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Fan J, Xu S, Liu Y, Ma X, Cao J, Fan C, Bao S. Influenza vaccination rates among healthcare workers: a systematic review and meta-analysis investigating influencing factors. Front Public Health 2023; 11:1295464. [PMID: 38026311 PMCID: PMC10657874 DOI: 10.3389/fpubh.2023.1295464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Healthcare workers risk of exposure to the influenza virus in their work, is a high-risk group for flu infections. Thus WHO recommends prioritizing flu vaccination for them-an approach adopted by >40 countries and/or regions worldwide. Methods Cross-sectional studies on influenza vaccination rates among healthcare workers were collected from PubMed, EMBASE, CNKI, and CBM databases from inception to February 26, 2023. Influenza vaccination rates and relevant data for multiple logistic regression analysis, such as odds ratios (OR) and 95% confidence intervals (CI), were extracted. Results A total of 92 studies comprising 125 vaccination data points from 26 countries were included in the analysis. The meta-analysis revealed that the overall vaccination rate among healthcare workers was 41.7%. Further analysis indicated that the vaccination rate was 46.9% or 35.6% in low income or high income countries. Vaccination rates in the Americas, the Middle East, Oceania, Europe, Asia, and Africa were 67.1, 51.3, 48.7, 42.5, 28.5, and 6.5%, respectively. Influencing factors were age, length of service, education, department, occupation, awareness of the risk of influenza, and/or vaccines. Conclusion The global influenza vaccination rate among healthcare workers is low, and comprehensive measures are needed to promote influenza vaccination among this population. Systematic review registration www.inplysy.com, identifier: 202350051.
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Affiliation(s)
- Jingchun Fan
- Center for Laboratory and Simulation Training, School of Public Health, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Shijie Xu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yijun Liu
- Social and Historical Sciences, University College London, London, United Kingdom
| | - Xiaoting Ma
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Juan Cao
- Department of Public Health, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Chunling Fan
- Department of Pharmacy, Gansu Provincial Cancer Hospital, Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
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Gallant AJ, Harding A, Johnson C, Steenbeek A, Curran JA. Identifying H1N1 and COVID-19 vaccine hesitancy or refusal among health care providers: a scoping review. JBI Evid Synth 2023; 21:913-951. [PMID: 36917102 PMCID: PMC10173945 DOI: 10.11124/jbies-22-00112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
OBJECTIVES The objective of this review was to describe and map the evidence on COVID-19 and H1N1 vaccine hesitancy or refusal by physicians, nurses, and pharmacists in North America, the United Kingdom and the European Union, and Australia. INTRODUCTION Since 2009, we have experienced two pandemics: H1N1 "swine flu" and COVID-19. While severity and transmissibility of these viruses varied, vaccination has been a critical component of bringing both pandemics under control. However, uptake of these vaccines has been affected by vaccine hesitancy and refusal. The vaccination behaviors of health care providers, including physicians, nurses, and pharmacists, are of particular interest as they have been priority populations to receive both H1N1 and COVID-19 vaccinations. Their vaccination views could affect the vaccination decisions of their patients. INCLUSION CRITERIA Studies were eligible for inclusion if they identified reasons for COVID-19 or H1N1 vaccine hesitancy or refusal among physicians, nurses, or pharmacists from the included countries. Published and unpublished literature were eligible for inclusion. Previous reviews were excluded; however, the reference lists of relevant reviews were searched to identify additional studies for inclusion. METHODS A search of CINAHL, MEDLINE, PsycINFO, and Academic Search Premier databases was conducted April 28, 2021, to identify English-language literature published from 2009 to 2021. Gray literature and citation screening were also conducted to identify additional relevant literature. Titles, abstracts, and eligible full-text articles were reviewed in duplicate by 2 trained reviewers. Data were extracted in duplicate using a structured extraction tool developed for the review. Conflicts were resolved through discussion or with a third team member. Data were synthesized using narrative and tabular summaries. RESULTS In total, 83 articles were included in the review. Studies were conducted primarily across the United States, the United Kingdom, and France. The majority of articles (n=70) used cross-sectional designs to examine knowledge, attitudes, and uptake of H1N1 (n=61) or COVID-19 (n=22) vaccines. Physicians, medical students, nurses, and nursing students were common participants in the studies; however, only 8 studies included pharmacists in their sample. Across health care settings, most studies were conducted in urban, academic teaching hospitals, with 1 study conducted in a rural hospital setting. Concerns about vaccine safety, vaccine side effects, and perceived low risk of contracting H1N1 or COVID-19 were the most common reasons for vaccine hesitancy or refusal across both vaccines. CONCLUSIONS With increased interest and attention on vaccines in recent years, intensified by the COVID-19 pandemic, more research that examines vaccine hesitancy or refusal across different health care settings and health care providers is warranted. Future work should aim to utilize more qualitative and mixed methods research designs to capture the personal perspectives of vaccine hesitancy and refusal, and consider collecting data beyond the common urban and academic health care settings identified in this review.
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Affiliation(s)
| | | | | | | | - Janet A. Curran
- IWK Health Centre, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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3
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Kocańda K, Zarębska-Michaluk D. Obligation Is Not a Compulsion-The Quality of the Law and the Effectiveness and Safety of Vaccination against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14003. [PMID: 36360882 PMCID: PMC9657154 DOI: 10.3390/ijerph192114003] [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: 10/05/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
In December 2021, the Minister of Health in Poland announced via Twitter that vaccination was not compulsory. Such a message from a public authority, who was to a significant extent responsible for organising the process of preventing and combating the infections caused by the SARS-CoV-2 pandemic, appeared to have a negative impact on the public perception of the role of vaccination in combating this disease. The impossibility of directly enforcing vaccination, in the sense that there is no legal basis for its compulsory administration, should not weaken the sense of obligation towards a socially necessary attitude of vaccination as a means of protecting the population against the disease; this should be promoted by public authorities. An auxiliary role in shaping this type of message should be played by the law of appropriate quality, regulating the rules related to vaccination in a way that encourages citizens' trust in the state and the law.
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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.
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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).
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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.
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Lefèvre H, Schrimpf C, Moro MR, Lachal J. HPV vaccination rate in French adolescent girls: an example of vaccine distrust. Arch Dis Child 2018; 103:740-746. [PMID: 29222179 DOI: 10.1136/archdischild-2017-313887] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/13/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To explore the clinical issues of human papillomavirus (HPV) vaccination to develop explanatory hypotheses for the low level of vaccination among adolescent girls in France where the full course coverage is low (<15%). DESIGN We used semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis. PARTICIPANTS 16 physicians regularly faced with the prescription of HPV vaccine, represented several medical specialties (paediatrics, general practice, internal medicine, gynaecology), with hospitalist or private practices. MAIN OUTCOME MEASURES The results connect three superordinate themes grouping three concentric levels: within society, during the consultation and in the individual doctor's feelings. RESULTS The modalities and contents of the information about HPV vaccination raise questions about the limitations of the information doctors receive. The ineluctable association between sexuality and HPV vaccination explains their reluctance to raise topics considered to be private. The reasons for HPV vaccination illustrate the difficulty of arguing in favour of it. In view of the frequent parental reluctance, which weakens the parent-physician alliance, physicians must take responsibility for defending the benefits of vaccination. They nonetheless remain citizens whose opinions may implicitly echo the general reluctance, promoted by disinformation. In delaying or avoiding the subject of vaccination, they involuntarily become an instrument of anti-vaccination discourse. CONCLUSIONS It is imperative to improve the distribution of credible information about vaccination, unbiased and scientifically supported by a strong institutional position and to rethink the place of the clinician in the system of adolescent health and disease prevention in France.
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Affiliation(s)
- Hervé Lefèvre
- AP-HP, Cochin Hospital, Paris, France.,CESP, Faculty de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,French Clinical Research Group, Adolescent Medicine and Health, Paris, France
| | - Cécile Schrimpf
- AP-HP, Cochin Hospital, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Paris, France.,CESP, Faculty de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jonathan Lachal
- AP-HP, Cochin Hospital, Paris, France.,CESP, Faculty de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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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: 174] [Impact Index Per Article: 24.9] [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.
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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.
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8
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Paula SID, Paula GID, Cunegundes KSA, Moraes-Pinto MID. ADHERENCE TO INFLUENZA VACCINATION AMONG MEDICAL STUDENTS DURING AND AFTER INFLUENZA A (H1N1) PANDEMIC. Rev Inst Med Trop Sao Paulo 2016; 58:82. [PMID: 27828623 PMCID: PMC5096636 DOI: 10.1590/s1678-9946201658082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/20/2016] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the adherence to influenza vaccination among medical students in 2010 and 2011. From August to December 2011, a questionnaire was used to record the influenza vaccination in 2010 and 2011, reasons for acceptance of the influenza vaccine and knowledge of healthcare workers about the influenza vaccine recommendation. One hundred and forty-four students from the 2ndto the 6th years of the medical school were interviewed. A great adherence to pandemic influenza vaccine was noted in 2010, (91% of the students), with "self-protection" being the most common reason cited for vaccination. Other determinants for the vaccination during pandemic were "convenient access to vaccine" and "encouragement by peers and teachers in workplaces and at the university". However, there was a great decay in the acceptance to vaccine in the next influenza season (2011). Only 42% of the students received the vaccine. They claimed "lack of time" and "have forgotten to take the vaccine" as the main reasons. The "knowledge on the recommendation of influenza vaccine to healthcare workers" increased when the students come to attend the last year of the medical school, but that was an insufficient motivator for vaccination. Strategies to increase vaccination should be based on the abovementioned aspects for the adoption of effective measures in both, pandemic and seasonal periods.
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9
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Scatigna M, Fabiani L, Micolucci G, Santilli F, Mormile P, Giuliani AR. Attitudinal variables and a possible mediating mechanism for vaccination practice in health care workers of a local hospital in L'Aquila (Italy). Hum Vaccin Immunother 2016; 13:198-205. [PMID: 27624736 PMCID: PMC5287314 DOI: 10.1080/21645515.2016.1225638] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Active immunization is an important concern for health care workers (HCWs) susceptible subjects and potential sources of infection for patients. However, the vaccine coverage for vaccine preventable diseases (VPDs) is below recommended standards. The aims of the study were to estimate the hospitals' HCWs' susceptibility and vaccination coverage rates for VPDs and to analyze the role of HCWs' attitudes and knowledge as determinants of the immunization practices. A cross-sectional study enrolled 334 HCWs (physicians, nurses, others) at local hospital in L'Aquila (Italy). By means of an anonymous questionnaire, self-report data about history of disease and active vaccination for seasonal influenza, chickenpox, measles-mumps-rubella and hepatitis B were collected, as well as attitudes and knowledge about vaccination in HCWs. The employees showed high levels of susceptibility and insufficient vaccination coverage rates, particularly for influenza. Specific trends were detected for different VPDs across age strata and professional categories, not always consistent with literature. Overall, the level of knowledge about recommended vaccination for HCWs was low, in all categories. The active immunization status against influenza was found the most clearly associated with difference levels in 3 psychometric variables: personal responsibility, beliefs on usefulness and beliefs on risk of vaccination. A mediation mechanism was analyzed between these constructs, and an interesting indirect effect was highlighted for beliefs that could enhance the advantage of increased responsibility for HCWs. Further effort in research is needed to evaluate the black-box of longitudinal intervention studies (education, environmental changes, policies), to improve HCWs immunization.
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Affiliation(s)
- Maria Scatigna
- a Department of Life, Health & Environmental Sciences - University of L'Aquila , L'Aquila , Italy
| | - Leila Fabiani
- a Department of Life, Health & Environmental Sciences - University of L'Aquila , L'Aquila , Italy
| | - Giovanna Micolucci
- b Local Health Office (ASL 1) of L'Aquila - Abruzzo Region , L'Aquila , Italy
| | - Flavio Santilli
- a Department of Life, Health & Environmental Sciences - University of L'Aquila , L'Aquila , Italy
| | - Pasquale Mormile
- a Department of Life, Health & Environmental Sciences - University of L'Aquila , L'Aquila , Italy
| | - Anna Rita Giuliani
- a Department of Life, Health & Environmental Sciences - University of L'Aquila , L'Aquila , Italy
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10
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Karafillakis E, Dinca I, Apfel F, Cecconi S, Wűrz A, Takacs J, Suk J, Celentano LP, Kramarz P, Larson HJ. Vaccine hesitancy among healthcare workers in Europe: A qualitative study. Vaccine 2016; 34:5013-5020. [PMID: 27576074 DOI: 10.1016/j.vaccine.2016.08.029] [Citation(s) in RCA: 261] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/06/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
Abstract
Healthcare workers (HCWs) are often referred to as the most trusted source of vaccine-related information for their patients. However, the evidence suggests that a number of HCWs are vaccine-hesitant. This study consists of 65 semi-structured interviews with vaccine providers in Croatia, France, Greece, and Romania to investigate concerns HCWs might have about vaccination. The results revealed that vaccine hesitancy is present in all four countries among vaccine providers. The most important concern across all countries was the fear of vaccine side effects. New vaccines were singled out due to perceived lack of testing for vaccine safety and efficacy. Furthermore, while high trust in health authorities was expressed by HCWs, there was also strong mistrust of pharmaceutical companies due to perceived financial interests and lack of communication about side effects. The notion that it is a doctor's responsibility to respond to hesitant patients was reported in all countries. Concerns were also seen to be country- and context-specific. Strategies to improve confidence in vaccines should be adapted to the specific political, social, cultural and economic context of countries. Furthermore, while most interventions focus on education and improving information about vaccine safety, effectiveness, or the need for vaccines, concerns raised in this study identify other determinants of hesitancy that need addressing. The representativeness of the views of the interviewed HCWs must be interpreted with caution. This a qualitative study with a small sample size that included geographical areas where vaccination uptake was lower or where hesitancy was more prevalent and it reflects individual participants' beliefs and attitudes toward the topic. As HCWs have the potential of influencing patient vaccination uptake, it is crucial to improve their confidence in vaccination and engage them in activities targeting vaccine hesitancy among their patients.
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Affiliation(s)
- Emilie Karafillakis
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Irina Dinca
- European Centre for Disease Prevention and Control (ECDC), Sweden
| | - Franklin Apfel
- World Health Communication Associates (WHCA), United Kingdom
| | - Sabrina Cecconi
- World Health Communication Associates (WHCA), United Kingdom
| | - Andrea Wűrz
- European Centre for Disease Prevention and Control (ECDC), Sweden
| | - Judit Takacs
- European Centre for Disease Prevention and Control (ECDC), Sweden
| | - Jonathan Suk
- European Centre for Disease Prevention and Control (ECDC), Sweden
| | | | - Piotr Kramarz
- European Centre for Disease Prevention and Control (ECDC), Sweden
| | - Heidi J Larson
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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Carlsen B, Glenton C. The swine flu vaccine, public attitudes, and researcher interpretations: a systematic review of qualitative research. BMC Health Serv Res 2016; 16:203. [PMID: 27338141 PMCID: PMC4919843 DOI: 10.1186/s12913-016-1466-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/20/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND During pandemics, health authorities may be uncertain about the spread and severity of the disease and the effectiveness and safety of available interventions. This was the case during the swine flu (H1N1) pandemic of 2009-2010, and governments were forced to make decisions despite these uncertainties. While many countries chose to implement wide scale vaccination programmes, few accomplished their vaccination goals. Many research studies aiming to explore barriers and facilitators to vaccine uptake have been conducted in the aftermath of the pandemic, including several qualitative studies. AIMS 1. To explore public attitudes to the swine flu vaccine in different countries through a review of qualitative primary studies. 2. To describe and discuss the implications drawn by the primary study authors. METHODS Systematic review of qualitative research studies, using a broadly comparative cross case-study approach. Study quality was appraised using an adaptation of the Critical Appraisal Skills Programme (CASP) quality assessment tool. RESULTS The review indicates that the public had varying opinions about disease risk and prevalence and had concerns about vaccine safety. Most primary study authors concluded that participants were uninformed, and that more information about the disease and the vaccine would have led to an increase in vaccine uptake. We find these conclusions problematic. We suggest instead that people's questions and concerns were legitimate given the uncertainties of the situation at the time and the fact that the authorities did not have the necessary information to convince the public. Our quality assessment of the included studies points to a lack of reflexivity and a lack of information about study context. We suggest that these study weaknesses are tied to primary study authors' lack of acknowledgement of the uncertainties surrounding the disease and the vaccine. CONCLUSION While primary study authors suggest that authorities could increase vaccine uptake through increased information, we suggest instead that health authorities should be more transparent in their information and decision-making processes in future pandemic situations.
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Affiliation(s)
| | - Claire Glenton
- />Norwegian Institute of Public Health, PO Box 7004, St. Olavs plass, N-0130 Oslo, Norway
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12
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Sundaram N, Purohit V, Schaetti C, Kudale A, Joseph S, Weiss MG. Community awareness, use and preference for pandemic influenza vaccines in Pune, India. Hum Vaccin Immunother 2016; 11:2376-88. [PMID: 26110454 PMCID: PMC4635903 DOI: 10.1080/21645515.2015.1062956] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Vaccination is a cornerstone of influenza prevention, but limited vaccine uptake was a problem worldwide during the 2009–2010 pandemic. Community acceptance of a vaccine is a critical determinant of its effectiveness, but studies have been confined to high-income countries. We conducted a cross-sectional, mixed-method study in urban and rural Pune, India in 2012–2013. Semi-structured explanatory model interviews were administered to community residents (n = 436) to study awareness, experience and preference between available vaccines for pandemic influenza. Focus group discussions and in-depth interviews complemented the survey. Awareness of pandemic influenza vaccines was low (25%). Some respondents did not consider vaccines relevant for adults, but nearly all (94.7%), when asked, believed that a vaccine would prevent swine flu. Reported vaccine uptake however was 8.3%. Main themes identified as reasons for uptake were having heard of a death from swine flu, health care provider recommendation or affiliation with the health system, influence of peers and information from media. Reasons for non-use were low perceived personal risk, problems with access and cost, inadequate information and a perceived lack of a government mandate endorsing influenza vaccines. A majority indicated a preference for injectable over nasal vaccines, especially in remote rural areas. Hesitancy from a lack of confidence in pandemic influenza vaccines appears to have been less of an issue than access, complacency and other sociocultural considerations. Recent influenza outbreaks in 2015 highlight a need to reconsider policy for routine influenza vaccination while paying attention to sociocultural factors and community preferences for effective vaccine action.
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Affiliation(s)
- Neisha Sundaram
- a Department of Epidemiology and Public Health ; Swiss Tropical and Public Health Institute ; Basel , Switzerland.,b University of Basel ; Basel , Switzerland.,c Saw Swee Hock School of Public Health; National University of Singapore; National University Health System ; Singapore , Singapore
| | - Vidula Purohit
- d Centre for Health Research and Development; The Maharashtra Association of Anthropological Sciences ; Pune , Maharashtra , India.,e Savitribai Phule Pune University ; Pune , Maharashtra , India
| | - Christian Schaetti
- a Department of Epidemiology and Public Health ; Swiss Tropical and Public Health Institute ; Basel , Switzerland.,b University of Basel ; Basel , Switzerland
| | - Abhay Kudale
- d Centre for Health Research and Development; The Maharashtra Association of Anthropological Sciences ; Pune , Maharashtra , India.,e Savitribai Phule Pune University ; Pune , Maharashtra , India
| | - Saju Joseph
- d Centre for Health Research and Development; The Maharashtra Association of Anthropological Sciences ; Pune , Maharashtra , India.,e Savitribai Phule Pune University ; Pune , Maharashtra , India
| | - Mitchell G Weiss
- a Department of Epidemiology and Public Health ; Swiss Tropical and Public Health Institute ; Basel , Switzerland.,b University of Basel ; Basel , Switzerland
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Wong MCS, Nelson EAS, Leung C, Lee N, Chan MCW, Choi KW, Rainer TH, Cheng FWT, Wong SYS, Lai CKC, Lam B, Cheung TH, Leung TF, Chan PKS. Ad Hoc Influenza Vaccination During Years of Significant Antigenic Drift in a Tropical City With 2 Seasonal Peaks: A Cross-Sectional Survey Among Health Care Practitioners. Medicine (Baltimore) 2016; 95:e3359. [PMID: 27175633 PMCID: PMC4902475 DOI: 10.1097/md.0000000000003359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/11/2016] [Accepted: 03/21/2016] [Indexed: 11/25/2022] Open
Abstract
We evaluated the acceptability of an additional ad hoc influenza vaccination among the health care professionals following seasons with significant antigenic drift.Self-administered, anonymous surveys were performed by hard copy questionnaires in public hospitals, and by an on-line platform available to all healthcare professionals, from April 1st to May 31st, 2015. A total of 1290 healthcare professionals completed the questionnaires, including doctors, nurses, and allied health professionals working in both the public and private systems.Only 31.8% of participating respondents expressed an intention to receive the additional vaccine, despite that the majority of them agreed or strongly agreed that it would bring benefit to the community (88.9%), save lives (86.7%), reduce medical expenses (76.3%), satisfy public expectation (82.8%), and increase awareness of vaccination (86.1%). However, a significant proportion expressed concern that the vaccine could disturb the normal immunization schedule (45.5%); felt uncertain what to do in the next vaccination round (66.0%); perceived that the summer peak might not occur (48.2%); and believed that the summer peak might not be of the same virus (83.5%). Furthermore, 27.8% of all respondents expected that the additional vaccination could weaken the efficacy of previous vaccinations; 51.3% was concerned about side effects; and 61.3% estimated that there would be a low uptake rate. If the supply of vaccine was limited, higher priority groups were considered to include the elderly aged ≥65 years with chronic medical conditions (89.2%), the elderly living in residential care homes (87.4%), and long-stay residents of institutions for the disabled (80.7%). The strongest factors associated with accepting the additional vaccine included immunization with influenza vaccines in the past 3 years, higher perceived risk of contracting influenza, and higher perceived severity of the disease impact.The acceptability to an additional ad hoc influenza vaccination was low among healthcare professionals. This could have a negative impact on such additional vaccination campaigns since healthcare professionals are a key driver for vaccine acceptance. The discordance in perceived risk and acceptance of vaccination regarding self versus public deserves further evaluation.
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Affiliation(s)
- Martin C S Wong
- From the School of Public Health and Primary Care (MCSW, SYSW); Department of Paediatrics (EASN, FWTC, TFL); Department of Anesthesia and Intensive Care (CL); Department of Medicine and Therapeutics (NL, KWC); Department of Microbiology (MCWC, PKSC); Accident and Emergency Medicine Academic Unit (THR); Department of Obstetrics and Gynaecology, Faculty of Medicine, Chinese University of Hong Kong (THC); Department of Pathology (Microbiology), Queen Elizabeth Hospital (CKCL); and Department of Pathology (Microbiology), Princess Margaret Hospital (BL), Hong Kong SAR
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Kadi Z, Atif ML, Brenet A, Izoard S, Astagneau P. Barriers of influenza vaccination in health care personnel in France. Am J Infect Control 2016; 44:361-2. [PMID: 26577627 DOI: 10.1016/j.ajic.2015.09.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/21/2015] [Accepted: 09/24/2015] [Indexed: 11/30/2022]
Abstract
To identify barriers against influenza vaccination of health care personnel in Northern France, a cross-sectional study was conducted in health care facilities. A total of 3,213 questionnaires from 67 health care facilities were completed. In multivariate analysis using a logistic model, influenza vaccine coverage in health care personnel was significantly associated with level of knowledge about influenza disease and vaccine.
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Affiliation(s)
- Zoher Kadi
- Antenne Régionale de Lutte contre les Infections Nosocomiales de Picardie, Centre de Coordination de la Lutte contre les Infections Nosocomiales, Centre Hospitalier Universitaire d'Amiens, Amiens, France.
| | - Mohamed-Lamine Atif
- Service d'épidémiologie et de médecine préventive, Centre Hospitalier Universitaire, Blida, Algeria
| | - Annie Brenet
- Antenne Régionale de Lutte contre les Infections Nosocomiales de Picardie, Centre de Coordination de la Lutte contre les Infections Nosocomiales, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Sylvain Izoard
- Antenne Régionale de Lutte contre les Infections Nosocomiales de Picardie, Centre de Coordination de la Lutte contre les Infections Nosocomiales, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Pascal Astagneau
- Centre de Coordination de la Lutte contre les Infections Nosocomiales Paris-Nord, Hôpital Broussais, Paris, France
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15
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Boiron K, Sarazin M, Debin M, Raude J, Rossignol L, Guerrisi C, Odinkemelu D, Hanslik T, Colizza V, Blanchon T. Opinion about seasonal influenza vaccination among the general population 3 years after the A(H1N1)pdm2009 influenza pandemic. Vaccine 2015; 33:6849-54. [PMID: 26322844 DOI: 10.1016/j.vaccine.2015.08.067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/09/2015] [Accepted: 08/20/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the opinions of the French general population about seasonal influenza vaccination three years after the A(H1N1)pdm 09 pandemic and identify factors associated with a neutral or negative opinion about this vaccination. STUDY DESIGN The study was conducted using data collected from 5374 participants during the 2012/2013 season of the GrippeNet.fr study. The opinion about seasonal influenza vaccination was studied on three levels ("positive", "negative" or "neutral"). The link between the participant's characteristics and their opinion regarding the seasonal influenza vaccination were studied using a multinomial logistic regression with categorical variables. The "positive" opinion was used as the reference for identifying individuals being at risk of having a "neutral" or a "negative" opinion. RESULTS Among the participants, 39% reported having a positive opinion about seasonal influenza vaccine, 39% a neutral opinion, and 22% a negative opinion. Factors associated with a neutral or negative opinion were young age, low educational level, lack of contact with sick or elderly individuals, lack of treatment for a chronic disease and taking a homeopathic preventive treatment. CONCLUSIONS These results show that an important part of the French population does not have a positive opinion about influenza vaccination in France. Furthermore, it allows outlining the profiles of particularly reluctant individuals who could be targeted by informative campaigns.
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Affiliation(s)
- Karine Boiron
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Marianne Sarazin
- INSERM, UMR_S 1136, F-75012 Paris, France; Département d'information médicale, Centre Hospitalier, Firminy, France
| | - Marion Debin
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Jocelyn Raude
- Department of Social and Behavioral Sciences, EHESP Rennes, Sorbonne Paris Cité, Rennes, France
| | - Louise Rossignol
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Caroline Guerrisi
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Didi Odinkemelu
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Thomas Hanslik
- INSERM, UMR_S 1136, F-75012 Paris, France; APHP, Service de médecine interne, Hôpital Ambroise-Paré, 92100 Boulogne-Billancourt, France; UFR des sciences de la santé Simone-Veil, Université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France
| | - Vittoria Colizza
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Thierry Blanchon
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France.
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16
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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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17
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Bonaccorsi G, Santomauro F, Porchia BR, Niccolai G, Pellegrino E, Bonanni P, Lorini C. Beliefs and Opinions of Health Care Workers and Students Regarding Influenza and Influenza Vaccination in Tuscany, Central Italy. Vaccines (Basel) 2015; 3:137-47. [PMID: 26344950 PMCID: PMC4494245 DOI: 10.3390/vaccines3010137] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/16/2015] [Accepted: 02/12/2015] [Indexed: 11/16/2022] Open
Abstract
Immunization of health care workers (HCWs) against influenza has been associated with improvements in patient safety. The aim of this study is to assess the beliefs, attitudes, and knowledge of HCWs and health profession students regarding influenza. An anonymous questionnaire was distributed to HCWs in three local Florentine healthcare units, at Careggi University Teaching Hospital, and to students in health profession degree programs. A total of 2576 questionnaires were fully completed. A total of 12.3% of subjects responded that they were "always vaccinated" in all three of the seasonal vaccination campaigns studied (2007-2008 to 2009-2010), 13.1% had been vaccinated once or twice, and 74.6% had not received vaccinations. Although the enrolled subjects tended to respond that they were "never vaccinated," they considered influenza to be a serious illness and believed that the influenza vaccine is effective. The subjects who refused vaccination more frequently believed that the vaccine could cause influenza and that it could have serious side effects. More than 60% of the "always vaccinated" group completely agreed that HCWs should be vaccinated. Self-protection and protecting family members or other people close to the respondent from being infected and representing potential sources of influenza infection can be considered motivating factors for vaccination. The results highlight the importance of improving vaccination rates among all HCWs through multi-component interventions. Knowledge of influenza should be reinforced.
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Affiliation(s)
- Guglielmo Bonaccorsi
- Department of Clinical and Experimental Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Francesca Santomauro
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Barbara Rita Porchia
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Giuditta Niccolai
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Elettra Pellegrino
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Paolo Bonanni
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Chiara Lorini
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
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Amour S, Djhehiche K, Zamora A, Bergeret A, Vanhems P. Perception of the A/H1N1 influenza pandemic and acceptance of influenza vaccination by Université Claude Bernard Lyon 1 staff: A descriptive study. Hum Vaccin Immunother 2015; 11:727-31. [PMID: 25715115 DOI: 10.1080/21645515.2015.1008887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.
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Affiliation(s)
- Sélilah Amour
- a Observatoire de la Santé des Personnels de Lyon 1; Université de Lyon; Université Claude Bernard Lyon 1 ; Lyon , France
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Hata A, Mano C, Nakamura Y, Nishida H, Kumakura A, Mizumoto H, Yoshioka T, Yoshida Y, Shiota M, Hata D, Takahashi K. Low response to a monovalent inactivated unadjuvanted influenza A (H1N1) pdm09 vaccine in pediatricians of a general hospital in Japan. Hum Vaccin Immunother 2014; 8:587-91. [DOI: 10.4161/hv.19296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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20
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Nowrouzi-Kia B, McGeer A. External cues to action and influenza vaccination among post-graduate trainee physicians in Toronto, Canada. Vaccine 2014; 32:3830-4. [PMID: 24837775 DOI: 10.1016/j.vaccine.2014.04.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 03/31/2014] [Accepted: 04/21/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Understanding factors affecting trainee physician choices about vaccination may permit the design of more effective vaccination programmes. METHODS To identify factors associated with seasonal and pandemic influenza vaccination, an online questionnaire based on the health belief model was sent to trainee physicians registered at the post-graduate medical education office at the University of Toronto in September 2011. RESULTS 963 complete responses were received from 1884 trainee physicians (51%); 28 (2.9%) reported an allergy to vaccine components and were excluded from further analysis. Reported seasonal influenza vaccination rates in 2008, 2009 and 2010 were 69% (648/935), 75% (708/935) and 76% (703/935), respectively; 788 (84%) reported receiving the A(H1N1)pdm09 vaccine. In multivariable analysis, number of years of post-graduate training (OR for 4+ versus 1-3 post-graduate years 2.2 (95% CL 1.3, 3.8)) was associated with receipt of the 2009 pandemic vaccine, as were four components of the health belief model: odds ratios were 4.7 (95% CL 3.0, 7.5) for perceived severity, 1.9 (95% CL 1.2, 2.9) for perceived benefits, .35 (95% CL .21, .59) for perceived barriers, and 5.8 (95% CLI 3.6, 9.1) for external cues to action. Both vaccinated and unvaccinated respondents reported that their decisions were significantly influenced by encouragement from their colleagues, families and employers. CONCLUSION Self-reported vaccination coverage among trainee physicians was high. External cues to action appear to be particularly important in trainee physician vaccination decisions: active institutional promotion may increase influenza vaccination rates in trainees.
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Affiliation(s)
| | - Allison McGeer
- Dalla Lana School of Public Health, University of Toronto, Canada; Department of Microbiology, Mount Sinai Hospital, Toronto, Canada.
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21
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Knowledge, attitudes and behaviour of hospital health-care workers regarding influenza A/H1N1: a cross sectional survey. BMC Infect Dis 2014; 14:208. [PMID: 24739890 PMCID: PMC4021506 DOI: 10.1186/1471-2334-14-208] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 04/09/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To assess the knowledge, the attitudes, and the behaviour towards influenza A/H1N1 and the vaccination among health-care workers (HCWs). METHODS A sample of HCWs was selected from a random sample of non-teaching public hospitals, located in the cities of Naples and Avellino (Italy), received a self-administered anonymous questionnaire including questions about socio-demographic characteristics, knowledge on modes of transmission and preventative measures, attitudes and behaviour relating to influenza A/H1N1. RESULTS Only 36.1% correctly knew the main modes of transmission, and that HCWs are a risk category and this level of knowledge was significantly higher in HCWs having received information through scientific journals. A higher perceived risk of contracting influenza A/H1N1 has been observed in the HCWs more knowledgeable, in those considering influenza A/H1N1 a serious disease, and in those working in surgical wards. Only 16.7% have received the influenza A/H1N1 vaccination and HCWs with more fear of contracting influenza A/H1N1, those considering vaccine more useful and less dangerous were more likely to receive vaccine. CONCLUSIONS Education and communication strategies for improving the level of knowledge and for the immunization uptake regarding influenza A/H1N1 HCWs are strongly needed.
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22
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Factors associated with influenza vaccine receipt in community dwelling adults and their children. Vaccine 2014; 32:1841-7. [PMID: 24530926 DOI: 10.1016/j.vaccine.2014.01.075] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/09/2014] [Accepted: 01/28/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Factors associated with influenza vaccine receipt are well studied in healthcare personnel, pregnant women, and the elderly. There has been substantially less research in community dwelling adults and children, and none among entire households. Many studies determine vaccination status by self-report or behavioral intention, outcomes susceptible to misclassification. Given that vaccine is recommended for everyone over six months, re-evaluating these factors is warranted. METHODS The Household Influenza Vaccine Effectiveness (HIVE) study is a prospective cohort of households with children. In 2010-2011, 549 adults representing 312 households completed surveys evaluating knowledge, attitudes, and practices regarding influenza vaccination for themselves and their children. Using the health belief model (HBM) as a framework, we examined factors associated with documented seasonal influenza vaccine receipt using log-binomial regression models. RESULTS In multivariate models, cues to action such as doctor recommendation, (RR 1.62, 95% CI: 1.25-2.10), perceived benefits (RR 1.25, 95% CI: 1.04-1.50), and perceived susceptibility (RR 1.21, 95% CI: 1.03-1.42) were significantly associated with increased likelihood of vaccine receipt among adults while high perceived barriers were associated with decreased likelihood (RR 0.38, 95% CI: 0.25-0.59). Similarly, parents reporting higher barriers were less likely (RR 0.58, 95% CI: 0.42-0.79) and those perceiving greater benefits (RR 4.16, 95% CI: 2.28-7.59) and severity (RR 1.13, 95% CI: 1.00-1.27 were more likely to vaccinate their children. The observed effects of perceptions of susceptibility, severity, and benefits were more pronounced at low cues to action for children, as were the effects of perceptions of barriers and severity among adults. CONCLUSION Perceived benefits and barriers are most strongly associated with vaccine receipt. However, the effects of various factors were most pronounced in the absence of cues to action, which may be an important component of targeted interventions.
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Abstract
Trust influences a range of human behaviors including health decision making. Over the past 60 years a significant industry has sprung up to influence public opinion and mobilize grassroots challenges against evidence-based threats to vested interests. Simultaneously, media reports of scientific fraud, misrepresentation, constantly changing “evidence” for health, and “hyped” predictions of disasters that were ultimately less significant amplify doubts about the reliability of scientific evidence and technology when hazards arise. This has contributed to the appearance of decay of trust in the veracity of scientific claims. Population responses during communicable disease epidemics illustrate these interacting processes that simultaneously create uncertainty and significant discomfort within communities. Research on the relative influences of formal versus informal information sources in driving protective behavior during recent influenza epidemics shows how both the uptake of everyday preventive practices such as hand hygiene, and specific health interventions, such as vaccination are affected by these processes. We review recent work on influenza-related personal preventive practices, with a particular focus on the shifting roles and utility of formal and informal sources in decision making among the public, and consider the implications within the context of prevailing levels of trust, uncertainty, and doubt surrounding health care recommendations.
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Affiliation(s)
- Julie Qiuyan Liao
- Health Behaviours Research Group, School of Public Health, University of Hong Kong, SAR China
| | - Richard Fielding
- Health Behaviours Research Group, School of Public Health, University of Hong Kong, SAR China
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Domínguez A, Godoy P, Castilla J, Soldevila N, Toledo D, Astray J, Mayoral JM, Tamames S, García-Gutiérrez S, González-Candelas F, Martín V, Díaz J, Torner N. Knowledge of and attitudes to influenza vaccination in healthy primary healthcare workers in Spain, 2011-2012. PLoS One 2013; 8:e81200. [PMID: 24260560 PMCID: PMC3832596 DOI: 10.1371/journal.pone.0081200] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/09/2013] [Indexed: 01/08/2023] Open
Abstract
Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011–2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72–6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83–3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56–3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine.
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Affiliation(s)
- Angela Domínguez
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- * E-mail:
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | | | | | - Vicente Martín
- Instituto de Biomedicina, Universidad de León, León, Spain
| | - José Díaz
- Servicio Andaluz de Salud, Sevilla, Spain
| | - Nuria Torner
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
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Freund R, Krivine A, Prévost V, Cantin D, Aslangul E, Avril MF, Claessens YE, Rozenberg F, Casetta A, Baixench MT, Dumaine V, Launay O, Loulergue P. Measles immunity and measles vaccine acceptance among healthcare workers in Paris, France. J Hosp Infect 2013; 84:38-43. [PMID: 23433868 DOI: 10.1016/j.jhin.2013.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/10/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND In Europe, including France, a measles outbreak has been ongoing since 2008. Unprotected healthcare workers (HCWs) may contract and spread the infection to patients. AIM The objective of this study was to evaluate HCWs' measles immunity and vaccine acceptance in our setting. METHODS In a survey-based study conducted in three university hospitals in Paris, 351 HCWs were included between April and June 2011. The following data were collected at enrolment: age, hospital unit, occupation, history of measles infection and vaccination, previous measles serology and acceptance of a measles vaccination in case of seronegativity. Sera were tested for the presence of specific anti-measles IgG antibodies using the CAPTIA(®) measles enzyme-linked immunosorbent assay. FINDINGS The mean age of the participating HCWs was 36 years (range: 18-67) and 278 (79.2%) were female. In all, 104 four persons (29.6%) declared a history of measles, and 90 (25.6%) declared never having received a measles vaccination. Among the 351 HCWs included in the study, 322 (91.7%) were immunized against measles (IgG >90 mIU/mL). The risk factors for not being protected were age [18-29 years, adjusted odds ratio: 2.7 (95% confidence interval: 1.1-6.9) compared with ≥30 years], no history of measles infection or vaccination. The global acceptance rate for a measles vaccination, before knowing their results, was 78.6%. CONCLUSION In this cohort of HCWs, 8.3% were susceptible to measles; the group most represented were aged <30 years. Acceptance of the measles vaccine was high. A vaccination campaign in healthcare settings should target specifically healthcare students and junior HCWs.
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Affiliation(s)
- R Freund
- Université Paris-Descartes, INSERM, CIC BT505, Assistance Publique-Hôpitaux de Paris, CIC de Vaccinologie Cochin Pasteur, Paris, France
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Hernández-Guerra M, González-Méndez Y, de Molina P, Gimeno-García AZ, Carrillo M, Casanova C, Pumarola T, Jimenez A, Hernández-Porto M, Torres A, Quintero E. Immunogenicity and acceptance of influenza A (H1N1) vaccine in a cohort of chronic hepatitis C patients receiving pegylated-interferon treatment. PLoS One 2012; 7:e48610. [PMID: 23144908 PMCID: PMC3493585 DOI: 10.1371/journal.pone.0048610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 09/27/2012] [Indexed: 11/20/2022] Open
Abstract
Background & Aims Individuals at risk of (H1N1) influenza A infection are recommended to receive vaccination. Chronic hepatitis C (CHC) patients receiving treatment might be at a higher risk of respiratory bacterial infections after influenza infection. However, there are no observational studies evaluating the immunogenicity, tolerance and acceptance of 2009 influenza A vaccine in CHC patients. Methods We evaluated the immunogenicity of influenza A vaccine (Pandemrix®) by using the hemagglutination inhibition (HI) titers method in a well defined cohort of CHC patients receiving or not receiving pegylated-interferon and ribavirin, and compared it with healthy subjects (controls). A group of patients with inflammatory bowel disease (IBD) under immunosuppression, thought to have a lower immune response to seasonal influenza vaccine, were also included as a negative control group. In addition, tolerance to injection site reactions and acceptance was assessed by a validated questionnaire (Vaccinees' perception of injection-VAPI-questionnaire). Results Of 114 subjects invited to participate, 68% accepted and, after exclusions, 72 were included. Post-vaccination geometric mean titers and seroprotection/seroconversion rates were optimal in CHC patients with ongoing treatment (n = 15; 232, CI95% 46–1166; 93%; 93%), without treatment (n = 10; 226, CI95% 69–743: 100%; 100%) and controls (n = 15;168, CI95% 42–680; 93%; 86%) with no differences between groups (P = 0.8). In contrast, IBD patients had a significantly lower immunogenic response (n = 27; 60, CI95% 42–680;66%;66%; P = 0.006). All the groups showed a satisfactory tolerance although CHC patients with ongoing treatment showed more local discomfort after vaccine injection. Conclusion There appeared to be no differences between CHC patients and healthy controls in serological response and acceptance of (H1N1) influenza vaccination.
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Mitchell R, Ogunremi T, Astrakianakis G, Bryce E, Gervais R, Gravel D, Johnston L, Leduc S, Roth V, Taylor G, Vearncombe M, Weir C. Impact of the 2009 influenza A (H1N1) pandemic on Canadian health care workers: a survey on vaccination, illness, absenteeism, and personal protective equipment. Am J Infect Control 2012; 40:611-6. [PMID: 22575285 DOI: 10.1016/j.ajic.2012.01.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 01/05/2012] [Accepted: 01/06/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Data are limited on the impact of the 2009 H1N1 influenza A pandemic on health care worker (HCW) vaccination, illness, absenteeism, and personal protective equipment (PPE) use. METHODS A survey was completed by HCWs from 14 hospitals participating in the Canadian Nosocomial Infection Surveillance Program who provided direct care to patients with pH1N1 influenza in high-risk units between September and December 2009. RESULTS Surveys were returned from 986 HCWs (80% nurses, 14% respiratory therapists, and 6% physicians). HCWs working in an intensive care unit (78%) or a designated influenza ward (67%) were more compliant with wearing an N95 respirator for aerosol-generating medical procedures than those working in an emergency department (47%; P < .001). HCWs who worked in health care for >11 years were more compliant with wearing protective eyewear than those who worked for ≤11 years (69% vs 54%; P < .001). A total of 815 HCWs (83%) reported having received the pH1N1 influenza vaccine, and 372 (38%) reported having received the 2009-2010 seasonal influenza vaccine. Influenza-like illness was reported by 236 (24%) HCWs, 170 of whom (72%) reported missing work. CONCLUSIONS Experience working in health care improves PPE use and HCWs in emergency departments should be targeted for interventions to improve PPE compliance. pH1N1 influenza vaccine coverage was high, but seasonal influenza vaccine coverage was low, and significant HCW illness and absenteeism were reported.
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Affiliation(s)
- Robyn Mitchell
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
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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.
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Prematunge C, Corace K, McCarthy A, Nair RC, Pugsley R, Garber G. Factors influencing pandemic influenza vaccination of healthcare workers--a systematic review. Vaccine 2012; 30:4733-43. [PMID: 22643216 DOI: 10.1016/j.vaccine.2012.05.018] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 05/07/2012] [Accepted: 05/10/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Maintaining the health and availability of Health care workers (HCW) is an essential component of pandemic preparedness. A key to protecting HCW during the H1N1 pandemic was influenza vaccination. Numerous researchers have reported on factors influencing H1N1 vaccination behaviour in various HCW groups. This systematic review aims to inform future influenza vaccine interventions and pandemic planning processes via the examination of literature in HCW H1N1 vaccination, in order to identify factors that are (1) unique to pandemic influenza vaccination and (2) similar to seasonal influenza vaccination research. METHODS We conducted a comprehensive review of literature (MEDLINE, PubMed, EMBASE, PsycINFO, CINHAL, AMED, Cochrane Library, ProQuest, and grey literature sources) published between January 2005 and December 2011 to identify studies relevant to HCW pH1N1 vaccine uptake/refusal. RESULTS 20 publications sampling HCW from different geographic regions are included in this review. H1N1 vaccine coverage was found to be variable (9-92%) across HCW populations, and self-reported vaccine status was the most frequently utilized predictor of pandemic vaccination. HCW were likely to accept the H1N1 vaccine if they perceived, (1) the H1N1 vaccine to be safe, (2) H1N1 vaccination to be effective in preventing infection to self and others (i.e. loved ones, co-workers and patients), and (3) H1N1 was a serious and severe infection. Positive cues to action, such as the access of scientific literature, trust in public health communications and messaging, and encouragement from loved ones, physicians and co-workers were also found to influence HCW H1N1 uptake. Previous seasonal influenza vaccination was found to be an important socio-demographic predictor of vaccine uptake. Factors unique to HCW pandemic vaccine behaviour are (1) lack of time and vaccine access related barriers to vaccination, (2) perceptions of novel and rapid pandemic vaccine formulation, and (3) the strong role of mass media on vaccine uptake. CONCLUSIONS Many of the factors that influenced HCW pandemic vaccination decisions have previously been reported in seasonal influenza vaccination literature, but some factors were unique to pandemic vaccination. Future influenza vaccine campaigns should emphasize the benefits of vaccination and highlight positive cues to vaccination, while addressing barriers to vaccine uptake in order to improve vaccine coverage among HCW populations. Since pandemic vaccination factors tend be similar among different HCW groups, successful pandemic vaccination strategies may be effective across numerous HCW populations in pandemic scenarios.
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Rebmann T, Iqbal A, Anthony J, Knaup RC, Wright KS, Peters EB. H1N1 influenza vaccine compliance among hospital- and non-hospital-based healthcare personnel. Infect Control Hosp Epidemiol 2012; 33:737-44. [PMID: 22669237 DOI: 10.1086/666336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The 2009 pandemic H1N1 influenza vaccine had lower uptake compared to seasonal influenza vaccine, and most studies examining uptake of H1N1 vaccine focused on hospital-based healthcare personnel (HCP). Determinants of H1N1 vaccine uptake among HCP in all work settings need to be identified so that interventions can be developed for use in encouraging uptake of future pandemic or emerging infectious disease vaccines. OBJECTIVE To identify factors influencing nonhospital HCP H1N1 influenza vaccine compliance. DESIGN AND SETTING An H1N1 influenza vaccine compliance questionnaire was administered to HCP working in myriad healthcare settings in March-June 2011. METHODS Surveys were used to assess H1N1 influenza vaccine compliance and examine factors that predicted H1N1 influenza vaccine uptake. RESULTS In all, 3,188 HCP completed the survey. Hospital-based HCP had higher compliance than did non-hospital-based personnel (Χ2 = 142.2, P < .001). In logistic regression stratified by hospital setting versus nonhospital setting, determinants of H1N1 vaccination among non-hospital-based HCP included extent to which H1N1 vaccination was mandated or encouraged, perceived importance of vaccination, access to no-cost vaccine provided on-site, no fear of vaccine side effects, and trust in public health officials when they say that the influenza vaccine is safe. Determinants of hospital-based HCP H1N1 vaccine compliance included having a mandatory vaccination policy, perceived importance of vaccination, no fear of vaccine side effects, free vaccine, perceived seriousness of H1N1 influenza, and trust in public health officials. CONCLUSIONS Non-hospital-based HCP versus hospital-based HCP reasons for H1N1 vaccine uptake differed. Targeted interventions are needed to increase compliance with pandemic-related vaccines.
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Affiliation(s)
- Terri Rebmann
- Division of Environmental and Occupational Health, Institute for Biosecurity, Saint Louis University, School of Public Health, 3545 Lafayette Avenue, St. Louis, MO 63104, USA.
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Guthmann JP, Fonteneau L, Ciotti C, Bouvet E, Pellissier G, Lévy-Bruhl D, Abiteboul D. Vaccination coverage of health care personnel working in health care facilities in France: results of a national survey, 2009. Vaccine 2012; 30:4648-54. [PMID: 22579863 DOI: 10.1016/j.vaccine.2012.04.098] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 04/24/2012] [Accepted: 04/26/2012] [Indexed: 10/28/2022]
Abstract
We conducted a national cross-sectional survey to investigate vaccination coverage (VC) in health care personnel (HCP) working in clinics and hospitals in France. We used a two-stage stratified random sampling design to select 1127 persons from 35 health care settings. Data were collected by face-to-face interviews and completed using information gathered from the occupational health doctor. A total of 183 physicians, 110 nurses, 58 nurse-assistants and 101 midwives were included. VC for compulsory vaccinations was 91.7% for hepatitis B, 95.5% for the booster dose of diphtheria-tetanus-polio (DTP), 94.9% for BCG. For non-compulsory vaccinations, coverage was 11.4% for the 10 year booster of the DTP pertussis containing vaccine, 49.7% for at least one dose of measles, 29.9% for varicella and 25.6% for influenza. Hepatitis B VC did not differ neither between HCP working in surgery and HCP in other sectors, nor in surgeons and anaesthesiologists compared to physicians working in medicine. Young HCP were better vaccinated for pertussis and measles (p<0.01), and those working in an obstetric or a paediatric ward were better vaccinated for influenza and pertussis (p<0.01). HCP are overall well covered by compulsory vaccinations, whereas VC for non-compulsory vaccinations is very insufficient. The vaccination policy regarding these latter vaccinations should be reinforced in France.
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Affiliation(s)
- Jean-Paul Guthmann
- InVS Institut de Veille Sanitaire (French Institute for Public Health Surveillance), 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France.
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Cheng VCC, To KKW, Tse H, Hung IFN, Yuen KY. Two years after pandemic influenza A/2009/H1N1: what have we learned? Clin Microbiol Rev 2012; 25:223-63. [PMID: 22491771 PMCID: PMC3346300 DOI: 10.1128/cmr.05012-11] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The world had been anticipating another influenza pandemic since the last one in 1968. The pandemic influenza A H1N1 2009 virus (A/2009/H1N1) finally arrived, causing the first pandemic influenza of the new millennium, which has affected over 214 countries and caused over 18,449 deaths. Because of the persistent threat from the A/H5N1 virus since 1997 and the outbreak of the severe acute respiratory syndrome (SARS) coronavirus in 2003, medical and scientific communities have been more prepared in mindset and infrastructure. This preparedness has allowed for rapid and effective research on the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the disease, with impacts on its control. A PubMed search using the keywords "pandemic influenza virus H1N1 2009" yielded over 2,500 publications, which markedly exceeded the number published on previous pandemics. Only representative works with relevance to clinical microbiology and infectious diseases are reviewed in this article. A significant increase in the understanding of this virus and the disease within such a short amount of time has allowed for the timely development of diagnostic tests, treatments, and preventive measures. These findings could prove useful for future randomized controlled clinical trials and the epidemiological control of future pandemics.
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Affiliation(s)
- Vincent C C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
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Suresh PS, Rajan T, Thejaswini V, Rajeshkannan R. Psychosocial determinants of 2009 pandemic influenza A (H1N1) vaccine acceptability among Indian health-care workers during the post-pandemic phase. J Infect 2012; 65:90-3. [PMID: 22406971 DOI: 10.1016/j.jinf.2012.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 03/04/2012] [Indexed: 01/05/2023]
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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.
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Affiliation(s)
- Kwok Kei Mak
- Department of Community Medicine and School of Public Health, Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
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Sočan M, Erčulj V, Lajovic J. Knowledge and attitudes on pandemic and seasonal influenza vaccination among Slovenian physicians and dentists. Eur J Public Health 2012; 23:92-7. [PMID: 22366387 DOI: 10.1093/eurpub/cks006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of our study was to determine vaccination coverage among Slovenian physicians and dentists and assess their knowledge and attitudes regarding the pandemic and seasonal influenza vaccine. METHODS In February 2010, an anonymous, self-administered questionnaire was developed and sent to all practising physicians and dentists in Slovenia. RESULTS Out of 7092 physicians/dentists, 1718 (24%) completed the questionnaire and 41.7% of the respondents were vaccinated against pandemic and seasonal influenza, while 58.3% of the study participants decided not to adhere to the recommendation: 15.6% received the pandemic vaccine only, 10.1% the seasonal vaccine only and 32.4% were not vaccinated at all. Acceptance of the pandemic and seasonal influenza vaccine was determined by higher age, being an internal medical trainee or specialist, working in a hospital, performing any kind of vaccination and having a chronic disease. Unvaccinated participants were more often working in out-patient clinics, were without a specialty, were dentists and were not performing any vaccinations. Those who declined vaccination believed that they did not need to be vaccinated, had safety concerns and were afraid of side effects. Physicians/dentists vaccinated against pandemic and seasonal influenza had better knowledge and a more positive attitude towards the issue compared with their non-vaccinated colleagues. CONCLUSIONS Education on the efficacy and safety of vaccines should be one of the priority public health measures taken to improve knowledge and eliminate misconceptions and attitudinal barriers regarding immunization in physicians and dentists.
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Affiliation(s)
- Maja Sočan
- Centre for Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia.
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Henriksen Hellyer JM, DeVries AS, Jenkins SM, Lackore KA, James KM, Ziegenfuss JY, Poland GA, Tilburt JC. Attitudes toward and uptake of H1N1 vaccine among health care workers during the 2009 H1N1 pandemic. PLoS One 2011; 6:e29478. [PMID: 22216290 PMCID: PMC3245279 DOI: 10.1371/journal.pone.0029478] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 11/29/2011] [Indexed: 01/04/2023] Open
Abstract
Background Though recommended by many and mandated by some, influenza vaccination rates among health care workers, even in pandemics, remain below optimal levels. The objective of this study was to assess vaccination uptake, attitudes, and distinguishing characteristics (including doctor-nurse differences) of health care workers who did and did not receive the pandemic H1N1 influenza vaccine in late 2009. Methodology/Principal Findings In early 2010 we mailed a self-administered survey to 800 physicians and 800 nurses currently licensed and practicing in Minnesota. 1,073 individuals responded (cooperation rate: 69%). 85% and 62% of Minnesota physicians and nurses, respectively, reported being vaccinated. Accurately estimating the risk of vaccine side effects (OR 2.0; 95% CI 1.5–2.7), agreeing with a professional obligation to be vaccinated (OR 10.1; 95% CI 7.1–14.2), an ethical obligation to follow public health authorities' recommendations (OR 9.9; 95% CI 6.6–14.9), and laws mandating pandemic vaccination (OR 3.1; 95% CI 2.3–4.1) were all independently associated with receiving the H1N1 influenza vaccine. Conclusions/Significance While a majority of health care workers in one midwestern state reported receiving the pandemic H1N1 vaccine, physicians and nurses differed significantly in vaccination uptake. Several key attitudes and perceptions may influence health care workers' decisions regarding vaccination. These data inform how states might optimally enlist health care workers' support in achieving vaccination goals during a pandemic.
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Affiliation(s)
| | - Aaron S. DeVries
- Infectious Disease, Epidemiology, Prevention and Control Division, Minnesota Department of Health, St. Paul, Minnesota, United States of America
| | - Sarah M. Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Kandace A. Lackore
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katherine M. James
- Biomedical Ethics Research Unit, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
| | - Jeanette Y. Ziegenfuss
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, United States of America
- Survey Research Center, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Gregory A. Poland
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, Minnesota, United States of America
- Program in Translational Immunovirology and Biodefense, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jon C. Tilburt
- Biomedical Ethics Research Unit, Mayo Clinic, Rochester, Minnesota, United States of America
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
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Suresh PS, Thejaswini V, Rajan T. Factors associated with 2009 pandemic influenza A (H1N1) vaccination acceptance among university students from India during the post-pandemic phase. BMC Infect Dis 2011; 11:205. [PMID: 21798074 PMCID: PMC3161886 DOI: 10.1186/1471-2334-11-205] [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] [Received: 03/11/2011] [Accepted: 07/29/2011] [Indexed: 11/13/2022] Open
Abstract
Background There was a low adherence to influenza A (H1N1) vaccination program among university students and health care workers during the pandemic influenza in many parts of the world. Vaccination of high risk individuals is one of the recommendations of World Health Organization during the post-pandemic period. It is not documented about the student's knowledge, attitude and willingness to accept H1N1 vaccination during the post-pandemic period. We aimed to analyze the student's knowledge, attitude and willingness to accept H1N1 vaccination during the post-pandemic period in India. Methods Vaccine against H1N1 was made available to the students of Vellore Institute of Technology, India from September 2010. The data are based on a cross-sectional study conducted during October 2010 to January 2011 using a self-administered questionnaire with a representative sample of the student population (N = 802). Results Of the 802 respondents, only 102/802 (12.7%) had been vaccinated and 105/802 (13%) planned to do so in the future, while 595/802 (74%) would probably or definitely not get vaccinated in the future. The highest coverage was among the female (65/102, 63.7%) and non-compliance was higher among men in the group (384/595; 64.5%) (p < 0.0001). The representation of students from school of Bio-sciences and Bio-technology among vaccinees is significantly higher than that of other schools. Majority of the study population from the three groups perceived vaccine against H1N1 as the effective preventive measure when compared to other preventive measures. 250/595 (42%) of the responders argued of not being in the risk group. The risk perception was significantly higher among female (p < 0.0001). With in the study group, 453/802 (56.4%) said that they got the information, mostly from media. Conclusions Our study shows that the vaccination coverage among university students remains very low in the post-pandemic period and doubts about the safety and effectiveness of the vaccine are key elements in their rejection. Our results indicate a need to provide accessible information about the vaccine safety by scientific authorities and fill gaps and confusions in this regard.
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Affiliation(s)
- Padmanaban S Suresh
- Centre for Biomedical Research, Vellore Institute of Technology University, Vellore, India.
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