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Guerrero-Soler M, Gras-Valenti P, Platas-Abenza G, Sánchez-Payá J, Sanjuan-Quiles Á, Chico-Sánchez P. Impact of the COVID-19 Pandemic on Influenza Vaccination Coverage of Healthcare Personnel in Alicante, Spain. Vaccines (Basel) 2024; 12:370. [PMID: 38675752 PMCID: PMC11055171 DOI: 10.3390/vaccines12040370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Influenza is a health problem and vaccination is the most effective measure to prevent it. The objective of this study was to evaluate the impact of the COVID-19 pandemic on vaccination coverage (VC) against influenza in healthcare workers (HCWs). A cross-sectional study was conducted at the Dr. Balmis University General Hospital in the province of Alicante (Spain), in which vaccination data were collected retrospectively. Adverse effects (AEs) were detected via telephone call between 15 and 30 days after vaccination. The existence of significant changes in VC between the different seasons studied was evaluated using Chi square with a statistical significance level of p < 0.05. A total of 8403 HCWs vaccinated throughout the different seasons were studied. The vaccination coverage of HCWs for influenza pre-COVID-19 pandemic (2019/20 season) was 51.9%; increased during the pandemic to 67.9% (2020/21 season) and 65.5% (2021/22 season); and, after the pandemic, it decreased to 42.7% (2022/23 season) (p < 0.05). The most frequent reason for vaccination during the periods evaluated was "self-protection", followed by "protection of patients" and "protection of family members". Of all HCWs evaluated, 26.6% (1460/5493) reported at least one AE. During the COVID-19 pandemic, HCWs' influenza vaccination coverage fluctuated considerably. There has been an increase in VC during the most critical moments of the pandemic, both in the 2020/21 and 2021/22 seasons, which has, subsequently, decreased in the 2022/2023 season, to levels below pre-pandemic (2019/2020 season), which justifies implementing specific measures to recover VC in Spain.
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Affiliation(s)
- María Guerrero-Soler
- Epidemiology Unit, Preventive Medicine Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.G.-S.); (G.P.-A.); (J.S.-P.); (P.C.-S.)
| | - Paula Gras-Valenti
- Epidemiology Unit, Preventive Medicine Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.G.-S.); (G.P.-A.); (J.S.-P.); (P.C.-S.)
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain
| | - Guillermo Platas-Abenza
- Epidemiology Unit, Preventive Medicine Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.G.-S.); (G.P.-A.); (J.S.-P.); (P.C.-S.)
| | - José Sánchez-Payá
- Epidemiology Unit, Preventive Medicine Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.G.-S.); (G.P.-A.); (J.S.-P.); (P.C.-S.)
| | | | - Pablo Chico-Sánchez
- Epidemiology Unit, Preventive Medicine Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain; (M.G.-S.); (G.P.-A.); (J.S.-P.); (P.C.-S.)
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain
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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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Ajejas Bazán MJ, Pérez-Rivas FJ, Wärnberg J, Fuentes Mora C, Ballester Orcal LE, Gómez Crespo JM, López-López C, Domínguez-Fernández S, Rico-Blázquez M, Pérez-Farinós N. Flu Vaccination Coverage and Predictors of Non-Vaccination in Military Health Corps Personnel 2016-2017 and 2019-2021. Vaccines (Basel) 2022; 10:460. [PMID: 35335092 PMCID: PMC8953286 DOI: 10.3390/vaccines10030460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: Vaccination is the most effective intervention to control seasonal influenza morbidity and mortality. The present study aimed to determine the influenza vaccination coverage in the Military Health Corps personnel in the 2020−2021 season, as well as the time trend and the possible influence of the pandemic on coverage, in order to study the reasons that led to the non-vaccination of health professionals and to analyze adverse drug reactions (ADRs). (2) Methods: A descriptive, cross-sectional study was conducted from February to May 2021. All FAS CMS personnel were included. A self-administered questionnaire was sent by e-mail to the selected personnel. (3) Results: Vaccination coverage in the 2016−2017 season was 15.8% (n = 276), in the 2019−2020 season it was 17.41% (n = 424), and in the 2020−2021 season it was 24.22% (n = 590). The percentage of vaccinated men was higher than the percentage of women. In 2019 and 2020 the most vaccinated group was 31−40 years old. Lieutenants had the highest vaccination uptake in 2019 and 2020. The personnel with the highest uptake of vaccines were those in the specialty of nursing in each of 2016, 2019 and 2020, with >30 years of time worked in 2016. In terms of factors leading to refusal of vaccination, the most reported was “not considered a risk group” (23.0%), and the least reported was “avoidance of vaccine administration” (2.2%). Eighty individuals presented adverse reactions after vaccine administration (9.6%). (4) Conclusions: The rate of influenza vaccination among healthcare professionals was lower during the 2020 season compared to the previous season, but was expected to increase in the upcoming 2021 season.
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Affiliation(s)
- María Julia Ajejas Bazán
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.J.P.-R.); (C.L.-L.); (M.R.-B.)
- Academia Central de la Defensa, Escuela Militar de Sanidad, Ministerio de Defensa, 28040 Madrid, Spain;
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
| | - Francisco Javier Pérez-Rivas
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.J.P.-R.); (C.L.-L.); (M.R.-B.)
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
| | - Julia Wärnberg
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Carlos Fuentes Mora
- Departamento de Coordinación y Docencia del Hospital Central de la Defensa, 28040 Madrid, Spain;
| | | | - Jose Manuel Gómez Crespo
- Academia Central de la Defensa, Escuela Militar de Sanidad, Ministerio de Defensa, 28040 Madrid, Spain;
| | - Candelas López-López
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.J.P.-R.); (C.L.-L.); (M.R.-B.)
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
- Department of Intensive Care, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), 28041 Madrid, Spain
| | - Silvia Domínguez-Fernández
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
- Madrid Salud, Ayuntamiento de Madrid, 28007 Madrid, Spain
| | - Milagros Rico-Blázquez
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.J.P.-R.); (C.L.-L.); (M.R.-B.)
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
- Unidad de Investigación de la Gerencia Asistencial de Atención Primaria, Servicio Madrileño de la Salud, 28035 Madrid, Spain
| | - Napoleón Pérez-Farinós
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.W.); (S.D.-F.); (N.P.-F.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
- Departamento de Salud Pública y Psiquiatría, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
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Martín-Rodríguez MDM, Díaz-Berenguer JA, Alonso-Bilbao JL, Cabeza-Mora A, Navarro-Vázquez F, Espiñeira-Francés A, Nuez-Herrera L. [Effect of influenza vaccination in Primary Healthcare workers and the general population in Gran Canaria: A cross-sectional study]. Aten Primaria 2019; 51:300-309. [PMID: 29656796 PMCID: PMC6837105 DOI: 10.1016/j.aprim.2017.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To estimate the effect of the influenza vaccination in Primary Healthcare workers and the general population vaccinated during the 2015/2016 campaign. DESIGN Cross-sectional study. SETTING All the Primary Healthcare centres within the Gran Canaria healthcare region. PARTICIPANTS A total of 1,868 Primary Healthcare workers (33.5% men; 66.5% women) and 795,605 individuals from the general population (49.4% men; 50.6% women). PRINCIPAL MEASUREMENTS The outcome variables in Primary Healthcare workers were: influenza cases reported to the Epidemiological Surveillance System, and the sick leave days due to illness. In the general population: reported flu cases and vaccination coverage in connection with the vaccination status of the healthcare professional. The magnitude of association between vaccination and morbidity was estimated applying logistic regression models. RESULTS Although not statistically significant, healthcare professionals that were not vaccinated had 1.7-fold increase in the risk of having influenza than those vaccinated. In the general population the association was significant in the female population (OR: 1.3; 95%CI: 1.1-1.5). Population coverage was significantly higher when both the doctor and nurse were vaccinated (OR: 1.3; 95%CI: 1.3-1.3), and reported flu cases decreased when the nurse was vaccinated (OR: 0.9; 95%CI: 0.9-0.9). CONCLUSION A possible protective effect of influenza vaccination was observed in the general population, as well as an influence of Primary Healthcare workers on the patients regarding this. Even so, the low coverages registered point to a need to implement measures that may lead to a more favourable attitude towards influenza vaccination.
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Affiliation(s)
| | | | | | - Antonio Cabeza-Mora
- Área Técnica, Gerencia de Atención Primaria de Gran Canaria, Las Palmas, España
| | | | | | - Lidia Nuez-Herrera
- Área Técnica, Gerencia de Atención Primaria de Gran Canaria, Las Palmas, España
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Fernández-Villa T, Molina AJ, Torner N, Castilla J, Astray J, García-Gutiérrez S, Mayoral JM, Tamames S, Domínguez Á, Martín V. Factors associated with acceptance of pandemic flu vaccine by healthcare professionals in Spain, 2009-2010. Res Nurs Health 2017; 40:435-443. [PMID: 28805243 DOI: 10.1002/nur.21815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/29/2017] [Indexed: 11/11/2022]
Abstract
The A(H1N1)pdm09 influenza virus reached pandemic level in Spain in 2009, prompting a national vaccination campaign. To avoid transmission to patients, healthcare professionals' vaccination against pandemic influenza is crucial. The main objective of this study was to analyze factors associated with the failure by healthcare professionals to accept the pandemic vaccination in 2009. A cross-sectional survey was conducted of healthcare professionals in seven of Spain's autonomous regions. A questionnaire was used to collect information about personal and professional details, the respondents' flu vaccination status in the 2008-2009 and 2009-2010 seasons (seasonal and pandemic vaccines), and their knowledge and attitudes. A total of 1,661 professionals completed the survey. In the 2009-2010 season, 38.2% had both the seasonal and the pandemic vaccine, 22.1% had had only the seasonal, and 4.7% only the pandemic vaccine. The strongest predictor of not receiving the pandemic vaccine was not having had seasonal vaccinations in that year or the previous year. Those who had not received the pandemic vaccine were more often female; nurses; under 45; denied contact with at-risk groups; and had negative beliefs about the vaccine effectiveness and little concern for getting the disease, being infected at work, or passing it on to patients. It would be prudent to direct preventive campaigns not only at individuals at risk of catching flu but also at health professionals with a negative view of flu vaccine, with a particular focus on nurses, who have a key role in recommending flu vaccine.
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Affiliation(s)
- Tania Fernández-Villa
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Antonio J Molina
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Nuria Torner
- Agencia de Salud Pública de Cataluña, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jesus Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, 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
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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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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Influenza vaccination coverages among high risk subjects and health care workers in Spain. Results of two consecutive National Health Surveys (2011–2014). Vaccine 2016; 34:4898-4904. [DOI: 10.1016/j.vaccine.2016.08.065] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/13/2016] [Accepted: 08/22/2016] [Indexed: 11/18/2022]
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To KW, Lai A, Lee KCK, Koh D, Lee SS. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions. J Hosp Infect 2016; 94:133-42. [PMID: 27546456 DOI: 10.1016/j.jhin.2016.07.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from <5% to >90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.
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Affiliation(s)
- K W To
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - A Lai
- Occupational Health Division, Ministry of Health, Negara Brunei Darussalam
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Negara Brunei Darussalam; SSH School of Public Health, National University of Singapore, Singapore
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
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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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Wang To K, Lee S, Lee SS. Intention of nurses to receiving influenza vaccination before the 2013-14 season. Hum Vaccin Immunother 2016; 11:1345-50. [PMID: 25975849 DOI: 10.1080/21645515.2015.1034916] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
A study was conducted to determine the influenza vaccination uptake rate of nurses in Hong Kong after the pH1N1 epidemic, and examine their intention for vaccination before the next influenza season. Questionnaires in Chinese with multiple choice responses were delivered by post through 4 nurses organizations. The following were explored: intentions and reasons for vaccination in the forthcoming season; perceptions of influenza outbreak risk; attitudes toward professional obligation and vaccination policies. Cramer's V and Eta values were calculated to analyze association and effect size. Between March and May 2013, analysis was made on 1,934 (6.8%) valid questionnaires, with 620 (30.7%) having received influenza vaccination before the season of 2012-13. Some 30.7% and 42% intended to accept and decline vaccination respectively in the forthcoming season (2013-14) while 27.3% remained indecisive. Over 80% of indecisive nurses had refused vaccination in the last season. More nurses refusing (18.1%) or indecisive (9.8%) of vaccination perceived being "significantly unwell" after past vaccinations, compared to only 1% in those who intended to accept. Expert opinions and guidelines were important for making decision on vaccination in 40% of nurses. The ranking of professional responsibilities of vaccination in indecisive nurses was between those declining and accepting future vaccination. Overall, past vaccination experience, professional responsibilities and reference to guidelines were major factors affecting nurses' decision on future vaccination against influenza in Hong Kong. The results might however not be generalizable to all nurses as the analyses were restricted to those responding to the appeal from selected professional organisations.
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Affiliation(s)
- Kin Wang To
- a Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong ; Hong Kong , China
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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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Giannattasio A, Mariano M, Romano R, Chiatto F, Liguoro I, Borgia G, Guarino A, Lo Vecchio A. Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients. BMC Infect Dis 2015; 15:329. [PMID: 26265328 PMCID: PMC4533948 DOI: 10.1186/s12879-015-1090-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009–2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012–2013. Methods The overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons. Results The first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were “Unsure of the efficacy of vaccine” and “Feel not at-risk of getting influenza or its complications”. Despite recommendations, influenza vaccine uptake remains poor. Conclusion Immunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1090-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antonietta Giannattasio
- Medicine and Health Sciences Department, University of Molise, Campobasso, Italy. .,Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Via S. Pansini, Naples, 80100, Italy.
| | - Miriam Mariano
- Medicine and Health Sciences Department, University of Molise, Campobasso, Italy.
| | - Roberto Romano
- Medicine and Health Sciences Department, University of Molise, Campobasso, Italy.
| | - Fabrizia Chiatto
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Via S. Pansini, Naples, 80100, Italy.
| | - Ilaria Liguoro
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Via S. Pansini, Naples, 80100, Italy.
| | - Guglielmo Borgia
- Clinical Medicine and Surgery Department, University of Naples Federico II, Naples, Italy.
| | - Alfredo Guarino
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Via S. Pansini, Naples, 80100, Italy.
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Via S. Pansini, Naples, 80100, Italy.
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Jiménez-García R, Rodríguez-Rieiro C, Hernandez-Barrera V, Carrasco Garrido P, López de Andres A, Esteban-Vasallo MD, Domínguez-Berjón MF, Astray-Mochales J. Negative trends from 2008/9 to 2011/12 seasons in influenza vaccination coverages among high risk subjects and health care workers in Spain. Vaccine 2013; 32:350-4. [PMID: 24269621 DOI: 10.1016/j.vaccine.2013.11.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 10/11/2013] [Accepted: 11/11/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We aim to describe influenza vaccination coverage for the Spanish population across four consecutive campaigns (2008/2009 to 2011/2012). The data was analyzed by high risk groups and health care workers (HCWs). Also, coverage trends were analyzed to assess uptake in post-pandemic seasons. METHODS We used data from two nation-wide representative health surveys namely the 2009/10 European Health Interview Survey for Spain (N=22,188) and the 2011-12 Spanish National Health Survey (N=21,007) Influenza vaccination status was self-reported. We analyzed influenza vaccine coverage by age, sex, number of chronic conditions, being a heath care worker (HCWs) and nationality. Time trends for campaigns among high risk groups were estimated by a multivariate logistic regression model. RESULTS We analyzed data from 43,072 subjects aged ≥ 16 years. As a whole, coverage decreased by 3.31% (22.57-19.26%) between the 2008/2009 and 2011/2012 campaigns with a significant decreasing trend (OR 0.92; 95% CI: 0.90-0.94). Coverage in people under 60 years with a chronic disease decreased significantly (OR 0.92: 95% CI: 0.85-0.99) during the analyzed period from 21.02% in 2008/2009 to 17.40% in 2011/2012. Among HCWs, the highest influenza vaccination coverage was achieved in 2009/2010 (31.08%) in the latest campaign coverage has almost halved (17.88%). For the 2011/2012 season and for all age groups the variables associated with a higher probability of having received the influenza vaccine were older age and presence of associated chronic conditions. Among those aged ≥ 60 years, immigrants had lower uptake (OR 0.60; 95% CI: 0.32-0.99). CONCLUSIONS Seasonal influenza vaccine uptake rates in the recommended target groups in Spain are unacceptably low and seem to be decreasing in the post pandemic seasons. Further studies are necessary to precisely identify reasons for non-compliance and barriers to influenza vaccination. Meanwhile urgent strategies to improve seasonal vaccination uptake must be discussed and implemented.
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Affiliation(s)
- Rodrigo Jiménez-García
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón 28922, Madrid, Spain.
| | - Cristina Rodríguez-Rieiro
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón 28922, Madrid, Spain.
| | - Valentín Hernandez-Barrera
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón 28922, Madrid, Spain.
| | - Pilar Carrasco Garrido
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón 28922, Madrid, Spain.
| | - Ana López de Andres
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón 28922, Madrid, Spain.
| | - María D Esteban-Vasallo
- Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/Julián Camarillo, 4B, 28037 Madrid, Spain.
| | - Maria Felicitas Domínguez-Berjón
- Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/Julián Camarillo, 4B, 28037 Madrid, Spain.
| | - Jenaro Astray-Mochales
- Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/Julián Camarillo, 4B, 28037 Madrid, Spain.
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Trends in influenza vaccine coverage among primary healthcare workers in Spain, 2008-2011. Prev Med 2013; 57:206-11. [PMID: 23732251 DOI: 10.1016/j.ypmed.2013.05.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/12/2013] [Accepted: 05/27/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate trends in seasonal influenza vaccination coverage in primary healthcare workers (PHCWs) in Spain between 2008 and 2011. METHODS We made an anonymous web survey of PHCWs in 2012. Information on attitudes towards and knowledge of influenza vaccine, and immunization in previous seasons was collected. Self-reported vaccination coverage and factors related to vaccination continuity were analysed. RESULTS Of 5433 workers contacted, 2625 (48.3%) responded to the survey: 47.0% were general practitioners, 10.3% paediatricians and 42.7% nurses. Their reported vaccination rates from seasons 2008-2009 to 2011-2012 decreased over time: 58.4%, 57.4%, 53.2% and 49.3% (linear trend, p < 0.001). Among workers vaccinated in any previous season, 70.2% were vaccinated again in 2011-2012, compared with 5.2% among those not previously vaccinated (p < 0.001). Continuity of vaccination increased with age and with the worker or cohabitant having a major chronic condition. Vaccination was higher in workers who recognized vaccination as effective and those worried about being infected or infecting patients. CONCLUSION Influenza vaccination coverage in PHCWs has declined, especially after the pandemic. Intensive interventions are needed to change this trend. Knowledge of vaccination should be reinforced by stressing the effectiveness of the vaccine and the risks of influenza for workers and patients.
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Poon CM, Lee SS, Lee S. Early uptake of seasonal influenza vaccines incorporated with pH1N1 strain among regularly vaccinated healthcare workers. J Infect Prev 2012. [DOI: 10.1177/1757177412458959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives: This study aims to assess the vaccination uptake and attitudes of healthcare workers (HCWs) towards seasonal influenza vaccination after incorporating pandemic H1N1 (pH1N1) strain in the vaccines. Methods: A self-administered anonymous questionnaire was issued to nurses registered with any of three collaborating nursing associations in Hong Kong. Results: A total of 709 questionnaires were completed, representing a response rate of 28.4%. The coverage of 2010/11 seasonal influenza vaccines was 24.1%. It was lower than that of 2009/10 seasonal influenza vaccines, in which pH1N1 strain was not yet included (37.1%), but higher than that of monovalent pH1N1 vaccines introduced during the pandemic in 2009 (14.2%). The reduction in the number of vaccinated HCWs varied among sub-groups classified by age, duration of employment, type of contacts with patients or past seasonal influenza vaccination record. Early recipients of the vaccine were more likely to have already been vaccinated in the preceding year (odds ratio (OR)=2.95, 95% confidence interval (95% CI) =1.15–7.59) and showed an intention to be vaccinated in the following year (OR=2.78, 95% CI=1.13–6.83). However, incorporation of pH1N1 strain in trivalent seasonal vaccines did not significantly increase the desire for vaccination. Conclusion: In addition to upholding the efficacy and safety standard of influenza vaccines, compliance and acceptance strategies shall be developed as early as possible, and tailored to the needs of different sub-groups.
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Affiliation(s)
- Chin Man Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
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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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