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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: 4] [Impact Index Per Article: 4.0] [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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2
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Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
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Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
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Bianchi FP, Stefanizzi P, Diella G, Martinelli A, Di Lorenzo A, Gallone MS, Tafuri S. Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis. Vaccine X 2022; 12:100195. [PMID: 36032697 PMCID: PMC9399279 DOI: 10.1016/j.jvacx.2022.100195] [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: 01/13/2022] [Revised: 03/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has changed the seroepidemiology of rubella among adults, showing lack of immunity in some subgroups. National and international guidelines recommend evaluating all healthcare workers (HCWs) for their immune status to rubella and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis to estimate the susceptibility rate to rubella among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Methods Eight studies were included in the meta-analysis, selected from scientific papers available in the MEDLINE/PubMed and Google Scholar (till page 10) databases between January 1, 2015 and November 30, 2021. The following terms were used for the search strategy: (sero* OR seroprevalence OR prevalence OR susceptibilit* OR immunit* OR immunogenict*) AND (healthcare worker* OR health personnel OR physician* OR nurse OR student*) AND (rubella OR german measles OR TORCH) AND (Italy) Results The prevalence of rubella-susceptible HCWs was 9.0 % (95 %CI: 6.4–12.1 %). In a comparison of female vs. male serosusceptible HCWs, the RR was 0.67 (95 %CI = 0.51–0.88). Occupational medicine examinations for rubella screening with possible subsequent vaccination of seronegatives and exclusion of susceptible HCWs from high-risk settings were common management strategies. Conclusions HCWs susceptible to rubella are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.
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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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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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Scatigna M, Appetiti A, Pasanisi M, D'Eugenio S, Fabiani L, Giuliani AR. Experience and attitudes on vaccinations recommended during pregnancy: survey on an Italian sample of women and consultant gynecologists. Hum Vaccin Immunother 2021; 18:1-8. [PMID: 33956557 PMCID: PMC8920149 DOI: 10.1080/21645515.2021.1894061] [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] [Indexed: 10/29/2022] Open
Abstract
Active immunization in pregnancy is recommended for the influenza and the tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. Evidence indicates vaccine effectiveness in preventing influenza-related hospitalizations and pertussis in early infancy. We investigate vaccine uptake in pregnant and non-pregnant women through a sample of young women and consultant gynecologists, along with the potential predisposing and/or enabling factors affecting attitudes to vaccination (knowledge, beliefs, barriers). A cross-sectional study was conducted between June and September 2019, with a sample of 251 women and 14 consultant gynecologists at the Local Health Authority (ASL01) of the Abruzzo Region (Italy), using an anonymous, self-report questionnaire survey. Among the participants, 5.6% of women had received influenza vaccination, 16.4% had received Tdap during pregnancy and only 1.2% had received both vaccines. The assessment of the psychometric attitudinal variables has suggested a more positive willingness to receive Tdap than influenza vaccine among women, as the former is considered more important for the maternal and neonatal health. Health care workers have reported vaccine safety concerns, lack of information, and misconceptions about the need for vaccination as barriers to immunization in pregnant women. The results of this study will contribute to defining the goals and strategies to increase vaccine uptake under the current recommendations, through promoting effective training programs for all health care workers involved (gynecologists, obstetricians, public health physicians).
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Affiliation(s)
- Maria Scatigna
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandro Appetiti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Silvia D'Eugenio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Anna Rita Giuliani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Coppeta L, D'Alessandro I, Pietroiusti A, Somma G, Balbi O, Iannuzzi I, Magrini A. Seroprevalence for vaccine-preventable diseases among Italian healthcare workers. Hum Vaccin Immunother 2020; 17:1342-1346. [PMID: 33017204 DOI: 10.1080/21645515.2020.1818523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Healthcare workers (HCWs) have an increased risk to be exposed to infectious diseases compared to the general population. For this reason, according to the National Immunization and Prevention Plan, all HCWs should have demonstrable evidence of immunity to measles, mumps, rubella, varicella and Hepatitis B. Earlier studies have already shown that a large percentage of Italian operators lacked immune protection for one or more of those pathogens.The aim of this study was to evaluate the immunization status for vaccine-preventable diseases of HCWs in a large Italian teaching hospital. We retrospectively evaluated clinical records and serological data of HCWs who followed the occupational health surveillance program between January 1 and December 31 2019. We reviewed the clinical records of 1,017 HCWs: 393 males and 624 females with a median age of 35.69 y (range: 19-67). Protective IgG antibody values were documented in the 88.0%, 75.7%, 90.3%, 87.4% and 85.7% of the HCWs screened, respectively, against measles, mumps, rubella, varicella and Hepatitis B. Age was significantly related to serological protection against measles, mumps and varicella but was not significantly related to protective IgG levels for rubella and HBV.Female gender was significantly related to a higher protection rate against Hepatitis B (87.8 vs 82.4%; p < .01) whereas males were significantly more protected against varicella (92-4 vs 84.1%; p < .01).Our study shows suboptimal levels of protection among Italian HCWs and a consequent increased risk of infection for them and their patients. Public health policies should be focused on improving preventive strategies, including serological screening and workplace vaccination of nonimmune individuals.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Iacopo D'Alessandro
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | | | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Ottavia Balbi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Ilaria Iannuzzi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Determinants of Vaccination Uptake in Risk Populations: A Comprehensive Literature Review. Vaccines (Basel) 2020; 8:vaccines8030480. [PMID: 32867126 PMCID: PMC7563537 DOI: 10.3390/vaccines8030480] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Vaccination uptake has decreased globally in recent years, with a subsequent rise of vaccine-preventable diseases. Travellers, immunocompromised patients (ICP), and healthcare workers (HCW) are groups at increased risk for (severe) infectious diseases due to their behaviour, health, or occupation, respectively. While targeted vaccination guidelines are available, vaccination uptake seems low. In this review, we give a comprehensive overview of determinants-based on the integrated change model-predicting vaccination uptake in these groups. In travellers, low perceived risk of infection and low awareness of vaccination recommendations contributed to low uptake. Additionally, ICP were often unaware of the recommended vaccinations. A physician's recommendation is strongly correlated with higher uptake. Furthermore, ICP appeared to be mainly concerned about the risks of vaccination and fear of deterioration of their underlying disease. For HCW, perceived risk of (the severity of) infection for themselves and for their patients together with perceived benefits of vaccination contribute most to their vaccination behaviour. As the determinants that affect uptake are numerous and diverse, we argue that future studies and interventions should be based on multifactorial health behaviour models, especially for travellers and ICP as only a limited number of such studies is available yet.
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Montagna MT, De Giglio O, Napoli C, Fasano F, Diella G, Donnoli R, Caggiano G, Tafuri S, Lopalco PL, Agodi A. Adherence to Vaccination Policy among Public Health Professionals: Results of a National Survey in Italy. Vaccines (Basel) 2020; 8:E379. [PMID: 32664507 PMCID: PMC7565131 DOI: 10.3390/vaccines8030379] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 02/07/2023] Open
Abstract
Starting from 2013, the number of unvaccinated people alarmingly increased in Italy; therefore, in 2017 a new Vaccine National Plan was approved. Healthcare workers (HCWs), especially public health professionals (PHPs, i.e., workers in in the sector of hygiene and preventive medicine), have an important role in informing and promoting vaccinations. In this context, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health (GISIO-SItI) conducted a national survey to assess knowledge, attitude, and practices towards recommended vaccinations among PHPs. The survey was conducted during October 2019 with an anonymous questionnaire distributed to PHPs attending the 52° SItI National Congress. Overall, 57.1% of operators answered correctly to all seven recommended vaccinations, 12.8% reported to be vaccinated for all seven recommended vaccinations, while 30% were naturally immunized. A higher immunization coverage was reported for anti-hepatitis B (88.9%) and measles (86.1%), and 81.3% of the participants reported being offered the influenza vaccination during the 2018/2019 season. The majority of our sample indicated that hepatitis B (95%) and influenza (93.7%) were the recommended vaccines for HCWs, while less was known regarding varicella, pertussis, diphtheria, and tetanus boosters every 10 years. PHPs who were vaccinated (or who intended to be vaccinated) were more likely to recommend vaccinations to their patients and provided a reassuring example to those hesitant patients. Finally, this is the first study that identified good algorithms (using the techniques of machine learning as Random Forest and Deep Learning) to predict the knowledge of PHPs regarding recommended vaccinations with possible applications in other national and international contexts.
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Affiliation(s)
- Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy;
| | - Fabrizio Fasano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | | | - Giuseppina Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (F.F.); (G.D.); (G.C.); (S.T.)
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126 Pisa, Italy;
| | - Antonella Agodi
- Coordinator of GISIO-SItI Working Group, Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy;
| | - GISIO-SItI Working Group
- GISIO-SItI Working Group–Italian Study Group of Hospital Hygiene–Italian Society of Hygiene, Preventive Medicine and Public Health, Viale Cittá d’Europa, 74, 00144 Rome, Italy;
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Bianchi FP, Mascipinto S, Stefanizzi P, de Nitto S, Germinario CA, Lopalco P, Tafuri S. Prevalence and management of measles susceptibility in healthcare workers in Italy: a systematic review and meta-analysis. Expert Rev Vaccines 2020; 19:611-620. [DOI: 10.1080/14760584.2020.1791091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Simona Mascipinto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Sara de Nitto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | | | - Pierluigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Bianchi FP, Vimercati L, Mansi F, De Nitto S, Stefanizzi P, Rizzo LA, Fragnelli GR, Cannone ESS, De Maria L, Larocca AMV, Tafuri S. Compliance with immunization and a biological risk assessment of health care workers as part of an occupational health surveillance program: The experience of a university hospital in southern Italy. Am J Infect Control 2020; 48:368-374. [PMID: 31753548 DOI: 10.1016/j.ajic.2019.09.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND The active immunization of health care workers (HCWs) is a primary measure to prevent nosocomial infection; despite this, vaccine coverage among HCWs in most countries is low. To increase vaccine coverage in the health care setting, the hygiene and occupational medicine departments of Bari Policlinico General University-Hospital implemented a vaccination procedure. This operative procedure requires that during the occupational medical examination, all employees are evaluated for immunity/susceptibility to vaccine-preventable diseases, with vaccination offered to those determined to be susceptible. METHODS The study sample comprised HCWs who attended the biological risk assessment program from December 2017 to January 2019 (n = 449). RESULTS Susceptibility was higher for hepatitis B virus (23%), followed by rubella (11%), varicella (9%), mumps (8%), and measles (7%). The seroconversion rate after the administration of booster dose(s) was >80% for all vaccines. Overall, 15% of the HCWs refused the offered vaccine(s), and the main determinants of vaccination compliance were younger age (P < .0001) and being a physician (P < .05). DISCUSSION Despite the several recommendations and campaigns to promote vaccinations, achieving high immunization rates among HCWs is still a challenge. CONCLUSIONS In this scenario, public health institutions have to choose between the enforcement of the promotion or the adoption of a mandatory policy.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Francesca Mansi
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Sara De Nitto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Letizia Alessia Rizzo
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Grazia Rita Fragnelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Enza Sabrina Silvana Cannone
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Su Z, Chengbo Z, Mackert M. Understanding the influenza vaccine as a consumer health technology: a structural equation model of motivation, behavioral expectation, and vaccine adoption. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/17538068.2019.1680038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Zhaohui Su
- Department of Mass Communication, College of Liberal Arts and Social Sciences, East Central University, Ada, OK, USA
| | - Zeng Chengbo
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Mackert
- Stan Richards School of Advertising & Public Relations, Moody College of Communication, The University of Texas at Austin, Austin, TX, USA
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
- Center for Health Communication, Moody College of Communication, The University of Texas at Austin, Austin, TX, USA
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Coppeta L, Morucci L, Pietroiusti A, Magrini A. Cost-effectiveness of workplace vaccination against measles. Hum Vaccin Immunother 2019; 15:2847-2850. [PMID: 31339463 DOI: 10.1080/21645515.2019.1616505] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Measles is one of the most contagious infectious diseases. Measles vaccine, which has been introduced in Italy in 1979, is highly effective in preventing the disease (two-dose vaccine effectiveness is 99%). In 2017, Italy was the second country of EU for number of cases of measles. A study conducted in the same year showed that 22.3% of measles infection happened in hospital settings and 6.6% of cases occurred in HCWs. This risk group showed low rates of adhesion to the vaccination campaign. For this reason, we hypothesized that workplace vaccination could lead to better vaccination rates in HCWs. Moreover, we focused the vaccination campaign on a specific target group composed of HCWs not serologically immune and previously not vaccinated. We analyzed the clinical records of measles-specific IgG antibodies of 2,940 HCWs, that underwent occupational health surveillance between 1 January 2017 and 31 December 2017. 15.3% (450) was seronegative for measles, especially in the age group under 35 years. We compared the costs related to strategies with and without serological screening. Our study confirmed that immunization strategy with pre-vaccination screening was cost-effective compared to the vaccination without screening. In our sample, in fact, administration of two dose vaccine only susceptible HCWs determine a saving of 146,262 €. The vaccination of HCWs remains a topical issue in preventing the transmission of infectious disease in the hospital setting. Due to the cost-effectiveness evaluation, we recommend extending the pre-vaccination screening to identify the real susceptible workers.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luca Morucci
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Coppeta L, Balbi O, Baldi S, Pietroiusti A, Magrini A. Pre-vaccination IgG screening for mumps is the most cost-effectiveness immunization strategy among Health Care Workers. Hum Vaccin Immunother 2019; 15:1135-1138. [PMID: 30779686 PMCID: PMC6605818 DOI: 10.1080/21645515.2018.1564442] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/05/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022] Open
Abstract
Health Care Workers (HCWs) have an increased risk of contracting contagious disease, including mumps. In January 2017 the Italian National Vaccine Prevention Plan 2017-2019, recommended the administration of a dose of MMR vaccine (Measles-Mumps-Rubella) to the Health Care Workers (HCWs) that, working in a risky environment, did not carry out the complete vaccination cycle of MMR or that are seronegative for at least one of the three vaccine viruses. In October of the same year, the Advisory Committee on Immunization Practices (ACIP) recommended a third dose of a vaccine containing Mumps Virus for people previously vaccinated with 2 doses, belonging to a group or to a population at increased risk of acquire mumps in the event of an epidemic. We analyzed the clinical records and values of mumps-specific IgG antibodies of 3032 HCWs (mean age 32.80 ± 10.75 years), that underwent occupational health surveillance between January 1st 2017 and March 31th 2018. The HCWs were also screened for measles, rubella, mumps using serological methods. 13% (405) was seronegative for mumps, especially among HCWs between 18 and 36 years. We calculated the cost-effectiveness of two-doses and three-doses MMR vaccination. The cost of vaccination without screening was significantly more expensive (cost difference: 99 712 € and 184 996 €) both in case of two-dose and three-dose MMR vaccination respectively. Our study suggests that, in HCWs, the assessment of the mumps antibody titer before vaccination may be a useful complement to vaccination itself, because it is more accurate and cost-effective than direct immunization of unvaccinated subjects.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ottavia Balbi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Savino Baldi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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16
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Coppeta L, Pietroiusti A, Morucci L, Neri A, Ferraro M, Magrini A. Workplace vaccination against measles in a teaching hospital of Rome. J Hosp Infect 2018; 101:364-365. [PMID: 30529439 DOI: 10.1016/j.jhin.2018.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 11/26/2018] [Indexed: 11/17/2022]
Affiliation(s)
- L Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - A Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - L Morucci
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - A Neri
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Ferraro
- School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - A Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Boccalini S, Bechini A, Innocenti M, Sartor G, Manzi F, Bonanni P, Panatto D, Lai PL, Zangrillo F, Rizzitelli E, Iovine M, Amicizia D, Bini C, Marcellusi A, Mennini FS, Rinaldi A, Trippi F, Ferriero AM, Lisi GC. [The universal influenza vaccination in children with Vaxigrip Tetra ® in Italy: an evaluation of Health Technology Assessment]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E1-E86. [PMID: 30465031 PMCID: PMC6219245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Sara Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Angela Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - Gino Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Federico Manzi
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Paolo Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - Donatella Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Piero Luigi Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | | | | | - Daniela Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - Chiara Bini
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
| | - Andrea Marcellusi
- Economic Evaluation and HTA (CEIS- EEHTA) - Facoltà di Economia, Università Tor Vergata
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Riccò M, Cattani S, Casagranda F, Gualerzi G, Signorelli C. Knowledge, attitudes, beliefs and practices of Occupational Physicians towards seasonal influenza vaccination: a cross-sectional study from North-Eastern Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2017; 58:E141-E154. [PMID: 28900354 PMCID: PMC5584083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The present study aims to characterize personal attitudes and knowledge of a sample of Italian Occupational Physicians (OPh) towards Seasonal Influenza Vaccine (SIV) in healthcare workers (HCWs). METHODS In total, 92 OPh (42.4% males, 57.6% females, mean age of 47.3 ± 10.4 years, 50 specialists in Occupational Medicine, 42 specialists in Hygiene and Public Health) were asked about their attitudes towards influenza vaccine, their general knowledge of vaccine practice, their propensity towards vaccines and, eventually, their risk perception about the influenza and influenza vaccine was investigated. A regression analysis was then performed in order to better characterize predictive factors for vaccine propensity. RESULTS Influenza was recognized as a vaccination recommended for HCWs in 89/92 of the sampled OPh (96.7%). However, prevalence of misconceptions about vaccines was relatively high, with 26/92 (28.3%) and 24/92 (26.1%) referring vaccinations as eliciting allergic and autoimmune diseases, respectively and identifying lethargic encephalitis (18/92, 19.6%), autism (17/92, 18.5%), diabetes mellitus (15/92, 16.3%) and multiple sclerosis (13/92, 14.1%) as causatively vaccine-related. Propensity towards influenza vaccination found a significant predictor in the general knowledge (beta coefficient 0.213, p value = 0.043), risk perception (beta coefficient 0.252, p value = 0.018) and general propensity towards vaccinations (beta coefficient 0.384, p value = 0.002). DISCUSSION In spite of a diffuse propensity towards SIV, adherence of OPh was still < 50% of the sample. Moreover, sharing of misbeliefs and misconceptions was significant. As knowledge and risk perceptions were identified as significant predictors of vaccine propensity, our results suggest that information and training programs for OPh should be appropriately designed.
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Affiliation(s)
- M. Riccò
- Azienda Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento, Unità Operativa di Prevenzione e Sicurezza degli Ambienti di Lavoro (UOPSAL), Trento, Italy;,Correspondence: Matteo Riccò, via A. Degasperi 79, 38123 Trento (TN), Italy - Tel. +39 0461 904654 - E-mail:
| | - S. Cattani
- University of Parma, Department of Clinical Surgery, General Surgery and Surgical Therapy, School of Nursing Sciences, Parma University Hospital, Parma, Italy
| | - F. Casagranda
- Azienda Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento, Unità Operativa di Promozione ed Educazione alla Salute, Sorveglianza Stili di Vita, Trento, Italy
| | - G. Gualerzi
- University of Parma, School of Medicine and Surgery, Parma, Italy
| | - C. Signorelli
- University of Parma, Department of Biomedical, Biotechnological, and Translational Sciences (SBiBiT), Parma, Italy
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