI: 10.1111/j.1365-2702.2007.01467.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thomas RE, Jefferson T, Demicheli V, Rivetti D. Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database Syst Rev 2006:CD005187. [PMID: 16856082 DOI: 10.1002/14651858.cd005187.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Healthcare workers (HCW) (nurses, doctors, other health professionals, cleaners and porters), have substantial rates of clinical and sub-clinical influenza during influenza seasons and may transmit influenza to those in their care, especially the vulnerable elderly. OBJECTIVES To identify and summarise comparative studies assessing the effects of vaccinating healthcare workers (HCW) on the incidence of influenza, influenza-like-illness (ILI) and its complications on elderly residents in long-term facilities. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews and the NHS Database of Abstracts of Reviews of Effectiveness (DARE) (The Cochrane Library Issue 1, 2006); MEDLINE (January 1966 to Week 1, February 2006); EMBASE (1974 to March 2006); Biological Abstracts (1969 to December 2004); and Science Citation Index-Expanded (1974 to March 2006). SELECTION CRITERIA Comparative randomised and non-randomised studies reporting the effects of influenza vaccines on the incidence of viral infections in institutions for the elderly of any type, in any schedule of vaccination given to HCW caring for elderly residents of long-term facilities aged 60 years or older. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed the methodological quality using criteria from the Cochrane Reviewers' Handbook and the Newcastle-Ottawa scale (for non-randomised studies). MAIN RESULTS We included two cluster randomised controlled trials (C-RCT) and one cohort study. Staff vaccination appears to have significant effect against ILI (absolute vaccine efficacy (VE) 86%, 95% confidence interval (CI) 40% to 97%) only when patients are vaccinated too; if patients are not vaccinated, staff immunisation shows no effect (based on one C-RCT). Based on a small number of observations from two C-RCTs, the vaccines have no efficacy against influenza (odds ratio (OR) 0.86, 95% CI 0.44 to 1.68) or lower respiratory tract infections (OR 0.70, 95% CI 0.41 to 1.20) but were effective against deaths from pneumonia (VE 39%, 95% CI 2% to 62%) and deaths from all causes (VE 40%, 95% CI 27% to 50%). All findings must be interpreted with caution given the presence of selection bias. AUTHORS' CONCLUSIONS We concluded that there is no credible evidence that vaccination of healthy people under the age of 60, who are HCWs caring for the elderly, affects influenza complications in those cared for. However, as vaccinating the elderly in institutions reduces the complications of influenza and vaccinating healthy persons under 60 reduces cases of influenza, those with the responsibility of caring for the elderly in institutions may want to increase vaccine coverage and assess its effects in well-designed studies.
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Affiliation(s)
- R E Thomas
- University of Calgary, Department of Medicine, UCMC, #1707-1632 14th Avenue, Calgary, Alberta, Canada T2M 1N7.
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Thomas RE, Jefferson TO, Demicheli V, Rivetti D. Influenza vaccination for health-care workers who work with elderly people in institutions: a systematic review. THE LANCET. INFECTIOUS DISEASES 2006; 6:273-9. [PMID: 16631547 DOI: 10.1016/s1473-3099(06)70462-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Our aim was to review the evidence of efficacy and effectiveness of influenza vaccination of health-care workers in reducing cases of influenza-like illness, influenza, complications from influenza, death from influenza, and death from all causes among the elderly people they care for in institutions. We searched 11 electronic databases in any language and identified two cluster-randomised controlled trials with moderate risk of bias and one cohort study at high risk of bias that addressed our questions. Staff vaccination had a significant effect on influenza-like illness (vaccine effectiveness [VE] 86%, 95% CI 40-97%) only when patients were vaccinated too. If patients were not vaccinated, staff immunisation had no effect. Vaccinating health-care workers did not appear efficacious against influenza (RR 0.87, 95% CI 0.46-1.63). There was no significant effect of vaccination on lower respiratory tract infections: (RR 0.70, 95% CI 0.41-1.20). Deaths from pneumonia were significantly reduced (VE 39%, 95% CI 2-62%), as were deaths from all causes (VE 40%, 95% CI 27-50%). These findings must be interpreted in the light of possible selection, performance, attrition, and detection biases.
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Affiliation(s)
- R E Thomas
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada.
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Canning HS, Phillips J, Allsup S. Health care worker beliefs about influenza vaccine and reasons for non-vaccination - a cross-sectional survey. J Clin Nurs 2005; 14:922-5. [PMID: 16102143 DOI: 10.1111/j.1365-2702.2005.01190.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS AND OBJECTIVES To identify reasons for poor uptake of influenza vaccine in healthcare workers. BACKGROUND When influenza is circulating in the community, influenza vaccination of healthcare workers may reduce morbidity and sick leave and may also reduce mortality in older hospitalized patients. Despite this, vaccine uptake in healthcare workers remains low. DESIGN Cross-sectional survey. METHODS Self-completed questionnaires were distributed to 144 nurses and healthcare assistants in two Liverpool hospitals. RESULTS Vaccination uptake in this sample was 7.6%. The main reasons given for not being vaccinated were: did not think it was needed (29%), not aware of the vaccine (18%) and concerned about side-effects (11%). The main perceived benefits of vaccination were reducing sick leave (44%) and personal protection against influenza (28%). CONCLUSION In this study, many healthcare workers demonstrated a lack of awareness and understanding of the vaccine, especially in relation to its benefits and side-effects. Relevance to clinical practice. Vaccinating healthcare workers against influenza can reduce staff sickness during times of winter pressure as well as reducing mortality in frail, older hospitalized patients. It is therefore important that hospitals maximize vaccine uptake by increasing awareness and promoting the benefits of influenza vaccine amongst healthcare workers as well as ensuring that all staff have the opportunity to receive the vaccine.
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Affiliation(s)
- Helen Sarah Canning
- Medical Student, Department of Medicine, University of Liverpool, Liverpool, UK.
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Conocimientos, actitudes y creencias de los profesionales de atención primaria sobre la vacuna y la vacunación antigripal. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s1576-9887(05)73000-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Manuel DG, Henry B, Hockin J, Naus M. Health behavior associated with influenza vaccination among healthcare workers in long-term-care facilities. Infect Control Hosp Epidemiol 2002; 23:609-14. [PMID: 12400892 DOI: 10.1086/501980] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the health behavior associated with influenza vaccination among healthcare workers (HCWs) in long-term-care facilities. DESIGN A cross-sectional, self-administered survey of HCWs, augmented with focus groups to further examine attitudes toward influenza vaccination. SETTING Two long-term-care facilities participated in the survey. The focus groups were held at one of the two facilities. PARTICIPANTS All HCWs were invited to participate in the survey and all nonmanagerial staff members were invited to participate in the focus groups. The response rate for the survey was 58% (231 of 401). RESULTS Vaccinated HCWs had a more positive attitude toward influenza vaccination and a greater belief that the vaccine is effective. This was not accompanied by differences in vaccine knowledge or values of potential preventive outcomes. Nonvaccinated respondents were more likely to believe that other preventive measures, such as washing hands, taking vitamins and supplements, eating a nutritious diet, exercising, and taking homeopathic or naturopathic medications, were more effective than vaccination. Additional findings from the focus groups suggest that HCWs believe that the main purpose of influenza vaccination programs is to protect residents' health at the expense, potential harm, and burden of responsibility of the staff. CONCLUSIONS This study identifies challenges to and opportunities for improving vaccination rates among HCWs. A message that emphasizes the health benefits of vaccination to staff members, such as including vaccination as part of a staff "wellness" program, may improve the credibility of influenza immunization programs and coverage rates.
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Affiliation(s)
- D G Manuel
- Field Epidemiology Training Program, Population and Public Health Branch, Health Canada, Ottawa, Ontario
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Abstract
Vaccine preventable diseases continue to be a sizable burden to adults in the United States. Despite availability of safe and effective vaccines, immunization rates remain low. While various patient, clinician, and system factors can be barriers to adult vaccination, physicians recommendations to their patients to receive the vaccinations for which they are indicated is strongly related to a patient's receipt of these immunizations.
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Affiliation(s)
- Tammy A Santibanez
- Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Avenue, Pittsburgh, PA 15261, USA
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Murray SB, Skull SA. Poor health care worker vaccination coverage and knowledge of vaccination recommendations in a tertiary Australia hospital. Aust N Z J Public Health 2002; 26:65-8. [PMID: 11895030 DOI: 10.1111/j.1467-842x.2002.tb00273.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Guidelines for vaccination of health care workers (HCWs) have been available in Victoria since 1998. We estimated knowledge and attitudes towards vaccination among HCWs as well as self-reported vaccination status in a tertiary adult hospital in Melbourne, Australia. METHODS A cross-sectional survey was conducted in July 2000 using a telephone questionnaire and proportionate random sampling. RESULTS Only 18% of 269 HCWs were fully vaccinated. Most (76%) had not heard of or seen current guidelines for HCW vaccination despite a stated belief in the importance of full vaccination (94%) and a willingness to update their vaccination status if necessary (96%). Less than half kept vaccination records (39%). Hepatitis B vaccination (95%) was most commonly completed. However, only half of all HCWs had received influenza vaccination in the past 12 months and other vaccines often had suboptimal coverage. A common reason cited for avoiding vaccination was concern over vaccine side effects (17%). While the hospital staff clinic was an acceptable site for vaccination, improved access was seen as important. CONCLUSIONS HCW vaccination coverage and knowledge of vaccination requirements were poor. Concerns about vaccine side effects were common. IMPLICATIONS Adequately resourced HCW vaccination programs that include ongoing education for HCWs and improved access to vaccination are necessary to improve vaccination coverage and reduce the risk of vaccine-preventable diseases among staff and patients.
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McArthur MA, Simor AE, Campbell B, McGeer A. Influenza vaccination in long-term-care facilities: structuring programs for success. Infect Control Hosp Epidemiol 1999; 20:499-503. [PMID: 10432163 DOI: 10.1086/501659] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine which influenza vaccination program characteristics were associated with high resident vaccination rates in Canadian long-term-care facilities (LTCFs). DESIGN A cross-sectional survey consisting of a mailed questionnaire conducted in spring 1991. PARTICIPANTS All 1,520 Canadian LTCFs for the elderly with at least 25 beds. RESULTS The mean overall influenza vaccination rate in the 1,270 (84%) responding facilities was 79%. In multivariate analysis, the variables significantly associated with increased vaccination rates were: a single nonphysician staff person organizing the program, having more program aspects covered by written policies, the offering of vaccine to all residents, a policy of obtaining consent on admission that was durable for future years rather than repeating consent annually, and automatically administering vaccine to residents whose guardians could not be contacted for consent. Any encouragement to staff to be vaccinated had a significant impact on staff vaccination rates. CONCLUSION Well-organized influenza vaccination programs increase the influenza vaccination rates of residents in Canadian LTCFs. Facilities need to develop resident vaccination programs further and to focus on vaccinating staff.
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Affiliation(s)
- M A McArthur
- Department of Microbiology, Princess Margaret Hospital, Toronto, Ontario, Canada
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Qureshi M, Gordon SM, Yen-Lieberman B, Litaker DG. Controlling varicella in the healthcare setting: barriers to varicella vaccination among healthcare workers. Infect Control Hosp Epidemiol 1999; 20:516-8. [PMID: 10432167 DOI: 10.1086/501663] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We surveyed healthcare workers to determine factors that may influence acceptance of varicella-zoster virus vaccine. Of 2,801 workers tested, 90 were susceptible to varicella; of workers offered vaccination, 68% accepted. Workers providing direct patient care were 3.7-fold more likely than other workers to accept VZV vaccination (P=.04).
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Affiliation(s)
- M Qureshi
- Department of General Internal Medicine, Cleveland Clinic Foundation, Ohio, USA
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Beguin C, Boland B, Ninane J. Health care workers: vectors of influenza virus? Low vaccination rate among hospital health care workers. Am J Med Qual 1998; 13:223-7. [PMID: 9833335 DOI: 10.1177/106286069801300408] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The influenza vaccination rate among health care workers is not very high and needs to be improved. The authorities of our university hospital decided to encourage vaccination among health care workers and to include it in the hospital quality of care program. A survey about knowledge of influenza disease and its vaccination was undertaken, and 37.2% of the workers participated in the survey. Among them, 31.8% were vaccinated. The vaccination rate was higher when workers were older, men, physicians, technicians, or laboratory workers, vaccinated in the previous flu season and had fewer contacts with patients. The variables with the highest impact on the vaccination rate were vaccination the previous year, belief that vaccination is highly effective, and affirmation that prevention is important. Our study shows that an active vaccination campaign is also necessary for health workers to put them in the stream of usually vaccinated people.
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Affiliation(s)
- C Beguin
- Medical Informatics, St-Luc University Hospital, Bruxelles, Belgium
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