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Flu and COVID-19 Vaccination: What Happens to the Flu Shot When the Campaigns Overlap? Experience from a Large Italian Research Hospital. Vaccines (Basel) 2022; 10:vaccines10060976. [PMID: 35746583 PMCID: PMC9228127 DOI: 10.3390/vaccines10060976] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/14/2022] Open
Abstract
Influenza represents a threat to global health and health care workers (HCWs) have an increased risk of contracting the influenza virus in the workplace. The COVID-19 pandemic has brought back the importance of influenza vaccination, as the influenza virus can circulate together with SARS-CoV-2. The aim of this report is to describe the actual flu vaccination coverage among healthcare workers of a research hospital and the trend changes, with respect to the past flu vaccination campaigns, in light of the present pandemic and COVID-19 vaccination. A Pearson’s χ2 test was used to test the correlation of flu vaccination coverage, across all professional categories, between the last two years. A linear regression model was adopted to predict the total vaccination coverage of this year. A statistically significant decrease (p < 0.01) was observed in vaccination coverage among all the professional categories with a 50% reduction in vaccination trends between the last two years. Analyzing the data from the previous six flu vaccination campaigns, the expected value, according to the linear regression model, was estimated to be 38.5% while the observed value was 24%. The decrease in vaccination coverage may be due to the fear of the pandemic situation and especially to the uncertainty related to the consequences of a concurrent administration which may overload the immune system or may be more reactogenic. The COVID-19 pandemic represents an opportunity to promote and support large-scale influenza vaccination among HCWs through structured programs, adequate funding, and tailored communication strategies.
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Costantino C, Mazzucco W, Restivo V, Mura II, Fara GM, Giammanco G, Vecchio Verderame S, Messano GA, Maida CM, Casuccio A, Vitale F. Proposal for an Alliance Between Healthcare and Legal Area Professionals for Shared Public Health and Preventive Strategies in Italy and Europe. Front Public Health 2020; 8:324. [PMID: 32793539 PMCID: PMC7390868 DOI: 10.3389/fpubh.2020.00324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 06/12/2020] [Indexed: 01/18/2023] Open
Abstract
Following the implementation of the new Italian legislation on responsibility of healthcare workers, a multi-professional framework, involving representatives of the Italian public health professionals and legal professionals expert in the field, drafted a proposal of the actionable recommendations to be implemented in the management of civil and penal disputes arising from the practice of public health interventions. In order to prevent legal disputes concerning some public health fields such as vaccinations, cancer screening, environmental health surveillance, and hospital management, it should be primary taken into account to update guidelines in supporting decision-making processes, in accordance with the “best scientific evidence available.” Furthermore, a multidisciplinary alliance between public health and legal area professionals should be encouraged and should be promoted both at national and European level.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Ida Iolanda Mura
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Gaetano Maria Fara
- Department of Public Health and Infectious Disease, University of Rome "La Sapienza", Rome, Italy
| | | | | | - Giuseppe Alessio Messano
- Department of Public Health and Infectious Disease, University of Rome "La Sapienza", Rome, Italy
| | - Carmelo Massimo Maida
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Gallagher MC, Haessler S, Babcock HM. Influenza Vaccination and Healthcare Personnel Compliance. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020; 12:71-76. [PMID: 32435160 PMCID: PMC7223640 DOI: 10.1007/s40506-020-00211-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of Review We reviewed the benefit of influenza vaccination in healthcare personnel (HCP), rates of vaccine coverage, and practices used to try to boost vaccine coverage among HCP. Recent Findings Influenza vaccination in HCP provides benefits to both HCP and patients, including reductions in patient morbidity and mortality and decreases in HCP absenteeism. Despite these benefits, influenza vaccine coverage among HCP still falls short of the Healthy People 2020 goal of 90%. As a result, healthcare institutions have used various practices to boost vaccination, including mandatory vaccine policies and requiring non-immunized HCP to wear masks during the influenza season. All of these efforts have been successful at increasing vaccination rates, and employer vaccination requirements have led to rates that meet the Healthy People 2020 goal. Rates of mandatory vaccine policies have increased over time, and several states now have influenza vaccine requirements. However, additional study into how these policies improve patient outcomes is needed. Summary Continued effort is needed to boost influenza vaccination rates among HCP, and mandatory vaccine policies may be used if other methods have not been effective in adequately raising vaccination rates. Future research should focus on how mandatory vaccine policies can improve patient outcomes.
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Affiliation(s)
- Megan C Gallagher
- 1Division of Infectious Disease, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Sarah Haessler
- 1Division of Infectious Disease, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Hilary M Babcock
- 2Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO USA
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Costantino C, Restivo V, Tramuto F, Casuccio A, Vitale F. Influenza vaccination of healthcare workers in Italy: could mandatory vaccination be a solution to protect patients? Future Microbiol 2019; 14:45-49. [PMID: 31210543 DOI: 10.2217/fmb-2018-0238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Several studies have reported that influenza infections in healthcare workers (HCWs) can lead to nosocomial outbreaks. HCWs can potentially be infected with influenza every year, and may continue to work, encouraging the spread of the virus. Different strategies, such as informative interventions on influenza and influenza vaccination, 'onsite' vaccination weeks, communicative strategies through dedicated web and social media pages, and mandatory informed dissent form, were organized for HCWs working at the University Hospital of Palermo, during previous influenza seasons. However, the increased vaccination rates observed among HCWs still remain far from the 75% recommended by Public Health Authorities. The level of coverage observed in countries with mandatory vaccination policies for HCWs, could suggest the adoption of this strategy for increase influenza vaccination adherence in Italy.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Excellence Specialist Medicine 'G D'Alessandro' - University of Palermo, Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Excellence Specialist Medicine 'G D'Alessandro' - University of Palermo, Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Excellence Specialist Medicine 'G D'Alessandro' - University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Excellence Specialist Medicine 'G D'Alessandro' - University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Excellence Specialist Medicine 'G D'Alessandro' - University of Palermo, Palermo, Italy
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Benin AL, Lockwood G, Creatore T, Donovan D, Predmore M, MacArthur S. Improving Mandatory Vaccination Against Influenza: Minimizing Anxiety of Employees to Maximize Health of Patients. Am J Med Qual 2018; 33:372-382. [PMID: 29301403 DOI: 10.1177/1062860617748738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective was to describe qualitatively the attitudes among employees toward mandatory vaccination against influenza to ultimately improve such programs and prevent hospital-acquired influenza. Qualitative interviews were conducted with 21 employees at a freestanding children's hospital. Analysis of interview transcripts used grounded theory and the constant comparative method; codes were iteratively revised and refined as themes emerged. Themes emerged elucidating promoters and concerns. Promoters included a desire to protect self, family, and patients; perception of vaccination as part of professional responsibility; and free vaccination as a benefit from the organization. Concerns included negative feelings surrounding the forced nature and substantial anxiety about the physical injection. Participants expressed a strong desire for a private, compassionate, unhurried environment for the injection. Managing personal anxiety and a desire for privacy emerged as strong concerns among health care workers getting vaccinated at work. This information enabled future improvements in the mandatory vaccination campaign.
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Affiliation(s)
| | - Gina Lockwood
- 1 Connecticut Children's Medical Center, Hartford, CT
| | | | - Donna Donovan
- 1 Connecticut Children's Medical Center, Hartford, CT
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Nunn A, Campbell AC, Naus M, Kwong JC, Puddicombe D, Quach S, Henry B. Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada. Vaccine 2017; 36:395-399. [PMID: 29223487 DOI: 10.1016/j.vaccine.2017.11.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/25/2017] [Accepted: 11/27/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). METHODS Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. RESULTS A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. CONCLUSION Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities.
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Affiliation(s)
- Alexandra Nunn
- Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Audrey C Campbell
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Naus
- Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David Puddicombe
- Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Susan Quach
- Public Health Ontario, Toronto, Ontario, Canada
| | - Bonnie Henry
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada.
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Ozisik L, Tanriover MD, Altınel S, Unal S. Vaccinating healthcare workers: Level of implementation, barriers and proposal for evidence-based policies in Turkey. Hum Vaccin Immunother 2017; 13:1198-1206. [PMID: 28059668 PMCID: PMC5443379 DOI: 10.1080/21645515.2016.1269992] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/29/2016] [Accepted: 12/05/2016] [Indexed: 11/02/2022] Open
Abstract
The role of healthcare workers in life-long vaccination is very important in the means of 2 sided infection, rising patient awareness and being a role model for the patients. Numerous organizations publish guidelines for vaccination of HCWs, while healthcare facilities develop vaccination policies according to the accreditation standards. Nevertheless, vaccination rates among HCWs are far below targets. The obstacles to getting vaccinated or recommending vaccination may include rather universal factors such as the vaccine paradox, however in the case of HCWs, probably a different set of factors are included. The aims of this article are to gain an overview of vaccination strategies for HCWs, to assess the coverage rates of HCWs and make in-depth analyses of the potential barriers to vaccination and potential factors to motivate HCWs for vaccination in Turkey and to compare them with the global picture to improve implementation of policies concerning vaccination of HCWs.
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Affiliation(s)
- Lale Ozisik
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Mine Durusu Tanriover
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | | | - Serhat Unal
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
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8
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Pless A, Shaw D, McLennan S, Elger BS. Nurses' attitudes towards enforced measures to increase influenza vaccination: A qualitative study. Influenza Other Respir Viruses 2017; 11:247-253. [PMID: 27943585 PMCID: PMC5410727 DOI: 10.1111/irv.12441] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Despite studies demonstrating that the annual influenza vaccination of healthcare workers reduces morbidity and mortality among vulnerable patients, vaccination rates remain very low, particularly in nursing staff. Educational programmes have failed to improve rates, which has led to a diverse range of enforced approaches being advocated and implemented. OBJECTIVES To examine the attitudes of non-vaccinated nursing staff towards various enforced measures aimed at increasing rates of influenza vaccination. METHODS Semi-structured qualitative interviews with a purposive sample of 18 non-vaccinated nurses, working in units with high-risk patients at two hospitals in Switzerland. Analysis of interviews was done using conventional content analysis. RESULTS Nurses were critical of enforced measures. However, measures that include an element of choice were perceived as more acceptable. Declination forms and mandatory vaccinations as part of the employment requirements were found to be the most accepted measures. CONCLUSION The perception of choice is crucial to the acceptance of a measure. Respect for choice and autonomy has a positive effect on behavioural change. Mandatory influenza vaccination as a condition of new (and perhaps ongoing) employment could be a feasible, effective and ethical measure to increase vaccination rates among nurses who oppose vaccination.
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Affiliation(s)
- Anina Pless
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - David Shaw
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Stuart McLennan
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Institute for History, Ethics and Philosophy of Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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Maltezou HC, Poland GA. Immunization of Health-Care Providers: Necessity and Public Health Policies. Healthcare (Basel) 2016; 4:E47. [PMID: 27490580 PMCID: PMC5041048 DOI: 10.3390/healthcare4030047] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/22/2016] [Accepted: 07/20/2016] [Indexed: 01/05/2023] Open
Abstract
Health-care providers (HCPs) are at increased risk for exposure to vaccine-preventable diseases (VPDs) in the workplace. The rationale for immunization of HCPs relies on the need to protect them and, indirectly, their patients from health-care-associated VPDs. Published evidence indicates significant immunity gaps for VPDs of HCPs globally. Deficits in knowledge and false perceptions about VPDs and vaccines are the most common barriers for vaccine uptake and may also influence communication about vaccines between HCPs and their patients. Most countries have immunization recommendations for HCPs; however, there are no universal policies and significant heterogeneity exists between countries in terms of vaccines, schedules, frame of implementation (recommendation or mandatory), and target categories of HCPs. Mandatory influenza immunization policies for HCPs have been implemented with high vaccine uptake rates. Stronger recommendations for HCP immunization and commitment at the level of the health-care facility are critical in order to achieve high vaccine coverage rates. Given the importance to health, mandatory immunization policies for VPDs that can cause serious morbidity and mortality to vulnerable patients should be considered.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece.
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, 611C Guggenheim Building, Mayo Clinic and Foundation, 200 First Street, SW Rochester, Rochester, MN 55905, USA.
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Dorribo V, Lazor-Blanchet C, Hugli O, Zanetti G. Health care workers' influenza vaccination: motivations and mandatory mask policy. Occup Med (Lond) 2015; 65:739-45. [PMID: 26276758 DOI: 10.1093/occmed/kqv116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. AIMS To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. METHODS A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. RESULTS There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). CONCLUSIONS The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW.
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Affiliation(s)
- V Dorribo
- Service of Occupational Medicine, Institute for Work and Health, CH-1066 Epalinges - Lausanne, Switzerland,
| | - C Lazor-Blanchet
- Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - O Hugli
- Emergency Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - G Zanetti
- Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland, Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
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Talbot TR, Babcock H, Caplan AL, Cotton D, Maragakis LL, Poland GA, Septimus EJ, Tapper ML, Weber DJ. Revised SHEA Position Paper: Influenza Vaccination of Healthcare Personnel. Infect Control Hosp Epidemiol 2015; 31:987-95. [PMID: 20807037 DOI: 10.1086/656558] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Executive SummaryThis document serves as an update and companion piece to the 2005 Society for Healthcare Epidemiology of America (SHEA) Position Paper entitled “Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages.” In large part, the discussion about the rationale for influenza vaccination of healthcare personnel (HCP), the strategies designed to improve influenza vaccination rates in this population, and the recommendations made in the 2005 paper still stand. This position paper notes new evidence released since publication of the 2005 paper and strengthens SHEA's position on the importance of influenza vaccination of HCP. This document does not discuss vaccine allocation during times of vaccine shortage, because the 2005 SHEA Position Paper still serves as the Society's official statement on that issue.
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Affiliation(s)
- Thomas R Talbot
- Departments of Medicine and Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
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Betsch C. Overcoming healthcare workers’ vaccine refusal – competition between egoism and altruism. Euro Surveill 2014; 19:20979. [DOI: 10.2807/1560-7917.es2014.19.48.20979] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- C Betsch
- University of Erfurt, Erfurt, Germany
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Gruben V, Siemieniuk RA, McGeer A. Health care workers, mandatory influenza vaccination policies and the law. CMAJ 2014; 186:1076-80. [PMID: 24863919 PMCID: PMC4188651 DOI: 10.1503/cmaj.140035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Vanessa Gruben
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont
| | - Reed A Siemieniuk
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont
| | - Allison McGeer
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont.
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Antommaria AHM. An ethical analysis of mandatory influenza vaccination of health care personnel: implementing fairly and balancing benefits and burdens. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2013; 13:30-37. [PMID: 23952830 DOI: 10.1080/15265161.2013.814731] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Health care institutions have paid increasing attention to preventing nosocomial transmission of influenza through vaccination of health care personnel. While multifaceted voluntary interventions have increased vaccination rates, proponents of mandatory programs contend the rates remain unacceptably low. Conventional bioethical analyses of mandatory programs are inadequate; they fail to account for the obligations of nonprofessional personnel or to justify the weights assigned to different ethical principles. Using an ethics framework for public health permits a fuller analysis. The framework's focus on fairness accentuates the potential differences between the risk of transmitting infection and employment status, and the need to equitably evaluate exemptions. The framework's emphasis on balancing benefits and burdens highlights the need to justify a specific goal and questions the need to exclude all nonmedical exemptions. While mandatory vaccination programs are justifiable, greater attention should be paid to their implementation.
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Helms C, Leask J, Robbins SC, Chow MYK, McIntyre P. Implementation of mandatory immunisation of healthcare workers: Observations from New South Wales, Australia. Vaccine 2011; 29:2895-901. [DOI: 10.1016/j.vaccine.2011.02.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 01/21/2011] [Accepted: 02/04/2011] [Indexed: 10/18/2022]
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Helms C, Polgreen P, Polgreen L, Evans T, Roberts LL, Clabaugh G, Quinlisk P. Voluntary reporting of employee influenza vaccination rates by acute care hospitals in Iowa: The impact of a four year provider-based statewide performance improvement project. Vaccine 2011; 29:3483-8. [DOI: 10.1016/j.vaccine.2011.02.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 02/07/2011] [Accepted: 02/15/2011] [Indexed: 10/18/2022]
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Brandt C, Rabenau HF, Wicker S. Attitudes of influenza-vaccinated health care workers toward masks to prevent nosocomial transmission of influenza. Influenza Other Respir Viruses 2011; 5:61-6. [PMID: 21138542 PMCID: PMC4941655 DOI: 10.1111/j.1750-2659.2010.00174.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Influenza viruses are highly contagious. Health care workers (HCWs) are at risk of occupational exposure to influenza and may transmit the infection to their patients and coworkers. OBJECTIVES The aim of the study was to characterize the attitudes of HCWs regarding the use of surgical masks to prevent nosocomial influenza transmission. Furthermore, we assessed the informational needs of HCWs with regard to infection control measures. METHODS A survey was conducted among HCWs, using an anonymous questionnaire, at a German University Hospital during an influenza vaccination campaign. RESULTS Overall, 40·5% of the HCWs were vaccinated against seasonal influenza, and 35·2% were vaccinated against Influenza A/H1N1 ("swine flu"). In total, 1445 vaccinees completed the anonymous questionnaire. Of all respondents, 70·5% stated that the infection control recommendation "wearing a surgical" mask was appropriate to avoid influenza transmission. The percentage of HCWs who would like to have had more information about the infection control measures was 67·5%. CONCLUSIONS Appropriate interventions ought to be taken to reduce the risk of exposure to influenza viruses among HCWs. Adherence to recommendations for the use of masks among HCWs needs to be evaluated. Further work is required to highlight the informational needs of HCWs to gain an appreciation of infection control measures.
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Affiliation(s)
- Christian Brandt
- Institute of Medical Microbiology and Infection Control, Hospital of the Johann Wolfgang Goethe‐University, Frankfurt am Main, Germany
| | - Holger F. Rabenau
- Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe‐University, Frankfurt am Main, Germany
| | - Sabine Wicker
- Occupational Health Service, Hospital of the Johann Wolfgang Goethe‐University, Frankfurt am Main, Germany
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Lam PP, Chambers LW, MacDougall DMP, McCarthy AE. Seasonal influenza vaccination campaigns for health care personnel: systematic review. CMAJ 2010; 182:E542-8. [PMID: 20643836 DOI: 10.1503/cmaj.091304] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In Canada, vaccination coverage for seasonal influenza among health care personnel remains below 50%. The objective of this review was to determine which seasonal influenza vaccination campaign or campaign components in health care settings were significantly associated with increases in influenza vaccination among staff. METHODS We identified articles in eight electronic databases and included randomized controlled trials, controlled before-and-after studies and studies with interrupted time series designs in our review. Two reviewers independently abstracted the data and assessed the risk of biases. We calculated risk ratios and 95% confidence intervals for randomized controlled trials and controlled before-and-after studies and described interrupted time series studies. RESULTS We identified 99 studies evaluating influenza vaccination campaigns for health care workers, but only 12 of the studies were eligible for review. In nonhospital health care settings, including long-term care facilities, campaigns with a greater variety of components (including education or promotion, better access to vaccines, legislation or regulation and/or role models) were associated with higher risk ratios (i.e, favouring the intervention group). Within hospital settings, the results reported for various types of campaigns were mixed. Many of the criteria for assessing risk of bias were not reported. INTERPRETATION Campaigns involving only education or promotion resulted in minimal changes in vaccination rates. Further studies are needed to determine the appropriate components and combinations of components in influenza vaccination campaigns for health care personnel.
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Affiliation(s)
- Po-Po Lam
- Elisabeth Bruyère Research Institute, Ottawa, Ontario, Canada
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Wicker S, Rabenau HF, Kempf VAJ, Brandt C. Vaccination against classical influenza in health-care workers: self-protection and patient protection. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:567-72. [PMID: 19890412 DOI: 10.3238/arztebl.2009.0567] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Accepted: 04/23/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND Health-care workers are at risk of occupational exposure to influenza and can also transmit the disease to their patients. METHODS Selective literature review and description of the influenza vaccination program at the Frankfurt University Hospital. RESULTS AND CONCLUSIONS Many studies demonstrate that influenza vaccination for health-care workers lowers morbidity and mortality in their patients. Official immunization recommendations and free, voluntary immunization programs for health-care workers have been in existence for many years. Nevertheless, influenza vaccination rates are unacceptably low. Therefore, mandatory vaccination ought to be considered. In addition, infection-control measures (covering the mouth and nose with a mask, meticulous hand disinfection) should be rigorously observed in the hospital to prevent the nosocomial transmission of influenza and other infectious diseases. Vaccination rates might be improved if health-care workers were made aware that they themselves face a risk of infection.
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Affiliation(s)
- Sabine Wicker
- Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt
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Influenza vaccination for healthcare workers: from a simple concept to a resistant issue? Aging Clin Exp Res 2009; 21:216-21. [PMID: 19571645 DOI: 10.1007/bf03324908] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Different strategies for the management of influenza epidemics are particularly important in elderly population. High morbidity and mortality rates are associated with influenza in the elderly, and annual vaccination against flu is considered to be the best cost-effective strategy. However, its efficiency is reduced in older adults and only half of them are protected. Several studies show that vaccinating healthcare workers is an efficient way of decreasing mortality rates in nursing home residents within influenza season. National and international public health authorities recommend therefore healthcare worker vaccinations for up to 5 years. However, influenza healthcare worker vaccination coverages are still low. Here we summarize data regarding the justification of healthcare worker vaccination, the efficiency of this strategy, the reasons of the reluctance of vaccination, the means and results of interventional programs and, then, focus on the debate of a mandatory healthcare worker influenza vaccination. Because several interventional programs are efficient but still need high financial and human support, only a strong political-will can improve this chosen strategy.
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