Knowledge, risk perception and attitudes toward vaccination among Austrian health care workers: A cross-sectional study

Knowledge, attitudes, and practices of vaccinators about expanded programs on immunization: a cross-sectional study

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.

Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy

Introduction

During the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors.

Methods

The survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire.

Results

HCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information.

Discussion

The survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.

Influenza vaccination rates among healthcare workers: a systematic review and meta-analysis investigating influencing factors

Introduction

Healthcare workers risk of exposure to the influenza virus in their work, is a high-risk group for flu infections. Thus WHO recommends prioritizing flu vaccination for them-an approach adopted by >40 countries and/or regions worldwide.

Methods

Cross-sectional studies on influenza vaccination rates among healthcare workers were collected from PubMed, EMBASE, CNKI, and CBM databases from inception to February 26, 2023. Influenza vaccination rates and relevant data for multiple logistic regression analysis, such as odds ratios (OR) and 95% confidence intervals (CI), were extracted.

Results

A total of 92 studies comprising 125 vaccination data points from 26 countries were included in the analysis. The meta-analysis revealed that the overall vaccination rate among healthcare workers was 41.7%. Further analysis indicated that the vaccination rate was 46.9% or 35.6% in low income or high income countries. Vaccination rates in the Americas, the Middle East, Oceania, Europe, Asia, and Africa were 67.1, 51.3, 48.7, 42.5, 28.5, and 6.5%, respectively. Influencing factors were age, length of service, education, department, occupation, awareness of the risk of influenza, and/or vaccines.

Conclusion

The global influenza vaccination rate among healthcare workers is low, and comprehensive measures are needed to promote influenza vaccination among this population.

Systematic review registration

www.inplysy.com, identifier: 202350051.

Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review

This study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians' average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health.

Hepatitis B vaccination and serology among health personnel in a municipality in the Recôncavo Baiano, Brazil, 2019

Introduction

Health personnel are more susceptible to contamination by the hepatitis B virus due to occupational risk and need special care. Previous studies have found, however, that not all health personnel were fully vaccinated against hepatitis B, as recommended by the Ministry of Health.

Objectives

To analyze the factors associated with full hepatitis B vaccination and to evaluate post-vaccination serological response among health personnel.

Methods

Cross-sectional study, conducted in the municipality of Santo Antônio de Jesus, Bahia, Brazil. The sample consisted of 453 health personnel from primary and medium-complex care.

Results

The prevalence of full hepatitis B vaccination among health personnel was 56.9%. The variables associated with the prevalence of complete hepatitis B vaccination in the final analysis model were: working in primary health care (prevalence ratio = 1.31; 95% CI 1.04-1.65) and medicine preparation or administration (prevalence ratio = 3.53; 95% CI 2.17-5.74). Around 72% of those who reported being shot with all three doses of the hepatitis B vaccine had been tested for circulating antibodies in their blood and 88.4% were immune to the hepatitis B virus.

Conclusions

The familiarity provided by routine primary health care and the awareness of occupational risk was associated with beter adherence to the hepatitis B vaccine schedule among health personnel. Nearly a third of those who were shot with the three doses of hepatitis B vaccine were not immunized, reinforcing the need for anti-HBs testing.

Measles and Varicella Vaccination Program in a Hospital: Implementation and Impact on Contact Tracing

Healthcare workers are recommended to get vaccinated against measles and varicella. This study aims to describe the implementation process of a measles and varicella vaccination program and report on the reduction in the number of susceptible healthcare workers exposed to measles, varicella, and disseminated herpes zoster at a tertiary hospital. The Consolidated Framework for Implementation Research (CFIR) model was used to describe the vaccination program implemented from October 2015 to September 2018. The number of exposed, reviewed, and susceptible healthcare workers during contact tracing for exposure to (a) measles and (b) varicella and disseminated herpes zoster in 2016, 2017, and 2018 is reported. A total of 6770 (95%) out of 7083 healthcare workers completed their immunization review by 2018. In 2016, 20 (10%) out of 198 healthcare workers exposed to measles were considered susceptible. In 2018, no one was found susceptible out of the 51 staff members exposed to measles (p < 0.01). For exposure to varicella and disseminated herpes zoster, seven (5%) out of 154 exposed healthcare workers were susceptible in 2016. In comparison, only two (1%) out of 377 exposed healthcare workers in 2018 were susceptible (p < 0.01). The vaccination program effectively reduced number of healthcare workers susceptible to measles, varicella, and disseminated zoster.

Uptake of Influenza Vaccine and Factors Associated with Influenza Vaccination among Healthcare Workers in Tertiary Care Hospitals in Bangladesh: A Multicenter Cross-Sectional Study

Influenza, highly contagious in hospital settings, imposes a substantial disease burden globally, and influenza vaccination is critical for healthcare workers (HCWs) to prevent this illness. This study assessed influenza vaccine uptake, including its associated factors among HCWs of tertiary care hospitals in Bangladesh. Between September and December 2020, this multicenter study included 2046 HCWs from 11 hospitals. Face-to-face interviews were conducted using a semi-structured questionnaire to collect data from physicians, nurses, and cleaning and administrative staff for the survey. Only 13.8% (283/2046) of HCWs received the influenza vaccine, of which the majority (76.7%, 217/283) received it for free from the hospital. Nurses had the highest (20.0%, 187/934) influenza vaccine coverage, followed by physicians at 13.5% (71/526), whereas cleaning staff had the lowest at 6.0% (19/318). Among unvaccinated HCWs, the desire to get vaccinated was high (86.2%), with half of the respondents even being willing to pay for it. The HCWs who were aware of the influenza vaccine were over five times more likely to get the vaccine (OR 5.63; 95% CI: 1.04, 1.88) compared to those who were not. HCWs in Bangladesh were vaccinated against influenza at a very low rate. Free and mandatory influenza vaccination programs should be initiated to optimize vaccine coverage among HCWs.

Perceptions and Cues to Action as Predictors of Nurses' Vaccination Intentions at Two Primary Health Care Facilities in Ghana

Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses' hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r = 0.14, P < 0.05; r = 0.17, P < 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r = -0.13, P < 0.05; r = -0.24, P < 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (β = -0.22, t = -2.48, P = 0.01). Nurses' vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses' vaccination uptake.

Analysis of Knowledge, Attitudes and Behaviours of Health Care Workers towards Vaccine-Preventable Diseases and Recommended Vaccinations: An Observational Study in a Teaching Hospital

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.

Beliefs and Sociodemographic and Occupational Factors Associated with Vaccine Hesitancy among Health Workers

Introduction: Vaccine hesitancy has been implicated in the low-vaccination coverage in several countries. Knowledge about vaccine hesitancy predictors in health workers is essential because they play a central role in communication about the importance and safety of vaccines. This study aimed to assess beliefs and sociodemographic and occupational factors associated with vaccine hesitancy in health workers. Methods: This was a cross-sectional study among 453 health workers in primary and medium complexity services in a municipality in the state of Bahia, Brazil. The variable vaccine hesitancy was operationalized based on the answers related to incomplete vaccination against hepatitis B, measles, mumps and rubella, and diphtheria and tetanus. Associations between variables were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI). Results: Endemic disease combat agents, administrative service workers, and support staff had the highest levels of vaccine hesitancy. Among the analyzed variables, the following were associated with vaccine hesitancy: working in secondary health care services (PR: 1.21; CI: 1.07-1.36), working as an endemic disease combat agent (PR = 1.42; 95% CI: 1.165-1.75), not sharing information about vaccines on social media (PR = 1.16; 95% CI: 1.05-1.28), distrusting information about vaccinations (PR: 0.86; CI: 0.75-0.99), and not feeling safe receiving new vaccines (PR = 1.16; 95% CI: 1.06-1.28). Conclusions: Strategies to enhance confidence in vaccination among health workers should consider differences in occupations and their working settings. Improving vaccination-related content in training and continuing education activities and facilitating access to onsite vaccinations at the workplace are crucial elements to reduce vaccine hesitancy among health workers.

Vaccines for healthcare associated infections without vaccine prevention to date

In spite of the widespread implementation of preventive strategies, the prevalence of healthcare-associated infections (HAIs) remains high. The prevalence of multidrug resistant organisms is high in HAIs. In 2019, the World Health Organization retained antimicrobial resistance as one of the ten issues for global health. The development of vaccines may contribute to the fight against antimicrobial resistance to reduce the burden of HAIs. Staphylococcus aureus, Gram negative bacteria and Clostridium difficile are the most frequent pathogens reported in HAIs. Consequently, the development of vaccines against these pathogens is crucial. At this stage, the goal of obtaining effective vaccines against S.aureus and Gram negative bacteria has not yet been achieved. However, we can expect in the near future availability of a vaccine against C. difficile. In addition, identifying populations who may benefit from these vaccines is complex, as at-risk patients are not great responders to vaccines, or as vaccination may occur too late, when they are already confronted to the risk. Vaccinating healthcare workers (HCWs) against these pathogens may have an impact only if HCWs play a role in the transmission and in the pathogens acquisition in patients, if the vaccine is effective to reduce pathogens carriage and if vaccine coverage is sufficient to protect patients. Acceptance of these potential vaccines should be evaluated and addressed in patients and in HCWs.

Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis

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.

Research on Knowledge, Attitudes, and Practices of Influenza Vaccination Among Healthcare Workers in Chongqing, China—Based on Structural Equation Model

Background

Influenza is associated with a large number of disease burdens, and it is generally recommended that all healthcare workers (HCWs) get an influenza vaccination. However, the vaccination rates among HCWs are still low. This study aimed to assess HCWs' knowledge, attitude, and practice (KAP) about the influenza vaccine, and by establishing a structural equation model (SEM) to explore the influencing factors of medical personnel's influenza vaccination in Chongqing, China.

Methods

From September to November 2019, we conducted a cross-sectional survey in four sentinel hospitals and four non-sentinel hospitals in Chongqing, China. We calculated knowledge, attitude, and behavior scores for each study participant and assessed the level of knowledge, attitude, and behavior of the medical staff. An SEM was used to evaluate the relationship between latent variables, and the path graph between knowledge, attitude, and behavior was established.

Results

A total of 1,412 valid questionnaires were collected in this survey, including four sentinel hospitals (N = 606, 42.92%) and four non-sentinel hospitals (N = 806, 57.08%). Women (N = 1,102, 78.05%) were more than men (N = 310, 21.95%), with an average age of 32.36 ± 7.78 years old and under 30 years old (N = 737, 52.20%), respectively. Nurses (741, 52.48%) were the main subjects, followed by physicians (457, 32.37%). The final SEM model was obtained after the model was modified and adjusted. A bootstrap analysis of path coefficients was carried out on the final model. Knowledge has a direct influence on behavior. The normalized path coefficient is 0.071 (95% CI: 0.002–0.161), and the value of P of the hypothesis test result of the path coefficient is 0.042. The direct influence of knowledge on attitude standardization was 0.175 (95% CI: 0.095–0.281). The direct influence of attitude on practice standardization was 0.818 (95% CI: 0.770–0.862). The indirect effect of knowledge on the standardization of practice through attitude was 0.144 (95% CI: 0.076–0.235).

Conclusions

According to the SEM, there is a direct positive correlation between KAP and the influenza vaccine. The indirect influence of knowledge on the standard of behavior through attitude is about two times as much as the direct influence on behavior, indicating that attitude plays a strong mediating role between knowledge and practice.

Vaccine hesitancy in health-care providers in Western countries: a narrative review

INTRODUCTION

Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant.

AREAS COVERED

This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience.

EXPERT OPINION

Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.

Knowledge, attitudes and practices related to influenza and influenza vaccine among healthcare workers in Chongqing, China-a cross-sectional study

Influenza is associated with a substantial disease burden, and influenza vaccination is recommended to all healthcare workers. We aimed to assess healthcare workers' knowledge, attitudes, and practices about influenza and its vaccine in Chongqing, China. A cross-sectional study was conducted at selected hospitals from September to November 2019, in which healthcare workers filled in a self-administered questionnaire. Both sentinel (42.92%) and non-sentinel hospitals (57.08%) were included. The majority were nurses (52.48%) and physicians (32.37%). Half (50.42%) of the respondents had a good command of knowledge, and the proportion of healthcare workers having a positive attitude accounted for 62.68%. The primary information sources were colleagues (58.81%), followed by television, newspapers and media (30.18%). The number of healthcare workers reported having got vaccinated last year was only 237 (16.78%), and the main reason was protecting themselves from influenza (93.25%). While the most common reasons given for not getting vaccinated were having no time (65.70%), believing it is unnecessary to get vaccinated (29.62%), worrying about the quality of influenza vaccine (27.49%) or the adverse reactions (25.70%). Factors associated with self-reported high vaccination were sentinel hospital (aOR: 1.427; 95% CI: 1.057-1.925), high-risk department (aOR: 1.919; 95% CI: 1.423-2.589), positive attitude (aOR: 2.429; 95% CI: 1.697-3.477) and taking the initiative to learn influenza information (aOR: 3.000; 95% CI: 1.983-4.538). We concluded that healthcare workers in Chongqing had some misconceptions although many of them showed a positive attitude toward the influenza vaccine. Various strategies, including educational training and on-site vaccination, are necessary to improve the knowledge and overall vaccination coverage.

Adherence of community health workers to hepatitis B vaccination

Introduction: Hepatitis B (HB) vaccination for health-care workers is essential for World Health Organization’s goals achievement of viral hepatitis (VH) elimination. However, recent studies showed low vaccination adherence by these professionals and lack of knowledge about HB vaccination adherence of community health workers (CHW). Objective: To identify the adherence of CHW to HB vaccination; to determine the causes of non-adherence; to investigate whether the prevalence of vaccination is different among surveyed towns, and to verify whether years practiced as CHW have any association with vaccination adherence. Methods: This cross-sectional study included five towns (T) of a Brazilian state. Data were collected at VH educational meetings, in which CHW answered a questionnaire. The proportions Z-test and the likelihood ratio test were used for statistical analysis. Significance was set at p<0.05. Results: The sample included 516 CHW. Most CHW (86.8%) reported to have taken the vaccine, but only 59.7% affirmed having taken all doses, and 28.1% correctly answered the number of doses. 24.4% of CHW pointed the unknowing about HB vaccine importance as the main reason for non-adherence. T4 and T5 showed higher vaccination prevalence than T2 and T1. Vaccination adherence was higher among individuals with more years working as CHW. Conclusion: CHW demonstrated low adherence to HB vaccination and pointed the lack of knowledge about HB vaccine importance as the main reason for that. There were differences in vaccination prevalence among the towns and adherence was positively associated with professional experience.

Changes in Behaviors and Attitudes in Response to COVID-19 Pandemic and Vaccination in Healthcare Workers and University Students in Italy

The objectives of the cross-sectional study were to measure how behaviors and attitudes about preventive measures toward COVID-19 changed over time among Italian vaccinated healthcare workers and university students, and the associated characteristics. The study was carried out between February and March 2021 in the city of Naples, Campania region, Southern Italy. The perceived personal risk of being infected by SARS-CoV-2 after the vaccination was significantly higher among males, in those having a higher perceived personal risk of being infected by SARS-CoV-2 before the vaccination, and in those who were more concerned about the efficacy of the vaccination. The fear of getting the disease as reason to have the COVID-19 vaccination was reported more frequently in younger participants, in those with at least one chronic medical condition, in those with a higher concern about the severity of COVID-19, in those with a higher level of trust in the information received, and in those who acquired information from scientific journals. Overall, 21.3% were willing to engage the three main public health measures (wearing a mask, careful hand washing, physical distancing) after receiving the second dose of the vaccination compared to the behavior before the pandemic began. This willingness was predicted by a higher level of trust in the information received and by a lower self-rated health status. Only 0.1% of participants were willing to engage all three measures after receiving the second dose of the vaccination compared to the behavior before receiving the first dose. These findings are useful in order to develop information strategies regarding vaccine safety and efficacy and the importance of public health measures against COVID-19.

Evaluation of testing and vaccination status of healthcare workers in Turkey for hepatitis A: A multicenter study

BACKGROUND

This study aimed to investigate the prevalence of the disease and testing and vaccination status of healthcare workers in terms of hepatitis A infection as well as their awareness. This study is a multicenter descriptive study performed with healthcare workers.

MATERIAL AND METHODS

Testing status for hepatitis A, awareness of the results and vaccination status of healthcare workers were compared.

RESULTS

Of the 12,476 healthcare workers participating in the study, only 65% (8,115 healthcare workers) had awareness of hepatitis A test results. Of the participants, 6,481 (66.3 %) stated that they were not vaccinated against hepatitis A. Vaccination rates against hepatitis A decreased with increasing age (P < .01). The rates of vaccination in all departments where participants worked were above 60% (P < .05). While the rate of protection among those working in departments creating a risk for hepatitis A virus infection was higher, no difference among vaccination rates was observed compared with the other departments.

CONCLUSION

Vaccination of seronegative individuals is the safest way for hepatitis A, which can progress to fulminant hepatitis at advanced ages. It must be aimed primarily to increase the awareness of healthcare professionals and to increase the vaccination rates for hepatitis B and hepatitis A for the prevention of viral hepatitis. In our study, the awareness level was found to be above 50%, and the vaccination level was 35%, which is a rate that must be increased.

Beyond the "information deficit model" - understanding vaccine-hesitant attitudes of midwives in Austria: a qualitative study

BACKGROUND

Healthcare workers are considered key stakeholders in efforts to address vaccine hesitancy. Midwives' influence in advising expectant parents on early-childhood vaccinations is unquestioned, yet they remain an understudied group. The literature on midwives' attitudes towards vaccinations is also inconclusive. We therefore conducted an explorative qualitative study on midwives' vaccine-hesitant attitudes towards MMR (measles-mumps-rubella) vaccinations in Austria.

METHODS

We conducted 12 in-depth interviews on their knowledge, concerns, and beliefs with midwives who self-identified as hesitant or resistant towards early-childhood MMR vaccinations. We analyzed the data using a grounded theory approach to distill common themes and meanings.

RESULTS

Healthcare workers' stewardship to address vaccine hesitancy is commonly framed in terms of the "information deficit model": disseminate the right information and remedy publics' information deficits. Our findings suggest that this approach is too simplistic: Midwives' professional self-understanding, their notions of "good care" and "good parenthood" inflect how they engage with vaccine information and how they address it to their clients. Midwives' model of care prioritized good counseling rather than sharing scientific information in a "right the wrong"-manner. They saw themselves as critical consumers of that information and as promoting "empowered patients" who were free, and affluent enough, to make their own choices about vaccinations. In so doing, they also often promoted traditional notions of motherhood.

CONCLUSIONS

Research shows that, for parents, vaccine decision-making builds on trust and dialogue with healthcare professionals and is more than a technical issue. In order to foster these interactions, understanding healthcare professionals' means of engaging with information is key to understanding how they engage with their constituents. Healthcare workers are more than neutral resources; their daily praxis influenced by their professional standing in the healthcare system. Similarly, healthcare professionals' views on vaccinations cannot be remedied with more information either. Building better and more diverse curricula for different groups of healthcare workers must attend to their respective roles, ethics of care, and professional beliefs. Taken together, better models for addressing vaccine hesitancy can only be developed by espousing a multi-faceted view of decision-making processes and interactions of healthcare workers with constituents.

Acceptance of COVID-19 Vaccination among Front-Line Health Care Workers: A Nationwide Survey of Emergency Medical Services Personnel from Germany

INTRODUCTION

The aim of this study was to evaluate the COVID-19 vaccination acceptance of emergency medical services (EMS) personnel as front-line health care workers (HCW) in Germany. Several studies have shown low willingness for vaccination (e.g., seasonal influenza) among HCWs and EMS personnel.

METHODS

We created a web-based survey. The questions were closed and standardized. Demographic data were collected (age, sex, federal state, profession). Experience with own COVID-19 infection, or infection in personal environment (family, friends) as well as willingness to vaccinate was queried.

RESULTS

The sample includes n = 1296 participants. A willingness to be vaccinated exists in 57%, 27.6% participants were undecided. Our results show a higher propensity to vaccinate among the following groups: male gender, higher medical education level, older age, own burden caused by the pandemic (p < 0.001).

CONCLUSIONS

Due to the low overall acceptance of vaccination by HCWs, we recommend that the groups with vaccination hesitancy, in particular, be recruited for vaccination through interventions such as continuing education and awareness campaigns.

Vaccination perception and coverage among healthcare students in France in 2019

BACKGROUND

Vaccine hesitancy in healthcare workers has been increasing especially in France while they are the cornerstone of vaccination programs. Greater understanding of healthcare students (HCS) vaccine knowledge, attitudes and beliefs is necessary to provide an adequate vaccination education to better equip them to promote vaccination in their future careers. The aim of this study was to assess vaccination perception (VP) (perception of benefits and risks of vaccines) and its impact on vaccination coverage (VC) for mandatory and recommended vaccines among HCS.

METHODS

A standardized, anonymous self-reporting electronic questionnaire was prospectively sent to HCS (medicine, nursing, pharmacy, midwifery, physiotherapy students and 1st year of health sciences students) of Normandy University in France between 18/03/2019 and 8/04/2019. VP was evaluated with questions regarding vaccination hesitancy, safety of vaccine and the benefit/risk balance of vaccination. Global VC (GVC) was defined as being vaccinated according to the mandatory and/or recommended vaccination schedule by national French law in 2018.

RESULTS

542 HCS took part in this survey. VC was high for mandatory (diphtheriae, poliomyelitis, tetanus 93.5%, hepatitis B virus 88.6%) and even most of recommended vaccinations (measles 95%, pertussis 88.2%). Global VC (40.4%) was not statistically different between HCS except for 1st year health sciences students who were less vaccinated (25.6%). Regarding VP, 97.8% of HCS thought that vaccine are effective. When vaccine safety and level of vaccine hesitancy were assessed (on a 0-10 scale, 0: not safe or not hesitant and 10: completely safe and strongly hesitant for vaccine), 91% of respondents stated that vaccine safety is ≥7 and in 80% the vaccine hesitancy was < 3. There was no difference among student categories. 80.6% of HCS recommended all vaccines but only 52% agreed that flu vaccination should be mandatory for HCS. In the multivariate analysis, being a 1st year health care sciences student was associated with a lower GVC (OR 95% CI = 2 [1.2-3.3], p = 0.004) than being a medical student.

CONCLUSION

HCS perceived vaccine as effective and secure. Despite the good perception of vaccines, less than half HCS are well vaccinated.

Determinants of Vaccination Uptake in Risk Populations: A Comprehensive Literature Review

Vaccination uptake has decreased globally in recent years, with a subsequent rise of vaccine-preventable diseases. Travellers, immunocompromised patients (ICP), and healthcare workers (HCW) are groups at increased risk for (severe) infectious diseases due to their behaviour, health, or occupation, respectively. While targeted vaccination guidelines are available, vaccination uptake seems low. In this review, we give a comprehensive overview of determinants-based on the integrated change model-predicting vaccination uptake in these groups. In travellers, low perceived risk of infection and low awareness of vaccination recommendations contributed to low uptake. Additionally, ICP were often unaware of the recommended vaccinations. A physician's recommendation is strongly correlated with higher uptake. Furthermore, ICP appeared to be mainly concerned about the risks of vaccination and fear of deterioration of their underlying disease. For HCW, perceived risk of (the severity of) infection for themselves and for their patients together with perceived benefits of vaccination contribute most to their vaccination behaviour. As the determinants that affect uptake are numerous and diverse, we argue that future studies and interventions should be based on multifactorial health behaviour models, especially for travellers and ICP as only a limited number of such studies is available yet.

Adherence to Vaccination Policy among Public Health Professionals: Results of a National Survey in Italy

Starting from 2013, the number of unvaccinated people alarmingly increased in Italy; therefore, in 2017 a new Vaccine National Plan was approved. Healthcare workers (HCWs), especially public health professionals (PHPs, i.e., workers in in the sector of hygiene and preventive medicine), have an important role in informing and promoting vaccinations. In this context, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health (GISIO-SItI) conducted a national survey to assess knowledge, attitude, and practices towards recommended vaccinations among PHPs. The survey was conducted during October 2019 with an anonymous questionnaire distributed to PHPs attending the 52° SItI National Congress. Overall, 57.1% of operators answered correctly to all seven recommended vaccinations, 12.8% reported to be vaccinated for all seven recommended vaccinations, while 30% were naturally immunized. A higher immunization coverage was reported for anti-hepatitis B (88.9%) and measles (86.1%), and 81.3% of the participants reported being offered the influenza vaccination during the 2018/2019 season. The majority of our sample indicated that hepatitis B (95%) and influenza (93.7%) were the recommended vaccines for HCWs, while less was known regarding varicella, pertussis, diphtheria, and tetanus boosters every 10 years. PHPs who were vaccinated (or who intended to be vaccinated) were more likely to recommend vaccinations to their patients and provided a reassuring example to those hesitant patients. Finally, this is the first study that identified good algorithms (using the techniques of machine learning as Random Forest and Deep Learning) to predict the knowledge of PHPs regarding recommended vaccinations with possible applications in other national and international contexts.

Self-reported vaccination status and attitudes towards mandatory vaccinations for health care workers among medical students

Health care workers (HCWs) are exposed to a high risk of infectious diseases at work, and of transmitting these to their patients and colleagues. Medical students constitute an important, yet neglected, group within HCW because of their contact with patients in the course of compulsory or voluntary practical training courses at health care institutions. The aim of this study was to determine the current vaccination status of medical students at the Medical University of Vienna and assess their attitudes towards occupationally indicated mandatory vaccinations for doctors and other HCW. Nearly 80% of the students considered mandatory vaccinations for doctors an appropriate measure and 88% would recommend them in settings involving immunocompromised patients. The acceptance of mandatory immunisation differs very markedly for individual vaccinations; it ranges from 82.8% for hepatitis B to 40% for influenza. The self-reported vaccination status among medical students was 90.1%, 89.9%, 88.1% and 84.4% for hepatitis B, tetanus, polio and hepatitis A, respectively. Inadequately low rates of 78%, 70.5% and 70.5%, and 28.7% were reported for MMR, varicella, pertussis and influenza (2014/15 season), respectively. CONCLUSION: The majority of medical students at the MUW had a positive attitude towards vaccinations and considered mandatory vaccinations for doctors and HCW an appropriate measure. However, the large majority of the vaccination rates are worthy of improvement.

Knowledge and Attitude towards Vaccination among Healthcare Workers: A Multicenter Cross-Sectional Study in a Southern Italian Region

Background: In Italy, the loss of confidence towards vaccination resulted in low vaccine coverage, also among healthcare workers (HCWs). Indeed, low vaccination coverage among HCWs can lead to dangerous outbreaks of disease, reduce productivity, and increase absenteeism. The aim of this study was to investigate the vaccine coverage and attitudes toward vaccination among HCWs. Methods: A multicenter cross-sectional study was conducted among HCWs referred to all hospitals of the Local Health Authority 02 of Abruzzo Region, Italy. The survey was based on the questionnaire proposed by the H-ProImmune Project. Results: A total of 347 HCWs were enrolled in the study. Of these, 57.3% reported missing diphtheritis-tetanus-pertussis (DTP) vaccination, 50.1% reported missing measles-mumps-rubella (MMR) vaccination, and 62.5% reported missing flu vaccination. Regarding attitudes, other healthcare professionals reported to believe more in natural immunization compared to vaccination (26.5%; p < 0.001), and they were worried about long-term effects of vaccination (10.2%; p = 0.044). Conclusions: This survey showed all vaccination coverage considered resulted below the 95% threshold. Training on vaccination and mandatory measures may be needed in order to achieve better coverage.

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Understanding the change in intention for influenza vaccine among health-care workers (HCWs) is important to increase influenza vaccination uptake. We aimed to investigate the psychosocial beliefs associated with a change in the intention for influenza vaccine. An anonymous cross-sectional survey was distributed to tertiary hospital HCWs in 2016. Of 3007 HCWs, 70% were compliant (vaccinated, with an intention to revaccinate), 8% were resistant (unvaccinated, without intention to vaccinate), 10% had positive change (unvaccinated, but with intention) and 12% had negative change (vaccinated, but without intention). Across HCW groups, medical staff had both the highest proportion receiving all influenza vaccinations in the last 5 years (101, 28.4%), as well as the highest proportion who had never received vaccination (41, 11.5%). With increasing age, HCWs were less likely to have a negative (p = .02) or positive change (p = .06) in intention, compared to the vaccine-resistant group. HCWs were more likely to be compliant or have a positive change in intention to receive influenza vaccine, if they perceived the vaccine as effective, safe, or had a higher frequency of influenza vaccination in the last 5 years (all with p < .05). HCWs who were medical staff, who believed that side effects of the vaccine were common, or had worked for 6 to 10 years (vs 5 years or less) were less likely to be compliant (all with p < .05). In conclusion, older HCWs were more likely to maintain the status quo in their behavior toward influenza vaccination. Influenza vaccination strategies should place emphasis on vaccine effectiveness and safety.

Barriers and facilitators to seasonal influenza vaccination uptake among nurses: A mixed methods study

AIM

To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses.

BACKGROUND

Seasonal influenza causes significant mortality and morbidity among older people and high-risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low.

DESIGN

An explanatory sequential mixed methods study design.

DATA SOURCES

Qualified nurses attending mandatory training in two large acute hospitals in Ireland.

METHODS

A paper-based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 - February 2018. A self-selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 - October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process.

RESULTS

Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure.

CONCLUSION

Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi-faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence-based knowledge, accessibility, and external cues to action.

IMPACT

Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses.

Healthcare Workers' Knowledge, Attitudes, and Practices about Vaccinations: A Cross-Sectional Study in Italy

The cross-sectional study assessed the knowledge, attitudes, and practices regarding the recommended vaccinations and factors affecting such outcomes among a sample of healthcare workers (HCWs) in public hospitals in Italy. Only 14.1% knew all the recommended vaccinations for HCWs. Physicians and those who had received information about vaccinations from scientific journals, educational activities, or professional associations were more likely to have this knowledge, while those aged 36–45 were more likely to have less knowledge than those in the age group below 36 years. Only 57.3% agreed that the information received about vaccinations was reliable. Respondents who had children, who worked in pediatric/neonatal wards, who were more knowledgeable, or who did not need further information about vaccinations considered the available information to be reliable. Only 17.7% of respondents always recommended vaccinations to their patients. This behavior was more likely to occur in physicians, in HCWs, in pediatric/neonatal wards, in those who considered the information received about vaccinations reliable, and in those who considered themselves to be at high risk of transmitting an infectious disease to their patients. Health promotion programs and efforts are needed to improve the level of knowledge about vaccinations and immunization coverage among HCWs.

Healthcare workers' knowledge, beliefs, and coverage regarding vaccinations in critical care units in Italy

BACKGROUND

Low rates of vaccine coverage have resulted in a resurgence of several vaccine-preventable diseases in many European countries. Routine vaccination of healthcare workers (HCWs) is important to reduce disease transmission, and to promote vaccine awareness and acceptance in the population. The objectives of this cross-sectional study were to investigate knowledge and beliefs about vaccines and to evaluate self-reported immunization coverage with vaccines recommended for HCWs. Additionally, the effects of several factors on these outcomes have been evaluated.

METHODS

A survey was conducted between September and November 2018 among a random sample of HCWs in cardiac, adult, and neonatal critical care units of 8 randomly selected hospitals across the Campania and Calabria Regions in Italy. Multivariate logistic and linear regression analysis has been performed.

RESULTS

A total 531 HCWs returned the questionnaire for a response rate of 54.9%. Based on a vaccination knowledge score ranging from 0 to 9, more than half of the participants (55.4%) knew few of the vaccines recommended for HCWs (≤3 correct answers), 16.2% knew some vaccines (4-6 correct answers), and 28.4% knew most vaccines (≥7 correct answers), and only 13.2% knew all the vaccines recommended for HCWs. However, two-thirds (62.2%) knew that hepatitis B and influenza vaccines were recommended, and this knowledge was significantly higher among females (p < 0.001), among HCWs aged between 50 and 59 years (p = 0.01) compared with those aged < 30 years, and in those who search for information about recommended vaccines for HCWs (p = 0.012). The vaccine knowledge was significantly lower among nurses and nursing supporting staff compared with physicians (p = 0.032). Approximately two-thirds (62.7%) of HCWs considered themselves at risk of contracting vaccine-preventable infectious diseases during their professional practice. High rates of coverage were self-reported for hepatitis B (96.3%), tetanus and pertussis (93.7%), whereas they were lower for measles/mumps/rubella (80.5%), chickenpox (65.3%), and influenza (35.8%). Only 9.2% of HCWs reported prior receipt of all recommended vaccines. Male HCWs were less likely to report prior receipt of all recommended vaccines (p = 0.011). HCWs aged between 30 and 39 years compared with those aged < 30 years (p = 0.001) and those who knew some (p < 0.001) and most (p = 0.007) of all vaccines recommended for HCWs were more likely to self-report to be immunized.

CONCLUSIONS

Additional training about the vaccinations is needed to improve HCWs knowledge and to address specific concerns which may lead to better uptake among this group.

Healthcare workers' vaccination at European and Italian level: a narrative review

Today some vaccine-preventable diseases remain an important cause of morbidity and mortality worldwide despite the availability of new vaccines. Healthcare workers are particularly at risk to acquire an infection disease, playing a fundamental role in nosocomial transmission, which makes them an important target group for vaccination. The vaccination recommendations of HCWs, as well as the general population, differ from country to country. Furthermore, coverage rates vary widely a lot over the world, making HCWs vulnerable to disease and so healthcare settings to outbreaks. The motivations of vaccine hesitancy are many and maybe other studies would help policymakers and stake-holders to shape programs to improve vaccination coverage and the control of infectious diseases through the correct application of guidelines on prevention. (www.actabiomedica.it)

Vaccination status of resident pediatricians and the potential risk for their patients - a cross-sectional questionnaire study in pediatric practices in Vienna

Background

Pediatricians are advised by the Austrian ministry of health to be vaccinated against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, varicella, hepatitis A, hepatitis B, meningococcus ACWY and meningococcus B, pneumococcus and seasonal influenza. As they take care of a vulnerable patient group including newborns and infants, who have not been vaccinated yet, it is important that they have a positive immunization status in order to protect their patients. This cross-sectional study aims to investigate the vaccination status of pediatricians and their assistants in practices in Vienna.

Methods

All 196 resident pediatricians in Vienna were invited to participate in this cross-sectional, questionnaire-based study. They had to specify their sex, medical profession, self-reported vaccination status for the respective vaccine preventable diseases and the type of practice they are working in (private versus government funded practice).

Results

High vaccination rates above 90% were found for measles, poliomyelitis, pertussis and hepatitis B, whereas seasonal influenza, meningococcus and pneumococcus were the least accepted vaccinations in this cohort. No significant differences were observed for male and female vaccination habits. Influenza and pneumococcus vaccines were more frequently received by pediatricians than their assistants. Health care workers (HCW) of private practices had significantly lower hepatitis B vaccination rates compared to those working in practices covered by the Vienna health insurance fund.

Conclusion

Resident pediatricians in Vienna reveal rather high vaccination rates for some but not all of the recommended immunizations, which puts their pediatric patients at risk. Measures for higher vaccination rates are needed especially for this medical professional group.

Electronic supplementary material

The online version of this article (10.1186/s12887-019-1529-0) contains supplementary material, which is available to authorized users.

Web-based analysis of adherence to influenza vaccination among French healthcare workers

BACKGROUND

Influenza is recognized as a public health threat. However, vaccine hesitancy and poor vaccine uptake have been seen in French healthcare workers (HCWs). As a result, authorities have considered implementing mandatory influenza vaccination for HCWs.

OBJECTIVES

This study aimed to describe factors associated with influenza vaccine adherence or non-adherence in French HCWs and to collect their perception about mandatory influenza vaccination.

STUDY DESIGN

In February 2017, during the influenza season, a standardized questionnaire was sent electronically to the professional email addresses of French HCWs. Analyses were performed having collected 3000 responses.

RESULTS

Between February 1 and 16, 2017, a 14-question survey was sent to HCWs professional email addresses. After a two week period had elaspsed, 3000 answers were collected for analysis. Overall, 45.7% of responders reported they had received influenza vaccination in 2016-2017, with statistical differences relating to professional status, age and practice. In addition, 92.2% reported caring for at-risk patients and 62.9% had a community-based practice. Finally, accepting mandatory influenza vaccination was statistically associated with higher age, a higher socio-professional category, and seasonal influenza vaccine uptake, but not with management of at-risk patients.

CONCLUSIONS

Electronically submitted questionnaires are a rapid and easy tool that can be used to describe factors associated with influenza vaccine uptake in HCWs. In our study, differences in receiving influenza vaccination related to age, practice and professional categories, and provided an insight into potential adherence to mandatory influenza vaccination in HCWs. If repeated, these surveys may also monitor the evolution of vaccine uptake by professional categories.

Knowledge, attitude, and practice of influenza vaccine immunization among primary healthcare providers in Dubai health authority, 2016-2017

Background: Vaccination of healthcare providers (HCPs) against seasonal influenza has been consistently recommended worldwide. Despite that, healthcare providers (HCPs) globally and in other Middle Eastern countries continue to have a low rate of influenza vaccination due to various reasons. No data are available from our country, United Arab Emirates. Objectives: To identify the percentage of vaccinated HCPs, identify the most common reason for receiving the vaccine or not and to identify the level of HCPs knowledge towards the influenza vaccine itself. Methods: Using a cross-sectional study design, anonymous 18-item self-administered questionnaires were distributed among healthcare providers in the 11 primary healthcare centers of Dubai Health Authority over a period of 5 months. Results: Of the 431 participants who completed the questionnaires, 53.4% reported getting vaccinated. The difference in the vaccine uptake between the different professional categories was significant [P value < .000].The most common reason reported by HCPs for getting the vaccine was to protect themselves (94.8%). Of the 46.6% who did not accept the vaccine, the most common reason for not being vaccinated was their belief of not being at high risk to contract influenza (39.8%). Despite fairly good knowledge (63.3%), healthcare providers continue to have their reservations with regards to the yearly influenza vaccination. Conclusion: Although our HCPs attitude towards vaccine uptake, knowledge and practice were positive; the misconception about the vaccine remains the main reason for not being vaccinated as per our study findings. Overall, the study results raise hope of prospective increase in vaccination through educational and technical interventions and by increasing physician involvement. One suggested method would be to apply mandatory vaccination policies since voluntary vaccinations have shown lesser than satisfactory results and to be integrated in the online staff file system to be able to verify the uptake, in addition to provide easily accessible vaccine centers, during the season in order to facilitate tracking and verification of the vaccination status & to encourage staff compliance.

Predictors for influenza vaccine acceptance among patients with inflammatory rheumatic diseases

BACKGROUND

Patients with inflammatory rheumatic diseases are at higher risk for influenza and current guidelines recommend vaccination for this group of patients. The aim of this study was to evaluate the vaccination coverage and predictors for influenza vaccination among patients with inflammatory rheumatic diseases.

METHODS

This survey was conducted at the outpatient rheumatology clinic at the Medical University of Vienna between July and October 2017. All patients diagnosed with an inflammatory rheumatic disease and receiving immunosuppressive therapy were asked to complete a questionnaire about their influenza vaccination status for 2016/17.

RESULTS

490 patients with rheumatic diseases completed a questionnaire (33% male, mean age 55.3 years). The influenza vaccination rate for the previous season was 25.3% (n = 124/490). Predictors for a positive influenza vaccination status were higher age (Adjusted Odds Ratio 5.0, 95% Confidence Interval 2.4-10.4) and treatment with biological disease-modifying antirheumatic drugs (AOR 2.0, 95% CI 1.3-3.1). Patients who received a recommendation for influenza vaccination by their general practitioner were significantly more likely to be vaccinated than those who did not (57% vs. 15%, AOR 6.6, 95% CI 4.1-10.8); even more so if they received a recommendation by their rheumatologist (62% vs. 19%, AOR 9.0, 95% CI 4.9-16.5). The main reasons for patients to decline influenza vaccination were fear of side effects (36%), concerns that vaccination might not be effective due to their immunosuppressed condition (38%) or that it might worsen the rheumatic disease (20%).

CONCLUSIONS

A moderate influenza vaccination rate of 25.3% was detected among patients with inflammatory rheumatic diseases. Recommendation of the influenza vaccine by a physician exerts the most effective impact on a positive vaccination status.

Knowledge, attitudes and practices (KAP) towards vaccinations in the school settings: an explorative survey

Background

Past researches have shown that schoolteachers’ (STs) interventions maximize the consent for vaccination programs. European data regarding knowledge, attitudes and practices of STs towards vaccination are otherwise lacking.

Objectives

The aim of this study was therefore to evaluate knowledge and attitudes of STs regarding vaccinations in a sample from North Italy.

Material and methods

In this cross sectional study, 154 STs from Lombardy region (Northern Italy) responded to a specific questionnaire assessing their attitude towards vaccination and vaccine related knowledge.

Results

In general, 88.3% of subjects were somehow favourable to vaccinations. The main reason for declining vaccination was the risk of side effects whereas the main reason to be vaccinated was to avoid to be infected by VPDs (67.6%). Main information sources were health professionals (75.3%), and new media (13.1%), and the latter were STs more frequently associated with a negative attitude towards vaccinations (p < 0.001). Eventually, regression analysis identified risk perception as positively associated with propensity towards vaccinations, both for Students- and STs-recommended vaccinations (B = 0.372, 95% CI 0.247 to 0.496 and B = 0.005, 95%CI 0.004 to 0.006, respectively).

Conclusions

Our results are consistent with previous reports suggesting a significant knowledge gap in STs, with the risk perception of infectious diseases as the main predictor for vaccine propensity. Moreover, the better knowledge of official vaccination recommendations and policies among STs identifying Health Professionals as information source enlightens the role of the School Physicians and Occupational Physicians, whose intervention may ultimately increase the vaccination acceptance and vaccination rates.

Les vaccins dans la prévention des infections associées aux soins

Les infections associées aux soins (IAS) constituent un véritable problème de santé publique. Escherichia coli, Staphylococcus aureus, Clostridium difficile sont les plus souvent à l’origine des IAS. L’antibiorésistance fréquente complique encore la prise en charge et des impasses thérapeutiques existent à présent. Les mesures d’hygiène hospitalière bien qu’essentielles sont insuffisantes pour diminuer drastiquement les IAS. Ainsi, des stratégies alternatives à l’antibiothérapie s’avèrent nécessaires pour prévenir et traiter les IAS. Parmi celles-ci, la vaccination et l’immunisation passive sont probablement les plus prometteuses. Nous avons fait une mise au point sur les vaccins disponibles et en développement clinique pour lutter contre les IAS, chez les patients à risque d’IAS et les soignants. L’intérêt de la vaccination grippale et rotavirus chez les patients pour prévenir ces IAS virales a été examiné. Le développement d’un vaccin anti-S. aureus, déjà émaillé de 2 échecs est complexe. Toutefois, ces échecs ont permis d’améliorer les connaissances sur l’immunité anti-S. aureus. La mise à disposition d’un vaccin préventif anti-C. difficile semble plus proche. Pour les autres bactéries gram négatif responsables d’IAS, le développement est moins avancé. La vaccination des patients à risques d’IAS pose également des problèmes de réponse vaccinale qu’il faudra résoudre pour utiliser cette stratégie. Ainsi, la vaccination des soignants, de par l’effet de groupe permet également de prévenir les IAS. Nous faisons ici le point sur l’intérêt de la vaccination des soignants contre la rougeole, la coqueluche, la grippe, la varicelle, l’hépatite B pour réduire les IAS avec des vaccins déjà disponibles.

Predictors for and coverage of influenza vaccination among HIV-positive patients: a cross-sectional survey

OBJECTIVES

Influenza vaccination is recommended for HIV-infected patients, but limited data about vaccination rates are available. The aim of this study was to evaluate the coverage of and predictors for influenza vaccination among HIV-positive patients.

METHODS

All HIV-positive patients who visited the HIV out-patient department of the University Hospital of Vienna, Austria, between June and August 2015 were asked to participate in this survey by completing a questionnaire.

RESULTS

A total of 455 HIV-positive patients completed a questionnaire, with 359 male and 96 female participants with a mean age of 46 years. The influenza vaccination rate for the previous season (2014/2015) was 11.9% [n = 54/455; 95% confidence interval (CI) 9.2-15.2%]. Older age was significantly associated with a positive influenza vaccination status. Obtaining information through a medical consultation or receiving a direct recommendation for vaccination by a physician had a significant impact on vaccination behaviour. The probability of being vaccinated against influenza was about 13 times higher among patients who received a recommendation for vaccination by their family physician or by their HIV specialist (P < 0.001). Important reasons for declining vaccination were fear of side effects (39%), not considering influenza as a severe disease (36%) and reasons related to HIV: 17% were worried that the vaccine could worsen the course of HIV infection and 16% believed vaccination would fail because of their compromised immune system.

CONCLUSIONS

A low influenza vaccination rate of 11.9% was detected in this HIV-positive cohort. The most effective impact for a positive vaccination status was direct recommendation of the influenza vaccine by the attending physician.