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Stefanizzi P, Di Lorenzo A, Capodiferro L, Moscara L, Noviello C, Vimercati L, De Maria L, Tafuri S. Increasing vaccination coverage among healthcare workers: Active call and mandatory laws. Data from a large general hospital in Southern Italy. Vaccine 2024:S0264-410X(24)00739-4. [PMID: 39013692 DOI: 10.1016/j.vaccine.2024.06.065] [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: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/18/2024]
Abstract
Influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are respiratory pathogens which significantly impact healthcare systems. Seasonal vaccination is recommended for all healthcare workers (HCWs) to reduce the risk for both operators and patients. Puglia, a region in Southern Italy, has been enforcing since 2018 a law mandating influenza vaccination in healthcare workers. However, vaccination coverages for this category have always been suboptimal. Our study tests the effectiveness of an active recall intervention on vaccination coverage for influenza and SARS-CoV-2 in the HCWs of a large Apulian hospital (Southern Italy). During the 2023-2024 influenza vaccination season, unvaccinated HCWs of Bari's Policlinico General Hospital were contacted. The e-mail reminded them of a regional law mandating influenza vaccination to all HCWs and offered an appointment for vaccination. SARS-CoV-2 vaccination was also offered. In 2022-2023, 43.16 % of HCWs were vaccinated against influenza and 21.87 % against SARS-CoV-2. Coverage changed during the 2023-2024 season to 54.11 % and 13.58 %, respectively. A regression model showed that vaccination uptake's increase was associated with the e-mail reception and with the operator being a physician vs. non-medical personnel. On the contrary, subjects who received the e-mail did not show an increased SARS-CoV-2 vaccination uptake, which was on the contrary influenced by the worker's age, sex, job title, and area of risk. Our soft-mandate intervention was effective in increasing vaccination uptake by HCWs. Communication with a trained specialist was probably useful, and the possibility to access vaccination services with dedicated appointments increased convenience. Mandatory vaccination policies and active recall seem to synergically impact vaccination uptake.
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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, Board of Medical Directors, Control Room Program Unit, Italy
| | - Lorenza Moscara
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Chiara Noviello
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luigi Vimercati
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luigi De Maria
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Silvio Tafuri
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
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Cuerda ADL, González MIT, López Aparicio A, Monfort Vinuesa C, López Pedraza MJ, Isidoro B, Mayordomo-Cava J, Barberán LC, Collazos J, Pérez-Ortiz JM, Barberán J. Seroprevalence for measles among healthcare workers in Madrid, Spain. J Hosp Infect 2024; 147:63-67. [PMID: 38040037 DOI: 10.1016/j.jhin.2023.11.006] [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: 07/04/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Immunity of healthcare workers (HCWs) against measles is a particular concern. They are more likely to contract it than the general population due to their occupational exposure which may cause a nosocomial outbreak. AIM To assess the measles immune status of HCWs at five Spanish university hospitals. PATIENTS AND METHODS Serologic testing (IgG) for measles by chemiluminescence indirect immunoassay (CLIA) was carried out prospectively and consecutively in HCWs from five university hospitals. All HCWs were classified into four epidemiological groups: vaccinated individuals, those with a history of measles disease, subjects with no history of measles or vaccination, and those who did not know whether they had measles or were vaccinated, and into five professional categories: physicians, nurses, nursing assistants, other clinical workers and non-clinical workers. A logistic regression model was constructed to identify the factors independently associated with immunity to measles. RESULTS The study group was composed of 2157 HCWs. 89% had protective antibodies against measles. Of the 238 non-immune HCWs, 199 (83.6%) had been vaccinated, compared with 1084 of the 1919 (56.5%) immune individuals (P<0.0001). The parameters significantly predictive of having protective antibodies against measles were: older age (P<0.0001), epidemiological status (P=0.0002, mainly past measles disease), and professional category (P=0.02, in particular nurses). CONCLUSION This study shows that HCWs, including those previously vaccinated, are currently at risk of measles and suggests that those with a natural history of infection are better protected. Therefore, knowledge and maintenance of immunity to measles are an essential part of infection control among HCWs.
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Affiliation(s)
- A de la Cuerda
- Occupational Risk Prevention Service, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - M I Tejeda González
- Infectious Diseases Unit, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - A López Aparicio
- Infectious Diseases Unit, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - C Monfort Vinuesa
- Infectious Diseases Unit, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - M J López Pedraza
- Preventive Medicine Department, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - B Isidoro
- Preventive Medicine Department, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - J Mayordomo-Cava
- School of Health Sciences - HM Hospitals, Universidad Camilo José Cela, Madrid, Spain
| | - L C Barberán
- Infectious Diseases Unit, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain
| | - J Collazos
- Infectious Diseases Unit, Hospital de Galdácano, Vizcaya, Spain
| | - J M Pérez-Ortiz
- School of Health Sciences - HM Hospitals, Universidad Camilo José Cela, Madrid, Spain
| | - J Barberán
- Infectious Diseases Unit, Hospital Universitario HM Montepríncipe, Universidad Camilo José Cela, Madrid, Spain.
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Kaddour O, Ben Mabrouk A, Arfa S, Lassoued N, Berriche O, Chelli J. Knowledge and attitudes of healthcare workers about influenza vaccination. Infect Dis Health 2024:S2468-0451(24)00027-0. [PMID: 38679564 DOI: 10.1016/j.idh.2024.04.005] [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: 08/05/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Influenza infection is a highly contagious viral disease. It may cause several nosocomial outbreaks. This study aimed to evaluate the knowledge and attitudes of healthcare workers (HCWs) about influenza vaccination and to identify factors associated with the uptake of influenza vaccination. METHODS We conducted a cross-sectional study over 5 months between November 2021 and March 2022. Data was collected using an anonymous self-administered questionnaire. We included all HCWs at Taher Sfar University Hospital who were willing to participate in the study. RESULTS A total of 395 HCWs were included. They were mainly women (78.7%) with an average age of 27 years. The medical personnel was the largest group (67.8%). Most respondents considered the vaccination to be optional and knew that it should be renewed every year, but 97.5% of them judged the efficacy of the vaccine to be low. The influenza vaccination uptake was only 20.2%. The main reasons for accepting vaccination were to protect patients and families. However, misconceptions about the severity and the risk of influenza and the belief that barrier measures were sufficient to prevent infection were the main causes of avoiding vaccination. The factors associated with adherence to vaccination were being a medical professional, old age, longer professional experience, and considering vaccination to be mandatory for HCWs. CONCLUSION Our study showed a low adherence to influenza vaccination with misconceptions about vaccine efficacy and safety. More efforts are needed to improve the knowledge of HCW about the vaccine and boost the adherence rates.
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Affiliation(s)
- Oussama Kaddour
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Asma Ben Mabrouk
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia.
| | - Sondess Arfa
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Najoua Lassoued
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Olfa Berriche
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Jihene Chelli
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
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Livesey A, Quarton S, Pittaway H, Adiga A, Grudzinska F, Dosanjh D, Parekh D. Practices to prevent non-ventilator hospital-acquired pneumonia: a narrative review. J Hosp Infect 2024:S0195-6701(24)00120-8. [PMID: 38663517 DOI: 10.1016/j.jhin.2024.03.019] [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: 12/21/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 07/19/2024]
Abstract
Nosocomial infection has significant consequences in health care, both at the individual level due to increased morbidity and mortality, and at the organizational level due to increased costs. Hospital-acquired pneumonia (HAP) is the most common nosocomial infection, and is associated with high excess mortality, frequent use of broad-spectrum antimicrobials and increased length of stay. This review explores the preventative strategies that have been examined in non-ventilator HAP (NV-HAP). The management of aspiration risk, interventions for oral hygiene, role of mobilization and physiotherapy, modification of environmental factors, and vaccination are discussed. Many of these interventions are low risk, acceptable to patients and have good cost-benefit ratios. However, the evidence base for prevention of NV-HAP is weak. This review identifies the lack of a unified research definition, under-recruitment to studies, and variation in intervention and outcome measures as limitations in the existing literature. Given that the core risk factors for acquisition of NV-HAP are increasing, there is an urgent need for research to address the prevention of NV-HAP. This review calls for a unified definition of NV-HAP, and identification of a core outcome set for studies in NV-HAP, and suggests future directions for research in NV-HAP. Improving care for people with NV-HAP will reduce morbidity, mortality and healthcare costs significantly.
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Affiliation(s)
- A Livesey
- National Institute for Health Research/Wellcome Trust Clinical Research Facility, University Hospitals Birmingham, Birmingham, UK.
| | - S Quarton
- National Institute for Health Research/Birmingham Biomedical Research Centre, Institute of Translational Medicine, Birmingham, UK
| | - H Pittaway
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, UK
| | - A Adiga
- Warwick Hospital, South Warwickshire University NHS Foundation Trust, Warwick, UK
| | - F Grudzinska
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D Dosanjh
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D Parekh
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Hasan T, Lynch M, King C, Wehbe C, Plymoth M, Islam MS, Iannuzzi T, Dao A, Lai J, Martiniuk A, Desai S, Sheel M. Vaccine-Preventable Disease Outbreaks among Healthcare Workers: A Scoping Review. Clin Infect Dis 2024:ciae209. [PMID: 38630638 DOI: 10.1093/cid/ciae209] [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: 11/14/2023] [Revised: 03/19/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Outbreaks of vaccine preventable diseases (VPDs) in health care workers (HCWs) can result in morbidity and mortality and cause significant disruptions to health care services, patients and visitors as well as an added burden on the health system. This scoping review is aimed to describe the epidemiology of VPD outbreaks in HCW, caused by diseases which are prevented by the ten vaccines recommended by World Health Organization (WHO) for HCWs. METHODS In April 2022 CINAHL, MEDLINE, Global Health and EMBASE were searched for all articles reporting on VPD outbreaks in HCWs since the year 2000. Articles were included regardless of language and study type. Clinical and epidemiological characteristics of VPD outbreaks were described. RESULTS Our search found 9363 articles, of which 216 met inclusion criteria. Studies describing six of the ten VPDs were found: influenza, measles, varicella, tuberculosis, pertussis and rubella. Most articles (93%) were from high- and upper middle-income countries. While most outbreaks occurred in hospitals, several influenza outbreaks were reported in long term care facilities. Based on available data, vaccination rates amongst HCWs were rarely reported. CONCLUSION We describe several VPD outbreaks in HCWs from 2000 to April 2022. The review emphasises the need to understand the factors influencing outbreaks in HCWs and highlight importance of vaccination amongst HCWs.
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Affiliation(s)
- Tasnim Hasan
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- Western Sydney Local Health District, New South Wales, Australia
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
| | - Michelle Lynch
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Catherine King
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
| | - Charbel Wehbe
- Western Sydney Local Health District, New South Wales, Australia
| | - Martin Plymoth
- Western Sydney Local Health District, New South Wales, Australia
| | - Md Saiful Islam
- School of Population Health, University of New South Wales, Australia
| | | | - Aiken Dao
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Jana Lai
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
| | - Alexandra Martiniuk
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
- Dalla Lana School of Public Health, the University of Toronto, Canada
| | - Shalini Desai
- Immunization, Vaccines and Biologicals Department, The World Health Organization, Geneva, Switzerland
| | - Meru Sheel
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
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Medeni V, Altıner ÖT, Medeni İ. Measles vaccination coverage and immunization status of nurses: An interventional study in Türkiye. Vaccine 2024; 42:2716-2721. [PMID: 38503662 DOI: 10.1016/j.vaccine.2024.03.037] [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: 12/08/2023] [Revised: 03/02/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Healthcare workers are more likely to contract measles than the general population. Our study aimed to assess measles vaccination and immunization levels among nurses, examine the influencing factors and implement an intervention program to increase immunization coverage. MATERIALS AND METHODS Our study was conducted in a university hospital in Türkiye. The study included 1012 nurses. It was an intervention study, continued between 01/11/2021 and 30/10/2023. Measles IgG and vaccination status of the participants were evaluated. Participants with negative measles IgG results who had not been vaccinated against measles or received a single dose of the vaccine were invited to the outpatient clinic to receive two doses. Participants who had received two doses of the measles vaccine and had negative measles IgG results were invited to the outpatient clinic for one dose of the measles vaccine. Nine hundred seventy-eight people participated in our study. The access frequency was 96.6%. RESULTS Among the participants aged 21-30, 68.4 % were Measles IgG (+). Measles IgG (+) prevalence was higher in women than men (85.3 % vs. 61.0 %). The department with the lowest measles IgG positivity was intensive care (75.8 %). Measles IgG (+) prevalence became higher as the duration of employment increased. The measles seropositivity in total population rose from 83.1 % before the intervention to 94.3 % after, to 91.8 % in the 21-30 age group, and to 90.2 % in male. Sixteen people had never received measles vaccination. Of the 37 participants who had previously received two doses of measles vaccine, 22 received a single dose and after the intervention 16 (72.7 %) were positive. Only 1 person was found to have vaccine refusal during the intervention. CONCLUSION Expanding the immunization scope in hospitals by screening for measles antibodies among healthcare personnel and vaccinating those who are seronegative can be considered an effective public health strategy.
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Affiliation(s)
- Volkan Medeni
- Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Türkiye.
| | | | - İrem Medeni
- Employee Health Department, General Directorate of Public Health, Ministry of Health, Ankara, Türkiye
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Takougang I, Lekeumo Cheuyem FZ, Ze BRS, Tsamoh FF, Moneboulou HM. Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon). BMC Health Serv Res 2024; 24:424. [PMID: 38570843 PMCID: PMC10993453 DOI: 10.1186/s12913-024-10855-x] [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: 10/23/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Healthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital. METHODS The present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant. RESULTS Out of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B. CONCLUSIONS Most HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.
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Affiliation(s)
- Innocent Takougang
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon.
| | - Fabrice Zobel Lekeumo Cheuyem
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Billy Ralph Sanding Ze
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Forlemu Fabiola Tsamoh
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Hortense Mengong Moneboulou
- Department of Odonto-Stomatology & Maxillofacial Surgery, Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
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Azhar S, Rashid L, Islam T, Akhtar S, Hopkins KL, Sommers T, Ikram A, Anwer N, Maqbool NA, Khan Z, Ahmed N, Akhtar H. Knowledge, attitudes, and practices of vaccinators about expanded programs on immunization: a cross-sectional study. Front Public Health 2024; 12:1366378. [PMID: 38510352 PMCID: PMC10953913 DOI: 10.3389/fpubh.2024.1366378] [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: 01/06/2024] [Accepted: 02/16/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction The periodic evaluation of knowledge, attitudes, and practices (KAP) of healthcare workers, including vaccinators, concerning expanded programs on immunization (EPI) is very crucial for a better healthcare system. This study was carried out to assess the KAP of vaccinators about the EPI, including cold storage of vaccines and their practices related to vaccine cold chain management. Method A cross-sectional study was conducted from January 2022 to June 2022 among registered vaccinators in the twin cities (Islamabad and Rawalpindi) of Pakistan. A structured self-administered questionnaire (English and Urdu) was developed as per the Pakistan national EPI policy and strategic guidelines 2022 and World Health Organization (WHO) guidelines, as well as from earlier studies (Cronbach's alpha value of 0.734). The final questionnaire consisted of closed-ended questions in four sections, including sociodemographic information, knowledge (with dichotomous variables of yes/no), attitudes (with a 5-point Likert scale ranging from strongly agree to strongly disagree), and handling of vaccines and cold chain management. Completed questionnaires were entered into Microsoft Excel and then imported into SPSS version 25 for statistical analysis. Results A total of 186 vaccinators completely filled out their questionnaires, with a 97.9% response rate. More than half of the participants (57.5%) had no training related to EPI. Most of the respondents had a moderate to poor level of knowledge regarding EPI. The overall attitude was positive, and 57% of the participants strongly agreed that the national immunization programs can significantly contribute to the decrease in morbidity and mortality rates among children. In the current study, participants showed good practices toward EPI, vaccine storage, and cold chain management. The majority (93.5%) of the participants checked the expiry of vaccines at regular intervals to maintain the first expiry first out (FEFO) in their healthcare setting. Discussion In conclusion, most of the vaccinators had moderate to poor knowledge, a positive attitude, and good practices toward EPI, vaccine cold storage, and cold chain management. Lack of training among vaccinators on EPI was also observed. These findings have suggested that continuous training, education, and regular supervision of vaccinators in EPI are important for maximum immunization effectiveness and coverage.
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Affiliation(s)
- Sunia Azhar
- Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan
| | - Laiba Rashid
- Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan
| | - Taskeen Islam
- Communication and Media Studies, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Samar Akhtar
- Yusra Institute of Pharmaceutical Sciences, Yusra Medical and Dental College, Zaraj Housing Society, Islamabad, Pakistan
| | | | | | - Aamer Ikram
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Naveed Anwer
- Department of Pharmacy, Quaid.i.Azam University, Islamabad, Pakistan
| | - Nabeel Ahmed Maqbool
- Vaccines Preventable Infectious Diseases, Chemonics International Global Health Supply Chain – Procurement and Supply, Management (GHSC-PSM) Project, Islamabad, Pakistan
| | - Zakir Khan
- Department of Pharmacy Practice, Riphah Institute of Pharmaceutical Sciences (RIPS), Riphah International University Gulberg Green Campus, Islamabad, Pakistan
| | - Naveed Ahmed
- Department of Pharmacy, Quaid.i.Azam University, Islamabad, Pakistan
| | - Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan
- Department of Global Health, Health Services Academy, Chak Shahzad, Islamabad, Pakistan
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Kalunga L, Bulut E, Chen Z, Li Y, Ivanek R. Increasing vaccine uptake among employees within the non-health related critical infrastructure sectors: A review. Hum Vaccin Immunother 2023; 19:2135852. [PMID: 36628470 PMCID: PMC9980543 DOI: 10.1080/21645515.2022.2135852] [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: 01/12/2023] Open
Abstract
This review aimed to identify barriers to employee vaccination, motivators for vaccination, and vaccine uptake strategies within the critical infrastructure sectors. We focused on non-healthcare-related sectors, including food and agriculture, manufacturing, and education where employee vaccination is rarely mandated. We conducted a search for literature published from 2012 to 2022 from MEDLINE-PubMed, PsycINFO, and Web of Science Core Collection, which resulted in 22 studies that met the inclusion criteria. We found that 1) barriers to vaccination differ by infectious disease and population; 2) common motivators for vaccination were about protecting self, family, and community; and 3) common uptake strategies for influenza (which accounted for 83% of uptake strategies in reviewed studies) addressed convenience and confidence barriers such as vaccination cost and education. Our review highlights the need for employers, policymakers, and researchers to identify infectious disease and population-specific barriers to vaccination and implement strategies aimed at addressing the identified barriers.
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Affiliation(s)
- Linda Kalunga
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA,CONTACT Linda Kalunga Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Ece Bulut
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Ziqian Chen
- College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - Yihong Li
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Renata Ivanek
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Utpat S, Utpat N, Nookala V, Podakula L, Utpat K. Case report: Hospital-acquired chickenpox in a healthcare setting. Epidemiol Infect 2023; 152:e3. [PMID: 38112097 PMCID: PMC10804131 DOI: 10.1017/s0950268823001917] [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: 06/28/2023] [Revised: 09/26/2023] [Accepted: 11/16/2023] [Indexed: 12/20/2023] Open
Abstract
Chickenpox (varicella) is a rare occurrence in healthcare settings in the USA, but can be transmitted to healthcare workers (HCWs) from patients with herpes zoster who, in turn, can potentially transmit it further to unimmunized, immunosuppressed, at-risk, vulnerable patients. It is uncommon due to the inclusion of varicella vaccination in the recommended immunization schedule for children and screening for varicella immunity in HCWs during employment. We present a case report of hospital-acquired chickenpox in a patient who developed the infection during his prolonged hospital stay through a HCW who had contracted chickenpox after exposure to our patient's roommate with herpes zoster. There was no physical contact between the roommates, but both patients had a common HCW as caregiver. The herpes zoster patient was placed in airborne precautions immediately, but the HCW continued to work and have physical contact with our patient. The HCW initially developed chickenpox 18 days after exposure to the patient with herpes zoster, and our patient developed chickenpox 17 days after the HCW. The timeline and two incubation periods, prior to our patient developing chickenpox, indicate transmission of chickenpox in the HCW from exposure to the herpes zoster patient and subsequently to our patient. The case highlights the potential for nosocomial transmission of chickenpox (varicella) to unimmunized HCWs from exposure to patients with herpes zoster and further transmission to unimmunized patients. Verification of the immunization status of HCWs at the time of employment, mandating immunity, furloughing unimmunized staff after exposure to herpes zoster, and postexposure prophylaxis with vaccination or varicella zoster immunoglobulin (Varizig) will minimize the risk of transmission of communicable diseases like chickenpox in healthcare settings. Additionally, establishing patients' immunity, heightened vigilance and early identification of herpes zoster in hospitalized patients, and initiation of appropriate infection control immediately will further prevent such occurrences and improve patient safety. This is a case report of a varicella-unimmunized 31-year-old patient who developed chickenpox during his 80-day-long hospitalization. He had different roommates during his long hospital stay but had no physical contact with them and neither had visitors. On most days, the same HCW rendered care to him and his roommates. One of the patient’s roommates was found to have herpes zoster and was immediately moved to a different room with appropriate infection prevention measures. The HCW is presumably unimmunized to varicella and sustained significant exposure to the patient with herpes zoster during routine patient care which involved significant physical contact. The HCW was not furloughed, assessed for immunity, or given postexposure prophylaxis (PEP). The HCW had continued contact with our patient as part of routine care. On day 18, after exposure to the patient with herpes zoster, the HCW developed chickenpox. 17 days thereafter, our patient developed chickenpox. The time interval of chickenpox infection in the HCW after one incubation period after exposure to the patient with herpes zoster followed by a similar infection of chickenpox in our patient after another incubation period suggests the spread of varicella zoster virus (VZV) from the herpes zoster patient to the HCW and further from the HCW to our patient. Assessing the immunity of HCWs to varicella at the time of employment, ensuring only HCWs with immunity take care of herpes zoster and varicella patients, furloughing unimmunized exposed HCWs, offering PEP, and documentation of patients’ immunity to varicella at the time of hospital admission could help prevent VZV transmission in hospital settings. This is an attempt to publish this novel case due to its high educational value and relevant learning points.
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Affiliation(s)
- Sandeepa Utpat
- Faculty, Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Nishka Utpat
- Independent Scholar, Internal Medicine, Infectious Diseases, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Vinod Nookala
- Faculty, Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Lalitha Podakula
- Independent Scholar, Internal Medicine, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
| | - Kaanchi Utpat
- Independent Scholar, Internal Medicine, Research Assistant at Rutgers Health/Community Medical Center, Toms River, NJ, USA
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Pascucci D, Lontano A, Regazzi L, Marziali E, Nurchis MC, Raponi M, Vetrugno G, Moscato U, Cadeddu C, Laurenti P. Co-administration of SARS-CoV-2 and influenza vaccines in healthcare workers: Results of two vaccination campaigns in a large teaching hospital in Rome. Hum Vaccin Immunother 2023; 19:2287282. [PMID: 38016914 PMCID: PMC10732597 DOI: 10.1080/21645515.2023.2287282] [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: 08/12/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
The concurrent administration of COVID-19 and influenza vaccines has arisen as a promising approach to bolster protection against respiratory pathogens and improve vaccination rates. However, there remains a lack of data regarding the prevalence of co-administration across several vaccination campaigns, especially among healthcare workers (HCWs). Therefore, this study aims to shed light on the acceptance of co-administration strategies among HCWs during the two campaigns following the introduction of the anti-SARS-CoV-2 vaccine. A retrospective cohort study was conducted among the HCWs of the Fondazione Policlinico Universitario "A. Gemelli" IRCCS, a research hospital in Rome. Hospital administrative databases were accessed to gather information about vaccination for SARS-CoV-2 and influenza during the 2021/2022 and 2022/2023 vaccination campaigns. The study included 7399 HCWs. The co-administration of anti-SARS-CoV-2 and influenza vaccines presented a significant rise in 2022/2023 compared to the previous vaccination campaign (+38%): this was confirmed for every professional category, with the largest increases among resident doctors (+47%) and physicians (+44%), and also for every age category, but it was particularly evident for the youngest health professionals. The probability of co-administration uptake during the 2022/2023 campaign was significantly higher for males, and for those that received co-administration during the 2021/2022 campaign, while the probability was lower for nurses and administrative staff. This study highlights the co-administration procedure as a valuable and effective tool in annual vaccination campaigns for SARS-CoV-2 and influenza. The procedure's safety and streamlined logistics make it increasingly attractive for implementation, particularly among HCWs.
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Affiliation(s)
- Domenico Pascucci
- Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Lontano
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eleonora Marziali
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Cesare Nurchis
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- School of Economics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Raponi
- Department of Women, Child and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Vetrugno
- Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Health Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Umberto Moscato
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Women, Child and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizia Laurenti
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Women, Child and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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12
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Ledda C, Motta G, Rapisarda V, Maltezou HC. Influenza immunization of healthcare personnel in the post-COVID-19 pandemic era: Still a lot to do! Vaccine X 2023; 15:100402. [PMID: 38058792 PMCID: PMC10696103 DOI: 10.1016/j.jvacx.2023.100402] [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: 05/10/2022] [Revised: 09/28/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
Healthcare-associated influenza is frequently encountered in healthcare settings with significant morbidity and mortality among vulnerable patients, absenteeism among healthcare personnel (HCP), and interruption of healthcare services. Numerous investigations indicate that nosocomial outbreaks are often traced to HCP. Despite the international and national endorsements, seasonal influenza vaccine acceptance among HCP continues suboptimal worldwide. Infection control is the major objective for healthcare risk management in order to guarantee patient safety, limit the cost of hospitalization and assurance health management in controlling influenza seasons. Vigilance and anticipation are required as globally we are moving from a reactive COVID-19 pandemic response phase to one of planning for the co-circulation of viral respiratory infections. Declining to understand HCP perception of influenza risk and acceptance of vaccination might have impact patient safety as well as healthcare services.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Motta
- Occupational Medicine Unit, “Garibaldi” Hospital of Catania, Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Occupational Medicine Unit, “G. Rodolico – San Marco” University Hospital, Catania, Italy
| | - Helena C. Maltezou
- Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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13
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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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14
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Flanagan P, Dowling M, Sezgin D, Mereckiene J, Murphy L, Giltenane M, Carr P, Gethin G. The effectiveness of interventions to improve the seasonal influenza vaccination uptake among nurses: A systematic review. J Infect Prev 2023; 24:268-277. [PMID: 37969468 PMCID: PMC10638950 DOI: 10.1177/17571774231208115] [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: 09/29/2020] [Accepted: 09/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background Seasonal influenza is a significant cause of mortality and morbidity worldwide. Despite annual recommendations, influenza vaccination uptake rates are disproportionately lower among nurses compared to other health care professionals, especially when compared to physicians. Nurses have an additional risk of exposure to influenza infection due to the nature of their work. Aim To determine the effectiveness of interventions in increasing seasonal influenza vaccination uptake among nurses. Methods Evidence on the effectiveness of interventions to improve seasonal influenza vaccination uptake among nurses was systematically reviewed. A comprehensive search of six electronic databases and grey literature was undertaken. A minimum of two reviewers completed study selection, data extraction and risk of bias assessment independently. Results One hundred and thirty-four studies were identified of which one cluster randomised trial met the inclusion criteria. The results of the included study found the implementation of an intervention with multiple components increased nurses' seasonal influenza vaccination rates during a single influenza season in geriatric healthcare settings in France. As the evidence in this review was very limited, it was not possible to make recommendations regarding which interventions were effective at increasing the seasonal influenza vaccination rate for nurses. Conclusion This systematic review highlights a lack of high-quality studies that assessed interventions to improve the seasonal influenza vaccination of nurses. In view of the likelihood of influenza and the coronavirus (COVID-19) pandemic occurring together, it is imperative to have evidence on effective interventions for the nursing workforce and for policy decision makers.
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Affiliation(s)
- Paula Flanagan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | | | - Louise Murphy
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Martina Giltenane
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Peter Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Georgina Gethin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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15
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Townsend L, Kelly G, Kenny C, McGrath J, Donohue S, Allen N, Doherty L, Noonan N, Martin G, Fleming C, Bergin C. Healthcare Worker Characteristics Associated with SARS-CoV-2 Vaccine Uptake in Ireland; a Multicentre Cross-Sectional Study. Vaccines (Basel) 2023; 11:1529. [PMID: 37896933 PMCID: PMC10610998 DOI: 10.3390/vaccines11101529] [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: 09/04/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
The prevention of SARS-CoV-2 acquisition and transmission among healthcare workers is an ongoing challenge. Vaccination has been introduced to mitigate these risks. Vaccine uptake varies among healthcare workers in the absence of vaccine mandates. We investigated engagement with SARS-CoV-2 vaccination among healthcare workers and identified characteristics associated with lower vaccine uptake. This multi-site cross-sectional study recruited n = 1260 healthcare workers in both clinical and non-clinical roles over a three-month period from November 2022. Participants reported their engagement with the primary SARS-CoV-2 vaccination programme and subsequent booster programmes, as well as providing demographic, occupational and personal medical history information. Multivariable linear regression identified characteristics associated with vaccine uptake. Engagement with vaccination programmes was high, with 88% of participants receiving at least one booster dose after primary vaccination course. Younger age and female sex were associated with reduced vaccine uptake. Healthcare workers in non-clinical roles also had reduced vaccine uptake. These findings should inform vaccination strategies across healthcare settings and target populations with reduced vaccine uptake directly, in particular young, female, and non-clinical healthcare workers, both for SARS-CoV-2 and other healthcare-associated vaccine-preventable infections.
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Affiliation(s)
- Liam Townsend
- Department of Infectious Diseases, St James’s Hospital, D08 NHY1 Dublin, Ireland; (L.T.)
| | - Gavin Kelly
- Department of Infectious Diseases, University Hospital Galway, H91 YR71 Galway, Ireland
| | - Claire Kenny
- Department of Infectious Diseases, University Hospital Galway, H91 YR71 Galway, Ireland
| | - Jonathan McGrath
- Department of Infectious Diseases, St James’s Hospital, D08 NHY1 Dublin, Ireland; (L.T.)
| | - Seán Donohue
- Department of Infectious Diseases, St James’s Hospital, D08 NHY1 Dublin, Ireland; (L.T.)
| | - Niamh Allen
- Department of Infectious Diseases, St James’s Hospital, D08 NHY1 Dublin, Ireland; (L.T.)
| | | | - Noirin Noonan
- Department of Occupational Medicine, St James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Greg Martin
- Health Protection Surveillance Centre, D01 A4A3 Dublin, Ireland
| | | | - Catherine Fleming
- Department of Infectious Diseases, University Hospital Galway, H91 YR71 Galway, Ireland
| | - Colm Bergin
- Department of Infectious Diseases, St James’s Hospital, D08 NHY1 Dublin, Ireland; (L.T.)
- Department of Clinical Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
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16
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Yu X, Gan T, Zhu Y, Wang M, Qian L, Lu Y. Management of Occupational Bloodborne Pathogen Exposure among Medical Personnel: a 4-Year Prospective Study. Jpn J Infect Dis 2023; 76:289-294. [PMID: 37258178 DOI: 10.7883/yoken.jjid.2022.492] [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] [Indexed: 06/02/2023]
Abstract
This study examined the management of occupational bloodborne pathogen exposure at a tertiary hospital in China. This prospective study was conducted at the Zhejiang Hospital of Traditional Chinese Medicine between January 2016 and December 2019. Data on bloodborne occupational exposure management were collected. In total, 460 exposures were reported. The majority of exposures (40.2 %) were from hepatitis B virus (HBV)-positive index patients. Of the 460 cases, 453 (98.5%) exposures were reported timeously, and 371 (80.7%) cases received emergency treatment response and management. Sixty-eight personnel (93.2%) received timely prophylaxis treatment. Only 82/113 (72.6%) personnel completed the recommended follow-up period. Outsourced personnel(P = 0.002) and interns (P = 0.011) were independent follow-up factors. Although adequate compliance was achieved with timely reporting and prophylactic medication, there is room for improvement in terms of emergency treatment response and follow-up compliance. Furthermore, HBV vaccination and improved follow-up with outsourced personnel are recommended.
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Affiliation(s)
- Xuxia Yu
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Tieer Gan
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Yuexian Zhu
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Minfang Wang
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Lili Qian
- Medical Laboratory, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Ye Lu
- Institute of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, China
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17
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Frozanfar MK, Hamajima N, Fayaz SH, Rahimzad AD, Stanekzai H, Inthaphatha S, Nishino K, Yamamoto E. Factors associated with pentavalent vaccine coverage among 12-23-month-old children in Afghanistan: A cross-sectional study. PLoS One 2023; 18:e0289744. [PMID: 37552707 PMCID: PMC10409276 DOI: 10.1371/journal.pone.0289744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION This study aimed to identify the factors associated with the coverage of the third dose of pentavalent vaccine (Penta3) among children aged 12-23 months in Afghanistan. METHODS The data of 3,040 children aged 12-23 months were taken from the Afghanistan Health Survey 2018, including characteristics of the children and their households, household heads, and mothers/primary care givers. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using a logistic model. Multivariable stepwise logistic regression analysis with forward-selection (Model 1) and backward-selection (Model 2) was performed using variables that showed significant differences by bivariate analysis. RESULTS The coverage of Penta3 among 12-23-month-old children was 82.3%. Factors associated with Penta3 coverage in the two models of multivariable analysis were 18-23 months old compared to 12-17 months old; having no diarrhea in the last two weeks compared to having diarrhea; no bipedal edema compared to having edema; taking vitamin A supplement; 1-2 children under five years in a household compared to three or more; distance from residence to the nearest health facility ≤2 hours on foot; having a radio; having a TV; educated heads of households; non-smoking of heads of households; and literacy of mothers/primary caregivers. CONCLUSIONS Penta3 coverage among 12-23-month-old children improved but was still lower than the target. Primary education should be provided to all children throughout the country. TV and radio are useful tools for providing health information. Mobile outreach programs and the establishment of new health facilities should be promoted to improve access to health service for all people in Afghanistan.
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Affiliation(s)
- Muhammad Kamel Frozanfar
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Healthcare-Associated Infections and Antimicrobial Resistance Program, Office of Epidemiology, Virginia Department of Health, Richmond, Virginia, United States of America
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Said Hafizullah Fayaz
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland, United States of America
| | - Abdullah Darman Rahimzad
- Department of Ear, Nose and Throat, Balkh University Faculty of Medicine, Mazar-i-Sharif, Balkh, Afghanistan
| | | | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kimihiro Nishino
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Sumner KM, Duca LM, Arriola CS, Neyra J, Soto G, Romero C, Tinoco Y, Nogareda F, Matos E, Chavez V, Castillo M, Bravo E, Castro J, Thompson M, Azziz-Baumgartner E. Knowledge, attitudes, and practices associated with frequent influenza vaccination among healthcare personnel in Peru, 2016─2018. Vaccine X 2023; 14:100314. [PMID: 37234596 PMCID: PMC10205539 DOI: 10.1016/j.jvacx.2023.100314] [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: 11/08/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction Despite a government-subsidized vaccination program, healthcare personnel (HCP) influenza vaccination uptake remains low in Peru. Using three years of cross-sectional surveys and an additional five years of prior vaccination history of HCP in Peru, we explored HCP knowledge, attitudes, and practices (KAP) of influenza illness and its impact on vaccination frequency. Methods In 2016, the Estudio Vacuna de Influenza Peru (VIP) cohort was initiated in Lima, Peru, which collected information about HCP KAP and influenza vaccination history from 2011─2018. HCP were classified by their 8-year influenza vaccination history as never (0 years), infrequently (1─4 years), or frequently (5─8 years) vaccinated. Logistic regression models were used to describe KAP associated with frequent compared to infrequent influenza vaccination, adjusted for each HCP's healthcare workplace, age, sex, preexisting medical conditions, occupation, and length of time providing direct patient care. Results From 2016─2018, 5131 HCP were recruited and 3120 fully enrolled in VIP; 2782 consistently reported influenza vaccination status and became our analytic sample. From 2011─2018, 14.3% of HCP never, 61.4% infrequently, and 24.4% frequently received influenza vaccines. Compared to HCP who were infrequently vaccinated, frequently vaccinated HCP were more likely to believe they were susceptible to influenza (adjusted odds ratio [aOR]:1.49, 95% confidence interval [CI]:1.22─1.82), perceived vaccination to be effective (aOR:1.92, 95%CI:1.59─2.32), were knowledgeable about influenza and vaccination (aOR:1.37, 95%CI:1.06─1.77), and believed vaccination had emotional benefits like reduced regret or anger if they became ill with influenza (aOR:1.96, 95%CI:1.60─2.42). HCP who reported vaccination barriers like not having time or a convenient place to receive vaccines had reduced odds of frequent vaccination (aOR:0.74, 95%CI:0.61─0.89) compared to those without reported barriers. Conclusion Few HCP frequently received influenza vaccines during an eight-year period. To increase HCP influenza vaccination in middle-income settings like Peru, campaigns could strengthen influenza risk perception, vaccine knowledge, and accessibility.
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Affiliation(s)
- Kelsey M. Sumner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lindsey M. Duca
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carmen Sofia Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joan Neyra
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Giselle Soto
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Candice Romero
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Yeny Tinoco
- U.S. Naval Medical Research Unit No. 6, Bellavista, Peru
| | - Francisco Nogareda
- Consultant to the Pan American Health Organization, 525 23rd Street NW, Washington, DC 20037, USA
| | | | | | - Maria Castillo
- Hospital Nacional de Salud del Niño, Lima, Peru
- Medical School, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduar Bravo
- Medical School, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Juan Castro
- Hospital Nacional Daniel Alcides Carrion, Lima, Peru
| | - Mark Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Otaigbe II, Elikwu CJ. Drivers of inappropriate antibiotic use in low- and middle-income countries. JAC Antimicrob Resist 2023; 5:dlad062. [PMID: 37265987 PMCID: PMC10230568 DOI: 10.1093/jacamr/dlad062] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global security threat that accounts for about 700 000 deaths annually. Studies have shown that antimicrobial resistance could result in a 2% to 3.5% reduction in global Gross Domestic Product by 2050 and a loss of between 60 and 100 trillion US dollars, worth of economic output resulting in significant and widespread human suffering. Low- and middle-income countries (LMICs) will be worse hit by an unchecked rise of AMR. For example, it is predicted that AMR could kill about 4.1 million people in Africa by 2050 if it is not curbed. Similarly rising rates of AMR will lead to increased treatment costs and an inability to attain universal health coverage, in LMICs with fragile health systems. Sadly, AMR is driven by the inappropriate use of antimicrobials, especially antibiotics. Inappropriate antibiotic use is a pertinent problem in LMICs where regulatory frame works are weak. Inappropriate antibiotic use in LMICs is a multifaceted problem that cuts across clinical and veterinary medicine and agriculture. Therefore, efforts geared at curbing inappropriate antibiotic use in LMICs must identify the factors that drive this problem (i.e. inappropriate antibiotic use) in these countries. A clear knowledge of these factors will guide effective policy and decision making to curb inappropriate antibiotic use and ultimately AMR. The focus of this review is to discuss the factors that drive inappropriate antibiotic use in LMICs.
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Affiliation(s)
| | - Charles John Elikwu
- Department of Medical Microbiology, School of Basic Clinical Sciences, Benjamin Carson (Snr.) College of Health & Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
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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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Collett G, Godec T, Gupta AK. Factors influencing attitudes toward vaccine safety and vaccine effectiveness amongst UK healthcare professionals prior to and at the time of COVID-19 vaccine rollout: Insights from the CoPE-HCP cohort study. Hum Vaccin Immunother 2023; 19:2188823. [PMID: 36977613 PMCID: PMC10078128 DOI: 10.1080/21645515.2023.2188823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Given the potential for nosocomial outbreaks, we must understand factors associated with negative vaccine attitudes amongst healthcare professionals (HCPs) before the rollout of a newly developed vaccine in a pandemic setting. The aim of this prospective cohort study was to study the impact of preexisting and prevailing mental health on United Kingdom HCPs' attitudes towards a newly developed COVID-19 vaccine. Two online surveys were distributed: first during vaccine development (July-September, 2020) and second during nationwide vaccine rollout (December 2020-March 2021). Mental health (PHQ-9 for depression; GAD-7 for anxiety) was assessed in both surveys. Negative attitude regarding vaccine safety and vaccine effectiveness was assessed at vaccine rollout. A series of logistic regression models were developed relating mental health (preexisting during vaccine development, ongoing and new-onset during rollout, and changes in symptom severity) to negative vaccine attitudes. In 634 HCPs, the presence of depression and/or anxiety during vaccine development was associated with elevated negative attitude towards vaccine safety (adj. OR 1.74 [95% CI 1.10-2.75], p = .02), but not vaccine effectiveness (1.13 [0.77-1.66], p = .53) at rollout. This was independent of other characteristics: age, ethnicity, professional role, and history of contracting COVID-19. Ongoing depression and/or anxiety (1.72 [1.10-2.69], p = .02) was associated with elevated negative attitude regarding vaccine effectiveness, but not vaccine safety. Worsened combined symptom scores over time were associated with elevated negative vaccine effectiveness attitudes (1.03 [1.00-1.05], p < .05), but not vaccine safety. Overall, adverse mental health can impact on HCPs' attitudes towards a newly developed vaccine. Further work is required to understand how this translates to vaccine uptake.
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Affiliation(s)
- George Collett
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Thomas Godec
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ajay K Gupta
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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Sun J, Zhong Z, Zhu K, Xu P, Zhou C, Liu Z, Zhou Q, Wen J, Gao Y, Li Y, Zhang X. Anxiety and depression among medical staff facing SARS-CoV-2 vaccination in China. J Affect Disord 2023; 324:632-636. [PMID: 36610598 PMCID: PMC9811851 DOI: 10.1016/j.jad.2022.12.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/25/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND SARS-COV-2 vaccination is being carried out worldwide. However, little is known about the effect of SARS-COV-2 vaccination on psychological problems faced by the medical staff. This study aimed to examine the prevalence and factors contributing to anxiety and depression among medical staff facing SARS-COV-2 vaccination. METHODS The GAD-7 and the PHQ-9 scales were used to investigate the anxiety and depression among participants involved in SARS-CoV-2 vaccination. Multivariate logistics regression analysis method was used to assess the risk factors related to anxiety or depression. RESULTS A total of 6984 people responded to all the surveyed questions in our study, including 2707 medical staff and 4277 nonmedical staff. Of the participants, 680 reported anxiety, while 1354 reported depression. Higher anxiety levels were observed among medical staff (13.1 % vs. 7.6 % among the non-medical staff). Participants suffered from depression with higher numbers among medical staff (24.7 % vs. 16.0 % among the non-medical staff). Multivariate logistic regression analysis showed that female medical staff was at higher risk of anxiety and depression compared to their male counterparts (OR = 1.497; OR = 1.417). Pregnancy intention increased the risk of anxiety and depression among medical staff (OR = 1.601; OR = 1.724). LIMITATIONS Our findings may not be extrapolated to other countries. CONCLUSION Medical staff facing SARS-CoV-2 vaccination were more likely to suffer from anxiety or depression, especially the females planning for pregnancy. These results should assist in updating intervention guidelines for the mental health of medical staff facing vaccination.
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Affiliation(s)
- Juan Sun
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Zhenzhen Zhong
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Kai Zhu
- Jishou University, 120 Renmin South Road, 416000 Jishou City, Hunan Province, China
| | - Ping Xu
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Chaojun Zhou
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Zhenghao Liu
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Quan Zhou
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Jun Wen
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Yunchun Gao
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Yandeng Li
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China
| | - Xiaobo Zhang
- First People's Hospital of Changde City, 818 Renmin Road, 415000 Changde City, Hunan Province, China.
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Belkebir S, Maraqa B, Nazzal Z, Abdullah A, Yasin F, Al-Shakhrah K, Zink T. Exploring the Perceptions of Nurses on Receiving the SARS CoV-2 Vaccine in Palestine: A Qualitative Study. Can J Nurs Res 2023; 55:34-41. [PMID: 34913746 DOI: 10.1177/08445621211066721] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Uncertainty about vaccination among nurses are major barriers to managing the ongoing COVID-19 pandemic worldwide. PURPOSE To explore nurseś perceptions about receiving the SARS CoV-2 vaccine to inform the upcoming Palestinian Ministry of Health (MOH) vaccination efforts. METHODS Four focus groups were conducted with nurses between January 18 and 30, 2021, before MOH launched vaccinations in Palestine. Participants working in government and private facilities were invited to participate and completed an online or paper form to provide demographics, review the study purpose, and give consent. Meetings were facilitated in Arabic either online via the Zoom platform or face-to-face using the same interview guide. Transcripts were translated into English and coded using a template analysis approach. RESULTS Forty-six nurses, with a median age of 29.5y (range, 22-57) from across Palestine participated. Three major themes emerged: uncertainty, trust, and the knowledge needed to move forward. Uncertainty related to the evolving nature of COVID-19, the rapidity of vaccine development, the types and timing of available vaccines. The need for trusted experts to share scientific information about the vaccines to counteract the misinformation in social media. Moreover, reliable vaccine information may help vaccine-hesitant nurses move to vaccine-acceptors and to convince others, including their patients. CONCLUSION The negative perception of nurses towards vaccines is problematic in Palestine and uncertainty about which vaccine(s) will be available adds to the lack of education and mass-media misinformation. Other countries with vaccination efforts that are not wholly planned or implemented and may be struggling with similar concerns.
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Affiliation(s)
- Souad Belkebir
- Faculty of Medicine and Health Sciences, 455978An-Najah National University, Nablus, Palestine
| | - Beesan Maraqa
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Zaher Nazzal
- Faculty of Medicine and Health Sciences, 455978An-Najah National University, Nablus, Palestine
| | | | - Ferial Yasin
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Kamal Al-Shakhrah
- Family and Public Health Deputy Minster office, 61171Ministry of Health, Palestine
| | - Therese Zink
- Department of Family Medicine & School of Public Health, Brown University, United States
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Zastawna B, Załuska R, Milewska A, Zdęba-Mozoła A, Ogonowska A, Kozłowski R, Owczarek A, Marczak M. Protective Vaccination Used by Doctors for Prevention of Infections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4153. [PMID: 36901165 PMCID: PMC10001470 DOI: 10.3390/ijerph20054153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Doctors, as with all healthcare workers, are a specific risk group due to a high probability of contact with contagious pathogens. An online survey was conducted among Polish doctors to establish their use of protective vaccination to decrease their personal risk of infection. The online survey was conducted using questions about medics' vaccination decisions and approaches. The results revealed that immunization against VPDs for most participants was not adequate based on recommendations or developments in vaccinology. To increase vaccination as a prophylactic method among doctors, especially those not involved in the immunization of patients, an educational campaign is demanded. As non-immunized medics are at risk themselves and are also a threat to the safety of patients, legal changes and the monitoring of vaccine acceptance and perception among medics are required.
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Affiliation(s)
- Beata Zastawna
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Roman Załuska
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Anna Milewska
- Department of Statistics and Medical Informatics, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Agnieszka Zdęba-Mozoła
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Agnieszka Ogonowska
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Remigiusz Kozłowski
- Center for Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
| | - Anna Owczarek
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-131 Lodz, Poland
| | - Michał Marczak
- Collegium of Management, WSB University in Warsaw, 03-204 Warszawa, Poland
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Vaccination against influenza, measles, pertussis and varicella in workers in healthcare facilities in France: A national cross-sectional study in 2019. Vaccine 2023; 41:812-820. [PMID: 36528442 DOI: 10.1016/j.vaccine.2022.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/30/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Vaccine recommendations for healthcare workers (HCW) aim to protect them and reduce transmission to susceptible patients. We conducted a national randomised survey in 2019 whose main objectives were to estimate national vaccination coverage (VC) for measles, pertussis, varicella, and influenza in HCW working in healthcare facilities (HCF) in France, and to identify determinants associated with higher VC. METHODS We performed a cross-sectional survey of physicians, nurses, midwives and nursing assistants in HCF using a random stratified three-stage sampling design. Data were collected during face-to-face interviews using a tablet computer and complemented with information from the individual HCW vaccination records. We investigated possible determinants of higher VC using univariate and multivariate Poisson regressions and estimated the prevalence ratio (PR). RESULTS We included 8594 HCW working in 167 HCF. Self-declared VC was 73.3% (CI95%: 71.0-75.5) for measles in HCW with no history of measles (at least one dose), 53.5% (49.9-57.0) for pertussis (booster dose during adulthood), 26.4% (23.0-30.2) for varicella in HCW with no history of varicella (at least one dose) and 34.8% (32.8-37.4) for influenza. Taking into account the history of each disease and related VC, 14.6% and 10.1 % of HCW were susceptible to measles and varicella. VC varied by profession, age group, ward and sex. Higher influenza VC was observed in HCW working in wards where i) there was a staff vaccination contact person (PRa: 1.2, CI95% 1.1-1.4), ii) staff vaccination was organized in the ward (1.4: 1.2-1.6), iii) information on influenza vaccines was provided (1.2: 1.1-1.4), and iv) the ward manager supported the HCW vaccination campaign (1.3: 1.1-1.6). DISCUSSION Over a 10-year period, VC for HCW working in HCF improved in France. However, vaccination objectives were not achieved for measles (95%) or influenza (80%). Vaccination efforts should be continued, especially in wards with at-risk patients.
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Riccio M, Marte M, Imeshtari V, Vezza F, Barletta VI, Shaholli D, Colaprico C, Di Chiara M, Caresta E, Terrin G, Papoff P, La Torre G. Analysis of Knowledge, Attitudes and Behaviours of Health Care Workers towards Vaccine-Preventable Diseases and Recommended Vaccinations: An Observational Study in a Teaching Hospital. Vaccines (Basel) 2023; 11:vaccines11010196. [PMID: 36680040 PMCID: PMC9867139 DOI: 10.3390/vaccines11010196] [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: 12/31/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Recommended vaccinations are the cheapest and most effective measure to reduce the risk of transmission and related complications, especially in high-risk healthcare settings. This study aimed to evaluate the knowledge, attitudes and behaviours of HCWs in relation to national recommendations. Methods: A transversal study was conducted through administration of a questionnaire by personal interview. The following care units were involved: Paediatric, Neonatal, Cardiac Surgery and General Intensive Care Units and Infectious Diseases Unit. Results: The study sample comprised 308 HCWs. Half the sample were aware of the vaccination recommendations, with occupation and age found to be predictive factors (OR = 9.38, 95%CI: 2.07−42.41; OR = 0.36, 95%CI: 0.22−0.60). A higher percentage defined the diseases as a risk for their patients’ health, although this perception was lower in the over-40 age group. In several cases, there were statistically significant differences between the care units (p < 0.001). Around three-quarters of the sample agreed that vaccination should be mandatory; willingness to undergo a future booster vaccination was statistically correlated with the variables of age and care unit (p < 0.001, p = 0.03). Conclusion: The protection of health in the workplace can be achieved through some strategic actions, such as the implementation of educational strategies, and protocols for the monitoring of immunocompetence and the improvement of vaccination.
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Affiliation(s)
- Marianna Riccio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Mattia Marte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Valentin Imeshtari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Francesca Vezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Vanessa India Barletta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - David Shaholli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Corrado Colaprico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Maria Di Chiara
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena Caresta
- Pediatric Intensive Care Unit, Department of Pediatrics, Umberto I Policlinico, Sapienza University of Rome, 00185 Rome, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Paola Papoff
- Pediatric Intensive Care Unit, Department of Pediatrics, Umberto I Policlinico, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-49970978
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Shi X, Zhang Y, Zhou L, Zhou L, Qiao H. Influenza vaccination coverage among health-care workers during the COVID-19 epidemic in 2020/2021 influenza season: Evidence from a web-based survey in northwestern China. Hum Vaccin Immunother 2022; 18:2102354. [PMID: 35920744 DOI: 10.1080/21645515.2022.2102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccinating health-care workers against influenza during the COVID-19 pandemic can effectively prevent and control influenza and reduce COVID-19 strain on health systems. This study was conducted to explore influenza vaccination coverage and determinants among health-care workers during the COVID-19 pandemic in 2020/2021 influenza season in Ningxia. This cross-sectional survey included demographic characteristics of health-care workers, influenza vaccination status, reasons for not getting vaccinated, and whether influenza vaccination was recommended for others. We found that influenza vaccine rate of health-care workers was 39.6%. A binary logistic regression analysis showed that health-care workers' vaccination coverage was higher when the individuals were aware of the effect of the influenza vaccine (OR = 0.624, 95% CI: 0.486-0.802). Health-care workers who from internal medicine (OR = 1.494, 95% CI: 1.146-1.948), pediatrics (OR = 2.091, 95% CI: 1.476-2.962), and surgery departments (OR = 1.373, 95% CI: 1.014-1.859) had a lower coverage than those who worked in vaccination and infectious disease departments. The main reasons that some stated for not getting vaccinated were that they felt it was unnecessary (52.22%). Health-care workers who were vaccinated against influenza were more likely to recommend influenza vaccination to their patients than health-care workers who had not been vaccinated. The incidence of influenza among health-care workers was higher than that of the general population in Ningxia. Under the policy of voluntary and self-pay influenza vaccination in Ningxia, the coverage rate of influenza vaccine among health-care workers was far below the vaccination requirements of influenza vaccine in influenza season even during the COVID-19 epidemic.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Ying Zhang
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Luping Zhou
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Liwei Zhou
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Hui Qiao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
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Jang B, Kim HW, Kim HS, Park JY, Seo H, Kim YK. Measles Virus Neutralizing Antibody Response and Durability Two Years after One or Two Doses of Measles-Mumps-Rubella Vaccine among Young Seronegative Healthcare Workers. Vaccines (Basel) 2022; 10:vaccines10111812. [PMID: 36366321 PMCID: PMC9698570 DOI: 10.3390/vaccines10111812] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 12/04/2022] Open
Abstract
Although there have been several studies regarding the immunogenicity of one or two booster doses of the measles−mumps−rubella (MMR) vaccine in measles-seronegative young adults, limited data are available about how long the immune response is sustained compared with natural infection. This study included seronegative healthcare workers (HCWs) (aged 21−38 years) who received one or two doses of the measles−mumps−rubella (MMR) vaccine and HCWs with laboratory-confirmed measles infection during an outbreak in 2019. We compared neutralizing antibody titers measured using the plaque reduction neutralization (PRN) test and measles-specific immunoglobulin G (IgG) using chemiluminescent immunoassays 2 years after vaccination or infection. Among 107 HCWs with seronegative measles IgGs, the overall seroconversion rate of measles IgGs remained 82.2% (88/107), and 45.8% (49/107) of the participants had a medium (121−900) or high (>900) PRN titer after 2 years from one or two booster doses. The measles-neutralizing antibody titers of both PRN titer (ND50) and geometric mean concentration 2 years after natural infection were significantly higher than those of one or two booster doses of the MMR vaccine (p < 0.001 and p < 0.001, respectively). Our results suggest that serologic screening followed by appropriate postexposure prophylaxis can be beneficial for young HCWs without a history of natural infection especially in a measles outbreak setting, because of possible susceptibility to measles despite booster MMR vaccination 2 years ago. Long-term data about sustainable humoral immunity after one or two booster vaccination are needed based on the exact vaccination history.
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Affiliation(s)
- Byungki Jang
- Ilsong Institute of Life Science, Hallym University, Seoul 01000, Korea
| | - Han Wool Kim
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14100, Korea
| | - Han-Sung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14100, Korea
| | - Ji Young Park
- Department of Internal Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14100, Korea
| | - Hyeonji Seo
- Department of Internal Medicine, Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14100, Korea
| | - Yong Kyun Kim
- Department of Internal Medicine, Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14100, Korea
- Correspondence: ; Tel.: +82-31-380-3724
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Development of a road map to scale up the uptake and utilization of influenza vaccine in 22 countries of Eastern Mediterranean Region. Vaccine 2022; 40:6558-6565. [PMID: 36208976 DOI: 10.1016/j.vaccine.2022.09.051] [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: 07/10/2022] [Revised: 09/06/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of this project was to develop a road map to support countries in Eastern Mediterranean Region in developing and implementing evidence-based seasonal influenza vaccination policy, strengthen influenza vaccination delivery program and address vaccine misperceptions and hesitancy. METHODS The road map was developed through consultative meetings with countries' focal points, review of relevant literature and policy documents and analysis of WHO/UNICEF Joint Reporting Form on immunization ((JRF 2015-2020) data. Countries were categorised into three groups, based on the existence of influenza vaccination policy and national regulatory authority, availability of influenza vaccine in the country and number of influenza vaccine doses distributed/ 1000 population. The final road map was shared with representatives of all countries in Eastern Mediterranean Region and other stakeholders during a meeting in September 2021. RESULT The goal for next 5 years is to increase access to and use of utilization of seasonal influenza vaccine in Eastern Mediterranean Region to reduce influenza-associated morbidity and mortality among priority groups for vaccination. Countries in the Eastern Mediterranean Region are at different stages of implementation of the influenza vaccination program, so activities are planned under four strategic priority areas based on current situations in countries. The consultative body recommended that some countries should establish a new seasonal influenza vaccination programme and ensure the availability of vaccines, while other countries need to reduce vaccine hesitancy and enhance current seasonal influenza vaccination coverage, particularly in all high-risk groups. Countries are also encouraged to leverage COVID-19 adult vaccination programs to improve seasonal influenza vaccine uptake. CONCLUSION This road map was developed through a consultative process to scale up the uptake and utilization of influenza vaccine in all countries of Eastern Mediterranean Region. The road map proposes activities that should be adopted in the local context to develop/ update national policies and programs.
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Sevilla JP. The value of vaccines. Curr Opin Immunol 2022; 78:102243. [PMID: 36156412 DOI: 10.1016/j.coi.2022.102243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/24/2022] [Accepted: 08/11/2022] [Indexed: 01/28/2023]
Abstract
Optimizing vaccine spending depends on recognizing the full value of vaccination (VoV). Existing taxonomies of such value are not comprehensive because they are not guided by general theories. I rely on two such theories: subjective-value theory claims that what has value is determined by what people actually or ideally want in life. A welfarist theory of government states that a fundamental objective of government is to promote social value (or social welfare). These jointly imply that any aspect of life that individuals actually or ideally value and that could be negatively affected by vaccine-preventable diseases (and therefore positively affected by preventive vaccines) is an element of VoV. I build a more comprehensive-value taxonomy than currently exists based on this implication.
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Affiliation(s)
- J P Sevilla
- Data for Decisions, LLC, Harvard T. H. Chan School of Public Health, USA.
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Bianchi FP, Stefanizzi P, De Maria L, Martinelli A, Diella G, Larocca AMV, Vimercati L, Tafuri S. Vaccination Offer during the Occupational Health Surveillance Program for Healthcare Workers and Suitability to Work: An Italian Retrospective Cohort Study. Vaccines (Basel) 2022; 10:vaccines10101633. [PMID: 36298499 PMCID: PMC9610769 DOI: 10.3390/vaccines10101633] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
The active immunization of health care workers (HCWs) is a crucial measure to avoid nosocomial infection; nevertheless, vaccine coverage (VC) among health personnel in Italy is unsatisfactory. To improve VC in the healthcare set, the Hygiene and Occupational Medicine departments of Bari Policlinico General University Hospital applied a specific program. The operative procedure demands that in the context of the occupational medical examination, all workers are evaluated for susceptibility to vaccine-preventable diseases (VDPs), with immunization prophylaxis offered to those determined to be susceptible. This study analyzed data from workers who attended the biological risk assessment protocol from December 2017 to October 2021 (n = 1477), who were evaluated for the immune status for measles, mumps, rubella, and varicella. Among the enrolled subjects, non-protective antibody titers were higher for measles and mumps (13%), followed by rubella (11%) and varicella (8%). Appropriate vaccinations were offered to all susceptible HCWs, and HCWs were re-tested one month after immunization. The seroconversion rate after the administration of one or more booster dose(s) was over 80%. Overall, 2.5% of the subjects refused the offered vaccine(s); the main determinant of immunization compliance was younger age (aOR = 0.86; 95%CI = 0.80–0.92). Especially during the COVID-19 pandemic, VPDs may still present a hazard in nosocomial environment. Our experience suggests that, despite hospital procedures and dedicated human assets, satisfactory VC cannot be reached without the provision of federal regulations. Nevertheless, public health policymakers have to improve the promotion of vaccine prophylaxis and education to reach higher VC.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Giusy Diella
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | | | - Luigi Vimercati
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-80-5478473; Fax: +39-80-5478472
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La Torre G, Marte M, Imeshtari V, Colaprico C, Ricci E, Shaholli D, Barletta VI, Serruto P, Gaeta A, Antonelli G. Susceptibility towards Chickenpox, Measles and Rubella among Healthcare Workers at a Teaching Hospital in Rome. Vaccines (Basel) 2022; 10:vaccines10101573. [PMID: 36298438 PMCID: PMC9612096 DOI: 10.3390/vaccines10101573] [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: 08/19/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 11/16/2022] Open
Abstract
Immunization is the best protection against chickenpox, measles and rubella. It is important to identify and immunize susceptible healthcare workers to prevent and control hospital infections. Our aim was to estimate the susceptibility level of healthcare workers at a Teaching Hospital in Rome concerning these diseases and the factors associated to the susceptibility. Methods: a cross sectional study was carried out at the Department of Occupational Medicine of the Umberto I General Hospital of Rome. Participants were recruited during routine occupational health surveillance. As far as inclusion criteria, the following professionals were considered: doctors, nurses, laboratory technicians and other health professionals. Concerning the exclusion criteria, patients with HIV, cancer and diseases of the immune system, and acute illness or fever more than 38.5 °C, were not included in the study. A blood sample was tested for the presence of antibodies against measles, rubella and chicken pox. Results: 1106 healthcare professionals were involved in the study (41.8% nurses, 30.4% doctors, 12.3% laboratory technicians, 15.1% other health professionals): 25 (2.3%), 73 (6.6%) and 35 (3.2%) of these were susceptible to measles, rubella and chicken pox, respectively. The only variable associated with susceptibility of measles was age (p < 0.001). Furthermore, there was evidence of an association between various susceptibilities, particularly between measles and chickenpox (OR: 4.38). Conclusion: this study showed that even if the majority of our healthcare professionals are immunized for MRV, it is necessary not to underestimate the seronegativity of non-immune ones. All health professionals should be vaccinated to ensure safety for patients, especially the weakest.
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Affiliation(s)
- Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Mattia Marte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentin Imeshtari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Corrado Colaprico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Eleonora Ricci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - David Shaholli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Vanessa India Barletta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Pasquale Serruto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Aurelia Gaeta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Laboratory of Virology, Sapienza University of Rome, 00185 Rome, Italy
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Evaluation of Vaccine Hesitancy and Anxiety Levels among Hospital Cleaning Staff and Caregivers during COVID-19 Pandemic. Vaccines (Basel) 2022; 10:vaccines10091426. [PMID: 36146504 PMCID: PMC9501219 DOI: 10.3390/vaccines10091426] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/20/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
It is important to vaccinate individuals working in the field of health who are more at risk compared to society during the pandemic period. The aim of this study was to evaluate the vaccine hesitancy and anxiety levels of hospital cleaning staff and caregivers during the COVID-19 pandemic. This descriptive type cross-sectional study was conducted with 460 hospital cleaning staff and caregivers. Demographic and social characteristics form, Coronavirus Anxiety Scale (CAS), and Vaccine Hesitancy Scale (VHS) adapted to the pandemic were used in the questionnaire form used to collect the data of the study. It was determined that the rates of hesitation against the COVID-19 vaccine and childhood vaccine were 42.2% (n = 194) and 10.9% (n = 50), respectively. Less than half of the participants (44.6%) believe that the COVID-19 vaccine is protective. COVID-19 anxiety (CAS score ≥ 9 point) was detected in 19.6% of participants and statistically significant differences were found between patients with (n = 90) and without (n = 370) anxiety regarding gender (p < 0.001), working unit (p = 0.002), vaccination status (p = 0.023) and history of psychological disease (p = 0.023). It has been shown that the VHS-total scores of those who are not vaccinated, those who are hesitant about vaccination, those who do not think that the vaccine is protective, and those who state that there is no need for a legal obligation in vaccination are higher. When participants were asked about the most anxious situation during the COVID-19 period, the highest response rate was 62.4% for my parents’ exposure to COVID-19. The most anxious situation among participants is their parents’ exposure to COVID-19. Although participants are highly vaccinated, they have serious hesitancy about the COVID-19 vaccine. This study also showed that there was a parallel relationship between COVID-19 anxiety and vaccine hesitancy.
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COVID-19 Vaccine Mandates for Healthcare Professionals in the United States. Vaccines (Basel) 2022; 10:vaccines10091425. [PMID: 36146503 PMCID: PMC9504674 DOI: 10.3390/vaccines10091425] [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: 07/12/2022] [Revised: 08/25/2022] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
Healthcare workers (HCWs) need to be vaccinated against COVID-19 because they care for vulnerable patients. Hesitation to receiving the COVID-19 vaccine stems from the argument of bodily autonomy, novel mRNA vaccine technology, and conspiracy theories. However, vaccinations may prevent thousands of hospitalizations and deaths. HCWs have previously complied with other required vaccinations to care for children, elderly, and immunocompromised patients. Yet, COVID-19 vaccination mandates in the healthcare setting have been faced with resistance and subsequent staffing shortages. As HCWs display their hesitation to the vaccine, the community loses trust in its efficacy and safety. Speculation on pharmaceutical profiteering has also contributed to vaccine mistrust. As the pandemic continues, the healthcare field must decide on a course of action: adhere to vaccination mandates and cope with decreased staffing, repeal vaccination mandates to recover staff, rely on personal protective equipment (PPE) alone for protection, or do nothing and expect survival through herd immunity. To date, the United States has chosen to mandate COVID-19 vaccinations for any healthcare worker employed by Medicare and/or Medicaid-accepting facilities, allowing allergy and religious exemptions. This COVID-19 vaccination mandate for HCWs ethically protects the vulnerable people who HCWs vow to care for.
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The Role of Psychological Factors and Vaccine Conspiracy Beliefs in Influenza Vaccine Hesitancy and Uptake among Jordanian Healthcare Workers during the COVID-19 Pandemic. Vaccines (Basel) 2022; 10:vaccines10081355. [PMID: 36016243 PMCID: PMC9413675 DOI: 10.3390/vaccines10081355] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 12/29/2022] Open
Abstract
Vaccination to prevent influenza virus infection and to lessen its severity is recommended among healthcare workers (HCWs). Health professionals have a higher risk of exposure to viruses and could transmit the influenza virus to vulnerable patients who are prone to severe disease and mortality. The aim of the current study was to evaluate the levels of influenza vaccine acceptance and uptake as well as its determinants, among Jordanian HCWs over the last influenza season of 2021/2022. This study was based on a self-administered electronic survey that was distributed in March 2022. Psychological determinants of influenza vaccine acceptance and vaccine conspiracy beliefs were assessed using the previously validated 5C scale questionnaire (confidence, complacency, constraints, calculation and collective responsibility) and the vaccine conspiracy beliefs scale. The study sample comprised a total of 1218 HCWs: nurses (n = 412, 33.8%), physicians (n = 367, 30.1%), medical technicians (n = 182, 14.9%), pharmacists (n = 161, 13.2%) and dentists (n = 87, 7.1%), among others. About two-thirds of the study sample expressed willingness to receive influenza vaccination if provided free of charge (n = 807, 66.3%), whereas less than one-third were willing to pay for the vaccine (n = 388, 31.9%). The self-reported uptake of the influenza vaccine in the last influenza season was 62.8%. The following factors were significantly associated with higher acceptance of influenza vaccination if provided freely, as opposed to vaccine hesitancy/rejection: male sex; physicians and dentists among HCW categories; higher confidence and collective responsibility; and lower complacency, constraints and calculation. Higher influenza vaccine uptake was significantly correlated with nurses and physicians among HCW categories, older age, a higher monthly income, higher confidence and collective responsibility, lower complacency and constraints and lower embrace of general vaccine conspiracy beliefs. The results of the current study can provide helpful clues to improve influenza vaccine coverage among HCWs in Jordan. Consequently, this can help to protect vulnerable patient groups and reserve valuable resources in healthcare settings. Psychological determinants appeared to be the most significant factors for vaccine acceptance and uptake, whereas the embrace of general vaccine conspiracy beliefs was associated with lower rates of influenza vaccine uptake, which should be considered in educational and interventional measures aiming to promote influenza vaccination.
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Martin S, Azzouz B, Morel A, Trenque T. Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis. Front Pharmacol 2022; 13:940780. [PMID: 36059934 PMCID: PMC9428621 DOI: 10.3389/fphar.2022.940780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/11/2022] [Indexed: 01/16/2023] Open
Abstract
Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto-immune neurological disorder characterized by the presence in the cerebrospinal fluid (CSF) of antibodies against the GluN1 subunit of NMDA receptors in the brain. The etiology of the disease remains largely unknown. In this study, we aimed to investigate the possible existence of pharmacovigilance signals relating to a link between vaccination and the occurrence of anti-NMDAR encephalitis. We performed a case/non-case study using data from the World Health Organization pharmacovigilance database (VigiBase) up to 31 December 2021. All individual case study reports (ICSRs) linked to a vaccine and coded with the MedDRA Lower Level Term (LLT) “anti-NMDA receptor encephalitis” were analysed. We calculated the Reporting Odds Ratio (ROR) and 95% Confidence Interval (CI) for each type of vaccine. A total of 29,758,737 ICSRs were registered in VigiBase, of which 70 were coded under the selected LLT, and 29/70 (41.4%) involved a vaccine. Of these cases, 53.8% involved children aged younger than 15 years. The median time to onset of anti-NMDAR encephalitis after vaccination was 4 days (range 0–730). The highest RORs were observed for the diphtheria/polio/tetanus/pertussis vaccine [54.72 (95% CI 26.2–114.3)], yellow fever vaccine [50.02 (95% CI 15.7–159)] and human papillomavirus vaccine [32.89 (15.8–68.7)]. All cases were coded as serious; 13 patients did not recover, or were left with permanent sequelae. Nine patients recovered without sequelae or are on the path to recovery, and one patient died. In summary, pharmacovigilance signals were observed for anti-NMDAR encephalitis and vaccination. Clinicians need to be aware of this potential risk, and encourage to report any case of anti-NMDAR encephalitis occurring after vaccination.
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Vaccine hesitancy and health care providers: Using the preferred cognitive styles and decision- making model and empathy tool to make progress. Vaccine X 2022; 11:100174. [PMID: 35782719 PMCID: PMC9241108 DOI: 10.1016/j.jvacx.2022.100174] [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: 12/17/2021] [Revised: 05/09/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Low vaccination rates among health care providers (HCPs) pose a risk to themselves, their colleagues, their patients, and the general public. This paper seeks to frame the issues surrounding health care provider vaccine hesitancy and vaccination rates, as well as explore factors influencing respective decision-making, including health care occupation and demographic characteristics. This paper will then propose the use of the Preferred Cognitive Style and Decision-Making (PCSDM) Model and the Empathy Tool to increase health care provider vaccination rates, and will end by discussing several recommendations. It is important while discussing HCP vaccination rates to not view them as a monolithic group or apply “one-size-fits-all” approaches, and thus it is essential to present information and engage in conversations in ways that align with how the HCP takes in and processes information and decisions. Furthermore, it is vital to increase health literacy across the spectrum of HCP programs and professions. To this end, it is important to teach and incorporate the PCSDM Model and Empathy Tool, along with information about how individuals think and make decisions, into vaccine education programs and training sessions.
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Swanepoel A, Abed R, Kaser M, St John Smith P. How evolutionary science can help us understand vaccine refusal in the COVID-19 pandemic. BJPsych Bull 2022:1-5. [PMID: 35818884 PMCID: PMC10387408 DOI: 10.1192/bjb.2022.36] [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] [Indexed: 11/23/2022] Open
Abstract
Unvaccinated people have a mortality rate from COVID-19 that is 32-fold that of fully vaccinated people. Yet, in the UK, more than 4% of adults have not accepted a vaccine to protect them against COVID-19 and at the time of writing only 73% of people were fully vaccinated. Psychological and societal factors underlying vaccine hesitation or refusal are complex. In this paper, we use evolutionary science to help explain how vaccine refusal can be the result of an historic adaptation to protect against the repetition of past trauma, including, for many, that of systemic racism and/or deprivation, and misguided attempt to preserve fertility. We discuss some resulting cognitive biases and conclude with recommendations for practice.
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Affiliation(s)
| | | | - Muzaffer Kaser
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; and University of Cambridge, UK
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Peters MD. Addressing vaccine hesitancy and resistance for COVID-19 vaccines. Int J Nurs Stud 2022; 131:104241. [PMID: 35489108 PMCID: PMC8972969 DOI: 10.1016/j.ijnurstu.2022.104241] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 01/12/2023]
Abstract
The COVID-19 vaccine rollout has had various degrees of success in different countries. Achieving high levels of vaccine coverage is key to responding to and mitigating the impact of the pandemic on health and aged care systems and the community. In many countries, vaccine hesitancy, resistance, and refusal are emerging as significant barriers to immunisation uptake and the relaxation of policies that limit everyday life. Vaccine hesitancy/ resistance/ refusal is complex and multi-faceted. Individuals and groups have diverse and often multiple reasons for delaying or refusing vaccination. These reasons include: social determinants of health, convenience, ease of availability and access, health literacy understandability and clarity of information, judgements around risk versus benefit, notions of collective versus individual responsibility, trust or mistrust of authority or healthcare, and personal or group beliefs, customs, or ideologies. Published evidence suggests that targeting and adapting interventions to particular population groups, contexts, and specific reasons for vaccine hesitancy/ resistance may enhance the effectiveness of interventions. While evidence regarding the effectiveness of interventions to address vaccine hesitancy and improve uptake is limited and generally unable to underpin any specific strategy, multi-pronged interventions are promising. In many settings, mandating vaccination, particularly for those working in health or high risk/ transmission industries, has been implemented or debated by Governments, decision-makers, and health authorities. While mandatory vaccination is effective for seasonal influenza uptake amongst healthcare workers, this evidence may not be appropriately transferred to the context of COVID-19. Financial or other incentives for addressing vaccine hesitancy may have limited effectiveness with much evidence for benefit appearing to have been translated across from other public/preventive health issues such as smoking cessation. Multicomponent, dialogue-based (i.e., communication) interventions are effective in addressing vaccine hesitancy/resistance. Multicomponent interventions that encompasses the following might be effective: (i) targeting specific groups such as unvaccinated/under-vaccinated groups or healthcare workers, (ii) increasing vaccine knowledge and awareness, (iii) enhanced access and convenience of vaccination, (iv) mandating vaccination or implementing sanctions against non-vaccination, (v) engaging religious and community leaders, (vi) embedding new vaccine knowledge and evidence in routine health practices and procedures, and (vii) addressing mistrust and improving trust in healthcare providers and institutions via genuine engagement and dialogue. It is universally important that healthcare professionals and representative groups, as often highly trusted sources of health guidance, should be closely involved in policymaker and health authority decisions regarding the establishment and implementation of vaccine recommendations and interventions to address vaccine hesitancy.
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Affiliation(s)
- Micah D.J. Peters
- University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre, City East Campus
- Centenary Building P4-32 North Terrace, Adelaide, SA 5000, Australia,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Nursing School, Adelaide, SA, Australia,The Centre for Evidence-based Practice South Australia (CEPSA): A Joanna Briggs Institute Centre of Excellence, Australia,Australian Nursing and Midwifery Federation (ANMF) Federal Office, Australia,Correspondence to: University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre, City East Campus
- Centenary Building P4-32 North Terrace, Adelaide, SA 5000, Australia
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COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review. Vaccines (Basel) 2022; 10:vaccines10060948. [PMID: 35746556 PMCID: PMC9227837 DOI: 10.3390/vaccines10060948] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.
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Araujo BC, Simakawa R, Munhoz LG, Carmo FB, de Menezes Succi RC, de Moraes-Pinto MI. Rubella antibodies in vertically and horizontally HIV-infected young adults vaccinated early in life and response to a booster dose in those with seronegative results. Vaccine 2022; 40:4496-4502. [PMID: 35717264 DOI: 10.1016/j.vaccine.2022.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Very limited data are available on the persistence of rubella antibodies in vertically HIV-infected individuals who were vaccinated early in life. METHODS Prospective, cohort study on 4 groups of patients: 96 vertically HIV-1-infected individuals (v-HIV), 69 horizontally HIV-1-infected individuals (h-HIV), 93 healthy controls previously vaccinated for rubella (vac-CON) and 20 healthy controls with history of rubella disease (dis-CON). A blood sample was collected and rubella antibodies were analyzed by ELISA. Rubella antibodies above 10 IU/mL were considered protective. Individuals with seronegative results were offered an extra MMR vaccine dose and were tested at least 30 days afterwards. RESULTS Time since previous rubella vaccination was similar in v-HIV, h-HIV and vac-CON (16, 11 and 11 years; p = 0.428). v-HIV and h-HIV were also comparable regarding median CD4 T cells (613 and 614 cells/mm3; p = 0.599) and percentage on ART (93.8% and 98.6%; p = 0.135) at study entry. v-HIV had less individuals on virological suppression (63.5%) compared to 85.5% in h-HIV (p < 0.001). Rubella seropositivity and antibodies were significantly lower in v-HIV compared to h-HIV (32.3% vs 65.5%, 4.3 IU/mL vs 21.1 IU/mL; p < 0.001). Time interval between the last rubella vaccine dose and study entry was associated with an increase of rubella seronegativity, with a 7% higher chance of seronegativity for each one-year increase. After an extra MMR dose, 40 out of 48 (83.3%) seronegative individuals responded, with no significant difference among groups considering rubella seropositivity and antibody levels. CONCLUSION As vertically HIV-infected individuals reach adolescence and adulthood, assessment of vaccine antibodies can identify those who might benefit from an extra vaccine dose.
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Affiliation(s)
- Beatriz Collaço Araujo
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Raquel Simakawa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Luiz Gustavo Munhoz
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Fabiana B Carmo
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Regina Célia de Menezes Succi
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Maria Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
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Comparison of Three Different Waves in Healthcare Workers during the COVID-19 Pandemic: A Retrospective Observational Study in an Italian University Hospital. J Clin Med 2022; 11:jcm11113074. [PMID: 35683462 PMCID: PMC9181027 DOI: 10.3390/jcm11113074] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/17/2022] [Accepted: 05/28/2022] [Indexed: 02/04/2023] Open
Abstract
Background: SARS-CoV-2 has infected many healthcare workers and (HCWs) worldwide. The aim of this study was to determine, analyze, and compare the frequency and characteristics of COVID-19 cases among HCWs of the University Hospital of Bari. Methods: A retrospective observational study was conducted after preventive protocol implementation. The SARS-CoV-2 infection frequency was determined by real-time reverse transcription-polymerase chain reaction on nasopharyngeal samples. Results: Overall, 519 HCWs (9%) tested positive among a total of 6030 HCWs during the three waves. The highest frequency of COVID-19 cases (n = 326; 63%) was observed during the 2nd wave, from September 2020 to December 2020, and the lowest (n = 34; 7%) was observed during the 1st wave, from March 2020 to August 2020 (p < 0.001). Working in a designated COVID-19 department was not a risk factor for infection. Conclusions: The correct use of personal protective equipment and the early identification of symptomatic workers are still essential factors to avoid nosocomial clusters, even in this current phase of vaccine availability.
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Vaux S, Fonteneau L, Venier AG, Gautier A, Soing Altrach S, Parneix P, Lévy-Bruhl D. Influenza vaccination coverage of professionals working in nursing homes in France and related determinants, 2018-2019 season: a cross-sectional survey. BMC Public Health 2022; 22:1049. [PMID: 35614428 PMCID: PMC9134603 DOI: 10.1186/s12889-022-13412-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The burden of influenza morbidity and mortality in nursing homes (NH) is high. Vaccination of residents and professionals working in NH is the main prevention strategy. Despite recommendations, vaccination coverage among professionals is generally low. METHODS We performed a nationwide cross-sectional survey of NH using a single-stage stratified random sampling design to estimate influenza vaccination coverage in NH healthcare workers (HCW) and non-medical professionals in France during the 2018-2019 season, and to identify measures likely to increase it. For each NH, a questionnaire was completed with aggregated data by one member of the management team. A multivariate analysis was performed using a negative binomial regression. RESULTS Five-hundred and eighty nine NH filled in the study questionnaire (response rate: 49.5%). When considering all professionals (i.e., HCW and non-medical professionals), overall vaccination coverage was 30.6% (95%CI [28.2-33.0], range: 1.6-96.2). Overall influenza vaccination coverage in HCW was 31.9% [29.7-34.1]. It varied according to occupational category: 75.5% [69.3-81.7] for physicians, 42.9% [39.4-46.4] for nurses, 26.7% [24.5-29.0] for nursing assistants, and 34.0% [30.1-38.0] for other paramedical personnel. Vaccination coverage was higher i) in private nursing homes (RRa: 1.3, [1.1-1.5]), ii) in small nursing homes (0.9 [0.8-0.9]), iii) when vaccination was offered free of charge (1.4, [1.1-1.8]), iv) when vaccination promotion for professionals included individual (1.6 [1.1-2.1]) or collective (1.3 [1.1-1.5]) information sessions, videos or games (1.4 [1.2-1.6], v) when information on influenza vaccines was provided (1.2 [1.0-1.3], and finally, vi) when a vaccination point of contact-defined as an HCW who could provide reliable information on vaccination-was nominated within the nursing home (1.7 [1.3-2.2]). CONCLUSIONS Urgent and innovative actions are required to increase coverage in HCW. Vaccination programmes should include free on-site vaccination and education campaigns, and particularly target nursing assistants. The results of this nationwide study provide keys for improving influenza vaccination coverage in HCW. Programmes should ensure that information on influenza vaccines is provided by a vaccination point of contact in NH using attractive media. Combining the different prevention measures proposed could increase coverage in NH nationwide by over 50%.
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Affiliation(s)
- Sophie Vaux
- Santé publique France (French Institute for Public Health Surveillance), Saint-Maurice, France.
| | - Laure Fonteneau
- Santé publique France (French Institute for Public Health Surveillance), Saint-Maurice, France
| | - Anne-Gaëlle Venier
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Arnaud Gautier
- Santé publique France (French Institute for Public Health Surveillance), Saint-Maurice, France
| | - Sophan Soing Altrach
- Santé publique France (French Institute for Public Health Surveillance), Saint-Maurice, France
| | - Pierre Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - Daniel Lévy-Bruhl
- Santé publique France (French Institute for Public Health Surveillance), Saint-Maurice, France
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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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PERCEPTION OF CONTROL, DISEASE, AND VACCINE FOR COVID-19: THE EXAMPLE OF HEALTHCARE PROFESSIONALS. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2022. [DOI: 10.33457/ijhsrp.983894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Long-Term Immunogenicity upon Pertussis Booster Vaccination in Young Adults and Children in Relation to Priming Vaccinations in Infancy. Vaccines (Basel) 2022; 10:vaccines10050693. [PMID: 35632449 PMCID: PMC9146390 DOI: 10.3390/vaccines10050693] [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: 03/31/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023] Open
Abstract
Booster vaccinations for pertussis are advised in many countries during childhood or adulthood. In a phase IV longitudinal interventional study, we assessed long-term immunity following an extra pertussis booster vaccination in children and adults. Children (9 years of age) were primed in infancy with either the Dutch whole cell pertussis (wP) vaccine (n = 49) or acellular pertussis (aP) vaccines (n = 59), and all children received a preschool aP booster. Adults (25–29 years, n = 86) were wP-primed in infancy and did not receive a preschool booster. All were followed-up for approximately 6 years. After the additional booster, antibody responses to pertussis were more heterogeneous but generally higher in adults compared with children, and additional modelling showed that antibody concentrations remained higher for at least a decade. Serologic parameters indicative of recent pertussis infection were more often found in aP-primed children (12%) compared with wP-primed individuals (2%) (p = 0.052). This suggests that the aP booster vaccination in aP-primed children offers less long-term protection against pertussis infection and consequently against transmission. Together, these data show that aP priming in combination with aP boosting may not be sufficient to prevent circulation and transmission, while wP-primed adults may benefit from enhanced long-lasting immunity.
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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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Turbat B, Sharavyn B, Tsai FJ. Attitudes towards Mandatory Occupational Vaccination and Intention to Get COVID-19 Vaccine during the First Pandemic Wave among Mongolian Healthcare Workers: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:329. [PMID: 35010589 PMCID: PMC8751197 DOI: 10.3390/ijerph19010329] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/21/2022]
Abstract
Mandatory occupational vaccination for health care workers (HCWs) is a debatable issue, especially during the COVID-19 pandemic. This study aimed to determine Mongolian HCWs' attitudes towards mandatory occupational vaccination, the intention to get the COVID-19 vaccine, and the associated factors. A cross-sectional study based on an online survey with a convenience sampling strategy was conducted from February to April 2021 among 238 Mongolia HCWs. Chi-square and logistic regression were performed for analysis. While only 39.9% of HCWs were aware of recommended occupational vaccinations, they highly agreed with the mandatory occupational vaccination on HCWs (93.7%). The agreement rate is significantly higher than their attitude toward general vaccination (93.7% vs. 77.8%). HCW's willingness to get the COVID-19 vaccine was high (67.2%). HCWs aged 26-35 years old who worked in tertiary level hospitals had less willingness to get the COVID-19 vaccine (50%). Participants with lower confidence in the efficacy of the COVID-19 vaccine (ORs = 15.659) and less positive attitudes toward general vaccination (ORs = 5.288) were less likely to get the COVID-19 vaccine. Mongolian HCWs' agreement rate of mandatory occupational vaccination is higher than other countries. Their intention to get the COVID-19 vaccine is high and associated with confidence in the effectiveness of the vaccine.
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Affiliation(s)
- Battsetseg Turbat
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Nursing, Mongolian University of Pharmaceutical Sciences, Ulaanbaatar 18130, Mongolia
| | - Bold Sharavyn
- Department of Traditional Medicine, International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia;
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- Master’s Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
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Fakonti G, Kyprianidou M, Toumbis G, Giannakou K. Knowledge and attitudes toward vaccination among nurses and midwives in Cyprus: A cross-sectional study. Int J Nurs Knowl 2021; 33:321-329. [PMID: 34806349 DOI: 10.1111/2047-3095.12354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/14/2021] [Accepted: 10/17/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess the level of knowledge and attitudes of nurses and midwives in Cyprus toward vaccinations and provide new insights into the determinants that influence them. METHODS An online cross-sectional study was carried out during the period between December 08 and 28 2020. Participants included registered nurses and midwives working in public or private service provision. A self-administered questionnaire was used with questions about sociodemographic characteristics, questions assessing attitudes and beliefs toward vaccination, and participants' general vaccine knowledge. FINDINGS A total of 437 responders answered the survey, with 93% being nurses and 7% midwives. Around two-thirds (67.3%) of the participants had a high vaccination knowledge, while the remaining have moderate (30.7%), and low (2.1%), respectively. Most of the participants agreed that by vaccinating they protect themselves and those around them (80.5%) and that when most people are not vaccinated, epidemics can easily initiate (74%). Oppositely, many participants disagreed with vaccination and avoided it due to a fear of injections (95.4%) or the belief that it is better to get sick rather than be vaccinated (69.1%). Neutral attitudes toward vaccine-mediated side effects (43.1%) and vaccination safety (41.7%) were observed. Sociodemographic factors such as age, educational status, and work setting significantly affected the nurses' and midwives' knowledge and attitudes toward vaccination (p < 0.05). CONCLUSIONS The findings indicate that the overall vaccination knowledge of participants was high, however, gaps in vaccination knowledge were observed. Individuals who adopted a neutral stance toward vaccination can be prone to changes either toward positive or negative attitudes. IMPLICATIONS FOR NURSING PRACTICE The survey findings suggest implementing educational strategies and targeted interventions in clinical settings to enhance nurses' and midwives' vaccination knowledge and awareness.
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Affiliation(s)
- Georgia Fakonti
- Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Maria Kyprianidou
- Department of Health Sciences of the European University Cyprus, Nicosia, Cyprus
| | - Giannos Toumbis
- Department of Health Sciences of the European University Cyprus, Nicosia, Cyprus
| | - Konstantinos Giannakou
- Public Health at the Department of Health Sciences of the European University Cyprus, Cyprus
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A Modern Perspective on Vaccinating Healthcare Service Providers in India: A Narrative Review. Infect Dis Ther 2021; 11:81-99. [PMID: 34773563 PMCID: PMC8590119 DOI: 10.1007/s40121-021-00558-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/21/2021] [Indexed: 10/28/2022] Open
Abstract
Healthcare providers (HCPs) are at increased risk of acquisition and transmission of infectious disease. Vaccinating HCPs is an essential preventive measure to protect them and their patients against communicable diseases, while positively and directly impacting the functioning of the healthcare system. In India, healthcare represents one of the largest employment sectors with 3.8 million HCPs; however, there is limited awareness of national immunisation guidelines for the Indian HCP population. Data from communicable disease outbreaks across India suggest inadequate vaccination rates amongst HCPs; studies have reported influenza and varicella vaccination rates as low as 4.4% and 16%, respectively. In this review, we discuss data highlighting the impact of insufficient vaccination coverage, barriers to vaccination, and the lack of immunisation guidelines amongst HCPs in India. COVID-19 vaccination programmes for HCPs have been critical in slowing the pandemic in India. This provides an opportunity to raise awareness about the importance of vaccines amongst HCPs in India.
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