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Gravagna K, Wolfson C, Basta NE. Influenza vaccine coverage and factors associated with non-vaccination among caregiving and care-receiving adults in the Canadian Longitudinal Study on Aging (CLSA). BMC Public Health 2024; 24:924. [PMID: 38553696 PMCID: PMC10981287 DOI: 10.1186/s12889-024-18372-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/17/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Influenza vaccination is recommended for those at increased risk of influenza complications and their household contacts to help reduce influenza exposure. Adults who require care often experience health issues that could increase the risk of severe influenza and have close contact with caregivers. Assessing influenza vaccination prevalence in caregivers and care recipients can provide important information about uptake. OBJECTIVES We aimed to (1) estimate influenza non-vaccination prevalence and (2) assess factors associated with non-vaccination among caregivers aged ≥ 45 years and among care recipients aged ≥ 65 years. METHODS We conducted an analysis of cross-sectional data from the Canadian Longitudinal Study on Aging collected 2015-2018. We estimated non-vaccination prevalence and reported adjusted odds ratios with 95% confidence intervals from logistic regression models to identify factors associated with non-vaccination among caregivers and care recipients. RESULTS Of the 23,500 CLSA participants who reported providing care, 41.4% (95% CI: 40.8%, 42.0%) reported not receiving influenza vaccine in the previous 12 months. Among the 5,559 participants who reported receiving professional or non-professional care, 24.8% (95% CI: 23.7%, 26.0%) reported not receiving influenza vaccine during the same period. For both groups, the odds of non-vaccination were higher for those who had not visited a family doctor in the past year, were daily smokers, and those who identified as non-white. DISCUSSION Identifying groups at high risk of severe influenza and their close contacts can inform public health efforts to reduce the risk of influenza. Our results suggest sub-optimal influenza vaccination uptake among caregivers and care recipients. Efforts are needed to increase influenza vaccination and highlight the direct and indirect benefits for caregiver-care recipient pairs. CONCLUSION The proportions of both caregivers and care recipients who had not been vaccinated for influenza was high, despite the benefits of vaccination. Influenza vaccination campaigns could target undervaccinated, high-risk groups to increase coverage.
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Affiliation(s)
- Katie Gravagna
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada
- Neuroepidemiology Research Unit, Research Institute of the McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | - Nicole E Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada
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Calabrò GE, Rumi F, Ricciardi R, Cicchetti A. The economic and fiscal impact of incremental use of cell-based quadrivalent influenza vaccine for the prevention of seasonal influenza among healthcare workers in Italy. Health Res Policy Syst 2024; 22:36. [PMID: 38519969 PMCID: PMC10960473 DOI: 10.1186/s12961-024-01122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Seasonal influenza has a significant impact on public health, generating substantial direct healthcare costs, production losses and fiscal effects. Understanding these consequences is crucial to effective decision-making and the development of preventive strategies. This study aimed to evaluate the economic and the fiscal impact of implementing an incremental strategy for seasonal influenza prevention using the cell-based quadrivalent influenza vaccine (QIVc) among healthcare workers (HCWs) in Italy. METHODS To estimate the economic impact of implementing this strategy, we performed a cost analysis that considered direct healthcare costs, productivity losses and fiscal impact. The analysis considered a 3-year time horizon. A deterministic sensitivity analysis was also conducted. RESULTS Assuming a vaccination coverage rate of 30% among HCWs, the analysis considered a total of 203 018 vaccinated subjects. On analysing the overall differential impact (including direct costs, indirect costs and fiscal impact), implementing QIVc vaccination as a preventative measure against influenza among HCWs in Italy would yield societal resource savings of €23 638.78 in the first year, €47 277.56 in the second year, and €70 916.35 in the third year, resulting in total resource savings of €141 832.69. CONCLUSIONS The study demonstrated that implementing the incremental use of QIVc as part of a preventive strategy for seasonal influenza among HCWs in Italy could yield positive economic outcomes, especially in terms of indirect costs and fiscal impact. The resources saved could be utilized to fund further public health interventions. Policy-makers should consider these findings when making decisions regarding influenza prevention strategies targeting HCWs.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.Go F. Vito 1, 00168, Rome, Italy.
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Scarinci S, Padovan M, Cosci B, Petillo A, Gattini V, Cosentino F, Mignani A, Foddis R, Guglielmi G. Evaluation of Smallpox Vaccination Coverage and Attitude towards Monkeypox Vaccination among Healthcare Workers in an Italian University Hospital. Vaccines (Basel) 2023; 11:1741. [PMID: 38140146 PMCID: PMC10747083 DOI: 10.3390/vaccines11121741] [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: 08/30/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: In 2022, monkeypox (Mpox) was declared a public health emergency. The European Medicines Agency has authorized the use of Imvanex/Jynneos, a smallpox vaccine, for coverage against pox. Healthcare workers (HCWs) are all considered by the European Centre for Disease Prevention and Control to be at risk, but in Italy, vaccination was offered only to laboratory personnel. The present study aims to investigate smallpox vaccination coverage (VC) that provides protection against Mpox among HCWs in an Italian university hospital and to assess HCWs' attitudes towards the possibility of getting vaccinated against Mpox. (2) Methods: We conducted a cross-sectional survey. 336 HCWs from selected wards were asked to fill out a self-declaration to collect their sex, profession, ward, vaccination status, and attitude toward Mpox vaccination. (3) Results: 60.71% of HCWs involved provided the requested data; 38.7% of them were previously vaccinated against smallpox, which corresponds to 23.5% of the total HCWs in the wards considered. Considering those born before 1979 as vaccinated, VC increases from 23.5% to 41.7%; the percentage of HCWs who adhered to vaccination is 23%; laboratory technicians showed a lower willingness to be vaccinated. The ward with the highest willingness to vaccinate is proctological surgery. (4) Conclusions: Based on our experience, a variability in smallpox VC and in willingness to vaccination has emerged both among different job titles and age categories and across the wards analyzed. Additionally, our survey reveals that vaccination attitudes are higher among HCWs from wards that currently do not have free access to such vaccinations.
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Affiliation(s)
- Sergio Scarinci
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Martina Padovan
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Bianca Cosci
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Armando Petillo
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Vittorio Gattini
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
| | - Francesca Cosentino
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
| | - Aldo Mignani
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
| | - Rudy Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Giovanni Guglielmi
- Occupational Preventive Medicine Ward, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (S.S.); (M.P.); (B.C.); (A.P.); (V.G.); (F.C.); (A.M.)
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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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López-Zambrano MA, Pita CC, Escribano MF, Galán Meléndez IM, Cebrián MG, Arroyo JJG, Huerta C, Cuadrado LM, Ruiperez CM, Núñez C, Zapata AP, de la Pinta MLR, Uriz MAS, Conejo ISA, Gomila CM, Carbajo MDL, Gómez AS. Factors associated to influenza vaccination among hospital's healthcare workers in the Autonomous Community of Madrid, Spain 2021-2022. Vaccine 2023; 41:6719-6726. [PMID: 37806803 DOI: 10.1016/j.vaccine.2023.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Influenza vaccination (IV) aims primarily to protect high-risk groups against severe influenza-associated disease and death. It is recommended in Spain for high-risk groups, including Healthcare workers (HCWs). However, vaccination uptake has been consistently below desirable levels. The objective of this study were to evaluate influenza vaccination coverage using data from the regional vaccination registry, during 2021-2022 season, among HCWs in public hospitals in Autonomous Community of Madrid (CAM) and to explore factors associated with influenza vaccination. We conducted a cross-sectional study using administrative data retrieved from the Regional Department of Health data repositories. A multilevel logistic regression model was designed to estimate Level 1 (individual) and Level 2 (contextual) variables that are associated with HCẂs vaccination. The study population was HCWs from 25 public hospitals in CAM who were active during the period of the influenza 2021-2022 vaccination campaign. The global influenza vaccination coverage (IVC) was 52.1 %. All study Level 1 variables were significantly associated with vaccine uptake. Greater IVC is associated with individual characteristics: female (OR1.14; 95 %CI 1.09-1.19), older age 59-69 years old (OR1.72; 95 %CI 1.60-1.84), born in Spain, medical staff, more than one high-risk condition (OR1.24; 95 %CI 1.10-1.40; respectively) and vaccinated in two previous campaigns (OR25.64; 95 %CI 24.27-27.09). IVC was highest among HCWs celiac disease (65.5 %) followed by diabetes mellitus (65.1 %) and chronic inflammatory disease (64.3 %). The hospital where the study subject worked also showed an effect on the vaccination uptake, although Level 2 variable (hospital complexity) was not positively associated. IVC in HCWs remains suboptimal. These findings may prove useful to tailor strategies to reach specific groups. It is recommended to delve into the identification of factors associated with the HCWs workplace that may have a positive impact on IV.
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Affiliation(s)
- María Alejandra López-Zambrano
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Covadonga Caso Pita
- Servicio de Prevención de Riesgos Laborales, Hospital Clínico San Carlos, Madrid, Spain.
| | | | - Isabel Mª Galán Meléndez
- Servicio de Prevención y Salud Laboral, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Manuela García Cebrián
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de La Princesa, Hospital Infantil Universitario Niño Jesús, Hospital Universitario Santa Cristina, Madrid, Spain.
| | | | - Carmen Huerta
- Servicio de Prevención Riesgos Laborales, Hospital Universitario de Móstoles, Madrid, Spain.
| | - Luis Mazón Cuadrado
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de Fuenlabrada, Madrid, Spain.
| | - Carmen Muñoz Ruiperez
- Servicio de Medicina del Trabajo y Prevención de Riesgos Laborales, Hospital Universitario 12 de octubre, Madrid, Spain.
| | - Concha Núñez
- Servicio de Prevención Riesgos Laborales, Hospital U. La Paz-Carlos III-Cantoblanco, Madrid, Spain.
| | - Aurora Pérez Zapata
- Servicio de Prevención de Riesgos Laborales - Salud Laboral, Hospital Universitario Príncipe de Asturias, Madrid, Spain.
| | | | - Mª Angeles Sánchez Uriz
- Servicio de Prevención Mancomunado de Grupo, Hospital Universitario Infanta Leonor, Madrid, Spain.
| | | | | | - Mª Dolores Lasheras Carbajo
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Amaya Sánchez Gómez
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
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Alsaif F, Twigg M, Scott S, Blyth A, Wright D, Patel A. A systematic review of barriers and enablers associated with uptake of influenza vaccine among care home staff. Vaccine 2023; 41:6156-6173. [PMID: 37673716 DOI: 10.1016/j.vaccine.2023.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
Barriers and enablers to vaccination of care home (CH) staff should be identified in order to develop interventions to address them that increase uptake and protect residents. We aimed to synthesis the evidence describing the barriers and enablers that affect the influenza vaccination uptake of care home (CH) staff. METHOD We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, IBSS, SCOPUS to identify quantitative, qualitative or mixed-method studies. Data related to health or social care workers in CHs reported barriers or enablers were extracted and mapped to the Theoretical Domains Framework (TDF); the data within each domain were grouped and categorized into key factors affecting influenza vaccine uptake among CH staff. RESULTS We screened 4025 studies; 42 studies met our inclusion criteria. Thirty-four (81 %) were surveys. Five theoretical domains were frequently reported as mediators of influenza vaccine uptake: Beliefs about consequences (32 studies), Environmental context and resources (30 studies), Emotions (26 studies), Social influences (25 studies), Knowledge (22 studies). The low acceptance rate of the influenza vaccine among CH staff can be attributed to multiple factors, including insufficient understanding of the vaccine, its efficacy, or misconceptions about the vaccine (knowledge), perceiving the vaccine as ineffective and unsafe (beliefs about consequences), fear of influenza vaccine and its side effects (emotions), and experiencing limited accessibility to the vaccine (environmental context and resources). CONCLUSION Interventions aimed at increasing influenza vaccine uptake among CH staff should focus on addressing the barriers identified in this review. These interventions should include components such as enhancing knowledge by providing accurate information about vaccine benefits and safety, addressing negative beliefs by challenging misconceptions, managing concerns and fears through open communication, and improving accessibility to the vaccine through convenient on-site options. This review provides a foundation for the development of tailored Interventions to improve influenza vaccine uptake among CH staff.
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Affiliation(s)
- Faisal Alsaif
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Michael Twigg
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Sion Scott
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Annie Blyth
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
| | - David Wright
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Amrish Patel
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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Bellali T, Liamopoulou P, Karavasileiadou S, Almadani N, Galanis P, Kritsotakis G, Manomenidis G. Intention, Motivation, and Empowerment: Factors Associated with Seasonal Influenza Vaccination among Healthcare Workers (HCWs). Vaccines (Basel) 2023; 11:1508. [PMID: 37766184 PMCID: PMC10534342 DOI: 10.3390/vaccines11091508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Vaccination against seasonal influenza has proven effective in preventing nosocomial influenza outbreaks among hospital patients and healthcare workers (HCWs). This study aims to explore the intention, motivation, and empowerment toward vaccination and vaccination advocacy as contributing factors for seasonal influenza vaccination in HCWs. METHODS A cross-sectional study in eight secondary hospitals in Greece was conducted from March to May 2022. An anonymous questionnaire was enclosed in an envelope and distributed to all participants, including questions on vaccine behavior and the MoVac-flu and MoVad scales. RESULTS A total of 296 participants completed the questionnaire. In multivariate logistic regression models adjusted for potential confounders, increased age, intention score, MoVac-flu scale score, and the presence of chronic diseases were significant predictors of influenza vaccination this year, while increased age, intention score, and presence of chronic diseases were predictors of vaccination every year. CONCLUSION Vaccination uptake is simultaneously affected by logical cognitive processes (intention), together with factors related to motivation and empowerment in distinct self-regulatory domains such as value, impact, knowledge, and autonomy. Interventions focused on these identified predictors may be used as a guide to increase HCWs' vaccination rates.
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Affiliation(s)
- Thalia Bellali
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
- Faculty of Nursing, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Polyxeni Liamopoulou
- Faculty of Nursing, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (N.A.)
| | - Noura Almadani
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (N.A.)
| | - Petros Galanis
- Faculty of Nursing, National and Kapodistrian University of Athens, 11524 Athens, Greece;
| | - George Kritsotakis
- Department of Business Administration & Tourism, Hellenic Mediterranean University, 72300 Herakleion, Greece;
| | - Georgios Manomenidis
- Faculty of Nursing, International Hellenic University, Didimoteicho Branch, 57400 Thessaloniki, Greece;
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Birt L, Katangwe-Chigamba T, Scott S, Wright DJ, Wagner AP, Sims E, Bion V, Seeley C, Alsaif F, Clarke A, Griffiths A, Jones L, Bryant A, Patel A. Protocol of the process evaluation of cluster randomised control trial for estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates compared to usual practice (FluCare). Trials 2023; 24:587. [PMID: 37715262 PMCID: PMC10503150 DOI: 10.1186/s13063-023-07613-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Influenza (flu) vaccination rates in UK care home staff are extremely low. Less than 40% of staff in care homes are vaccinated for influenza (flu), presenting risks to the health of frail residents and potential staff absence from cross-infection. Staff often do not perceive a need for vaccination and are unaware they are entitled to free flu vaccination. The FluCare study, a cluster randomised control trial (RCT), uses behavioural interventions to address barriers. Videos, posters, and leaflets are intended to raise awareness of flu vaccination benefits and debunk myths. On-site staff vaccination clinics increase accessibility. Financial incentives to care homes for improved vaccination rates and regular monitoring influence the environment. This paper outlines the planned process evaluation which will describe the intervention's mechanisms of action, explain any changes in outcomes, identify local adaptations, and inform design of the implementation phase. METHODS/DESIGN A mixed method process evaluation to inform the interpretation of trial findings. OBJECTIVES • Describe the intervention as delivered in terms of dose and fidelity, including adaptations and variations across care homes. • Explore the effects of individual intervention components on primary outcomes. • Investigate the mechanisms of impact. • Describe the perceived effectiveness of relevant intervention components (including videos, leaflets, posters, and flu clinics) from participant perspectives (care home manager, care home staff, flu clinic providers). • Describe the characteristics of care homes and participants to assess reach. A purposive sample of twenty care homes (ten in the intervention arm, ten in the control arm) for inclusion in the process evaluation. Data will include (1) study records including care home site profiles, (2) responses to a mechanism of action questionnaire, and (3) semi-structured interviews with care home staff and clinic providers. Quantitative data will be descriptively reported. Interview data will be thematically analysed and then categories mapped to the Theoretical Domains Framework. DISCUSSION Adopting this systematic and comprehensive process evaluation approach will help ensure data is captured on all aspects of the trial, enabling a full understanding of the intervention implementation and RCT findings. TRIAL REGISTRATION ISRCTN ISRCTN22729870. Registered on 24 August 2022.
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Affiliation(s)
- Linda Birt
- School of Healthcare, University of Leicester, Leicester, UK.
| | | | - Sion Scott
- School of Healthcare, University of Leicester, Leicester, UK
| | - David J Wright
- School of Healthcare, University of Leicester, Leicester, UK
| | - Adam P Wagner
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England (EoE), Cambridge, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Veronica Bion
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Carys Seeley
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Faisal Alsaif
- School of Pharmacy, University of East Anglia, Norwich, UK
| | - Allan Clarke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Alys Griffiths
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Liz Jones
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Alison Bryant
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Amrish Patel
- School of Economics, University of East Anglia, Norwich, UK
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Loi AST, Sridhar R, Lim SM. Measles and Varicella Vaccination Program in a Hospital: Implementation and Impact on Contact Tracing. Vaccines (Basel) 2023; 11:1131. [PMID: 37514947 PMCID: PMC10385976 DOI: 10.3390/vaccines11071131] [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: 05/31/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Healthcare workers are recommended to get vaccinated against measles and varicella. This study aims to describe the implementation process of a measles and varicella vaccination program and report on the reduction in the number of susceptible healthcare workers exposed to measles, varicella, and disseminated herpes zoster at a tertiary hospital. The Consolidated Framework for Implementation Research (CFIR) model was used to describe the vaccination program implemented from October 2015 to September 2018. The number of exposed, reviewed, and susceptible healthcare workers during contact tracing for exposure to (a) measles and (b) varicella and disseminated herpes zoster in 2016, 2017, and 2018 is reported. A total of 6770 (95%) out of 7083 healthcare workers completed their immunization review by 2018. In 2016, 20 (10%) out of 198 healthcare workers exposed to measles were considered susceptible. In 2018, no one was found susceptible out of the 51 staff members exposed to measles (p < 0.01). For exposure to varicella and disseminated herpes zoster, seven (5%) out of 154 exposed healthcare workers were susceptible in 2016. In comparison, only two (1%) out of 377 exposed healthcare workers in 2018 were susceptible (p < 0.01). The vaccination program effectively reduced number of healthcare workers susceptible to measles, varicella, and disseminated zoster.
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Affiliation(s)
| | - Revathi Sridhar
- Epidemiology Unit, Division of Infectious Diseases, National University Hospital, Singapore 119074, Singapore
| | - See Ming Lim
- Occupational Health Clinic, National University Hospital, Singapore 119074, Singapore
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10
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Vaux S, Fonteneau L, Péfau M, Venier AG, Gautier A, Altrach SS, Parneix P, Levy-Bruhl D. Acceptability of mandatory vaccination against influenza, measles, pertussis and varicella by workers in healthcare facilities: a national cross-sectional study, France, 2019. Arch Public Health 2023; 81:51. [PMID: 37020228 PMCID: PMC10076374 DOI: 10.1186/s13690-023-01069-4] [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: 11/22/2022] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Vaccination of healthcare workers (HCW) aims to protect them and to reduce transmission to susceptible patients. Influenza, measles, pertussis, and varicella vaccinations are recommended but not mandatory for HCW in France. Insufficient vaccine coverage for these diseases in HCW has raised the question of introducing mandatory vaccination. We conducted a survey to estimate acceptability of mandatory vaccination for these four vaccines by HCW working in healthcare facilities (HCF) in France, and to identify associated determinants. METHODS In 2019, we performed a cross-sectional survey of physicians, nurses, midwives and nursing assistants working in HCF in France using a randomised stratified three-stage sampling design (HCF type, ward category, HCW category). Data were collected in face-to-face interviews using a tablet computer. We investigated the possible determinants of acceptability of mandatory vaccination using univariate and multivariate Poisson regressions, and estimated prevalence ratios (PR). RESULTS A total of 8594 HCW in 167 HCF were included. For measles, pertussis, and varicella, self-reported acceptability of mandatory vaccination (very or quite favourable) was 73.1% [CI95%: 70.9-75.1], 72.1% [69.8-74.3], and 57.5% [54.5-57.7], respectively. Acceptability varied according to i) HCW and ward category for these three vaccinations, ii) age group for measles and pertussis, and iii) sex for varicella. For mandatory influenza vaccination, acceptability was lower (42.7% [40.6-44.9]), and varied greatly between HCW categories (from 77.2% for physicians to 32.0% for nursing assistants). CONCLUSION HCW acceptability of mandatory vaccination was high for measles, pertussis and varicella but not as high for influenza. Vaccination for COVID-19 is mandatory for HCW in France. Replication of this study after the end of the COVID-19 crisis would help assess whether the pandemic had an impact on their acceptability of mandatory vaccination, in particular for influenza.
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Affiliation(s)
- Sophie Vaux
- Santé Publique France, Saint-Maurice, France.
| | | | - Muriel Péfau
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Anne-Gaëlle Venier
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | | | | | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
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11
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Tylec A, Janiszewska M, Siejko K, Kucharska K. Determinants of the decision to be vaccinated against COVID-19 as exemplified by employees of a long-term health care centre. J Public Health (Oxf) 2023; 45:237-244. [PMID: 34929733 PMCID: PMC9383155 DOI: 10.1093/pubmed/fdab395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/05/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Health care professionals cover the front line in the battle against infectious diseases. Vaccination of healthcare workers represents a vital element of the strategy for enhancing epidemic safety and improving the quality of health care, inter alia, by limiting microorganism transmission, and reducing patient morbidity and mortality. METHOD The study group consisted of all employees of the long-term health care centre in Lublin, Poland. Participants were requested to complete a questionnaire prepared for the purpose of the study, along with a mandatory COVID-19 vaccination interview questionnaire. RESULTS The vaccination coverage rate for the group of medical workers was 77.3% and of non-medical 86%. The most frequently indicated sources of information on vaccination were the mass media. Males more often than females used the press as a source of information on vaccination. Scientific articles were the most common source of information for both people with higher education and medical professionals. The most common motive for vaccination for females is concern for the health of one's family, and for HCWs and people with at least secondary education-concern for the health of patients. CONCLUSION At least one assessed factor influences the decision to be vaccinated. The mass media are of the greatest importance in obtaining information about vaccination.
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Affiliation(s)
- Aneta Tylec
- Department of Psychiatry, Medical University of Lublin, Lublin 20-039, Poland
| | - Mariola Janiszewska
- Department of Medical Informatics and Statistics with E-Learning Lab, Medical University of Lublin, Lublin 20-090, Poland
| | - Krzysztof Siejko
- Department of Public Health, Medical University of Lublin, Lublin 20-090, Poland
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszyński University, Warsaw 01-938, Poland
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12
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Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
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Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
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13
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Patel A, Sims E, Blacklock J, Birt L, Bion V, Clark A, Griffiths A, Guillard C, Hammond A, Holland R, Jones A, Jones L, Katangwe-Chigamba T, Pitcher J, Ruby P, Scott S, Wagner AP, Ahmed S, Baqir W, Cook L, Dean T, Wright D. Cluster randomised control trial protocol for estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates compared to usual practice (FLUCARE). Trials 2022; 23:989. [PMID: 36494824 PMCID: PMC9733011 DOI: 10.1186/s13063-022-06925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022] Open
Abstract
The care home staff influenza vaccination rate in England is significantly lower than the 75% World Health Organisation recommendation. This represents a substantial potential for resident harm. Barriers to staff vaccination stem from individual and organisational levels. Existing interventions address some but not all barriers and are not underpinned by behavioural science theory. This study aims to estimate the effectiveness and cost-effectiveness of a theory-informed intervention to improve care home staff vaccination rates compared to routine practice.Set in care homes with both nursing and residential focus, and a range of ownership status, only homes providing long stay care to older people with a staff vaccination rate below 40% are eligible to participate. Participation expressions of interest will be sought using a variety of approaches prior to seeking consent.The primary outcome measure is the proportion of staff vaccinated at 6 months, with secondary outcome measures being proportion vaccinated at 3 months, numbers of staff sick days, general practitioner and nurse visits to care home, care home resident hospitalisations and mortality.Based on the assumptions that the mean cluster (care home) size is 54 staff, a coefficient of variation of 0.48, control vaccination rate is 55%, intervention 75%, intra-cluster correlation coefficient of 0.2 and with 90% power, and 20% attrition, we require 39 care homes per arm.Blocked randomisation will be at the level of care home, stratified by the proportion of non-white care home staff, and implemented by Norwich Clinical Trials Unit.The intervention comprises co-designed information videos and posters, provision of in-house staff vaccination clinics, and incentive scheme and monthly data collection on trial outcomes. Beyond usual practice, the control arm will additionally contribute monthly data.Data will be collected at the start, monthly and at 6 months, and analysis will be blind to allocation. Statistical analysis will use the intention-to-treat principle with the difference in vaccination rates between groups compared using a random effect logistic regression model at the staff-level.This will be the first study to use a theory-informed intervention designed to comprehensively address identified barriers to care home staff influenza vaccination.Trial registration: ISRCTN ISRCTN22729870 . Registered on 24 August 22. Secondary identifiers: R209939, IRAS 316820, CPMS 53812.
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Affiliation(s)
- Amrish Patel
- grid.8273.e0000 0001 1092 7967School of Economics, University of East Anglia, Norwich, UK
| | - Erika Sims
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Jeanette Blacklock
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
| | - Linda Birt
- grid.9918.90000 0004 1936 8411LOROS Associate Professor in Palliative Care and Frailty, University of Leicester, Leicester, UK
| | - Veronica Bion
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Allan Clark
- grid.8273.e0000 0001 1092 7967School of Medicine, University of East Anglia, Norwich, UK
| | - Alys Griffiths
- grid.10025.360000 0004 1936 8470Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Cecile Guillard
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Amber Hammond
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Richard Holland
- grid.9918.90000 0004 1936 8411Leicester Medical School, University of Leicester, Leicester, UK
| | - Andy Jones
- grid.8273.e0000 0001 1092 7967School of Medicine, University of East Anglia, Norwich, UK
| | - Liz Jones
- grid.10025.360000 0004 1936 8470Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Thando Katangwe-Chigamba
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Jennifer Pitcher
- grid.8273.e0000 0001 1092 7967School of Economics, University of East Anglia, Norwich, UK
| | - Po Ruby
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Sion Scott
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
| | - Adam P. Wagner
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England (EoE), Cambridge, UK
| | - Saiqa Ahmed
- Patient and Public Involvement Representative, NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK
| | - Wasim Baqir
- grid.451052.70000 0004 0581 2008Pharmacy Integration Programme, NHS England and Improvement, London, UK
| | - Luke Cook
- Askham Village Community, Doddington, UK
| | - Tony Dean
- Norfolk Local Pharmaceutical Committee, Great Bircham, UK
| | - David Wright
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
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14
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OGLIASTRO MATILDE, BORGHESI RICCARDO, COSTA ELISABETTA, FIORANO ANDREA, MASSARO ELVIRA, STICCHI LAURA, DOMNICH ALEXANDER, TISA VALENTINO, DURANDO PAOLO, ICARDI GIANCARLO, ORSI ANDREA. Monitoring influenza vaccination coverage among healthcare workers during the COVID-19 pandemic: a three-year survey in a large university hospital in North-Western Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E405-E414. [PMID: 36415296 PMCID: PMC9648543 DOI: 10.15167/2421-4248/jpmh2022.63.3.2700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Healthcare workers (HCWs) are one of the highest priority groups recommended for seasonal influenza vaccination (SIV). Greater awareness of the importance of influenza vaccination was observed among HCWs after the start of the COVID-19 pandemic. The aim of this study was to analyze SIV coverage rates in the 2019-2020, 2020-2021 and 2021-2022 seasons among HCWs employed at the IRCCS Ospedale Policlinico San Martino in Genoa, in order to observe how coverage has changed since the COVID-19 pandemic began. METHODS A retrospective, single-center study was conducted among HCWs working at the IRCCS Ospedale Policlinico San Martino in Genoa. The vaccinated population was stratified by gender, age, qualification and area of activity, and the characteristics of vaccinated HCWs were analyzed. RESULTS While SIV coverage was below the recommended target in all seasons, a sharp increase was observed in 2020/2021 (12.8%; 40.9% and 23% in 2019/2020, 2020/2021 and 2021/2022, respectively). The mean and median age of vaccinees also increased during the 2020/2021 vaccination campaign (46.7 and 49 years, respectively) in comparison with the 2019/2020 season (43.5 and 45, respectively). In the 2019/2020 and 2021/2022 seasons, a higher proportion of vaccinees were physicians. Vaccinated females outnumbered males, but the coverage rate resulted greater in males than females in all three seasons. While a higher proportion of vaccinated subjects worked in medical areas, the most evident increase over the three years was seen among subjects working in the services area. CONCLUSIONS This survey highlights the importance of studying the determinants that influence vaccination adherence and how the COVID-19 pandemic has affected SIV coverage.
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Affiliation(s)
| | | | - ELISABETTA COSTA
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - ANDREA FIORANO
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - ELVIRA MASSARO
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - LAURA STICCHI
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - VALENTINO TISA
- Medical Direction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - PAOLO DURANDO
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - GIANCARLO ICARDI
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - ANDREA ORSI
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Correspondence: Andrea Orsi, Via Antonio Pastore 16132 Genova, Italy. Tel.: +39 0105552095 - E-mail:
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15
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Calabrò GE, D’Ambrosio F, Fallani E, Ricciardi W. Influenza Vaccination Assessment according to a Value-Based Health Care Approach. Vaccines (Basel) 2022; 10:vaccines10101675. [PMID: 36298540 PMCID: PMC9612276 DOI: 10.3390/vaccines10101675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Seasonal influenza has a considerable public health impact, and vaccination is the key to preventing its consequences. Our aim was to describe how the value of influenza vaccination is addressed in the scientific literature considering a new value framework based on four pillars (personal, allocative, technical, and societal value). Methods: A systematic review was conducted by querying three databases. The analysis was performed on international studies focused on influenza vaccination value, and the four value pillars were taken into consideration for their description. Results: Overall, 40 studies were considered. Most of them focused on influenza vaccination in the general population (27.5%), emphasizing its value for all age groups. Most studies addressed technical value (70.4%), especially in terms of economic models and cost drivers to be considered for the economic evaluations of influenza vaccines, and societal value (63%), whereas few dealt with personal (37%) and allocative values (22.2%). Conclusions: The whole value of influenza vaccination is still not completely recognized. Knowledge and communication of the whole value of influenza vaccination is essential to guide value-based health policies. To achieve this goal, it is necessary to implement initiatives that involve all relevant stakeholders.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spinoff of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Floriana D’Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elettra Fallani
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Seqirus S.R.L., Via del Pozzo 3/A, San Martino, 53035 Monteriggioni, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Schoolteachers and Vaccinations: A Cross-Sectional Study in the Campania Region. Vaccines (Basel) 2022; 10:vaccines10091519. [PMID: 36146597 PMCID: PMC9501199 DOI: 10.3390/vaccines10091519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: This cross-sectional survey aimed to determine the knowledge, attitudes, and behaviors regarding vaccinations among schoolteachers in Italy. Methods: Data were collected through an online questionnaire from September 2020 to May 2021 from a sample of schoolteachers in the Campania region of southern Italy. Results: Only 27% of the participants had good knowledge about the vaccinations recommended for schoolteachers. Females who had children, who were unsatisfied by their health status, and not needing additional information about vaccinations were more likely to have good knowledge. Moreover, 61.5% perceived that vaccinations are useful in preventing infectious diseases, and 44.5% agreed or strongly agreed that vaccinations should be mandatory for schoolteachers. The results of multivariate logistic regression showed that schoolteachers who perceived that vaccinations are useful in preventing infectious diseases, who considered the recommended vaccinations to be useful to protecting their own and their students’ health, who believed that information received about vaccination was useful, and who needed additional information about vaccinations recommended for schoolteachers, were significantly more likely to agree or strongly agree that vaccinations should be mandatory for schoolteachers. Conclusions: These findings suggest the need for education strategies to ensure that schoolteachers are better informed about vaccinations recommended for their profession.
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Colaprico C, Ricci E, Bongiovanni A, Imeshtari V, Barletta VI, Manai MV, Shaholli D, Marte M, Serruto P, La Torre G. Flu Vaccination among Healthcare Professionals in Times of COVID-19: Knowledge, Attitudes, and Behavior. Vaccines (Basel) 2022; 10:vaccines10081341. [PMID: 36016229 PMCID: PMC9414714 DOI: 10.3390/vaccines10081341] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022] Open
Abstract
The seasonal flu vaccine is the most important way to prevent influenza epidemics, so it is useful to increase the awareness of health professionals. The aim of our study is to evaluate knowledge, attitudes, and behavior about flu vaccination among healthcare professionals in times of COVID-19. Methods: A cross sectional study was carried out between November 2020 and April 2021. Participants were recruited in teaching hospital ‘Policlinico Umberto I’ of Rome. A survey of 24 questions about flu vaccination was administered, evaluating their knowledge, attitude, and practice about this topic. Results: 872 healthcare professionals were involved in the study (36.9% men, 63.1% women). More than 90% of the HCWs, especially physicians, recognize the importance of getting influenza vaccination: The main reasons for not getting vaccinated were fear of vaccine side effects (20.3%) and fear of the needle (6.4%). Nevertheless, 40.7% of the healthcare providers consider mandatory vaccination as unethical, especially if they work in low-intensity wards. Conclusion: a high percentage of healthcare workers agree with the importance of influenza vaccination and only a small percentage is still opposed. It is therefore important to continue to promote the influenza vaccination through communication and health education programs.
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Flu and COVID-19 Vaccination: What Happens to the Flu Shot When the Campaigns Overlap? Experience from a Large Italian Research Hospital. Vaccines (Basel) 2022; 10:vaccines10060976. [PMID: 35746583 PMCID: PMC9228127 DOI: 10.3390/vaccines10060976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/14/2022] Open
Abstract
Influenza represents a threat to global health and health care workers (HCWs) have an increased risk of contracting the influenza virus in the workplace. The COVID-19 pandemic has brought back the importance of influenza vaccination, as the influenza virus can circulate together with SARS-CoV-2. The aim of this report is to describe the actual flu vaccination coverage among healthcare workers of a research hospital and the trend changes, with respect to the past flu vaccination campaigns, in light of the present pandemic and COVID-19 vaccination. A Pearson’s χ2 test was used to test the correlation of flu vaccination coverage, across all professional categories, between the last two years. A linear regression model was adopted to predict the total vaccination coverage of this year. A statistically significant decrease (p < 0.01) was observed in vaccination coverage among all the professional categories with a 50% reduction in vaccination trends between the last two years. Analyzing the data from the previous six flu vaccination campaigns, the expected value, according to the linear regression model, was estimated to be 38.5% while the observed value was 24%. The decrease in vaccination coverage may be due to the fear of the pandemic situation and especially to the uncertainty related to the consequences of a concurrent administration which may overload the immune system or may be more reactogenic. The COVID-19 pandemic represents an opportunity to promote and support large-scale influenza vaccination among HCWs through structured programs, adequate funding, and tailored communication strategies.
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Włodarczyk D, Ziętalewicz U. Medics as a Positive Deviant in Influenza Vaccination: The Role of Vaccine Beliefs, Self-Efficacy and Contextual Variables. Vaccines (Basel) 2022; 10:vaccines10050723. [PMID: 35632479 PMCID: PMC9148145 DOI: 10.3390/vaccines10050723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
The influenza vaccination rate remains unsatisfactorily low, especially in the healthy adult population. The positive deviant approach was used to identify key psychosocial factors explaining the intention of influenza vaccination in medics and compare them with those in non-medics. Methods: There were 709 participants, as follows: 301 medics and 408 non-medics. We conducted a cross-sectional study in which a multi-module self-administered questionnaire examining vaccination beliefs, risk perception, outcome expectations (gains or losses), facilitators’ relevance, vaccination self-efficacy and vaccination intention was adopted. We also gathered information on access to vaccination, the strength of the vaccination habit and sociodemographic variables. Results: We used SEM and were able to explain 78% of the variance in intention in medics and 56% in non-medics. We identified both direct and indirect effects between the studied variables. In both groups, the intention was related to vaccination self-efficacy, stronger habits and previous season vaccination, but access to vaccines was significant only in non-medics. Conclusions: Applying the positive deviance approach and considering medics as positive deviants in vaccination performance extended the perspective on what factors to focus on in the non-medical population. Vaccination promotion shortly before the flu season should target non- or low-intenders and also intenders by the delivery of balanced information affecting key vaccination cognitions. General pro-vaccine beliefs, which may act as implicit attitudes, should be created in advance to build proper grounds for specific outcome expectations and facilitators’ recognition. It should not be limited only to risk perception. Some level of evidence-based critical beliefs about vaccination can be beneficial.
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Jędrzejek MJ, Mastalerz-Migas A. Influenza Vaccination Coverage, Motivators for, and Barriers to Influenza Vaccination among Healthcare Workers in Wroclaw, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031586. [PMID: 35162609 PMCID: PMC8835710 DOI: 10.3390/ijerph19031586] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/29/2023]
Abstract
Background: Influenza vaccination, as a key element of control activities intended to prevent nosocomial influenza transmission, is recommended each year for all healthcare workers (HCWs). The objectives were to determine the rate of influenza vaccination and to identify reasons for receiving or declining the influenza vaccine among HCWs in the 2018/19 and 2019/20 influenza seasons. Methods: This study is a cross-sectional observational study carried out between January and March 2020, in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). Results: A total of 165 questionnaires were completed. The majority of participating HCWs were female—137 (83.0%), and, by profession, the majority were physicians 92 (55.8%). Influenza vaccination coverage was 61.2% in 2019/20, and 47.9% in the 2018/19 season for all participants. Participants who were male, physicians and personnel from PHCS were more frequently vaccinated in both seasons. According to the statistical analysis, physicians were more likely to receive vaccinations than nurses (p < 0.01), as were HCWs who had been vaccinated in the previous season (p < 0.001). Conclusion: The identified barriers were mainly caused by misconceptions (fear of vaccine adverse effects and perception of not being at risk/no need to get vaccinated) and an organizational barriers (lack of time). These findings may prove useful for designing immunization campaigns to tailor strategies to reach specific groups.
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Hall CM, Northam H, Webster A, Strickland K. Determinants of seasonal influenza vaccination hesitancy among healthcare personnel: An integrative review. J Clin Nurs 2021; 31:2112-2124. [PMID: 34716635 DOI: 10.1111/jocn.16103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the determinants of and behaviour change models for seasonal influenza vaccination compliance among healthcare personnel. BACKGROUND COVID-19 vaccine hesitancy among healthcare personnel may be better understood by exploring determinants of seasonal influenza vaccine hesitancy. DESIGN Integrative literature review. METHODS A systematic search was conducted in accordance with PRISMA guidelines. Six thousand and forty-eight articles were screened. Seventy-eight met inclusion criteria. Due to the heterogeneity of included articles, a narrative synthesis was conducted utilising a conceptual matrix to identify thematic categories. RESULTS Six thematic categories were identified as influencing HCP SIV compliance: 'perceived vulnerability', 'trust', 'past behaviour', 'professional duty', 'access and convenience' and 'knowledge and experience'. The Health Belief Model (HBM) was the most commonly utilised health behaviour change model within the seasonal influenza vaccination context. Few studies have examined seasonal influenza vaccine acceptance and uptake within the Australian HCP context, particularly involving community care and aged care. CONCLUSIONS Factors that appear to relate to influenza vaccination compliance among HCP can be grouped according to several thematic categories, and they also appear influential in COVID-19 vaccine uptake. In particular, an emerging focus on 'trust' or the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic. Efforts to influence these domains to increase compliance, however, are likely to be impeded by a lack of a well-developed and tested behaviour change model. RELEVANCE TO CLINICAL PRACTICE Healthcare personnel (HCP) face high levels of occupational exposure to seasonal influenza every year. An emerging focus on 'trust' and the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic.
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Affiliation(s)
- Caroline M Hall
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Holly Northam
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Adrian Webster
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Health Systems Group, Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
| | - Karen Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT, Auckland, New Zealand.,Robert Gordon University, Aberdeen, Scotland
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22
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Influenza vaccination at the workplace. Vaccine 2021; 40:2367-2368. [PMID: 34535314 DOI: 10.1016/j.vaccine.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/29/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
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23
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Healthcare Workers' Willingness to Receive Influenza Vaccination in the Context of the COVID-19 Pandemic: A Survey in Southern Italy. Vaccines (Basel) 2021; 9:vaccines9070766. [PMID: 34358182 PMCID: PMC8310353 DOI: 10.3390/vaccines9070766] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
This cross-sectional survey was designed to evaluate hospital healthcare workers’ (HCWs) willingness to receive the influenza vaccination during the COVID-19 pandemic and to identify the related determinants, since it is plausible that the two epidemics will coexist in future winters. Overall, 68% out of 490 participants expressed their willingness to receive influenza vaccination in the 2020/21 season, with 95% of those ever and 45.8% of those never vaccinated in the previous six influenza seasons. Belief that influenza vaccine is useful in distinguishing influenza symptoms from those of COVID-19 and that the influenza vaccine is useful to prevent influenza in hospital settings, willingness to receive COVID-19 vaccination, having no concern about influenza vaccine side effects, concern about the possibility to transmit influenza to hospitalized patients, and influenza vaccination in previous years were all predictors of willingness to receive influenza vaccination. In the context of the COVID-19 pandemic, a relevant increase in the willingness to undergo influenza vaccination was reported. Therefore, interventions focused primarily on enabling factors are needed to promote the adherence to influenza vaccination in future seasons among HCWs.
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24
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Ochoa-Hein E, Gutiérrez-López EN, Torres-Erazo DS, Núñez-Caamal NJ, Martínez-Longoria CA, García-Bonilla LA, Rivera-Fernández Galán B, Monroy-Colín VA, Prado-González TDJ, Vilar-Compte D, Huertas-Jiménez MA, Chávez-Ríos AR, Haro-Osnaya A, Colín-González KK, de Paz-García R, Vázquez-Andrade A, Romero-Oliveros C, Galindo-Fraga A. Factors associated with influenza vaccination acceptance in Mexican healthcare workers: A multicenter cross-sectional study. Prev Med 2021; 148:106560. [PMID: 33864859 DOI: 10.1016/j.ypmed.2021.106560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/22/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
Adherence of healthcare workers (HCWs) to influenza vaccination is far from optimal despite its being the most effective intervention for preventing influenza. In order to evaluate factors associated with influenza vaccination acceptance among Mexican HCWs during the 2017-2018 influenza season, a multicenter cross-sectional study spanning public and private hospitals was conducted. Participants were consecutively invited to answer a self-administered questionnaire. A total of 1513 out of 1553 questionnaires were evaluated. The median age of the participants was 32 (26-44) years and 65.8% were women. Nurses and physicians comprised 53.0% of the surveyed population. Total self-reported adherence to influenza vaccination among HCWs during the 2017-2018 season was 63.5% and varied across participating hospitals (P < 0.001). Factors positively associated with influenza vaccination were incremental doses of influenza vaccine received within the last 5 years (aOR = 1.94, 95% CI = 1.78-2.10), City 3 (aOR = 1.62, 95% CI = 1.19-2.20) and City 1 (aOR = 1.39, 95% CI = 1.02-1.91), whereas factors negatively associated were lack of a previous dose of influenza vaccine (aOR = 0.03, 95% CI = 0.01-0.08) and unawareness of the vaccination campaign (aOR = 0.57, 95% CI = 0.44-0.72). Lack of information and poor communication were barriers identified by both vaccinated and unvaccinated personnel. This study concluded that adherence to influenza vaccination in Mexican HCWs is suboptimal and that the factors associated with receipt of influenza vaccine are similar to those reported in other studies.
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Affiliation(s)
- Eric Ochoa-Hein
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Erika Noemi Gutiérrez-López
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Darwin Stalin Torres-Erazo
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Calle 22, Col. Altabrisa, Mérida, Yucatán 97133, Mexico
| | - Nelda Judith Núñez-Caamal
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Calle 22, Col. Altabrisa, Mérida, Yucatán 97133, Mexico
| | - César Adrián Martínez-Longoria
- Hospital San José, Sistema Tec Salud, Tecnologico de Monterrey, Av. Ignacio Morones Prieto 3000, Col. Doctores, Monterrey, Nuevo León 64710, Mexico; Hospital Zambrano Hellion, Sistema Tec Salud, Tecnologico de Monterrey, Av. Batallón de San Patricio 112, Col. Real San Agustín, San Pedro Garza García, Nuevo León 66278, Mexico
| | - Lyzette Alejandra García-Bonilla
- Hospital San José, Sistema Tec Salud, Tecnologico de Monterrey, Av. Ignacio Morones Prieto 3000, Col. Doctores, Monterrey, Nuevo León 64710, Mexico; Hospital Zambrano Hellion, Sistema Tec Salud, Tecnologico de Monterrey, Av. Batallón de San Patricio 112, Col. Real San Agustín, San Pedro Garza García, Nuevo León 66278, Mexico
| | - Barbara Rivera-Fernández Galán
- Hospital Regional de Alta Especialidad Materno Infantil, Secretaría de Salud de Nuevo León, Aldama 460, Col. San Rafael, Guadalupe, Nuevo León 67140, Mexico
| | - Víctor Antonio Monroy-Colín
- Centenario Hospital Miguel Hidalgo, Av. Gómez Morín S/N, Col. La Estación La Alameda, Aguascalientes, Aguascalientes 20259, Mexico; Universidad Autónoma de Aguascalientes, Av. Universidad 940, Ciudad Universitaria, Aguascalientes, Aguascalientes 20130, Mexico
| | | | - Diana Vilar-Compte
- Instituto Nacional de Cancerología. Av. San Fernando 22, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Martha Asunción Huertas-Jiménez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Alma Rosa Chávez-Ríos
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Anabel Haro-Osnaya
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Karla Karina Colín-González
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Roxana de Paz-García
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Alejandra Vázquez-Andrade
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Carmen Romero-Oliveros
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Arturo Galindo-Fraga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
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25
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Akande A, Ahmad M, Majid U. A qualitative meta-synthesis on how autonomy promotes vaccine rejection or delay among health care providers. Health Promot Int 2021; 37:6309734. [PMID: 34171926 DOI: 10.1093/heapro/daab099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In spite of the overwhelming evidence that highlights the effectiveness of routine vaccination, an increasing number of people are refusing to follow recommended vaccination schedules. While the majority of research in this area has focussed on vaccine hesitancy in parents, there is little research on the factors that promote vaccine hesitancy in health care providers (HCPs). Identifying factors that promote vaccine hesitancy in HCPs is essential because it may help broaden our understanding of vaccine hesitancy in patients. Therefore, the goal of this investigation was to review 21 studies and examine how professional autonomy and risk perception may promote vaccine acceptance, rejection and delay in physicians and nurses. We found that vaccine hesitant nurses and physicians shared similar views towards vaccines; both groups believed that their decision to vaccinate was separate from their role as an HCP. This belief comprised of three themes: decisional autonomy, personal risk perception and alternatives to vaccination. Both groups believed that mandatory vaccine policies reduced their ability to decide whether vaccination was in their best interests. We argue that decisional autonomy may weaken risk perception of disease, which in turn may encourage beliefs and behaviours that reinforce a 'hero persona' that reduces appropriate preventive and hygiene measures. We employ the Health Belief Model to discuss the crucial role that risk perceptions may play in reinforcing autonomy in vaccine hesitant physician and nurses. We conclude this paper by providing a set of recommendations that aim to improve the decision-making process surrounding mandatory vaccinations for HCPs.
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Affiliation(s)
- Adebisi Akande
- Department of Biological Sciences, University of Toronto, Toronto, Canada
| | - Mobeen Ahmad
- Department of Internal Medicine, Abington Memorial Hospital/Abington-Jefferson Health, Abington, PA, USA
| | - Umair Majid
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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26
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Della Polla G, Licata F, Angelillo S, Pelullo CP, Bianco A, Angelillo IF. Characteristics of Healthcare Workers Vaccinated against Influenza in the Era of COVID-19. Vaccines (Basel) 2021; 9:vaccines9070695. [PMID: 34202867 PMCID: PMC8310005 DOI: 10.3390/vaccines9070695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/20/2021] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Understanding the potential impact of COVID-19 on receiving influenza vaccination among healthcare workers (HCWs) is of utmost importance. The purposes of the present cross-sectional study were to describe the characteristics and to explore the predictors of receiving influenza vaccination among a large cohort of Italian HCWs in hospital settings. Information was collected through an anonymous questionnaire from December 2020 through January 2021. General and practice characteristics, perceived risk of seasonal influenza, attitudes towards efficacy and safety of influenza vaccination, and reasons behind the decision to be vaccinated against influenza were explored. Fewer than half (46.2%) of HCWs agreed that influenza is a serious illness and perceived the risk of getting infected with influenza, and concerns about the safety of the vaccination were significant positive predictors. Fewer than half of the respondents were not concerned at all about the efficacy (48.6%) and safety (49.8%) of influenza vaccination, and 51.9% reported that they have not received a seasonal influenza vaccine during the previous season. The most mentioned reason for receiving the influenza vaccine in the current season was that influenza and COVID-19 share some similar symptoms. Study results will aid policymakers in developing vaccination education programs, promotion of trust to address negative misconceptions, and to achieve future high coverage among this high-risk group.
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Affiliation(s)
- Giorgia Della Polla
- Health Direction, Teaching Hospital, University of Campania “Luigi Vanvitelli”, Via Santa Maria di Costantinopoli 104, 80138 Naples, Italy;
| | - Francesca Licata
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Silvia Angelillo
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy;
| | - Aida Bianco
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-081-566-7717
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27
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Di Giuseppe G, Pelullo CP, Della Polla G, Montemurro MV, Napolitano F, Pavia M, Angelillo IF. Surveying willingness toward SARS-CoV-2 vaccination of healthcare workers in Italy. Expert Rev Vaccines 2021; 20:881-889. [PMID: 33900148 DOI: 10.1080/14760584.2021.1922081] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Understanding healthcare workers (HCWs) willingness to receive a future vaccination against coronavirus disease 2019 (COVID-19) may be useful. METHODS Cross-sectional study, conducted in Italy from September 14th to November 30th, 2020, among 811 HCWs who undergo a voluntary antibody-testing for anti-SARS-CoV-2. RESULTS The perceived risk level of developing COVID-19, measured on a Likert-type scale ranging from 1 to 10, was 6.6 and it was higher among females, older HCWs, and in those who agreed that COVID-19 is a severe disease. Married/cohabitant, not physicians, and those who needed additional information regarding the vaccination against COVID-19 were more likely to be concerned that COVID-19 vaccination might not be safe. Males, physicians, those who did not have had any symptom compatible with COVID-19, those who agreed that COVID-19 is a severe disease, those who perceived to be at higher risk of developing COVID-19, those who were not concerned about the vaccine's safety, and those who had received information regarding the COVID-19 vaccination from scientific journals expressed willingness to receive vaccination against COVID-19. CONCLUSIONS Communication and education targeted to groups with lowest willingness are needed to raise awareness regarding the safety and benefits of the vaccination and to improve vaccine uptake.
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Affiliation(s)
- Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Concetta P Pelullo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giorgia Della Polla
- Health Direction, Teaching Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria V Montemurro
- Health Direction, Teaching Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Napolitano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Pavia
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Italo F Angelillo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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28
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Hamilton RA, Krockow EM, Vekria P. Attitudes towards influenza and uptake of the flu vaccine: A survey of pharmacy staff working in English hospitals. Vaccine 2021; 39:2636-2642. [PMID: 33846044 DOI: 10.1016/j.vaccine.2021.03.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Pharmacy staff working in hospitals are at risk of contracting and disseminating influenza. Previous research focuses on community pharmacists' attitudes towards influenza and vaccination. This survey investigates the beliefs and attitudes of pharmacists and other pharmacy staff working in English Hospitals regarding influenza and the vaccine and how this relates to vaccine uptake. METHODS A self-administered survey was provided to pharmacy staff at three hospitals in the East Midlands of England. Job role, age and vaccination status (vaccinated, intended to be vaccinated, and not vaccinated) were collected alongside ratings of agreement with 20 statements regarding influenza and vaccination using a Likert scale. RESULTS 170 pharmacy staff responded; 50.6% had been vaccinated, 17.1% intended to be vaccinated and 32.4% were not vaccinated. Increasing age showed a significant (p = 0.017) positive correlation with increased vaccine uptake as did the beliefs that vaccination protects the individual from influenza (p = 0.049) and that vaccination should be mandatory for NHS staff (p = 0.006). Fear of needles and believing their immune system is strong enough to protect against influenza were negatively correlated with vaccine uptake (p = 0.016 and p = 0.010, respectively). Job role was also strongly correlated with vaccine uptake (p = 0.001), with those holding a pharmacy degree more likely to report being vaccinated or intending to be vaccinated compared to all other pharmacy staff groups. CONCLUSIONS This is the first survey to focus on vaccine behaviours of all pharmacy staff groups working in hospitals. Current uptake of the influenza vaccine may be increased through engagement of senior pharmacy colleagues and providing education on influenza, vaccines, and vaccination. Similar studies should be undertaken on a larger scale to fully interrogate the differences between pharmacy staff groups.
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Affiliation(s)
- Ryan A Hamilton
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, United Kingdom; Pharmacy Department, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom.
| | - Eva M Krockow
- Department of Neuroscience, Psychology & Behaviour University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Priya Vekria
- Pharmacy Department, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom
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29
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Guillari A, Polito F, Pucciarelli G, Serra N, Gargiulo G, Esposito MR, Botti S, Rea T, Simeone S. Influenza vaccination and healthcare workers: barriers and predisposing factors. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021004. [PMID: 33855983 PMCID: PMC8138807 DOI: 10.23750/abm.v92is2.11106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Influenza is a disease that affects a large part of the world's population annually, with major health, social and economic impacts. Active immunisation practices have always been recommended to counter influenza, especially for people at risk. The recommendations of major health agencies strongly advise influenza vaccination for all healthcare workers, mostly for those in contact with at-risk or immunocompromised individuals. Yet, the influenza vaccination coverage among healthcare workers remains rather low worldwide. This review explore barriers and the facilitators of health care professional toward influenza's vaccination. METHODS Narrative review consulting the databases: PubMed, CINAHL by combining keywords health care worker, flu, influenza, vaccination, barrier, resistence, hesitangy, between November 2019 and February 2020 Results. From the 1031 records initially, twenty-two primary studies were included in this narrative review. Our results show that the identified facilitators are: desire for self-protection, protection for loved ones and community. Instead, the barriers to vaccination identified are: fear of contracting influenza from the vaccination itself; not considering themselves at risk; to believing believe that their immune system is capable of managing a trivial disease; disease considered trivial, laziness; false beliefs. DISCUSSION AND CONCLUSION Adherence rate on influenza vaccination among health professionals is quite low. The interventions that make it "complex and traceable" flu vaccination refusal increase adherence to this type of vaccination. The results show that current vaccination campaigns do not increase the rate of adherence by healthcare workers. Identifying the predisposing factors and barriers to such vaccination can help to create, develop and test targeted educational programmes.
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Affiliation(s)
- Assunta Guillari
- Department of Hygiene, University of Naples Federico II, Naples (Italy).
| | - Francesco Polito
- Department of Hygiene, University of Naples Federico II, Naples (Italy).
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome (Italy).
| | - Nicola Serra
- Department of Hygiene, University of Naples Federico II, Naples (Italy).
| | | | | | | | - Teresa Rea
- Department of Hygiene, University of Naples Federico II, Naples (Italy).
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome (Italy).
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Gualano MR, Corradi A, Voglino G, Catozzi D, Olivero E, Corezzi M, Bert F, Siliquini R. Healthcare Workers' (HCWs) attitudes towards mandatory influenza vaccination: A systematic review and meta-analysis. Vaccine 2021; 39:901-914. [PMID: 33451776 DOI: 10.1016/j.vaccine.2020.12.061] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 02/08/2023]
Abstract
Influenza is a disease responsible for thousands of deaths every year. Although healthcare workers (HCWs) represent a way of contagion for patients, vaccination coverage among them is low. Mandatory vaccination has been proposed, but controversies remain. This systematic review and meta-analysis aimed to assess the acceptance of mandatory vaccination by HCWs, and to investigate associated characteristics. MEDLINE, Scopus, Embase, PsycInfo, CINAHL and Web of Science were used to search for studies assessing the topic. PRISMA statements were followed. Of the 13,457 univocal records found, 52 studies were included in the systematic review and 40 in the meta-analysis. The pooled proportion of HCWs accepting the policy was of 61% (95% CI: 53%- 68%) but with great heterogeneity between continents (from 54% in Europe to 69% in Asia) and in different professionals (from 40% in nurses to 80% in students). Vaccinated HCWs agreed more frequently with mandatory vaccination than non-vaccinated ones. More studies that consider mandatory vaccination acceptance as the main outcome are needed, but the results of this study confirm that in some settings the majority of HCWs favour mandatory vaccination. This, combined with effects that a flu epidemic could have if overlapped to pandemics with similar symptoms, requires renewed considerations on mandatory vaccination.
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Affiliation(s)
- Maria Rosaria Gualano
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Alessio Corradi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Gianluca Voglino
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy.
| | - Dario Catozzi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Elena Olivero
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Michele Corezzi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Fabrizio Bert
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy; AOU City of Health and Science of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy; AOU City of Health and Science of Turin, Turin, Italy
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31
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Godinot LD, Sicsic J, Lachatre M, Bouvet E, Abiteboul D, Rouveix E, Pellissier G, Raude J, Mueller JE. Quantifying preferences around vaccination against frequent, mild disease with risk for vulnerable persons: A discrete choice experiment among French hospital health care workers. Vaccine 2021; 39:805-814. [PMID: 33419603 DOI: 10.1016/j.vaccine.2020.12.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
The individual determinants of vaccine acceptance among health workers (HCWs) have been described in the literature, but there is little evidence regarding the impact of vaccine characteristics and contextual factors (e.g., incentives, communication) on vaccination intentions. We developed a single profile discrete choice experiment (DCE) to assess the impact of seven attributes on stated vaccination intention against an unnamed disease, described as frequent with rapid clinical evolution and epidemic potential (similar to influenza or pertussis). Attributes evaluated vaccine characteristics (effectiveness, security profile), inter-individual aspects (epidemic risk, controversy, potential for indirect protection, vaccine coverage) and incentives (e.g., badge, hierarchical injunction). A total of 1214 French hospital-based HCWs, recruited through professional organizations, completed the online DCE questionnaire. The relative impact of each attribute was estimated using random effects logit models on the whole sample and among specific subgroups. Overall, 52% of included HCWs were vaccinated against influenza during 2017-18 and the average vaccination acceptance rate across all scenarios was 58%. Aside from the management stance, all attributes' levels had significant impact on vaccination decisions. Poor vaccine safety had the most detrimental impact on stated acceptance (OR 0.04 for the level controversy around vaccine safety). The most motivating factor was protection of family (OR 2.41) and contribution to disease control (OR 2.34). Other motivating factors included improved vaccine effectiveness (OR 2.22), high uptake among colleagues (OR 1.89) and epidemic risk declared by health authorities (OR 1.76). Social incentives (e.g., a badge I'm vaccinated) were dissuasive (OR 0.47). Compared to HCWs previously vaccinated against influenza, unvaccinated HCWs who were favorable to vaccination in general were most sensitive towards improved vaccine effectiveness. Our study suggests that vaccine safety considerations dominate vaccine decision-making among French HCWs, while adapted communication on indirect protection and social conformism can contribute to increase vaccination acceptance.
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Affiliation(s)
| | | | - Marie Lachatre
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France; Centre d'Investigation Clinique Cochin Pasteur CIC 1417, Hôpital Cochin, AP-HP, Paris, France
| | - Elisabeth Bouvet
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France; Haute autorité de santé (HAS), Commission technique des vaccinations (CTV), La Plaine Saint Denis, France
| | - Dominique Abiteboul
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Elisabeth Rouveix
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France; CHU Ambroise Paré, Assistance Publique Hôpitaux de Paris (APHP,) Université Paris Saclay, France
| | - Gérard Pellissier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Jocelyn Raude
- EHESP French School of Public Health, Paris and Rennes, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Judith E Mueller
- EHESP French School of Public Health, Paris and Rennes, France; Institut Pasteur, Paris, France
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Keske Ş, Mutters NT, Tsioutis C, Ergönül Ö. Influenza vaccination among infection control teams: A EUCIC survey prior to COVID-19 pandemic. Vaccine 2020; 38:8357-8361. [PMID: 33183855 DOI: 10.1016/j.vaccine.2020.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/09/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
We aimed to describe the influenza vaccination rate and its determinants among infection control team (ICT) across different countries. Online multilingual survey consisting of 23 items, between 17 May -15 July of 2019 targeting the opinions and practices of ICTs regarding the 2018-2019 influenza season was employed. Participants were reached via European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and European Union Certificate for Infection Control (EUCIC) newsletters,social media, and national societies. In total, 899 participants from 56 countries responded to the survey. The overall vaccination rate was 76%, being the highest in Finland, Portugal, Norway, and Israel (100%), whereas the lowest in Italy (68%) and Turkey (39%). Influenza vaccination rate was 86% among IC physicians and 52% among IC nurses. The most significant factors affecting participants' decision were personal influenza vaccine experience (49%) and attitude of the scientific authorities (48%). In multivariate analysis, vaccination of the ICT head (OR: 16.04, 95%CI: 8.4-30.8, p < 0.001) and having free vaccine (OR: 7.56, 95%CI: 2.1-27.4, p = 0.02) were found to be the strongest predictors for influenza vaccination, whereas working in Turkey (OR: 0.41, 95%CI: 0.22-0.77, p = 0.006) and being an IC nurse (OR:0.43, 95%CI: 0.24-0.80, p = 0.007) were significantly associated with not having been vaccinated. In conclusion, COVID-19 pandemic increased the importance of protection against respiratory viruses including influenza. Vaccination strategies should have a special emphasis on IC nurses, who have a relatively lower vaccination rate, should enhance the vaccination of the ICT leaders, and put effort to provide free availability of the influenza vaccine.
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Affiliation(s)
- Şiran Keske
- American Hospital, Department of Infectious Diseases, Istanbul, Turkey.
| | - Nico T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany
| | - Constantinos Tsioutis
- Department of Internal Medicine & Infection Prevention and Control, School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Önder Ergönül
- Koç University School of Medicine, Department of Infectious Diseases, Istanbul, Turkey
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Knowledge, attitudes and practices of healthcare workers during the early COVID-19 pandemic in a main, academic tertiary care centre in Saudi Arabia. Epidemiol Infect 2020; 148:e203. [PMID: 32854806 PMCID: PMC7492582 DOI: 10.1017/s0950268820001958] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
As the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia, we aimed to assess the knowledge, attitudes and intended practices of healthcare workers (HCWs) during the early stage of the COVID-19 pandemic and compare worry levels with previous findings during the MERS-CoV outbreak in 2015. We sent an adapted version of our previously published MERS-CoV questionnaire to the same cohort of HCWs at a tertiary hospital in Saudi Arabia. About 40% of our sample had previous experience with confirmed or suspected MERS-CoV patients, and those had a significantly higher knowledge score (13.16 ± 2.02 vs. 12.58 ± 2.27, P = 0.002) and higher adherence to protective hygienic practices (2.95 ± 0.80 vs. 2.74 ± 0.92, P = 0.003). The knowledge scores on COVID-19 were higher in the current cohort than the previous MERS-CoV outbreak cohort (68% vs. 79.7%, P < 0.001). HCWs from the current cohort who felt greater anxiety from COVID-19 compared to MERS-CoV were less likely to have been exposed to MERS-CoV infected/suspected cases (odds ratio (OR) = 0.646, P = 0.042) and were less likely to have attended the hospital awareness campaign on COVID-19 (OR = 0.654, P = 0.035). We concluded that previous experience with MERS-CoV was associated with increased knowledge and adherence to protective hygienic practices, and reduction of anxiety towards COVID-19.
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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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Antonelli Incalzi R, Bernabei R, Bonanni P, Conversano M, Ecarnot F, Gabutti G, Maggi S, Paolini D, Sandri F. Vaccines in older age: moving from current practice to optimal coverage-a multidisciplinary consensus conference. Aging Clin Exp Res 2020; 32:1405-1415. [PMID: 32572796 DOI: 10.1007/s40520-020-01622-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/03/2020] [Indexed: 12/18/2022]
Abstract
Vaccines are a key strategy to promote healthy aging, but vaccine coverage remains below target levels in at-risk adults and older individuals. We present here the results of a multidisciplinary consensus conference convened to perform a multidimensional assessment of vaccination in geriatric medicine, with a view to developing a well-defined strategy for the promotion of vaccines in older people. We discuss recommended vaccines in older individuals, and describe the wide regional heterogeneity between regions in the Italian context. The main obstacles to implementation of vaccines in practice are reviewed, as well as potential strategies to remove these barriers. Finally, the importance of including vaccines and vaccination in undergraduate and postgraduate medical education is underlined. The information summarized in this document is expected to help develop educational and promotional initiatives to achieve greater uptake of vaccines among older individuals, as a key means to promote healthy aging.
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Affiliation(s)
- Raffaele Antonelli Incalzi
- Dipartimento di Medicina Interna e Geriatria, Università Campus Bio-Medico, Rome, Italy
- Presidente Società Italiana di Geriatria e Gerontologia (SIGG), Florence, Italy
| | - Roberto Bernabei
- Direttore Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche, e della Testa-Collo, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Florence, Italy
| | - Michele Conversano
- Department of Prevention, Local Health Authority of Taranto, 74121, Taranto, Italy
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Jean Minjoz, Boulevard Fleming, 25000, Besancon, France.
- EA3920, University of Franche-Comté, Besancon, France.
| | - Giovanni Gabutti
- Dipartimento di Scienze Mediche, Università degli Studi di Ferrara, Ferrara, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Padua, Italy
- Consorzio di Ricerca Luigi Amaducci, Padua, Italy
| | - Diana Paolini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Florence, Italy
| | - Federica Sandri
- Dipartimento di Scienze Mediche, Università degli Studi di Ferrara, Ferrara, Italy
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Boey L, Roelants M, Vandermeulen C. Increased vaccine uptake and less perceived barriers toward vaccination in long-term care facilities that use multi-intervention manual for influenza campaigns. Hum Vaccin Immunother 2020; 17:673-680. [PMID: 32692943 DOI: 10.1080/21645515.2020.1788327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Seasonal influenza is an annually recurring threat to residents of long-term care facilities (LTCFs) since high age and chronic disease diminish immune response following vaccination. Although immunization of healthcare workers (HCWs) has proven to be an added value, coverage rates remain low. A ready-to-use instruction manual was designed to facilitate the implementation of interventions known to increase vaccination coverage in healthcare institutions. It includes easy-access vaccination, role model involvement, personalized promotional material, education and extensive communication. We evaluated this manual during the 2017-vaccination campaign in 11 LTCFs in Belgium. Vaccination coverage before and after the campaign was recorded by the LTCFs and the usefulness of the manual was assessed by interviewing the organizers of the local campaigns. Attitudes toward vaccination and reasons for vaccination were evaluated with a quantitative survey in HCWs before and after the campaign. The mean vaccination coverage reported by the LTCFs was 54% (range: 35-72%) in 2016 and 68% (range: 45-81%) in 2017. After the campaign, HCWs were less likely to expect side effects after influenza vaccination (OR (95%CI): 0.4 (0.2-0.9)) or to oppose vaccination (OR (95%CI): 0.3 (0.1-0.9)). The majority (>60%) indicated to be well informed about the risks of influenza and the efficacy of the vaccine. The main reason for vaccination in those who previously refused it was resident protection. The manual was found useful by the organizers of the campaigns. We conclude that the use of an intervention manual may support vaccination uptake and decrease perceived barriers toward influenza vaccination in countries without mandatory vaccination in HCWs.
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Affiliation(s)
- Lise Boey
- Leuven University Vaccinology Center, Department of Public Health and Primary Care, Leuven, Belgium
| | - Mathieu Roelants
- Department of Public Health and Primary Care, Environment and Health, Leuven, Belgium
| | - Corinne Vandermeulen
- Leuven University Vaccinology Center, Department of Public Health and Primary Care, Leuven, Belgium.,Department of Public Health and Primary Care, Environment and Health, Leuven, Belgium
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Montagna MT, De Giglio O, Napoli C, Fasano F, Diella G, Donnoli R, Caggiano G, Tafuri S, Lopalco PL, Agodi A. Adherence to Vaccination Policy among Public Health Professionals: Results of a National Survey in Italy. Vaccines (Basel) 2020; 8:E379. [PMID: 32664507 PMCID: PMC7565131 DOI: 10.3390/vaccines8030379] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 02/07/2023] Open
Abstract
Starting from 2013, the number of unvaccinated people alarmingly increased in Italy; therefore, in 2017 a new Vaccine National Plan was approved. Healthcare workers (HCWs), especially public health professionals (PHPs, i.e., workers in in the sector of hygiene and preventive medicine), have an important role in informing and promoting vaccinations. In this context, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health (GISIO-SItI) conducted a national survey to assess knowledge, attitude, and practices towards recommended vaccinations among PHPs. The survey was conducted during October 2019 with an anonymous questionnaire distributed to PHPs attending the 52° SItI National Congress. Overall, 57.1% of operators answered correctly to all seven recommended vaccinations, 12.8% reported to be vaccinated for all seven recommended vaccinations, while 30% were naturally immunized. A higher immunization coverage was reported for anti-hepatitis B (88.9%) and measles (86.1%), and 81.3% of the participants reported being offered the influenza vaccination during the 2018/2019 season. The majority of our sample indicated that hepatitis B (95%) and influenza (93.7%) were the recommended vaccines for HCWs, while less was known regarding varicella, pertussis, diphtheria, and tetanus boosters every 10 years. PHPs who were vaccinated (or who intended to be vaccinated) were more likely to recommend vaccinations to their patients and provided a reassuring example to those hesitant patients. Finally, this is the first study that identified good algorithms (using the techniques of machine learning as Random Forest and Deep Learning) to predict the knowledge of PHPs regarding recommended vaccinations with possible applications in other national and international contexts.
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Affiliation(s)
- Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy;
| | - Fabrizio Fasano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | | | - Giuseppina Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126 Pisa, Italy;
| | - Antonella Agodi
- Coordinator of GISIO-SItI Working Group, Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy;
| | - GISIO-SItI Working Group
- GISIO-SItI Working Group–Italian Study Group of Hospital Hygiene–Italian Society of Hygiene, Preventive Medicine and Public Health, Viale Cittá d’Europa, 74, 00144 Rome, Italy;
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Hsu CY, Liao HE, Huang LC. Exploring smoking cessation behaviors of outpatients in outpatient clinics: Application of the transtheoretical model. Medicine (Baltimore) 2020; 99:e20971. [PMID: 32629709 PMCID: PMC7337464 DOI: 10.1097/md.0000000000020971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
To examine the knowledge, attitudes, and behaviors of smokers towards smoking prevention and provide high-quality smoking cessation services and education on tobacco prevention and establish a smoke-free care network.This study is a cross-sectional survey. The research tool is a questionnaire composed of 4 sub-scales, namely, "tobacco harm awareness," "tobacco prevention attitude," "quitting smoking self-efficacy scale," and "intentional behavior to quit smoking."A positive correlation was identified between cessation-specific knowledge, attitude to quit smoking, and intentional behavior to quit smoking among outpatients. Following the regression analysis, 2 factors (cessation-specific knowledge and attitude toward quitting the smoking habit) were considered in the model and its total variance explained reached 53.2%.Regular smoking cessation classes should be conducted to increase the awareness of smoking hazards and improve the positive attitude toward smoking cessation to avoid smoking hazards.
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Affiliation(s)
- Ching-Yi Hsu
- Department of Healthcare Administration, Asia University
- Department of Rehabilitation, Taichung Hospital of the Ministry of Health and Welfare, Taichung
- Nursing Department, Zouying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hung-En Liao
- Department of Healthcare Administration, Asia University
| | - Li-Chun Huang
- Nursing Department, Zouying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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Liao Q, Ng TWY, Cowling BJ. What influenza vaccination programmes are preferred by healthcare personnel? A discrete choice experiment. Vaccine 2020; 38:4557-4563. [PMID: 32414654 PMCID: PMC7252056 DOI: 10.1016/j.vaccine.2020.05.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study examined the relative importance of factors relating to vaccine characteristics, social normative influence and convenience in access to vaccine for determining decision making for seasonal influenza vaccination (SIV) among healthcare personnel (HCP), aiming to optimize existing influenza vaccination programmes for HCP. METHODS A discrete choice experiment (DCE) was conducted in HCP working in public hospitals in Hong Kong. The DCE was designed to examine the relative importance of vaccine characteristics (vaccine efficacy and safety), social normative influence reflected by the proportion of HCP colleagues intending to take SIV, and convenience in access to vaccine indicated by vaccination programme duration, vaccination location, vaccination arrangement procedure and service hours in determining influenza vaccination choice among HCP. Mixed logit regression modelling was conducted to examine the preference weight (β) of factors included in the DCE for determining vaccination choice. RESULTS Vaccination probability increased with increase in vaccine efficacy (β = 0.02 for per 1% increase), vaccination location changing from "designated staff clinic" to "mobile station" (β = 0.37), vaccination arrangement procedure changing from "by appointment" to "by walk-in" (β = 0.99), but decreased with the increase in probability of mild reactions to vaccination (β = -0.05 for per 1% increase). CONCLUSION Vaccine safety was judged to be more important than vaccine efficacy for determining vaccination choice. Arranging vaccination service by walk-in and implementing mobile vaccination station should be considered in future SIV programmes to compensate for the effect of perceived low vaccination efficacy and concerns about vaccine safety to promote SIV uptake among HCP.
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Affiliation(s)
- Qiuyan Liao
- Division of Behavioural Sciences, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Tiffany W Y Ng
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Knowledge and Attitude towards Vaccination among Healthcare Workers: A Multicenter Cross-Sectional Study in a Southern Italian Region. Vaccines (Basel) 2020; 8:vaccines8020248. [PMID: 32456273 PMCID: PMC7350011 DOI: 10.3390/vaccines8020248] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 01/29/2023] Open
Abstract
Background: In Italy, the loss of confidence towards vaccination resulted in low vaccine coverage, also among healthcare workers (HCWs). Indeed, low vaccination coverage among HCWs can lead to dangerous outbreaks of disease, reduce productivity, and increase absenteeism. The aim of this study was to investigate the vaccine coverage and attitudes toward vaccination among HCWs. Methods: A multicenter cross-sectional study was conducted among HCWs referred to all hospitals of the Local Health Authority 02 of Abruzzo Region, Italy. The survey was based on the questionnaire proposed by the H-ProImmune Project. Results: A total of 347 HCWs were enrolled in the study. Of these, 57.3% reported missing diphtheritis-tetanus-pertussis (DTP) vaccination, 50.1% reported missing measles-mumps-rubella (MMR) vaccination, and 62.5% reported missing flu vaccination. Regarding attitudes, other healthcare professionals reported to believe more in natural immunization compared to vaccination (26.5%; p < 0.001), and they were worried about long-term effects of vaccination (10.2%; p = 0.044). Conclusions: This survey showed all vaccination coverage considered resulted below the 95% threshold. Training on vaccination and mandatory measures may be needed in order to achieve better coverage.
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Verhees RAF, Snellings R, Dinant GJ, Knottnerus JA. Influenza vaccination among Dutch general practitioners and their attitude toward influenza vaccination in the elderly. Hum Vaccin Immunother 2020; 16:2709-2718. [PMID: 32412833 PMCID: PMC7733997 DOI: 10.1080/21645515.2020.1732728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Knowledge, attitudes and beliefs (KABs) toward influenza vaccination (IV) play a key role in HCWs’ decisions to receive vaccination and can strongly influence patients’ IV uptake. We examined the knowledge, attitudes and beliefs of GPs toward IV, exploring their opinion on IV in the elderly, mandatory HCW vaccination and the desirability of an IV trial in the elderly with hospitalization/mortality as effect measure. From November 2018 to March 2019, surveys were emailed to GPs and GP-practices (n = 1676) in three regions of the Netherlands. We assessed the self-reported IV in GPs, reasons for (not) advising IV to personnel, (not) supporting mandatory IV for personnel and (not) desiring a trial on IV in the elderly on hospitalization/mortality. Multivariable logistic regression models were used to determine predictors for GP IV. A total of 552 surveys were completed and 71.9% of the GPs reported receiving IV. Determinants for IV in GPs were male sex (aOR 1.62, 95%CI 1.06–2.49, p = .03) and age ≥60 y (aOR 5.25, 95%CI 1.51–18.32, p = .01). Seventy-nine percent of the GPs recommend IV for their practice personnel. Mandatory IV for personnel was supported by 41.2% of the GPs with GP self-reporting IV being the only determinant (aOR 10.03 (95%CI 5.69–17.70 p = .00)). An IV trial on hospitalization and/or mortality was desired by 60.5% of the GPs. We concluded that the majority of Dutch GPs receives IV and recommends IV to their personnel. These high rates along with the hesitancy of GPs toward mandatory HCW IV should be considered when policymakers decide on a mandate for IV in HCW in general.
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Affiliation(s)
- Ruud Andreas Fritz Verhees
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
| | | | - Geert Jan Dinant
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
| | - Johannes Andreas Knottnerus
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht, The Netherlands
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Cummings CL, Kong WY, Orminski J. A typology of beliefs and misperceptions about the influenza disease and vaccine among older adults in Singapore. PLoS One 2020; 15:e0232472. [PMID: 32374754 PMCID: PMC7202625 DOI: 10.1371/journal.pone.0232472] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/15/2020] [Indexed: 01/18/2023] Open
Abstract
Access to the influenza vaccine pose little barriers in developed countries such as Singapore and vaccination against influenza is highly recommended for at-risk populations including older adults. However, vaccination rates are much lower than recommended despite the significant morbidity and mortality associated with the disease among this vulnerable population. Given timely goals to increase vaccine acceptance and uptake, we explored Singaporean older adults’ misperceptions about influenza disease and vaccine. Qualitative semi-structured interviews were conducted among 76 Singaporean adults aged 65 and above with no focus on a specific area in Singapore. Data were analyzed with grounded theory methods to understand participants’ attitudes, perceptions, and knowledge. We developed in vivo codes that reflect the verbiage used by participants and exhaustively catalogued themes through a constant comparison coding method. Focusing specifically on older adults’ misperceptions, seven main themes about influenza disease or vaccine emerged from our data analysis: familiarity with influenza, misperceptions about influenza, personal susceptibility to influenza, familiarity with the influenza vaccine, misperceptions about the influenza vaccine, misperceptions about influenza vaccine usage, and opinions about and barriers to influenza vaccine uptake. Notably, there is a lack of adequate knowledge and motivation in vaccinating against influenza among older adults in Singapore. Health communication needs to be more tailored toward older adults’ message processing systems and engage health professionals’ involvement in addressing the influenza disease and vaccine misperceptions identified in this study.
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Affiliation(s)
- Christopher L. Cummings
- Decision Analytica, LLC, North Carolina State University, Cary, North Carolina, United States of America
- * E-mail:
| | - Wei Yi Kong
- Gillings School of Global Public Health, University of North Carolina—Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jeanette Orminski
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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Mounier-Jack S, Bell S, Chantler T, Edwards A, Yarwood J, Gilbert D, Paterson P. Organisational factors affecting performance in delivering influenza vaccination to staff in NHS Acute Hospital Trusts in England: A qualitative study. Vaccine 2020; 38:3079-3085. [PMID: 32147294 PMCID: PMC7090903 DOI: 10.1016/j.vaccine.2020.02.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 12/19/2022]
Abstract
Wide variation in uptake of flu vaccine persists in English NHS hospitals. Many factors of high uptake are linked to leadership and organisational culture. Embedding the flu programme in well-being policy helps acceptability and adherence. A supportive culture is likely to achieve higher uptake than a coercive one. Middle managers’ facilitating role in delivering the programme is key to uptake.
Health care workers are a priority group for seasonal influenza vaccination, which is recommended by the World Health Organisation. There is a wide variation in uptake between and within countries. England has achieved 69.5% of health care workers vaccinated overall in 2017/18 across NHS acute and community health care settings, but it varies between Trusts from 50% to over 92.3%. While attitudinal factors have been well researched, there is limited evidence on organisational factors associated with high uptake. In England, most NHS Trusts are now implementing a similar range of interventions as part of their flu programme, and it remains unclear why performance remains so variable. This qualitative study is the first to explore reasons for this variation and provide recommendations for lower performing Trusts on how to improve. Fifty-seven interviews of managers and vaccinators were conducted in nine hospitals with flu vaccination uptake ranging from just over 55% to above 90%. Our study found that while Trusts deployed a wide range of both demand generating and supply interventions to increase uptake, there were marked differences in the organisational and delivery models utilised. Our study suggests that organisational culture was possibly the most important ingredient when trying to differentiate between high and low performing Trusts. We found that a positive culture aimed at fostering continuous improvement and favouring non-coercion on balance yielded more adherence from staff. Where influenza vaccination was embedded in the organisation wellbeing strategy, rather than executed as a siloed seasonal programme, this tended to foster good performance. Improving performance of influenza vaccination in health care workers will involve not only deploying the right interventions, and following “best practices”. It will require the adaptation of flu progamme delivery strategies to the organisation context, and embedding vaccination into the organisational culture, thus supporting the normalisation of yearly vaccination.
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Affiliation(s)
- Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
| | - Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Tracey Chantler
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Angela Edwards
- Department of Immunisation and Countermeasures, Public Health England, UK
| | - Jo Yarwood
- Department of Immunisation and Countermeasures, Public Health England, UK
| | | | - Pauline Paterson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
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Bocquier A, Cortaredona S, Fressard L, Galtier F, Verger P. Seasonal influenza vaccination among people with diabetes: influence of patients' characteristics and healthcare use on behavioral changes. Hum Vaccin Immunother 2020; 16:2565-2572. [PMID: 32209014 PMCID: PMC7644174 DOI: 10.1080/21645515.2020.1729628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but vaccine coverage remains low. We estimated the probabilities of stopping or starting SIV, their correlates, and the expected time spent in the vaccinated state over 10 seasons for different patient profiles. We set up a retrospective cohort study of patients with diabetes in 2006 (n = 16,026), identified in a representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06–2015/16). We used a Markov model to estimate transition probabilities and a proportional hazards model to study covariates. Between two consecutive seasons, the probabilities of starting (0.17) or stopping (0.09) SIV were lower than those of remaining vaccinated (0.91) or unvaccinated (0.83). Men, older patients, those with type 1 diabetes, treated diabetes or more comorbidities, frequent contacts with doctors, and with any hospital stay for diabetes or influenza during the last year were more likely to start and/or less likely to stop SIV. The mean expected number of seasons with SIV uptake over 10 seasons (range: 2.6–7.9) was lowest for women <65 years with untreated diabetes and highest for men ≥65 years with type 1 diabetes. Contacts with doctors and some clinical events may play a key role in SIV adoption. Healthcare workers have a crucial role in reducing missed opportunities for SIV. The existence of empirical patient profiles with different patterns of SIV uptake should encourage their use of tailored educational approaches about SIV to address patients’ vaccine hesitancy.
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Affiliation(s)
- A Bocquier
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - S Cortaredona
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France
| | - L Fressard
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - F Galtier
- INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France.,CIC 1411, CHU Montpellier, Hôpital Saint Eloi , Montpellier, France
| | - P Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France
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Attitudes of Nursing Home Staff Towards Influenza Vaccination: Opinions and Factors Influencing Hesitancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061851. [PMID: 32178426 PMCID: PMC7143910 DOI: 10.3390/ijerph17061851] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/17/2022]
Abstract
Seasonal influenza is recognized to be a significant public health problem and a cause of death, especially in fragile persons. In nursing homes (NHs), vaccination for both residents and staff is the best preventive strategy. However, professionals' immunization rates are far from reaching the international recommended values. This study aims to describe the adherence and attitudes of NH staff towards flu vaccination and to explore staff hesitancy. A questionnaire was developed based on a literature review and on the 3Cs (confidence, complacency, convenience) of the WHO framework and administered among the staff of four NHs of a province in the northeast of Italy. Results demonstrated a low adherence towards annual vaccination (i.e., only 3% declared getting the flu vaccination each year). Complacency, confidence and convenience all showed a significant impact on the attitude towards vaccination both in univariate and multivariable analysis, with complacency being the most strongly associated area. The area of confidence resulted in strongly challenging factors. Only 24.8% of interviewees appeared trustful towards the efficacy of receiving immunization and 34% declared safety issues. Insights from the study can support the implementation of effective interventions to improve vaccination adherence in NHs. Specifically, increasing complacency by raising awareness related to the risks of influenza appears to be an essential strategy to effectively promote vaccination uptake.
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Liu H, Tan Y, Zhang M, Peng Z, Zheng J, Qin Y, Guo Z, Yao J, Pang F, Ma T, Duan W, Li Z, Feng L, Hao M. An Internet-Based Survey of Influenza Vaccination Coverage in Healthcare Workers in China, 2018/2019 Season. Vaccines (Basel) 2019; 8:vaccines8010006. [PMID: 31887994 PMCID: PMC7158694 DOI: 10.3390/vaccines8010006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/21/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022] Open
Abstract
Influenza vaccination coverage was low among healthcare workers (HCWs) in China. In October 2018, the National Health Commission of China began to require all hospitals to provide free influenza vaccination for HCWs to increase vaccine uptake, and no study on vaccine coverage among HCWs at the national level after the announcement of new policy. This evaluation aims to investigate self-reported influenza vaccination coverage among HCWs and factors that may affect vaccine receipt during the 2018/2019 influenza season. We delivered an opt-in internet panel survey among registered HCWs of DXY forum (the biggest online forum for HCWs in China). The survey was self-administered using a standard questionnaire to collect information on demographics, occupational characteristics, policy implementation, influenza vaccination and influence factors. We conducted multivariate logistic regression analysis to assess factors associated with receipt of influenza vaccine. The response rate of this online survey was 3.6%. The seasonal influenza vaccine coverage reported among HCWs surveyed during the 2018/2019 season was 11.6% (472/4078). Only 19.0% (774/4078) of HCWs surveyed reported free policy in their workplace. Combing free policy and workplace requirement proved to be effective to improve influenza vaccination coverage in HCWs (PR = 6.90, 95% CI: 6.03–7.65). The influenza vaccination coverage among surveyed HCWs in China was low during the 2018/2019 season. To increase future vaccination uptake, we recommend a multi-faceted strategy that include free policy, workplace requirement and promotion, on-site vaccination, and monitoring.
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Affiliation(s)
- Haitao Liu
- Research Institute of Health Development Strategies & Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Yayun Tan
- Suzhou Center for Disease Control and Prevention, Suzhou 215000, China
| | - Muli Zhang
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zhibin Peng
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jiandong Zheng
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Ying Qin
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zhiqiang Guo
- Beijing Dingxiangyuan Tiantian Health Technology, Beijing 100020, China
| | - Junhua Yao
- Beijing Dingxiangyuan Tiantian Health Technology, Beijing 100020, China
| | - Fen Pang
- Beijing Dingxiangyuan Tiantian Health Technology, Beijing 100020, China
| | - Teng Ma
- Beijing Dingxiangyuan Tiantian Health Technology, Beijing 100020, China
| | - Wenjing Duan
- Beijing Dingxiangyuan Tiantian Health Technology, Beijing 100020, China
| | - Zhongjie Li
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Luzhao Feng
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
- Correspondence: (L.F.); (M.H.); Tel.: +86-10-58900541 (L.F.); +86-21-33561022 (M.H.)
| | - Mo Hao
- Research Institute of Health Development Strategies & Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
- Correspondence: (L.F.); (M.H.); Tel.: +86-10-58900541 (L.F.); +86-21-33561022 (M.H.)
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Emergency Medical Services Providers’ Experiences and Attitudes Toward Infection Prevention and Control Measures in Saudi Arabia: a Qualitative Study. Disaster Med Public Health Prep 2019; 14:713-718. [DOI: 10.1017/dmp.2019.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:This study explores the experiences and practices of emergency medical services (EMS) providers, as well as the motivations that underpin perceptions toward standard infection prevention and control (IPC). The current literature suggests that EMS providers have a low compliance level with preventive measures, with misperceptions about risks and self-justification of personal skills reported.Methods:The study used qualitative methods and conducted 2 distinct focus group discussions and 20 in-depth interviews with both prehospital and inter-facility EMS providers. Data were thematically analyzed using the Framework approach.Results:The participants considered respiratory infections the most significant nosocomial risks. Lack of full disclosure of medical history to EMS providers was considered a significant threat. Beliefs about low effectiveness and harmful effects of the influenza vaccine, as well as low perceptions of influenza risks, were common. While apparent misperceptions contributed largely to the inappropriate use of preventive measures, the reliance on intuition and individual experiences was attributed to the inaccessibility of appropriate guidelines, and lack of formal IPC training programs.Conclusions:There is need to address EMS doubts and fears, improve IPC practices and awareness by institutionalizing IPC training programs, and ensure the design and accessibility of simplified and well-tailored IPC guidelines for EMS providers.
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Awadalla NJ, Al-Musa HM, Al-Musa KM, Asiri AM, Albariqi AA, Majrashi HM, Alasim AA, Almuslah AS, Alshehri TK, AlFlan MA, Mahfouz AA. Seasonal influenza vaccination among primary health care workers in Southwestern Saudi Arabia. Hum Vaccin Immunother 2019; 16:321-326. [PMID: 31526228 DOI: 10.1080/21645515.2019.1666500] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: Vaccination of primary healthcare workers (PHCWs) help to prevent the spread of influenza among at-risk patients.Objectives: To assesses seasonal influenza vaccination (SIV) coverage and the factors affecting SIV's utilization among PHCWs in Abha city, southwestern Saudi Arabia.Methods: A cross-sectional survey was carried out between June 2018 and August 2018 in all primary healthcare centers in Abha city. It targeted physicians, nurses, technicians, and pharmacists. A self-administered questionnaire was used to collect data regarding SIV status during the 2017-2018 season, obtain knowledge regarding SIV and influenza disease, and identify potential motivators for and barriers to SIV.Results: Of 312 PHCWs, the SIV coverage rate was 45.5% in the 2017-2018 vaccination season. A multivariable logistic regression model showed that the risk groups for non-vaccination were PHCWs less than 40 years old (adjusted Odds Ratio (aOR) = 4.07, 95% CI: 1.50-11.03), technicians (aOR = 3.73, 95% CI: 1.20-11.54), single PHCWs (aOR = 2.36, 95% CI:1.20-4.62), and PHCWs lacking adequate influenza vaccine knowledge (aOR = 4.22, 95% CI: 2.13-8.35). Approximately 23% and 32% of PHCWs were found to have inadequate knowledge about SIV and influenza disease, respectively. PHCWs' awareness about their risk of infection and their need for protection was found to be the most common motivator (77.5%), and a fear of side effects was found to be the most frequent barrier (40%).Conclusion: SIV coverage rate is suboptimal. Knowledge gaps and misconceptions about the influenza vaccine are the main barriers to an adequate coverage.
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Affiliation(s)
- Nabil J Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,Department of Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hassan Mohammed Al-Musa
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Yu J, Ren X, Ye C, Tian K, Feng L, Song Y, Cowling BJ, Li Z. Influenza Vaccination Coverage among Registered Nurses in China during 2017-2018: An Internet Panel Survey. Vaccines (Basel) 2019; 7:E134. [PMID: 31569475 PMCID: PMC6963313 DOI: 10.3390/vaccines7040134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/15/2022] Open
Abstract
Influenza vaccination is recommended for nurses in China but is not mandatory or offered free of charge. The main objective of this study was to determine influenza vaccination coverage and the principal factors influencing influenza vaccination among nurses in China. During 22 March-1 April 2018, we conducted an opt-in internet panel survey among registered nurses in China. Respondents were recruited from an internet-based training platform for nurses. Among 22,888 nurses invited to participate, 4706 responded, and 4153 were valid respondents. Overall, 257 (6%) nurses reported receiving the seasonal influenza vaccine during the 2017/2018 season. Vaccination coverage was highest among nurses working in Beijing (10%, p < 0.001) and nurses working in primary care (12%, p = 0.023). The top three reasons for not being vaccinated were lack of time (28%), not knowing where and when to get vaccinated (14%), and lack of confidence in the vaccine's effectiveness (12%). Overall, 41% of nurses reported experiencing at least one episode of influenza-like illness (ILI) during the 2017/2018 season; 87% of nurses kept working while sick, and 25% of nurses reported ever recommending influenza vaccination to patients. Compared with nurses who did not receive influenza vaccination in the 2017/2018 season, nurses who received influenza vaccination were more likely to recommend influenza vaccination to patients (67% vs. 22%, p < 0.001). Influenza vaccination coverage among nurses was low, and only a small proportion recommended influenza vaccine to patients. Our findings highlight the need for a multipronged strategy to increase influenza vaccination among nurses in China.
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Affiliation(s)
- Jianxing Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Chuchu Ye
- Research Base of Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China.
| | - Keqing Tian
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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Napolitano F, Bianco A, D'Alessandro A, Papadopoli R, Angelillo IF. Healthcare workers' knowledge, beliefs, and coverage regarding vaccinations in critical care units in Italy. Vaccine 2019; 37:6900-6906. [PMID: 31564452 DOI: 10.1016/j.vaccine.2019.09.053] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 09/05/2019] [Accepted: 09/16/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Low rates of vaccine coverage have resulted in a resurgence of several vaccine-preventable diseases in many European countries. Routine vaccination of healthcare workers (HCWs) is important to reduce disease transmission, and to promote vaccine awareness and acceptance in the population. The objectives of this cross-sectional study were to investigate knowledge and beliefs about vaccines and to evaluate self-reported immunization coverage with vaccines recommended for HCWs. Additionally, the effects of several factors on these outcomes have been evaluated. METHODS A survey was conducted between September and November 2018 among a random sample of HCWs in cardiac, adult, and neonatal critical care units of 8 randomly selected hospitals across the Campania and Calabria Regions in Italy. Multivariate logistic and linear regression analysis has been performed. RESULTS A total 531 HCWs returned the questionnaire for a response rate of 54.9%. Based on a vaccination knowledge score ranging from 0 to 9, more than half of the participants (55.4%) knew few of the vaccines recommended for HCWs (≤3 correct answers), 16.2% knew some vaccines (4-6 correct answers), and 28.4% knew most vaccines (≥7 correct answers), and only 13.2% knew all the vaccines recommended for HCWs. However, two-thirds (62.2%) knew that hepatitis B and influenza vaccines were recommended, and this knowledge was significantly higher among females (p < 0.001), among HCWs aged between 50 and 59 years (p = 0.01) compared with those aged < 30 years, and in those who search for information about recommended vaccines for HCWs (p = 0.012). The vaccine knowledge was significantly lower among nurses and nursing supporting staff compared with physicians (p = 0.032). Approximately two-thirds (62.7%) of HCWs considered themselves at risk of contracting vaccine-preventable infectious diseases during their professional practice. High rates of coverage were self-reported for hepatitis B (96.3%), tetanus and pertussis (93.7%), whereas they were lower for measles/mumps/rubella (80.5%), chickenpox (65.3%), and influenza (35.8%). Only 9.2% of HCWs reported prior receipt of all recommended vaccines. Male HCWs were less likely to report prior receipt of all recommended vaccines (p = 0.011). HCWs aged between 30 and 39 years compared with those aged < 30 years (p = 0.001) and those who knew some (p < 0.001) and most (p = 0.007) of all vaccines recommended for HCWs were more likely to self-report to be immunized. CONCLUSIONS Additional training about the vaccinations is needed to improve HCWs knowledge and to address specific concerns which may lead to better uptake among this group.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy
| | - Aida Bianco
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Via T. Campanella, 115, 88100 Catanzaro, Italy
| | - Alessia D'Alessandro
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Via T. Campanella, 115, 88100 Catanzaro, Italy
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy.
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