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Di Lorenzo A, Capodiferro L, Illuzzi M, Scaltrito C, Vimercati L, Moscara L, Tafuri S, Stefanizzi P. Active offer of Tdap vaccination in a cohort of healthcare workers of Maternal and Neonatal Department: Data from a large hospital in Southern Italy. Vaccine X 2024; 19:100530. [PMID: 39157686 PMCID: PMC11326957 DOI: 10.1016/j.jvacx.2024.100530] [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: 06/03/2024] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Pertussis is a vaccine-preventable respiratory disease. Pertussis vaccination is currently mandatory for all children in Italy, and is administered in three doses at the beginning of the third, fifth, and twelfth month of life, respectively. Booster doses are also recommended at five-six years, at eleven-twelve years, and then once every ten years. Healthcare workers (HCWs) are a high-risk population for pertussis. Strategies to increase HCWs' compliance to this vaccination have not been investigated in depth. Our study investigates the determinants of acceptance of a "soft nudge" vaccination campaign in a large hospital in Apulia (Southern Italy). HCWs from the Gynaecology and Neonatology Units of Bari's Policlinico General Hospital were screened in June 2023 for pertussis vaccination. Non-vaccinated subjects were offered a vaccination appointment. Vaccination determinants were studied, and a logistic regression model was built to identify determinants that significantly influence vaccination acceptance. At the time of screening, only 31.34% of target HCWs (68/217) had already been vaccinated. After the active call intervention, vaccine coverage rose to 70.00% (152/217). Significantly higher coverage was found in the Neonatology Unit (30/43, 69.77%) than in the Gynaecology unit (54/106, 50.94%) (Chi2: 4.41; p-value: 0.036). A logistic regression model confirmed a higher compliance to vaccination in HCWs staffed in the Neonatology Unit (Chi2: 2.08; 95%CI: 1.04 - 4.73; p-value: 0.038). Our intervention increased vaccination coverage in a high-risk cohort. The solicitation was effective, as communication with a trained specialist might have improved the subjects' perception of vaccination and individual risk of contagion and transmission to others. A synergistic approach, mixing active call with a vaccination mandate, might have greater effectiveness.
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Affiliation(s)
- Antonio Di Lorenzo
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luca Capodiferro
- Bari Policlinico General University Hospital, Control Room Program Unit, Italy
| | - Michele Illuzzi
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Chiara Scaltrito
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luigi Vimercati
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Lorenza Moscara
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Silvio Tafuri
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
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Clari M, Albanesi B, Comoretto RI, Conti A, Renzi E, Luciani M, Ausili D, Massimi A, Dimonte V. Effectiveness of interventions to increase healthcare workers' adherence to vaccination against vaccine-preventable diseases: a systematic review and meta-analysis, 1993 to 2022. Euro Surveill 2024; 29:2300276. [PMID: 38426238 PMCID: PMC10986662 DOI: 10.2807/1560-7917.es.2024.29.9.2300276] [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: 03/22/2023] [Accepted: 12/13/2023] [Indexed: 03/02/2024] Open
Abstract
BackgroundVaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.AimThis systematic review and meta-analysis aimed to describe interventions meant to increase HCWs' adherence to vaccination and estimate the effectiveness of these interventions.MethodsWe searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs' adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.ResultsThe systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95% CI: 1.13-1.66) and in observational studies (RR = 1.43; 95% CI: 1.29-1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95% CI: 1.49-1.68) than in hospitals (RR = 1.24; 95% CI: 0.76-2.05).ConclusionInterventions aimed at increasing HCWs' adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.
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Affiliation(s)
- Marco Clari
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- These authors contributed equally to this work and shared first authorship
| | - Beatrice Albanesi
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- These authors contributed equally to this work and shared first authorship
| | | | - Alessio Conti
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano - Bicocca, Milan Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Valerio Dimonte
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy
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Cardona RSB, Weckx LY, de Moraes-Pinto MI, Ramos BCF, Dos Santos ARA, Spina FG, de Araújo BC, Clemens R, Clemens SAC. Pertussis antibodies and vaccination coverage among healthcare professionals in Brazil is inadequate: A cross-sectional serological study. Vaccine 2023; 41:5769-5774. [PMID: 37573201 DOI: 10.1016/j.vaccine.2023.08.008] [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: 04/23/2023] [Revised: 06/26/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Worldwide, tetanus-diphtheria-acellular pertussis (Tdap) vaccination coverage of healthcare professionals (HCPs) is below 40%, but this data is not available for Brazil. We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalence of anti-pertussis toxin (anti-PT IgG) among HCPs. Secondary objectives were to evaluate Tdap vaccination coverage, to assess predictive factors associated with anti-PT IgG, and to estimate the decay of anti-PT IgG and time to Tdap vaccination. METHODS Observational cross-sectional serological study in 352 HCPs who worked at São Paulo Hospital - Federal University of São Paulo (UNIFESP) in 2020, approved by UNIFESP Ethics Committee. Data collected included sociodemographics, knowledge about Tdap, and vaccination status. Anti-PT IgG were quantified by ELISA: <10 IU/mL seronegative and ≥ 10-1000 IU/mL seropositive. Titers ≥ 10-50 IU/mL were classified low positivity, indicating no recent B. pertussis infection or Tdap vaccination; >50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and > 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsońs correlation, at 5% p-level. RESULTS 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG > 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p < 0.001). There was a weak but significant correlation between anti-PT IgG and interval of Tdap vaccination (r = 0.404; p = 0.001). Anti-PT IgG dropped 5 IU/mL/year (p = 0.001). CONCLUSION Better education of HCPs on needs and benefits of Tdap vaccination is critical. Goals must be to improve HCPs vaccination coverage.
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Affiliation(s)
| | - Lily Yin Weckx
- Federal University of São Paulo, Rua Borges Lagoa 770, Vila Clementino, São Paulo - SP, 04038-001 São Paulo, Brazil
| | - Maria Isabel de Moraes-Pinto
- Federal University of São Paulo, Rua Borges Lagoa 770, Vila Clementino, São Paulo - SP, 04038-001 São Paulo, Brazil
| | | | | | - Fernanda Garcia Spina
- Federal University of São Paulo, Rua Borges Lagoa 770, Vila Clementino, São Paulo - SP, 04038-001 São Paulo, Brazil
| | - Beatriz Collaço de Araújo
- Federal University of São Paulo, Rua Borges Lagoa 770, Vila Clementino, São Paulo - SP, 04038-001 São Paulo, Brazil
| | - Ralf Clemens
- International Vaccine Institute, 1 Gwanak-ro, Nakseongdae-dong, Gwanak-gu, Seoul, South Korea
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Politis M, Sotiriou S, Doxani C, Stefanidis I, Zintzaras E, Rachiotis G. Healthcare Workers' Attitudes towards Mandatory COVID-19 Vaccination: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11040880. [PMID: 37112791 PMCID: PMC10142794 DOI: 10.3390/vaccines11040880] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND COVID-19 vaccine mandates are considered a controversial public health policy both in public debate and among healthcare workers (HCWs). Thus, the objective of this systematic review is to give a deep insight into HCWs' views and attitudes towards COVID-19 vaccination mandates amid the ongoing COVID-19 pandemic. METHODS A systematic literature search of five databases (PubMed, Scopus, Embase, CINAHL, and Web of Science) was conducted between July 2022 and November 2022. Original quantitative studies that addressed the attitudes of HCWs regarding COVID-19 vaccine mandates were considered eligible for this systematic review. All the included studies (n = 57) were critically appraised and assessed for risk of systematic bias. Meta-analyses were performed, providing a pooled estimate of HCWs' acceptance towards COVID-19 vaccine mandates for: 1. HCWs and 2. the general population. RESULTS In total, 64% (95% CI: 55%, 72%) of HCWs favored COVID-19 vaccine mandates for HCWs, while 50% (95% CI: 38%, 61%) supported mandating COVID-19 vaccines for the general population. CONCLUSIONS Our findings indicate that mandatory vaccination against COVID-19 is a highly controversial issue among HCWs. The present study provides stakeholders and policy makers with useful evidence related to the compulsory or non-compulsory nature of COVID-19 vaccinations for HCWs and the general population. Other: The protocol used in this review is registered on PROSPERO with the ID number: CRD42022350275.
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Affiliation(s)
- Marios Politis
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Sotiris Sotiriou
- Department of Pathology, Faculty of Medicine, Aristotle University, 54124 Thessaloniki, Greece
| | - Chrysoula Doxani
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Ioannis Stefanidis
- Department of Nephrology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
- Center for Clinical Evidence Synthesis, Tufts University School of Medicine, Boston, MA 02111, USA
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
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5
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Basov AA, Zhernov YV, Kashutina MI, Kashkovskaya NN, Kombarova SY, Enilenis II, Severova LP, Fadeeva IA, Vysochanskaya SO, Belova EV, Shashina EA, Makarova VV, Shcherbakov DV, Skopin AY, Mitrokhin OV. Diphtheria, tetanus, and pertussis immunity among healthcare professionals and pregnant women in the Moscow region, Russian federation: A preliminary cross-sectional study. Front Pediatr 2023; 11:1043707. [PMID: 36896403 PMCID: PMC9989173 DOI: 10.3389/fped.2023.1043707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
Despite more than 50 years of primary immunization against diphtheria, pertussis, and tetanus in Russia, complicated illnesses, including fatal ones, still occur. The goal of this preliminary cross-sectional study is to see how well pregnant women and healthcare workers are protected against diphtheria, pertussis, and tetanus. The required sample size (pregnant women and healthcare professionals, as well as pregnant women of two age categories) for this preliminary cross-sectional study was calculated using a confidence value of 0.95 and a probability of 0.05. The required number of participants in each group calculated sample size must be at least 59 people. In the Moscow region (Solnechnogorsk city, Russia), a cross-sectional study of pregnant patients and healthcare professionals interacting with children regularly as part of their job from numerous medical organizations was conducted in the year 2021 (n = 655). Antibodies to diphtheria, tetanus, and pertussis toxoids and microorganisms were measured using an enzyme-linked immunosorbent assay (ELISA). The STATISTICA and IBM SPSS Statistics 26.0 were used to process the study results statistically. Descriptive statistics methods, the Mann-Whitney U-test, discriminant analysis with the stepwise selection and analysis of ROC-curves were applied. IgG against diphtheria was found in 99.5% of pregnant women, tetanus in 91.5%, and pertussis in only 36.5%. According to the results of the discriminant analysis, the value of IgG to pertussis is linked to the value of IgA to pertussis and the gestational periods. Immunity to diphtheria was discovered in 99.1% of medical personnel, tetanus in 96.9%, and pertussis in 43.9%, no significant variations with age. When comparing the levels of immunity of pregnant women and healthcare professionals, it was shown that healthcare workers have greater levels of immunity against diphtheria and tetanus. The novel contribution of this study is that it will reveal the proportion of those vulnerable to pertussis, diphtheria, and tetanus among health workers and pregnant women in all age groups under the current national immunization program in Russia. Considering the data obtained from the preliminary cross-sectional study, we believe that it is necessary to conduct a full-scale study on a larger sample and, based on that, make certain changes to the national immunization program in Russia.
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Affiliation(s)
- Artem A Basov
- Diphtheria and Pertussis Surveillance Laboratory, G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia.,Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yury V Zhernov
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Department of Chemistry, Lomonosov Moscow State University, Moscow, Russia.,Center of Life Sciences, Skolkovo Institute of Science and Technology, Moscow, Russia.,Center for Medical Anthropology, N.N. Miklukho-Maclay Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Moscow, Russia
| | - Maria I Kashutina
- Department of Diagnostics and Treatment of Diseases of the Breast and Reproductive System No 2, Women's Health Clinic - Mammological Center, Loginov Moscow Clinical Scientific and Practical Center, Moscow, Russia.,Department of Healthcare Promotion, National Research Center for Therapy and Preventive Medicine, Moscow, Russia.,Department of Therapy, Clinical Pharmacology and Emergency Medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Natalia N Kashkovskaya
- Diphtheria and Pertussis Surveillance Laboratory, G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia
| | - Svetlana Yu Kombarova
- Diphtheria and Pertussis Surveillance Laboratory, G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia
| | - Inga I Enilenis
- M.I. Perelman Department of Phthisiopulmonology and Thoracic Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Lyudmila P Severova
- M.I. Perelman Department of Phthisiopulmonology and Thoracic Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Inna A Fadeeva
- Department of English Language, Institute of World Economy, Diplomatic Academy of the Russian Foreign Ministry, Moscow, Russia
| | - Sonya O Vysochanskaya
- Diphtheria and Pertussis Surveillance Laboratory, G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia.,Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena V Belova
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ekaterina A Shashina
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Valentina V Makarova
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Denis V Shcherbakov
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anton Yu Skopin
- Department of Scientific Support for Laboratory Research of Products and Environment Objects, F.F. Erisman Federal Scientific Center of Hygiene of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow Region, Mytishchi, Russia
| | - Oleg V Mitrokhin
- Department of General Hygiene, F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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[Translated article] Whooping Cough: The Visible Enemy. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2021.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Seyman D, Keskin AS, Küçükateş E, Ceylan MR, Kul G, Tosun S, Oğuzöncül AF, Gazel ÖZ, Uzar H, Uysal S, Aliravcı ID, Kaya SY, Uğuz M, Can M, Demirkıran BÇ, Kul H, Şölen EY, Can H, Deniz M, Altuntaş B. Healthcare personnel's attitude and coverage about tetanus vaccination in Turkey: a multicenter study. Hum Vaccin Immunother 2022; 18:2014732. [PMID: 35172681 PMCID: PMC8973359 DOI: 10.1080/21645515.2021.2014732] [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] [Indexed: 12/02/2022] Open
Abstract
The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p < .001] compared with all other HCPs except nurses. Older age (≥40 years) and length of professional experience were significantly correlated with TVC. Of the 8353 HCPs who received tetanus vaccines during their lifetime, 73.03% received tetanus vaccination in the past 10 years. The self-vaccination rate for protection against tetanus was 13.1%. Acute injuries (25.42%) and pregnancy (23.9%) were the most common reasons for having the tetanus vaccine. One-third (33.7%) of HCPs did not have information about whether pregnant women could receive tetanus vaccinations. This survey study provided excellent baseline information about HCPs’ coverage rates and attitudes regarding tetanus vaccination. The present results suggested that tetanus boosters for HCPs should be established as soon as possible, and revealed that the HCPs younger than 30 years with relatively less professional experience and all other HCPs except nurses and physicians should be identified as the target population for future intervention programs.
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Affiliation(s)
- Derya Seyman
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Ayşegül Seremet Keskin
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Emine Küçükateş
- Cerrahpasa Cardiology Institution, Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
| | - Mehmet Reşat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Harran University Medical Faculty, Şanlıurfa, Turkey
| | - Gülnur Kul
- Department of Infectious Diseases and Clinical Microbiology, Kırıkhan State Hospital, Hatay, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Education and Research Hospital, İzmir, Turkey
| | | | - Özlem Zanapalıoğlu Gazel
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Cengiz Gökçek Maternity and Children Hospital, Gaziantep, Turkey
| | - Hanife Uzar
- Department of Infectious Diseases and Clinical Microbiology, Viranşehir State Hospital, Şanlıurfa, Turkey
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Balıkesir University Medical Faculty, Balıkesir, Turkey
| | - Işıl Deniz Aliravcı
- Department of Infectious Diseases and Clinical Microbiology, Manavgat State Hospital, Antalya, Turkey
| | - Sibel Yıldız Kaya
- Department of Infectious Diseases and Clinical Microbiology, Sungurlu State Hospital, Çorum, Turkey
| | - Mustafa Uğuz
- Department of Infectious Diseases and Clinical Microbiology, Mersin City Education and Research Hospital, Mersin, Turkey
| | - Müçteba Can
- Department of Anaesthesiology and Intensive Care Medicine, Ankara City Hospital, Ankara, Turkey
| | - Burcu Çalışkan Demirkıran
- Department of Infectious Diseases and Clinical Microbiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Halil Kul
- Department of Neurosurgery, Hatay State Hospital, Hatay, Turkey
| | - Emine Yeşilyurt Şölen
- Department of Medical Microbiology, Bozok University Medical Faculty, Yozgat, Turkey
| | - Hüseyin Can
- Departments of Family Medicine, Private Aymira Nursing Home and Elderly Care Center, İzmir, Turkey
| | - Mustafa Deniz
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Bülent Altuntaş
- Departments of Family Medicine, Şişli Hamidiye Etfal Education and Research Hospital, İstanbul, Turkey
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González-Barcala FJ, Villar-Álvarez F, Martinón-Torres F. Tosferina en el adulto: el enemigo visible. Arch Bronconeumol 2021; 58:300-302. [DOI: 10.1016/j.arbres.2021.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 01/21/2023]
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Yörük S, Türkmen H, Durgut A, Erbek M. Vaccine mistrust among family healthcare professionals and vaccine hesitancy in the communities they serve in Turkey in 2019: a cross-sectional study. Hum Vaccin Immunother 2020; 16:3155-3162. [PMID: 33121313 DOI: 10.1080/21645515.2020.1806671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIM This study aims to determine the causes of vaccine mistrust among family healthcare professionals (FHP) in the unit where they serve and vaccine hesitancy of families. METHOD The study group consisted of 682 FHPs working in a primary health care institution. The data collection tools of the study included a sociodemographic data form and a vaccine hesitancy data form. Pearson's chi-square analysis and logistic regression analysis were performed to analyze the data. FINDINGS To the question of "Do you trust the active ingredient in the vaccines?", only 2.1% of FHPs responded "I do not trust" and 18.9% answered "I am indecisive". 70.7% of FHPs said that at least one vaccine hesitant family was in the unit where they served. The most important reasons stated by FHPs on behalf of such families were vaccine mistrust (73.2%), the belief that they may be harmful for the child (58.7%), and the belief that vaccines cause autism (55.6%). In the univariate analysis, vaccine mistrust was significantly higher in FHPs who were measles-hesitant and responded "The decision to get vaccinated or not should belong to the family voluntarily". From logistic regression analysis, vaccine mistrust in FHPs increased 2.8-fold for those who did not think vaccination should be compulsory, 2.7-fold for those who did not think that vaccination refusal should be legally enforced, and 1.61-fold for those under age 35 years. CONCLUSION It was observed that FHPs had high sensitivity and positive attitudes toward vaccination in general.
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Affiliation(s)
- Selda Yörük
- Balıkesir University, School of Health, Department of Midwifery, Cagis Campus , Balikesir, Turkey
| | - Hülya Türkmen
- Balıkesir University, School of Health, Department of Midwifery, Cagis Campus , Balikesir, Turkey
| | - Aysegul Durgut
- Altieylul 2 Number Family Health Center , Balikesir, Turkey
| | - Meliz Erbek
- Altieylul 2 Number Family Health Center , Balikesir, Turkey
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Squeri R, Di Pietro A, La Fauci V, Genovese C. Healthcare workers' vaccination at European and Italian level: a narrative review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:45-53. [PMID: 31517889 PMCID: PMC7233663 DOI: 10.23750/abm.v90i9-s.8703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 01/29/2023]
Abstract
Today some vaccine-preventable diseases remain an important cause of morbidity and mortality worldwide despite the availability of new vaccines. Healthcare workers are particularly at risk to acquire an infection disease, playing a fundamental role in nosocomial transmission, which makes them an important target group for vaccination. The vaccination recommendations of HCWs, as well as the general population, differ from country to country. Furthermore, coverage rates vary widely a lot over the world, making HCWs vulnerable to disease and so healthcare settings to outbreaks. The motivations of vaccine hesitancy are many and maybe other studies would help policymakers and stake-holders to shape programs to improve vaccination coverage and the control of infectious diseases through the correct application of guidelines on prevention. (www.actabiomedica.it)
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Affiliation(s)
- Raffaele Squeri
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
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Seth-Smith HMB, Egli A. Whole Genome Sequencing for Surveillance of Diphtheria in Low Incidence Settings. Front Public Health 2019; 7:235. [PMID: 31497588 PMCID: PMC6713046 DOI: 10.3389/fpubh.2019.00235] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
Corynebacterium diphtheriae (C. diphtheriae) is a relatively rare pathogen in most Western countries. While toxin producing strains can cause pharyngeal diphtheria with potentially fatal outcomes, the more common presentation is wound infections. The diphtheria toxin is encoded on a prophage and can also be carried by Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. Currently, across Europe, infections are mainly diagnosed in travelers and refugees from regions where diphtheria is more endemic, patients from urban areas with poor hygiene, and intravenous drug users. About half of the cases are non-toxin producing isolates. Rapid identification of the bacterial pathogen and toxin production is a critical element of patient and outbreak management. Beside the immediate clinical management of the patient, public health agencies should be informed of toxigenic C. diphtheriae diagnoses as soon as possible. The collection of case-related epidemiological data from the patient is often challenging due to language barriers and social circumstances. However, information on patient contacts, vaccine status and travel/refugee route, where appropriate, is critical, and should be documented. In addition, isolates should be characterized using high resolution typing, in order to identify transmissions and outbreaks. In recent years, whole genome sequencing (WGS) has become the gold standard of high-resolution typing methods, allowing detailed investigations of pathogen transmissions. De-centralized sequencing strategies with redundancy in sequencing capacities, followed by data exchange may be a valuable future option, especially since WGS becomes more available and portable. In this context, the sharing of sequence data, using public available platforms, is essential. A close interaction between microbiology laboratories, treating physicians, refugee centers, social workers, and public health officials is a key element in successful management of suspected outbreaks. Analyzing bacterial isolates at reference centers may further help to provide more specialized microbiological techniques and to standardize information, but this is also more time consuming during an outbreak. Centralized communication strategies between public health agencies and laboratories helps considerably in establishing and coordinating effective surveillance and infection control. We review the current literature on high-resolution typing of C. diphtheriae and share our own experience with the coordination of a Swiss-German outbreak.
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Affiliation(s)
- Helena M. B. Seth-Smith
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Adrian Egli
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
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Randi BA, Miyaji KT, Lara AN, Ibrahim KY, Infante V, Rodrigues CCM, Lopes MH, Sartori AMC. Low tetanus-diphtheria-acellular pertussis (Tdap) vaccine coverage among healthcare workers in a quaternary university hospital in São Paulo, Brazil: need for continuous surveillance and implementation of active strategies. Braz J Infect Dis 2019; 23:231-236. [PMID: 31351815 PMCID: PMC9427826 DOI: 10.1016/j.bjid.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/05/2019] [Accepted: 06/14/2019] [Indexed: 01/05/2023] Open
Abstract
Introduction Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014. Objective To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School. Methods A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap. Results The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations. Conclusions Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.
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Affiliation(s)
- Bruno Azevedo Randi
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, São Paulo, SP, Brazil.
| | - Karina Takesaki Miyaji
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil
| | - Amanda Nazareth Lara
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil
| | - Karim Yaqub Ibrahim
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil
| | - Vanessa Infante
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, São Paulo, SP, Brazil
| | | | - Marta Heloísa Lopes
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, São Paulo, SP, Brazil
| | - Ana Marli Christovam Sartori
- Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, São Paulo, SP, Brazil
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