Acceptation de la vaccination antigrippale par les soignants au sein d’une institution gériatrique et médicosociale

Non-familial paid caregivers as potential flu carriers and cause of spread: the primary prevention of flu measured through their adhesion to flu vaccination campaigns-A Florentine experience

Introduction: Influenza vaccination is recommended for caregivers of elderly people. In a study aimed at assessing the level of health literacy (HL) in a sample non-familial caregivers in the Florence Health District (Tuscany), data were collected regarding access and adherence to the flu vaccination campaigns.

Methods: The sample consists of 47 non-familial paid caregivers.

We collected information regarding socio-demographic characteristics, services provided and daily work time, whether or not influenza vaccination was administered for the 2016/2017 season and in the previous three years. The level of HL was assessed through the Newest Vital Sign.

Results: 63.8% of non-familial caregivers have not joined the flu campaigns over the last four years, 14.9% have been vaccinated only sometimes (in some epidemic seasons), and 21.3% have received a flu shot in all the seasons investigated. Most of the non-familial caregivers who do not get vaccinated (27.7%) do not perceive that they are in direct contact with a person at-risk; those who get the vaccine regularly (12.8%) reported they want to protect the assisted person as motivation for vaccine uptake. Vaccination was not associated with HL.

Conclusion: Adhesion to anti-flu vaccination campaigns for these homecare workers has been resulted rather poor. Coverage does not seem to be related with HL level. It seems appropriate to promote extensively flu vaccination among family carers by actively offering the vaccination in appropriate forms, places and times, to avoid serious consequences on elderly people with higher risk of comorbidity and frailty.

Seasonal influenza vaccination coverage and its determinants among nursing homes personnel in western France

BACKGROUND

Influenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide. Vaccination coverage among residents is high but poorly effective due to immunosenescence. Hence, vaccination of personnel is an efficient way to protect residents. Our objective was to quantify the seasonal influenza vaccination (IV) coverage among NH for elderly workers and identify its determinants in France.

METHODS

We conducted a cross-sectional study in March 2016 in a randomized sample of NHs of the Ille-et-Vilaine department of Brittany, in western France. A standardized questionnaire was administered to a randomized sample of NH workers for face-to-face interviews. General data about the establishment was also collected.

RESULTS

Among the 33 NHs surveyed, IV coverage for the 2015-2016 season among permanent workers was estimated at 20% (95% Confidence Interval (CI) 15.3%-26.4%) ranging from 0% to 69% depending on the establishments surveyed. Moreover, IV was associated with having previously experienced a "severe" influenza episode in the past (Prevalence Ratio 1.48, 95% CI 1.01-2.17), and varied by professional categories (p < 0.004) with better coverage among administrative staff. Better knowledge about influenza prevention tools was also correlated (p < 0.001) with a higher IV coverage. Individual perceptions of vaccination benefits had a significant influence on the IV coverage (p < 0.001). Although IV coverage did not reach a high rate, our study showed that personnel considered themselves sufficiently informed about IV.

CONCLUSIONS

IV coverage remains low in the NH worker population in Ille-et-Vilaine and also possibly in France. Strong variations of IV coverage among NHs suggest that management and working environment play an important role. To overcome vaccine "hesitancy", specific communication tools may be required to be adapted to the various NH professionals to improve influenza prevention.

[The seasonal flu vaccination among caregivers in geriatric units: Up-to-date]

BACKGROUND

Flu vaccinations for healthcare professionals seems to be one of the most effective preventive actions in the face of a disease that carries a high risk of a potentially serious nosocomial epidemic in a geriatric environment. The aim of this study was to take stock of the flu vaccination status among caregivers in the geriatric units and to understand the reasons for their reluctance to be vaccinated, in order to put forward proposals to improve vaccination coverage.

METHOD

A literature search of articles published since 2000 in the area of geriatrics, infectious diseases or pneumology was mainly conducted on PubMed using the keywords "caregivers", "elderly", "flu", "influenza", "nosocomial" and "vaccination". After reading all abstracts in English or French and ruling out irrelevant articles, only 64 relevant articles have been listed in bibliography section.

RESULTS

Despite official recommendations, the literature reveals insufficient vaccination coverage of healthcare personnel at both the national and international level. Vaccination coverage seems to be lower among younger female non-medical staff. The factors that determine the likelihood of vaccination are the wish to protect one's self, one's family and patients/residents, as well as the experience of earlier bouts of flu. Factors that oppose vaccination are complex and related to the fear of side effects, the use of other preventive measures, the feeling that vaccination is ineffective, poor understanding of the disease and the vaccine, forgetfulness and problems of organization. Campaigns to promote vaccination that target healthcare professionals must be multidimensional and very incentive. The pedagogical message must be centered on the benefits to the individual and adjusted to socio-professional categories. Mobile strategies in the different departments to encourage staff are a pragmatic solution to this challenge. The referring doctor has an essential role to play, as does the occupational doctor in association with the hospital hygiene services.

CONCLUSION

Flu vaccinations must be included in the education and training of caregivers.