1
|
Kalatzi P, Travlos AK, Geladas N, Iliadou M, Tzavara C, Chryssanthopoulos C, Mihopoulos A, Tziaferi S. Vaccination coverage of primary care providers against seasonal influenza, tetanus, pneumococcal pneumonia and herpes zoster: A cross-sectional study in Greece. AIMS Public Health 2023; 10:952-963. [PMID: 38187900 PMCID: PMC10764975 DOI: 10.3934/publichealth.2023061] [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: 06/10/2023] [Revised: 10/17/2023] [Accepted: 11/14/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Primary care providers' (PCPs) compliance to self-immunization is important for their protection and the protection of their colleagues and patients and has been associated with the coverage of the general public. In this study, we aim to investigate the vaccination coverage of PCPs. Methods A questionnaire-based cross-sectional survey was conducted among physicians, nurses and pharmacists employed in public or private primary care settings in Greece. Demographic and occupational characteristics as well as vaccination coverage data for influenza, tetanus, pneumococcal pneumonia and herpes zoster were collected. Statistical significance was set at 0.05. Results In total, 748 (61.7% response rate) PCPs participated. Vaccination rates were 66.4% (496/747) for influenza (2019/2020 flu season), 62.9% (469/746) for tetanus (10-year Td or Tdap booster dose), 70% (14/20) for pneumococcal pneumonia (≥ 1 dose of PPSV23 or PCV13) and 12.3% (10/81) for herpes zoster. Multiple logistic regression revealed that nurses had significantly lower probability of being vaccinated against influenza [odds ratio (OR) = 0.25; 95% confidence interval (CI) = 0.14-0.45] and pharmacists had significantly lower probability of being vaccinated against both influenza (OR = 0.44; 95% CI = 0.31-0.62) and influenza & tetanus (OR = 0.52; 95% CI = 0.37-0.73) compared to physicians. Older age (>40 years) was an independent risk factor for not receiving a tetanus vaccine (40-49 vs. 19-39; OR = 0.42; 95% CI = 0.28-0.63, over 50 years old vs. 19-39; OR = 0.54; 95% CI = 0.36-0.79). Conclusions The results revealed suboptimal vaccination rates among health providers who are in the frontline of adult immunization. Individualized and targeted measures to improve their vaccination coverage and indirectly the vaccination coverage of their patients, are therefore required.
Collapse
Affiliation(s)
- Panagiota Kalatzi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Antonios K. Travlos
- Department of Sports Organization and Management, University of Peloponnese, Sparti, Greece
| | - Nickos Geladas
- Department of Physical Education & Sport Science, National & Kapodistrian University of Athens, Athens, Greece
| | - Maria Iliadou
- Department of Midwifery, University of West Attica, Athens, Greece
| | - Chara Tzavara
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Alexandros Mihopoulos
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Styliani Tziaferi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, Tripoli, Greece
| |
Collapse
|
2
|
Tsiligianni I, Bouloukaki I, Papazisis G, Paganas A, Chatzimanolis E, Kalatharas M, Platakis I, Tirodimos I, Dardavesis T, Tsimtsiou Z. Vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake among adults in Greece. Public Health 2023; 224:195-202. [PMID: 37820537 DOI: 10.1016/j.puhe.2023.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/16/2023] [Accepted: 09/05/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Insufficient adult vaccination coverage rates remain an international challenge. This nationwide study aimed at exploring vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake, following the recommendations of the National Immunization Program for adults. STUDY DESIGN This was a multicenter, mixed-methods study conducted at 23 primary care units in six different regions of Greece. METHODS A pretested questionnaire was administered to three randomly selected adults who visited each practice daily for 30 consecutive working days. RESULTS Among the 1571 participants, vaccination coverage for influenza in the high-risk groups was 55%, 36% for pneumococcal disease, 12% for herpes zoster (HZ), 21% for tetanus, 33% for measles, and 11% for hepatitis B. Perception of low susceptibility to disease due to good health status, concerns about side-effects and vaccines' efficacy, and mistrust in pharmaceutical companies were among common factors associated with the vaccines uptake. The strongest factor associated with the participants' vaccination status was their doctor's recommendation (odds ratio [95% confidence interval] influenza: 6.06 [4.52-8.14], pneumococcal disease: 15.73 [10.98-22.52], HZ: 17.01 [9.05-31.96], tetanus: 23.93 [16.20-35.35], measles: 33.47 [16.85-66.47], and hepatitis B: 73.92 [17.47-312.74]). Being well-informed about each vaccine was also a predictor of its uptake. CONCLUSIONS Vaccination coverage was suboptimal and especially low in tetanus, HZ, and hepatitis B immunization. Person-centered approach, with provision of appropriate information about vaccines' safety and efficacy, responding to each patient's needs, as well as physicians' strong recommendation for vaccination are considered crucial to advocate against the spread of vaccine misinformation and increase vaccination coverage.
Collapse
Affiliation(s)
- I Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Research Committee of Greek Association of General Practitioners, Greece
| | - I Bouloukaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - G Papazisis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Paganas
- Health Center of Litochoro, Litochoro, Pieria, Greece
| | - E Chatzimanolis
- Research Committee of Greek Association of General Practitioners, Greece; Rural Practice of Aiani, Aiani, Kozani, Greece
| | - M Kalatharas
- Rural Practice of Pedino, Pedino, Karditsa, Greece
| | - I Platakis
- Health Center of Moires, Moires, Crete, Greece
| | - I Tirodimos
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Dardavesis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Tsimtsiou
- Research Committee of Greek Association of General Practitioners, Greece; Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| |
Collapse
|
3
|
Avakian I, Dadouli K, Anagnostopoulos L, Fotiadis K, Lianos A, Mina P, Hadjichristodoulou C, Mouchtouri VA. Nationwide Survey on Seasonal Influenza Vaccination among Health Care Workers during the COVID-19 Pandemic in Greece: Determinants, Barriers and Peculiarities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6247. [PMID: 37444095 PMCID: PMC10341827 DOI: 10.3390/ijerph20136247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/10/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Seasonal influenza vaccination (SIV) of health care workers (HCWs) is critical in protecting patients' and HCWs' health. Our objective was to examine HCW SIV coverage and related determinants. METHODS AND MATERIALS A nationwide cross-sectional questionnaire survey was conducted among HCWs during the first half of 2021. The questionnaire (online or paper-based) included knowledge, attitude and practice questions regarding SIV, COVID-19 vaccines and vaccination. RESULTS Out of 6500 questionnaires administered, 2592 were completed (response rate: 39.9%). SIV coverage reached 69.4% (95% CI: 67.6-71.2%) based on self-reported vaccine uptake. Nurses and administrative staff were found to be more skeptical and have lower vaccine acceptance in comparison with physicians (aOR = 0.66 and aQR = 0.59, respectively). Other SIV hesitancy risk factors included working in secondary health care (aOR = 0.59) and working in northern Greece (aQR = 0.66). Determinants for SIV acceptance included being or living with high-risk people due to medical history (aOR = 1.84 and aOR = 1.46, respectively), positive attitudes towards routine vaccinations (aOR: 1.86), knowledge about COVID-19 vaccines (aOR = 1.53) and COVID-19 vaccine uptake (aOR = 3.45). The primary reason for SIV refusal was low risk perception (58.7%). CONCLUSIONS SIV coverage (2020/2021) was relatively high, but remained far from formal recommendations. Specific occupational groups were skeptical and low-risk perception was the main reason for vaccine refusal. Targeted policies should be developed and enforced.
Collapse
Affiliation(s)
- Ioanna Avakian
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | | | - Athanasios Lianos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| |
Collapse
|
4
|
Benedict Kpozehouen E, Arrudsivah B, Raina Macintyre C. Knowledge, attitudes and practices of health care workers in a cardiology department on influenza vaccination. Vaccine 2023; 41:2349-2356. [PMID: 36801083 DOI: 10.1016/j.vaccine.2023.01.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Evidence has accrued that influenza vaccination may be effective in preventing myocardial infarction (MI). However, vaccination rates in both adults and health care workers (HCW) are low, and hospitalisation is often a missed opportunity for vaccination. We hypothesised that knowledge, attitude and practices of health care workers regarding vaccination impacts vaccine uptake in hospitals. The cardiac ward admits high-risk patients, many of whom are indicated for influenza vaccine, especially those caring for patients with acute MI. AIM To understand the knowledge, attitudes, and practices of HCW in cardiology ward within a tertiary institution, on influenza vaccination. METHODS We used focus group discussions with HCW caring for AMI patients in an acute cardiology ward, to explore the knowledge, attitudes, and practices of HCW regarding influenza vaccination for patients under their care. Discussions were recorded, transcribed, and thematically analysed using NVivo software. In addition, participants completed a survey on their knowledge and attitudes towards the uptake of influenza vaccination. RESULTS A lack of awareness regarding the associations between influenza, vaccination and cardiovascular health was identified amongst HCW. Participants did not routinely discuss the benefits of influenza vaccination or recommend influenza vaccinations to patients under their care; this may be due to a combination of a lack of awareness, not seeing it as part of their job and workload issues. We also highlighted difficulties in access to vaccination, and concerns of adverse reactions to the vaccine. CONCLUSION There is limited awareness among HCW of the role of influenza on cardiovascular health and the benefits of influenza vaccine in the prevention of cardiovascular events. Improved vaccination of at-risk patients in hospital may need active engagement of HCW. Improving the health literacy of HCW regarding the benefits of vaccination as a preventative strategy may result in better health care outcomes for cardiac patients.
Collapse
Affiliation(s)
| | | | - C Raina Macintyre
- Biosecurity Program, The Kirby Institute for Infection and Immunity, UNSW Sydney, Australia
| |
Collapse
|
5
|
Factors contributing to coronavirus disease 2019 vaccine hesitancy among healthcare workers in Iran: A descriptive-analytical study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 18:101182. [PMCID: PMC9678224 DOI: 10.1016/j.cegh.2022.101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022] Open
|
6
|
Papageorgiou C, Mazeri S, Karaiskakis M, Constantinou D, Nikolaides C, Katsouris S, Patsalou M, Kourouzidou D, Pantelas G, Koliou M. Exploring vaccination coverage and attitudes of health care workers towards influenza vaccine in Cyprus. Vaccine 2022; 40:1775-1782. [PMID: 35168841 DOI: 10.1016/j.vaccine.2022.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/30/2021] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
Seasonal influenza is a major public health problem. Nosocomial influenza is particularly concerning as it may affect patients at high risk for complications. Unvaccinated health care workers (HCWs) are an important source of nosocomial influenza and therefore a priority target group for vaccination. Despite the fact that some European countries have high coverage rates such as UK (76.8% in season 2020/21), others continue to have low coverage rates for influenza vaccines. This study aims to estimate vaccination coverage in HCWs in Cyprus, an island country located in the Eastern Mediterranean region and describe their attitudes towards influenza vaccination. METHODS This is a questionnaire based, nation-wide study assessing flu vaccination coverage in 2019-2020 and attitudes related to vaccination acceptance, of 962 HCWs in both public and private health care facilities. Multivariable logistic regression was used to investigate factors associated with flu vaccination status. RESULTS Flu vaccination coverage was estimated as 31.8%. The top two reasons for getting vaccinated were to protect their family (81.4%) and themselves (77.4%). The top two reasons for not getting immunised, besides "no particular reason" (25.7%), included disbelief for vaccine effectiveness (21.5%) and safety (29.3%). The regression model showed that doctors compared to nurses had 10 times the odds of being vaccinated. Other factors positively associated with flu vaccination were encouragement by the supervisor, having sufficient knowledge on flu and flu vaccination and easy access to vaccination. A percentage of 54.8% of participants stated that COVID-19 pandemic strongly or somewhat influenced their decision to get vaccinated. CONCLUSION Flu vaccination coverage in HCWs in Cyprus is rather low, similar to some other European countries. Barriers and facilitators in this study can be considered in strategies to increase flu vaccination uptake. Such questionnaire-based surveys should be repeated in order to evaluate effectiveness of targeted vaccination campaigns.
Collapse
Affiliation(s)
| | - Stella Mazeri
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK.
| | | | | | | | | | - Maria Patsalou
- Infection Control Nurse, Paphos General Hospital, Cyprus.
| | | | - George Pantelas
- State Health Services Organisation of Cyprus, Nicosia, Cyprus.
| | - Maria Koliou
- Department of Paediatrics, Medical School, University of Cyprus, Nicosia, Cyprus.
| |
Collapse
|
7
|
Pilalas D, Daios S, Kachrimanidou M, Kaiafa G, Avgeri S, Ztriva E, Kontana A, Keramari S, Karlafti E, Kanellos I, Savopoulos C. Diabetic Patient Adherence to Yearly Influenza Vaccination in Northern Greece. Cureus 2022; 14:e22250. [PMID: 35340457 PMCID: PMC8930191 DOI: 10.7759/cureus.22250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/07/2022] Open
Abstract
Background Influenza virus infection is associated with increased morbidity and mortality in patients with diabetes mellitus. Public health authorities recommend yearly vaccination of diabetic patients against seasonal influenza. Methods We surveyed to define the adherence to influenza vaccination and associated factors among diabetic patients in Thessaloniki, Greece. Predictors of adherence to yearly influenza vaccination were assessed with logistic regression models. Results A total of 206 patients were enrolled, with 47.1% reporting yearly vaccination against influenza (95% confidence interval, CI:40.3% to 53.9%). In univariate models, the absence of additional indications for vaccination was associated with a decreased likelihood of vaccination uptake (OR:0.29, 95% CI:0.11 to 0.68, p=0.007); older diabetic patients were more likely to receive influenza vaccination (34% increase per 10 years of age). These associations were attenuated in multivariable analysis. Conclusion Our study demonstrates a significant gap in influenza vaccination coverage rate in diabetic patients. Our data could be extrapolated to enhance the uptake of vaccines against SARS-CoV-2: emphasis should be placed on patient education.
Collapse
|
8
|
Jędrzejek MJ, Mastalerz-Migas A. Influenza Vaccination Coverage, Motivators for, and Barriers to Influenza Vaccination among Healthcare Workers in Wroclaw, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031586. [PMID: 35162609 PMCID: PMC8835710 DOI: 10.3390/ijerph19031586] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/29/2023]
Abstract
Background: Influenza vaccination, as a key element of control activities intended to prevent nosocomial influenza transmission, is recommended each year for all healthcare workers (HCWs). The objectives were to determine the rate of influenza vaccination and to identify reasons for receiving or declining the influenza vaccine among HCWs in the 2018/19 and 2019/20 influenza seasons. Methods: This study is a cross-sectional observational study carried out between January and March 2020, in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). Results: A total of 165 questionnaires were completed. The majority of participating HCWs were female—137 (83.0%), and, by profession, the majority were physicians 92 (55.8%). Influenza vaccination coverage was 61.2% in 2019/20, and 47.9% in the 2018/19 season for all participants. Participants who were male, physicians and personnel from PHCS were more frequently vaccinated in both seasons. According to the statistical analysis, physicians were more likely to receive vaccinations than nurses (p < 0.01), as were HCWs who had been vaccinated in the previous season (p < 0.001). Conclusion: The identified barriers were mainly caused by misconceptions (fear of vaccine adverse effects and perception of not being at risk/no need to get vaccinated) and an organizational barriers (lack of time). These findings may prove useful for designing immunization campaigns to tailor strategies to reach specific groups.
Collapse
|
9
|
HAJIABDOLBAGHI MAHBOUBEH, HAVASTIN NAZANINGHORBANIAN, AFHAMI SHIRIN, MONTAZERI MAHNAZ, MOHAMMADNEJAD ESMAEIL, REZAEI PARVIN, HAJINOORI MITRA, GHAHAN AZAM, AFIFEH AKRAM, VESROUDI ROGHAYEHBABAEI, HADADI AZAR, ASADOLLAHI-AMIN ALI, SEIFI ARASH. Influenza vaccination coverage and obstacles in healthcare workers (HCWs) and the follow up of side effects: a multicenter investigation in Iran. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E377-E381. [PMID: 34604576 PMCID: PMC8451352 DOI: 10.15167/2421-4248/jpmh2021.62.2.1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/26/2021] [Indexed: 11/23/2022]
Abstract
Introduction Seasonal influenza is an annual common occurrence in cold seasons; but the COVID-19 pandemic is also currently ongoing. These two diseases can’t be distinguished from their symptoms alone; therefore, the importance of preventing influenza by vaccination is more than ever. Due to the high exposure of hospital personnel, widespread influenza vaccination of these high-risk groups seems to be a necessity. This Study conducted to determine vaccination coverage in the personnel of four tertiary referral collegiate hospitals in 2019 and to further investigate individual obstacles for Influenza vaccination. Methods In this cross-sectional descriptive study, 637 personnel were selected randomly from distinctive hospitals in a list-wised. Ones vaccinated filled the side effects questionnaire and who not vaccinated filled the vaccination obstacles questionnaire. The study was approved by the ethics committee of Tehran University of Medical Sciences with this reference number: IR.TUMS.IKHC.REC.1398.218 Results The mean vaccination coverage was 29.4% and the coverage difference among centers was not statistically significant (p = 0.192). The following items had the most impact on personnel decision: confidence about one’s immune system (p < 0.05), the experience of side effects from previous vaccinations (p = 0.011), attitude about vaccination in colleagues (p = 0.021) and work experience (p < 0.05). About 23% of vaccinated individuals reported side effects following vaccination and the most common side effect was mild cold symptoms with 12.3% prevalence. Conclusion The results of the current study revealed that influenza vaccination coverage among HCWs is not satisfactory in Iran. Hospital authorities and infection control units should plan to remove the obstacles of influenza vaccination.
Collapse
Affiliation(s)
- MAHBOUBEH HAJIABDOLBAGHI
- Department of Infectious Diseases, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - NAZANIN GHORBANIAN HAVASTIN
- Department of Infectious Diseases, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - SHIRIN AFHAMI
- Department of Infectious Diseases, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - MAHNAZ MONTAZERI
- Department of Infectious Diseases, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - ESMAEIL MOHAMMADNEJAD
- Department of Medical-Surgical Nursing and Basic Sciences, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - PARVIN REZAEI
- Department of Nursing, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - MITRA HAJINOORI
- Department of Nursing, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - AZAM GHAHAN
- Department of Nursing, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - AKRAM AFIFEH
- Department of Nursing, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - AZAR HADADI
- Department of Infectious Diseases, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - ALI ASADOLLAHI-AMIN
- Department of Infectious Diseases, Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
| | - ARASH SEIFI
- Department of Infectious Diseases, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence: Arash Seifi, Department of Infectious Diseases, Faculty of Medicine, Tehran University of Medical Sciences, Keshavarz Blvd. Tohid Sq., 1419733141 Tehran, Iran - Tel.: +98.9124000193 - Fax: +98.2166581598 - E-mail:
| |
Collapse
|
10
|
Giannouchos TV, Steletou E, Saridi M, Souliotis K. Should vaccination be mandated? Individuals' perceptions on mandatory vaccination in Greece. J Eval Clin Pract 2021; 27:1104-1111. [PMID: 33783070 PMCID: PMC8251106 DOI: 10.1111/jep.13568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to explore factors that influence individuals' attitudes towards mandatory vaccination in Greece. METHODS A nationally representative cross-sectional telephone survey was conducted via a random multistage selection process in October 2019 in Greece. The survey was designed to obtain information about whether vaccination should be mandated or not among adults 18 years of age or older. A multivariable logistic regression model was used to estimate the association between individuals' sociodemographic, contextual and clinical characteristics, utilization, satisfaction, and trust in the healthcare system and providers and their preference over mandatory vaccination. RESULTS A total of 901 participants fully completed the survey (response rate 90%-901/1001). About 85% of the respondents supported mandatory vaccination. Individuals who used preventive services more often compared to those who never or rarely used such, those who reported increased trust in official healthcare authorities' guidelines and recommendations compared to those who reported no trust and those who had underage children living in the household were significantly more likely to support mandatory vaccination. No differences were observed for sociodemographic factors and mandatory vaccination support. CONCLUSION This survey revealed that most Greek citizens support mandatory vaccination, which was critically affected by the utilization of preventive services and trust in healthcare authorities. Our results suggest that healthcare policy interventions should promote mandatory vaccination through multi-level initiatives to improve healthcare providers' and the general public's understanding of the value of vaccination.
Collapse
Affiliation(s)
- Theodoros V Giannouchos
- Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA.,Laboratory of Health Economics & Management, Economics Department, University of Piraeus, Piraeus, Greece
| | - Evaggelia Steletou
- University Regional General Hospital of Patras, University of Patras, Patras, Greece
| | - Maria Saridi
- Department of Social and Education Policy, University of Peloponnese, Corinth, Greece
| | - Kyriakos Souliotis
- Department of Social and Education Policy, University of Peloponnese, Corinth, Greece.,Health Policy Institute, Athens, Greece
| |
Collapse
|
11
|
Kearns AJ. Should nurses take a COVID-19 vaccine? Nurs Outlook 2021; 69:1081-1089. [PMID: 34493400 PMCID: PMC8343374 DOI: 10.1016/j.outlook.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/12/2021] [Accepted: 07/29/2021] [Indexed: 12/23/2022]
Abstract
The issue as to whether health care professionals have a moral obligation to take a vaccine for a communicable disease is not new. Nonetheless, this issue takes on a fresh urgency within nursing practice in the context of the present COVID-19 pandemic, i.e., is there an ethical requirement for nurses to take a COVID-19 vaccine? This paper approaches the issue by using a hypothetical example of Nurse X who has inadvertently infected Patient Y. French's (1984a) Principle of Responsive Adjustment is adapted to claim that there would be a moral expectation that Nurse X takes a COVID-19 vaccine (unless there are justifiable reasons not to). The proposition is also made that, should Nurse X not take a COVID-19 vaccine, they could be morally associated with originally infecting Patient Y.
Collapse
Affiliation(s)
- Alan J Kearns
- School of Theology, Philosophy, and Music, Dublin City University, Dublin 9, Ireland.
| |
Collapse
|
12
|
Raftopoulos V, Iordanou S, Katsapi A, Dedoukou X, Maltezou HC. A comparative online survey on the intention to get COVID-19 vaccine between Greek and Cypriot healthcare personnel: is the country a predictor? Hum Vaccin Immunother 2021; 17:2397-2404. [PMID: 33754953 PMCID: PMC8475582 DOI: 10.1080/21645515.2021.1896907] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/05/2021] [Accepted: 02/22/2021] [Indexed: 12/18/2022] Open
Abstract
Vaccine hesitancy amongst healthcare personnel (HCP) is a critical issue. The aim was to explore the factors that determine the intention to opt for COVID-19 vaccine among HCP from two southern European countries. An anonymous online self-administered survey using Google Forms has been conducted between December 1st to December 15th, 2020 among the HCP in Greece and the Republic of Cyprus. A total of 2,238 HCPs participated in the study (1,220/54.5% from Republic of Cyprus and 1,018 from Greece). Overall 1,082 (48.3%) stressed their intention to get vaccinated (64.4% for Greece and 34.9% for Republic of Cyprus). The main reasons for those who intend to get the COVID-19 vaccine include self (94.2%), family (98.7%), and patients protection (95.2%) as well as mitigation of COVID-19 pandemic (95.4%). The multivariate logistic regression that was performed for the total sample revealed that the following variables were significantly associated with an increased probability to get vaccinated against COVID-19: being a physician, a member of the nursing personnel, paramedical staff, working in Greece, age, the belief that influenza vaccination should be mandatory for HCP, and the rating of the overall management of COVID-19 pandemic in the country and from the public hospitals. Physicians were more likely to get vaccinated against COVID-19 than other HCP. The age was a predictor of COVID-19 uptake intention in the Republic of Cyprus. The belief that there was a successful management of the COVID-19 pandemic contributed to the intention to COVID-19 vaccination uptake.
Collapse
Affiliation(s)
- Vasilios Raftopoulos
- Epidemiological Surveillance of HIV/AIDS Division, National Public Health Organization, Athens, Greece
| | - Stelios Iordanou
- Intensive Care Unit, Limassol General Hospital, Limassol, Cyprus
| | - Angeliki Katsapi
- Euro-Mediterranean Institute for Quality and Safety in Health Services Avedis Donabedian, Athens, Greece
| | | | - Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
| |
Collapse
|
13
|
Maltezou HC, Pavli A, Dedoukou X, Georgakopoulou T, Raftopoulos V, Drositis I, Bolikas E, Ledda C, Adamis G, Spyrou A, Karantoni E, Gamaletsou MN, Koukou DM, Lourida A, Moussas N, Petrakis V, Panagopoulos P, Hatzigeorgiou D, Theodoridou M, Lazanas M, Gargalianos P, Sipsas NV. Determinants of intention to get vaccinated against COVID-19 among healthcare personnel in hospitals in Greece. Infect Dis Health 2021; 26:189-197. [PMID: 33906828 PMCID: PMC8011642 DOI: 10.1016/j.idh.2021.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND To investigate intention rates to get vaccinated against COVID-19 among healthcare personnel (HCP) in Greece. METHODS Cross-sectional survey. RESULTS The response rate was 14.5%. Of 1521 HCP with a known profession, 607 (39.9%) were nursing personnel, 480 (31.6%) physicians, 171 (11.2%) paramedical personnel, 72 (4.7%) supportive personnel, and 191 (12.6%) administrative personnel. Overall, 803 of 1571 HCP (51.1%) stated their intention to get vaccinated while 768 (48.9%) stated their intention to decline vaccination. Most HCP (71.3%) who reported intent to get vaccinated noted contributing to the control of the pandemic and protecting their families and themselves as their reasons, while the most common reason for reporting intent to decline vaccination was inadequate information about the vaccines (74.9%), followed by concerns about vaccine safety (36.2%). Logistic regression analysis revealed that the probability of intending to get vaccinated increased with male gender, being a physician, history of complete vaccination against hepatitis B, history of vaccination against pandemic A (H1N1) in 2009-2010, belief that COVID-19 vaccination should be mandatory for HCP, and increased confidence in vaccines in general during the COVID-19 pandemic. The following factors were associated with a lower intention to get vaccinated: no vaccination against influenza the past season, no intention to get vaccinated against influenza in 2020-2021, and no intention to recommend COVID-19 vaccination to high-risk patients. CONCLUSION There is an urgent need to built safety perception towards COVID-19 vaccines and raise vaccine uptake rates by HCP, and thus to protect the healthcare workforce and the healthcare services.
Collapse
Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, 11523, Greece.
| | - Androula Pavli
- Department for Travel Medicine, National Public Health Organization, Athens, 11523, Greece
| | | | - Theano Georgakopoulou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, 11523, Greece
| | - Vasilios Raftopoulos
- HIV Surveillance Department, National Public Health Organization, Athens, 11523, Greece
| | - Ioannis Drositis
- Medical Oncology Department, Venizeleio-Pananeio General Hospital, Heraklion, 71409, Greece
| | - Emmanouil Bolikas
- Infection Control Committee, Venizeleio-Pananeio General Hospital, Heraklion, 71409, Greece
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, 95124, Italy
| | - Georgios Adamis
- First Department of Internal Medicine, Infectious Diseases Unit, Gennimatas General Hospital, Athens, 11527, Greece
| | - Andronikos Spyrou
- First Department of Internal Medicine, Infectious Diseases Unit, Gennimatas General Hospital, Athens, 11527, Greece
| | - Eleni Karantoni
- Medical Directorate, Hellenic Air Force General Staff, Athens, 11525, Greece
| | - Maria N Gamaletsou
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527, Greece
| | - Dimitra Maria Koukou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece
| | - Athanasia Lourida
- Infection Prevention and Control Committee, Aghia Sofia Children's Hospital, Athens, 11527, Greece
| | - Nikolaos Moussas
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, 11523, Greece
| | - Vasilios Petrakis
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Periklis Panagopoulos
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | | | - Maria Theodoridou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece
| | - Marios Lazanas
- Internal Medicine and Infectious Diseases Department, Iaso Maternity Hospital, Athens, 11523, Greece
| | - Panagiotis Gargalianos
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, 11523, Greece
| | - Nikolaos V Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527, Greece
| |
Collapse
|
14
|
Determinants of Vaccination Uptake in Risk Populations: A Comprehensive Literature Review. Vaccines (Basel) 2020; 8:vaccines8030480. [PMID: 32867126 PMCID: PMC7563537 DOI: 10.3390/vaccines8030480] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Vaccination uptake has decreased globally in recent years, with a subsequent rise of vaccine-preventable diseases. Travellers, immunocompromised patients (ICP), and healthcare workers (HCW) are groups at increased risk for (severe) infectious diseases due to their behaviour, health, or occupation, respectively. While targeted vaccination guidelines are available, vaccination uptake seems low. In this review, we give a comprehensive overview of determinants-based on the integrated change model-predicting vaccination uptake in these groups. In travellers, low perceived risk of infection and low awareness of vaccination recommendations contributed to low uptake. Additionally, ICP were often unaware of the recommended vaccinations. A physician's recommendation is strongly correlated with higher uptake. Furthermore, ICP appeared to be mainly concerned about the risks of vaccination and fear of deterioration of their underlying disease. For HCW, perceived risk of (the severity of) infection for themselves and for their patients together with perceived benefits of vaccination contribute most to their vaccination behaviour. As the determinants that affect uptake are numerous and diverse, we argue that future studies and interventions should be based on multifactorial health behaviour models, especially for travellers and ICP as only a limited number of such studies is available yet.
Collapse
|
15
|
Vrachnaki O, Vergadi E, Ioannidou E, Galanakis E. Determinants of low uptake of vaccination against influenza, measles, and hepatitis B among healthcare professionals in Greece: a multicenter cross-sectional study. Hum Vaccin Immunother 2020; 16:2663-2669. [PMID: 32401656 DOI: 10.1080/21645515.2020.1741311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Vaccination is recommended for healthcare professionals (HCPs) to protect them against vaccine-preventable diseases (VPDs); however, uptake rates are low. This study aimed to evaluate HCPs' influenza, hepatitis B, and measles vaccine uptake in all healthcare levels in Crete, Greece. We conducted a questionnaire-based, cross-sectional multicenter study in 2018, including HCPs employed at 18 primary care centers and 3 hospitals. Overall, 2,246 HCPs responded (57.2% of the target population). The influenza vaccine uptake rate was 36.1% (810/2,246), with the annual vaccination rate at 14.8% (332/2,246) over the previous 5 years. Concurrently, the hepatitis B 3-dose vaccine uptake rate was 60.3% (1,316/2,181). Among the participating HCPs, 70.7% (1,457/2,061) had measles immunity due to previous illness (959/2,061, 46.5%), a 2-dose vaccination scheme (461/2,061, 22.4%), or serological confirmation (37/2,061, 1.8%). Vaccine uptake rates differed between groups depending on age, profession, and workplace setting. Logistic regression analysis revealed that risk factors for no influenza vaccine uptake during the previous season were younger age (≤45 years; odds ratio [OR] 1.35, 95% confidence interval [CI]: 1.08-1.66), profession other than physician (OR 2.94, 95%CI: 2.09-4.12), and working in hospitals (OR 1.39, 95%CI 1.02-1.89). Older age (>45 years) was an independent risk factor for not receiving a measles (OR 26.74, 95%CI: 17.41-41.06) or hepatitis B vaccine (OR 1.36, 95%CI 1.09-1.7). Working in primary care was an independent risk factor for not getting a hepatitis B vaccine (OR 1.52, 95%CI: 1.15-2.1). Our findings indicate that individualized and targeted interventions should be implemented to increase vaccine uptake among HCPs.
Collapse
Affiliation(s)
- Olga Vrachnaki
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece
| | - Eleni Vergadi
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece.,Department of Paediatrics, Medical School, University of Crete , Heraklion, Greece
| | - Eleni Ioannidou
- Department of Internal Medicine, Rethymnon General Hospital , Rethymnon, Greece
| | - Emmanouil Galanakis
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece.,Department of Paediatrics, Medical School, University of Crete , Heraklion, Greece
| |
Collapse
|
16
|
Diomidous M, Isaakidou M. Factors Influencing the Implementation of Flu Vaccination in Healthcare Professionals: Pros and Cons. Mater Sociomed 2020; 32:307-314. [PMID: 33628135 PMCID: PMC7879438 DOI: 10.5455/msm.2020.32.307-314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Vaccination is the best method for microbial and viral infections prevention. Especially for health professionals, flu vaccination is the best method to protect them, and the same applies for the patients and the general population from being infected. One of the most important preventive measure is vaccination and the main types of vaccines available, the limitations and side effects are briefly presented. Aim: The aim of this paper is to present the necessity of the healthcare professionals to conceptualize the importance of flu vaccination ifor themselves and the general population. Healthcare professionals are influenced by their knowledge, attitudes, and beliefs. Epidemiological surveys on this issue are presented for Greece, European Union, and the USA. Methods: A broad scope literature review was conducted based on a strict selection process of articles referring to the general population and the healthcare professionals with emphasis on the time period from the fall of 2018 until the spring of 2020 across Greece. The method used in this research obtained information through bibliographical references throughout Europe, USA, and relevant studies in Greece. Results: The results of this research indicated that influenza vaccination among healthcare professionals in Greece in the time period 2018-2019 was higher in primary health centers (PHCs) with a percentage of 43.8% than in Hospitals which was 30.6%. In addition, in the time period 2019-2020 flu vaccination among health professionals was higher in PHCs with a percentage of 57.9% rather than in Hospitals with a percentage of 38.8%. Specifically, flu vaccination rate which took place in hospitals was higher among physicians than in other healthcare personnel. Furthermore, the fundamental reasons for recommending flu vaccination in healthcare professionals are presented, and issues related to denial or acceptance of it are highlighted. Measures and strategies are proposed in order to increase flu vaccination coverage in healthcare facilities in Greece. Conclusions: Based on this research review healthcare professionals (HCPs) especially the ones working in ICUs, in ICUs for newborn children, in Departments for acute care infections, in Departments caring of persons with immunodeficiency or Units for transplantation, Oncology and Haematology Departments, and finally, in Emergency Care Units need directly to be vaccinated for the flu virus. Different measures have been undertaken to promote flu vaccination and the percentage of implementation has been highlighted.
Collapse
Affiliation(s)
- Marianna Diomidous
- Department of Public Health, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | - Marianna Isaakidou
- Department of Public Health, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
17
|
Souza TPD, Lobão WM, Santos CADST, Almeida MDCCD, Moreira Júnior ED. [Factors associated with the acceptance of the influenza vaccine among health workers: knowledge, attitude and practice]. CIENCIA & SAUDE COLETIVA 2019; 24:3147-3158. [PMID: 31389561 DOI: 10.1590/1413-81232018248.21912017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 02/09/2018] [Indexed: 11/22/2022] Open
Abstract
Influenza vaccine is recommended for all health workers, but vaccination coverage remains unsatisfactory. A cross-sectional study that aimed to identify factors associated with influenza vaccination was carried out with health workers from a large Hospital Complex in Salvador, Bahia. A self-administered questionnaire was used based on the models "Knowledge, Attitudes and Practices" and "Health Belief Model". The dependent variable was the vaccination status against influenza in 2014, and the independent variables were sociodemographic factors, vaccine history, knowledge and attitudes about influenza/influenza vaccine. Logistic regression was used, odds ratio was calculated with 95% confidence intervals, adjusting for sex, age and occupation. The best multivariate model was chosen through backwards elimination and the Akaike Information Criterion. 755 workers participated. Influenza vaccine coverage was 61.5%, being higher among nurses (69.0%) and lower among physicians (49.1%). The factors associated with being vaccinated against influenza were: knowing that even when healthy, one must vaccinate against influenza (OR = 3.15; 95%CI:1.74-5.71); knowing that the vaccine does not protect for many years (OR = 2.08; 95%CI:1.30-3.33); and not to be afraid of post-vaccine adverse effects (OR = 1.93; 95%CI: 1.26-2.95).
Collapse
Affiliation(s)
- Tiago Pereira de Souza
- Instituto Gonçalo Muniz, Fiocruz. R. Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - William Mendes Lobão
- Instituto Gonçalo Muniz, Fiocruz. R. Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | | | | | | |
Collapse
|
18
|
Kyaw WM, Chow A, Hein AA, Lee LT, Leo YS, Ho HJ. Factors influencing seasonal influenza vaccination uptake among health care workers in an adult tertiary care hospital in Singapore: A cross-sectional survey. Am J Infect Control 2019; 47:133-138. [PMID: 30293741 DOI: 10.1016/j.ajic.2018.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to evaluate the factors influencing seasonal influenza vaccination uptake among different health care professional groups. METHODS A single-center, cross-sectional survey using a standardized anonymous, self-administered questionnaire to assess knowledge, attitudes, and uptake of seasonal influenza vaccination was used. Associations between respective health care groups and vaccination acceptance were then assessed. RESULTS In total, 3,873 health care workers completed the questionnaire. Of these, 7% were administrative staff, 17% were allied health staff, 7% were ancillary staff, 11% were medical staff, and 58% were nursing staff. The overall vaccination rate for the Southern Hemisphere 2015 influenza season was 82%. In a multivariate logistic regression model, after controlling for gender and presence of chronic disease, associated factors for accepting influenza vaccination were age, education level of bachelor degree or higher, preference for vaccination provided by mobile teams, having 1-50 patient contacts per week, and belief in the potential severity of influenza and vaccine safety (P < .05). In contrast, factors negatively associated with vaccination acceptance included being a medical staff member or allied health staff member, living with family members under the age of 16, fear of adverse reactions, and disbelief in vaccination effectiveness (P < .05). CONCLUSIONS Although vaccine coverage in Singapore has been high, our findings provide guidance for the development of strategies to further improve vaccine coverage among different groups of health care workers.
Collapse
Affiliation(s)
- Win Mar Kyaw
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore.
| | - Angela Chow
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore
| | - Aung Aung Hein
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore
| | - Lay Tin Lee
- Occupational Health Services, Tan Tock Seng Hospital, Singapore
| | - Yee Sin Leo
- Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore
| | - Hanley J Ho
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore
| |
Collapse
|
19
|
Karafillakis E, Larson HJ. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017; 35:4840-4850. [PMID: 28760616 DOI: 10.1016/j.vaccine.2017.07.061] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The success of vaccination strategies depends in part on population perceptions of benefits and risks of vaccines and related confidence in vaccination. Better knowledge of public concerns about vaccines and what is driving them is needed to inform vaccination strategies and communications. This literature reviewer examined studies on vaccine and vaccination risk perceptions and concerns across European populations. METHODS A systematic literature review was conducted to identify studies published between 2004 and 2014 in Europe. A descriptive analysis was performed. FINDINGS A total of 145 articles were selected, most of which were conducted in the UK, the Netherlands and France and studied seasonal influenza, HPV and pandemic influenza vaccination. Across all countries and vaccines, the primary area of concern was vaccine safety, followed by perceptions of low likelihood of contracting vaccine-preventable diseases (VPDs), perceived low severity of VPDs, beliefs that vaccines do not work, and overall lack of information. Concerns were found to be vaccine-, country- and population-specific. CONCLUSION In addition to identifying concerns about vaccination in Europe, this study confirmed the notion that individuals have many safety concerns about vaccination and often believe that the risks of vaccination outweigh their benefits. More research needs to be conducted to explore the impact of different types of communication strategies, which would frame the benefits of vaccination as well as risks of not vaccinating. Strategies to better inform public perceptions of vaccines should include the provision of unbiased, comprehensive information tailored to population information needs, and delivered using multiple and new communication technologies such as social media.
Collapse
Affiliation(s)
- Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
| | | |
Collapse
|
20
|
Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 720] [Impact Index Per Article: 102.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
Collapse
Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| |
Collapse
|
21
|
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: 48] [Impact Index Per Article: 6.0] [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.
Collapse
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.
| |
Collapse
|
22
|
To KW, Lai A, Lee KCK, Koh D, Lee SS. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions. J Hosp Infect 2016; 94:133-42. [PMID: 27546456 DOI: 10.1016/j.jhin.2016.07.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from <5% to >90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.
Collapse
Affiliation(s)
- K W To
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - A Lai
- Occupational Health Division, Ministry of Health, Negara Brunei Darussalam
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Negara Brunei Darussalam; SSH School of Public Health, National University of Singapore, Singapore
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
| |
Collapse
|
23
|
Lytras T, Kossyvakis A, Melidou A, Andreopoulou A, Exindari M, Gioula G, Kalliaropoulos A, Tryfinopoulou K, Pogka V, Spala G, Malisiovas N, Mentis A. Influenza vaccine effectiveness in preventing hospitalizations with laboratory-confirmed influenza in Greece during the 2014-2015 season: A test-negative study. J Med Virol 2016; 88:1896-904. [PMID: 27088266 DOI: 10.1002/jmv.24551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2016] [Indexed: 11/09/2022]
Abstract
The 2014-2015 influenza season was marked by circulation of antigenically drifted A/H3N2 strains, raising the possibility of low seasonal influenza Vaccine Effectiveness (VE). We assessed VE against hospitalization with laboratory-confirmed influenza for the 2014-2015 season, using routine surveillance data. Non-sentinel swab samples from Greek hospital inpatients were tested for influenza by RT-PCR in three laboratories, covering the entire country. We estimated VE using a test-negative design. Out of 883 patients with known vaccination status, 161 (18.2%) were vaccinated, and 392/883 patients (44.4%) tested positive for influenza, of whom 162 (41.3%) had type B and 151 (38.5%) had A/H3N2. Adjusted VE was 31.6% (95%CI: 2.9-51.8%) against any influenza, 46.8%, 95%CI: 12.5-67.6%) against type B and -1.9%, 95%CI: -69.5 to 38.7%) against A/H3N2. VE against non-ICU hospitalization appeared to be higher, but the difference did not reach statistical significance. Circulating A/H3N2 viruses showed substantial antigenic drift, while about half of the type B strains were similar to the vaccine strain. Despite the antigenic drift of the A/H3N2 strains, the vaccine still offered substantial protection against hospitalization with laboratory-confirmed influenza, mostly due to a surge in type B influenza late in the season. Vaccine coverage was low, even among groups targeted for vaccination, and considerable effort should be made to improve it. J. Med. Virol. 88:1896-1904, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Theodore Lytras
- Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece.,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Athanasios Kossyvakis
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| | - Angeliki Melidou
- National Influenza Reference Laboratory for Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Andreopoulou
- Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Maria Exindari
- National Influenza Reference Laboratory for Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Gioula
- National Influenza Reference Laboratory for Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Kalliaropoulos
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| | - Kyriaki Tryfinopoulou
- Antimicrobial Resistance and Health Associated Infections Laboratory, Central Public Health Laboratory, Hellenic Centre for Disease Control and Prevention, Athens, Greece.,European Public Health Microbiology Training programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Vasiliki Pogka
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| | - Georgia Spala
- Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Nikolaos Malisiovas
- National Influenza Reference Laboratory for Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Mentis
- National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, Athens, Greece
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Godoy P, Castilla J, Mayoral JM, Martín V, Astray J, Torner N, Toledo D, Soldevila N, González-Candelas F, García S, Diaz-Borrego J, Tamames S, Domínguez A. Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study. BMC FAMILY PRACTICE 2015; 16:44. [PMID: 25880501 PMCID: PMC4389995 DOI: 10.1186/s12875-015-0259-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/19/2015] [Indexed: 11/24/2022]
Abstract
Background To assess the contribution of physician-related factors, especially their influenza vaccine status, in the vaccination coverage of their patients. Methods A study of vaccination coverage was carried out in Spain in 2011–12. The dependent variable (vaccination coverage in patients aged ≥65 years) was obtained from regional records. Information was gathered on the vaccination of physicians through an anonymous web survey. We compared the vaccination coverage of patients with the vaccination of their physicians using the Student t test. Associations were determined using a multilevel regression model. Results The coverage in patients aged ≥ 65 years was 56.3% and was higher (57.3%) in patients whose physician had been vaccinated than in those whose physician had not (55.2%) (p = 0.008). In the multilevel regression model, vaccination of the physician was associated (p = 0.049) with vaccination of their patients after controlling for the effects of age (p = 0.046), region (p = 0.089), and opinions on the effectiveness of the vaccine (p = 0.013). Conclusions Vaccination of physicians together with their opinions on the effectiveness of the vaccine may be a predictor of vaccination coverage in their patients. Further studies are required to confirm this. Electronic supplementary material The online version of this article (doi:10.1186/s12875-015-0259-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Pere Godoy
- Agencia de Salud Pública de Cataluña, Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Instituto de Investigación Biomédica de Lleida, Universidad de Lleida (IRBLleida), Lleida, Spain.
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Instituto de Salud Pública de Navarra, Pamplona, Spain.
| | | | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Instituto de Biomedicina, Universidad de León, León, Spain.
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain.
| | - Núria Torner
- Agencia de Salud Pública de Cataluña, Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain.
| | - Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain. .,Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain.
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain.
| | - Fernando González-Candelas
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Centro Superior de Investigación en Salud Pública, Universidad de Valencia, Valencia, Spain.
| | - Susana García
- Unidad de Investigación, Hospital Galdakao-Usansolo, Guipúzcoa, Spain.
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain.
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain.
| | | |
Collapse
|
26
|
Ciancio BC, Rezza G. Costs and benefits of influenza vaccination: more evidence, same challenges. BMC Public Health 2014; 14:818. [PMID: 25103561 PMCID: PMC4139610 DOI: 10.1186/1471-2458-14-818] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/29/2014] [Indexed: 11/29/2022] Open
Abstract
Seasonal influenza vaccination coverage in most EU/EEA remains suboptimal. Providers’ and users’ confidence in influenza vaccines is undermined by reports of moderate to low vaccine effectiveness and by the lack of solid evidence on disease burden. A study from Preaud and co. indicates that even with current levels of vaccine effectiveness, increasing vaccination coverage would significantly reduce disease burden and health cost. The results of the study should be interpreted cautiously because some of the assumptions are not generalizable or are imprecise, especially those on vaccine coverage, disease burden and health cost. Increasing vaccination coverage in EU/EEA countries is very challenging. Multifaceted approaches and country specific strategies are needed to address vaccine hesitancy in health care workers and in the population, and to manage organisational and financial obstacles. One key element for increasing vaccination coverage is the development of better influenza vaccines, e.g. vaccines that are more effective, provide longer lasting immunity and do not require annual administration. Vaccine producers should consider this as the highest research priority in the field of influenza vaccine development.
Collapse
|
27
|
Wicker S, Marckmann G. Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe? Vaccine 2014; 32:4844-8. [DOI: 10.1016/j.vaccine.2013.09.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/25/2013] [Accepted: 09/26/2013] [Indexed: 01/05/2023]
|
28
|
Barbadoro P, Marigliano A, Di Tondo E, Chiatti C, Di Stanislao F, D'Errico MM, Prospero E. Determinants of influenza vaccination uptake among Italian healthcare workers. Hum Vaccin Immunother 2014; 9:911-6. [PMID: 24064543 DOI: 10.4161/hv.22997] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We analyzed seasonal influenza vaccination coverage among the Italian healthcare workers (HCW) in order to identify socio-demographic and clinical determinants of vaccination. We used data from the survey "Health and health care use in Italy," which comprised interviews of 5,336 HCWs For each respondent, information on socioeconomic, health conditions, self-perceived health and smoking status were obtained. After bivariate analysis, we used multilevel regression models to assess determinants of immunization. Overall 20.8% of HCWs (95%CI 19.7-21.9) reported being vaccinated against seasonal influenza. After controlling for potential confounders, multilevel regression revealed that older workers have a higher likelihood of vaccine uptake (OR = 6.07; 95% CI 4.72-7.79). Conversely, higher education was associated with lower vaccine uptake (OR = 0.65; 95% IC 0.50-0.83). Those suffering from diabetes (OR = 2.07; 95% CI 1.19-1.69), COPD (OR = 1.95; 95% CI 1.31-2.89) and cardiovascular diseases (OR = 1.48 95% CI 1.11-1.96) were more likely to be vaccinated. Likewise, smokers, or former smokers receive more frequently the vaccination (OR = 1.40; 95% CI 1.15-1.70; OR = 1.54; 95% CI 1.24-1.91, respectively) compared with never-smokers as well as those HCWs reporting fair or poor perceived health status (ORs of 1.68, 95% CI 1.30-2.18). Vaccine coverage among HCWs in Italy remains low, especially among those with no comorbidities and being younger than 44 y old. This behavior not only raises questions regarding healthcare organization, infection control in healthcare settings and clinical costs, but also brings up ethical issues concerning physicians who seem not to be very concerned about the impact of the flu on themselves, as well as on their patients. Influenza vaccination campaigns will only be effective if HCWs understand their role in influenza transmission and prevention, and realize the importance of vaccination as a preventive measure.
Collapse
Affiliation(s)
- Pamela Barbadoro
- Section of Hygiene; Department of Biomedical Sciences and Public Health; Università Politecnica delle Marche; Ancona, Italy
| | | | | | | | | | | | | |
Collapse
|
29
|
Mamma M, Spandidos DA. Economic evaluation of the vaccination program against seasonal and pandemic A/H1N1 influenza among customs officers in Greece. Health Policy 2012. [PMID: 23195436 DOI: 10.1016/j.healthpol.2012.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Health policies from many countries recommend influenza vaccination of "high-priority" professional groups, including customs officers. Our aim was to estimate the economic impact of the vaccination program against influenza among customs officers in Greece during the 2009/2010 period. MATERIALS AND METHODS We developed a decision analytical computational simulation model including dynamic transmission elements that estimated the economic impact of various scenarios with different attack rates, symptomatic percentages and vaccination participation among customs officers. We also assessed in real-time the economic impact of the national 2009/2010 campaign against seasonal and pandemic A/H1N1 influenza. RESULTS Implementing a seasonal and pandemic A/H1N1 influenza vaccination program among customs officers in Greece with a participation rate of 30%, influenza vaccination was not cost-saving in any of the studied influenza scenarios. When the participation rate reached 100%, the program was cost-saving, when the influenza attack rate was 30% and the symptomatic rate 65%. The real-time estimated mean net cost-benefit value in 2009/2010 period was -7.3 euros/custom officer. CONCLUSIONS With different clinical scenarios, providing a vaccination program against seasonal and pandemic A/H1N1 influenza can incur a substantial net benefit for customs offices. However, the size of the benefit strongly depends upon the attack rate of influenza, the symptomatic rate as well as the participation rate of the customs officers in the program.
Collapse
Affiliation(s)
- Maria Mamma
- Department of Virology, University of Crete School of Medicine, Heraklion, Greece
| | | |
Collapse
|
30
|
Dhont PA, Albert A, Brenders P, Podwapinska A, Pollet A, Scheveneels D, Tihon F, Verheyden I, Victor J, Samson SI. Acceptability of Intanza® 15 μg intradermal influenza vaccine in Belgium during the 2010-2011 influenza season. Adv Ther 2012; 29:562-77. [PMID: 22678831 DOI: 10.1007/s12325-012-0025-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Intradermal (ID) influenza vaccination induces an enhanced immune response in the elderly when compared with intramuscular (IM) vaccination. In 2009, an ID seasonal influenza vaccine (Intanza(®) [Sanofi Pasteur MSD, Lyon, France] 15 μg) was approved for use in individuals aged ≥ 60 years in Europe. This survey conducted in Belgium was the first in Europe to assess the acceptability of this vaccine in routine clinical practice by vaccinees and their general practitioners (GPs). METHODS GPs willing to use both the ID and IM influenza vaccines were selected during the 2010-2011 influenza season. Each GP recruited ≤ 10 patients aged ≥ 60 years who received the ID vaccine. Vaccinees and GPs completed questionnaires about their opinions on influenza vaccination and the acceptability of the ID influenza vaccine. RESULTS In total, 105 GPs and 837 vaccinees completed questionnaires. A high proportion of vaccinees (40.3%) was aged ≥ 75 years, and 95.5% had been vaccinated the previous year. The majority of vaccinees was very satisfied (70.0%) or satisfied (27.9%) with the ID vaccine. The main reasons for the high satisfaction rate were that the injection was not very painful, administration was quick, and the vaccinee felt confident about the micro-needle injection system. Most vaccinees (91.1%) who had previously received IM influenza vaccination preferred the ID vaccine, and 98.5% of vaccinees reported they would consider receiving the ID vaccine the following year. The majority of GPs was very satisfied (78.6%) or satisfied (18.4%) with the ID vaccine, and most GPs (87.6%) expressed a preference for the ID vaccine over IM influenza vaccine. CONCLUSION The ID influenza vaccine was well accepted by vaccinees and their GPs, who expressed a preference for the ID vaccine over conventional IM influenza vaccine. The availability of the ID influenza vaccine may help to improve uptake of seasonal influenza vaccination in the elderly.
Collapse
|
31
|
Influenza vaccination among nurses in Greece. Am J Infect Control 2012; 40:276-8. [PMID: 21840087 DOI: 10.1016/j.ajic.2011.04.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Revised: 04/14/2011] [Accepted: 04/14/2011] [Indexed: 11/20/2022]
Abstract
Seasonal influenza has become a serious public health problem worldwide, and vaccination is recognized as the most effective preventative measure. However, data suggest that influenza vaccination rates are generally low among health care workers. The present study showed that the vaccination rates for influenza among nurses are 21.2%.
Collapse
|
32
|
Mak KK, Yiu YF, Ko KL, Hui KSH, Mak KM, Mak LY, To WP, Wu KH, Yeung F, Lee PPW. Attitudes and perceptions of influenza vaccination among Hong Kong doctors and medical students before the 2009 pandemic. Eur J Public Health 2012; 23:257-62. [PMID: 22383477 DOI: 10.1093/eurpub/cks014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vaccination is an important preventive measure for preparing against the influenza pandemics. This study investigated the attitudes and perceptions of influenza vaccination among doctors and medical students in Hong Kong. METHODS A cross-sectional survey was conducted among 204 doctors and 242 medical students in a teaching hospital in 2009. Participants' demographic and job characteristics, and influenza experience and vaccination in the previous year were assessed in the questionnaire. Logistic regression models were used to examine the associations between uptake of influenza vaccination and the perceived benefits. RESULTS Medical students were more likely to have receive an influenza vaccination in the previous year (66.9 vs. 39.7%) and acknowledged the related benefits than doctors. Moreover, uptake of influenza vaccine was associated with perceived benefits of vaccination in both doctors and medical students. CONCLUSIONS The perceived benefits of influenza vaccination are an important factor in vaccine uptake for both doctors and medical students in Hong Kong, and should be reinforced in the professional training.
Collapse
Affiliation(s)
- Kwok Kei Mak
- Department of Community Medicine and School of Public Health, Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Nikolopoulos G, Tsiodras S, Bonovas S. Influenza vaccination: Cassandra's prophecy. Public Health 2011; 126:82-3. [PMID: 22119135 DOI: 10.1016/j.puhe.2011.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 08/07/2011] [Accepted: 09/27/2011] [Indexed: 10/15/2022]
|
34
|
Influenza Vaccine and Healthcare Workers. Arch Med Res 2011; 42:652-7. [DOI: 10.1016/j.arcmed.2011.12.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 11/10/2011] [Indexed: 11/17/2022]
|
35
|
Attitudes toward Vaccination for Pandemic H1N1 and Seasonal Influenza in Patients with Hematologic Malignancies. ACTA ACUST UNITED AC 2011; 9:156-60. [DOI: 10.1016/j.suponc.2011.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
36
|
Maltezou HC, Tsakris A. Vaccination of health-care workers against influenza: our obligation to protect patients. Influenza Other Respir Viruses 2011; 5:382-8. [PMID: 21668685 PMCID: PMC5780654 DOI: 10.1111/j.1750-2659.2011.00240.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Please cite this paper as: Maltezou and Tsakris. (2011) Vaccination of health‐care workers against influenza: our obligation to protect patients. Influenza and Other Respiratory Viruses 5(6), 382–388. Nosocomial influenza poses a threat for specific groups of patients and is associated not only with the disruption of health‐care services but also excess costs. Although vaccination of health‐care workers (HCWs) has been recommended for almost three decades and constitutes the most convenient and effective means to prevent nosocomial transmission, vaccine uptake within this group remains unacceptably low worldwide. In regard to the pandemic influenza A H1N1, HCWs constitute a priority group for immunization. Nevertheless, low vaccination rates have been documented regarding the influenza pandemic and associated with the onset of nosocomial cases and outbreaks. HCWs, health‐care institutions, and public health bodies have the moral obligation to protect vulnerable patients and therefore weigh the benefits of mandatory vaccination. Key effective interventions, such as the education of HCWs concerning the benefits and safety of influenza vaccination, the reinforcement of on‐site, free of charge vaccinations, and the use of mobile vaccination teams in conjunction with incentives, should be widely implemented.
Collapse
Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Centre for Diseases Control and Prevention, Athens, Greece.
| | | |
Collapse
|
37
|
Gavazzi G, Filali-Zegzouti Y, Guyon AC, De Wazieres B, Lejeune B, Golmard JL, Belmin J, Piette F, Rothan-Tondeur M. French healthcare workers in geriatric healthcare settings staunchly opposed to influenza vaccination: The VESTA study. Vaccine 2011; 29:1611-6. [DOI: 10.1016/j.vaccine.2010.12.067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 12/04/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022]
|