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de Koning R, Gonzalez Utrilla M, Spanaus E, Moore M, Lomazzi M. Strategies used to improve vaccine uptake among healthcare providers: A systematic review. Vaccine X 2024; 19:100519. [PMID: 39105135 PMCID: PMC11299578 DOI: 10.1016/j.jvacx.2024.100519] [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: 04/18/2024] [Revised: 06/25/2024] [Accepted: 06/30/2024] [Indexed: 08/07/2024] Open
Abstract
Background Vaccination is one of the most effective available public health tools, preventing infectious diseases to safeguard public health and save millions of lives annually. However, in recent years vaccine hesitancy has increased among all populations, including healthcare workers. Healthcare providers are central to vaccination efforts due to their increased exposure to disease and vulnerable patients, and their role in patient confidence and decision-making. These decreasing uptake rates highlight a critical need to address specific barriers within this target group. This systematic review aims to explore the strategies used to improve vaccine uptake among healthcare providers. Methods A literature search was conducted in PubMed, EMBASE, and MEDLINE databases, alongside a grey literature search, to identify studies describing interventions to improve vaccine uptake among healthcare providers. This was followed by de-duplication and double-blinded screening processes using Rayyan. Data extraction and thematic analysis focused on categorising interventions and identifying frequencies of use, to develop recommendations for further interventions tailored to target regions. Results 60 studies were identified, predominantly concerning influenza vaccination. Interventions included educational initiatives, reminders, incentives, access solutions, feedback, and policy implementation. Key strategies included targeted educational lectures, posters, and pamphlets; mobile vaccination units; extended vaccination hours; and leadership engagement. The findings underscore the importance of a multifaceted approach combining educational efforts, enhanced accessibility, and motivational incentives to improve vaccination rates within the healthcare providers, especially where mandatory vaccination is controversial. Conclusions This review evaluates tailored strategies to enhance vaccine confidence and uptake among healthcare providers, advocating for a holistic approach that includes educational initiatives, reminder systems, incentives, improved access, feedback mechanisms, and policy enactment to effectively address hesitancy and promote public health.
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Affiliation(s)
- Rosaline de Koning
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Department of Medical Anthropology, University College London, Gower St, London WC1E 6BT, United Kingdom
| | | | - Emma Spanaus
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Fulda University of Applied Sciences, Fulda, Germany
| | - Michael Moore
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia
| | - Marta Lomazzi
- World Federation of Public Health Associations, Ch des Mines 9, 1202 Geneva, Switzerland
- Global Health Institute, University of Geneva, Ch des Mines 9, 1202 Geneva, Switzerland
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2
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Bianchi FP, Stefanizzi P, Di Lorenzo A, De Waure C, Boccia S, Daleno A, Migliore G, Tafuri S. Attitudes toward influenza vaccination in healthcare workers in Italy: A systematic review and meta-analysis. Hum Vaccin Immunother 2023; 19:2265587. [PMID: 37849235 PMCID: PMC10586073 DOI: 10.1080/21645515.2023.2265587] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
Healthcare workers (HCWs) are among the at-risk groups for whom influenza vaccination is strongly recommended. To assess the proportion of Italian HCWs with positive attitudes toward influenza vaccination, we conducted a systematic review of relevant literature and a meta-analysis. Our focus was on the influenza seasons from 2017/18 to 2021/22. The prevalence of favorable attitudes toward vaccination varied, ranging from 12% during the 2017/18 influenza season to 59% in the 2020/21 season. The significant increase in the 2020/21 season can be attributed to adaptations necessitated by the COVID-19 pandemic. During the 2021/22 influenza season, there was a decline in vaccination coverage (37%), likely due to the absence of a robust preventive culture. Various strategies have been employed to enhance HCWs' attitudes to achieve higher vaccination rates, but none of them have demonstrated satisfactory results. Policymakers should consider implementing a policy of mandatory vaccination to ensure elevated vaccination coverage among HCWs.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Chiara De Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, University Cattolica of Sacred Hearth, Rome, Italy
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Daleno
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Giovanni Migliore
- Health Direction, University-General Hospital Policlinico, Bari, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
- Health Direction, University-General Hospital Policlinico, Bari, Italy
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3
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Qu S, Yang M, He W, Xie H, Zhou M, Campy KS, Tao X. Determinants of parental self-reported uptake of influenza vaccination in preschool children during the COVID-19 pandemic. Hum Vaccin Immunother 2023; 19:2268392. [PMID: 37964617 PMCID: PMC10653755 DOI: 10.1080/21645515.2023.2268392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
In China, the coverage rate of influenza vaccination among the general population is significantly lower than that of high-income countries, with only 2.46% of the population vaccinated. Preschool-aged children are particularly susceptible to influenza viruses, yet the factors that influence parents' willingness to vaccinate their children are not well understood. To address this research gap, we developed a theoretical model grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), which explores six key factors influencing parental self-reported uptake of influenza vaccination in preschool children: performance expectancy, effort expectancy, social influence, facilitating conditions, knowledge, and behavioral intention. We collected data from 872 parents of children in five major cities in China and employed structural equation modeling to examine the significance of the theoretical model and explore the potential moderating effects of demographic variables on path relationships. Our analysis revealed that several positive factors influenced parents' intention of influenza vaccination for preschool children, including effort expectancy (β = 0.38), social influence (β = 0.17), and knowledge (β = 0.52). Facilitating conditions (β = 0.34), knowledge (β = 0.40), and behavioral intention (β = 0.34) were found to be associated with self-reported uptake. Furthermore, we observed significant moderating effects of the child's gender and age, as well as the guardian's category and income, on the theoretical models. Parents' willingness to vaccinate preschool children against influenza is influenced by both psychological and demographic variables. Further studies are needed to determine if these relationships persist over time and across different regions.
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Affiliation(s)
- Shujuan Qu
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Minghua Yang
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei He
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hao Xie
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhou
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kathryn S. Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Xinyu Tao
- Graduate School of Science and Engineering, Chuo University, Tokyo, Japan
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Minardi V, Gallo R, Possenti V, Contoli B, Di Fonzo D, D'Andrea E, Masocco M. Influenza Vaccination Uptake and Prognostic Factors among Health Professionals in Italy: Results from the Nationwide Surveillance PASSI 2015-2018. Vaccines (Basel) 2023; 11:1223. [PMID: 37515039 PMCID: PMC10386716 DOI: 10.3390/vaccines11071223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than the general population. (2) The study's purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs. Non-HP (NHP). We analyzed 2014-2018 data (n = 105,608) from the Italian Behavioral Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8-26.1%) of MDs and 8.5% (CI 7.5-9.5%) of NMHP reported to have been vaccinated vs. 6.3% (CI 6.1-6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34 yy, respectively, 9.9%, 4.4%, 3.4% vs. 28.4%, 13.9%, 10.6% in 50-64 yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs. 30.5% in 2018). (4) Despite such an increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.
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Affiliation(s)
- Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Rosaria Gallo
- Primary Healthcare Unit, Health District 9, Local Health Unit Roma 2, 00159 Rome, Italy
- PhD Course Advances in Infectious Diseases, Microbiology, Legal Medicine and Public Health Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Possenti
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Benedetta Contoli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | | | - Elvira D'Andrea
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
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5
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Bianchi FP, Stefanizzi P, Cuscianna E, Di Lorenzo A, Martinelli A, Tafuri S. Effectiveness of on-site influenza vaccination strategy in Italian healthcare workers: a systematic review and statistical analysis. Expert Rev Vaccines 2023; 22:17-24. [PMID: 36409195 DOI: 10.1080/14760584.2023.2149500] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION One of the main determinants of non-adherence to influenza vaccination among healthcare workers (HCWs) is lack of time to attend vaccination services. Therefore, international Public Health Organizations have recommended on-site influenza vaccination in order to improve vaccination coverage among HCWs. AREAS COVERED We conducted a systematic narrative review of the relevant literature to evaluate the effectiveness of this strategy among HCWs in Italy. Fifteen studies, selected among scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge and Scopus and published from January 1st, 2018, to May 31st, 2022, were included. A significant relationship was evidenced between influenza vaccine uptake and adoption of an on-site outpatient clinic (OR = 2.06; 95%CI = 1.43-2.95). The review highlighted a significant increase in VC when on-site vaccination was implemented (even exceeding +150% compared to the previous season), among other measures. Nevertheless, none of the reported experiences proved to meet the minimum target of 75% VC among HCWs. EXPERT OPINION Despite strategies to achieve greater willingness to immunize in this category, mandatory vaccination appears to be the only one that can guarantee protection for HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Andrea Martinelli
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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6
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Calabrò GE, Rumi F, Fallani E, Ricciardi R, Cicchetti A. The Economic and Fiscal Impact of Influenza Vaccination for Health Care Workers in Italy. Vaccines (Basel) 2022; 10:vaccines10101707. [PMID: 36298572 PMCID: PMC9609125 DOI: 10.3390/vaccines10101707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Influenza has a significant impact on the health care system and also on production and economic systems. Vaccinated health care workers (HCWs) are more likely to have improved productivity compared to unvaccinated workers. The study aim was to estimate the economic and fiscal impact of an influenza vaccination program for HCWs in Italy. We performed a cost analysis aimed to estimate the indirect costs (productivity losses due to working days lost) and the increase in tax revenues derived from the increase in vaccination coverage among HCWs. Assuming an incremental increase in vaccination coverage of 10% per year over a period of 5 years, total savings could be obtained in terms of a reduction in productivity losses equal to −€4,475,497.16 and an increase in tax revenues of €327,158.84. This revenue could be used to finance other health interventions. Our results are fundamental in view of the sustainability of health systems and of a value-based allocation of health resources. Therefore, a complete social perspective, including the fiscal impact of flu vaccination, should be adopted to assess the economic value of influenza vaccines. Currently, health policies based on the whole value of flu vaccination are needed.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elettra Fallani
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Seqirus S.r.l., 53035 Monteriggioni, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Colaprico C, Ricci E, Bongiovanni A, Imeshtari V, Barletta VI, Manai MV, Shaholli D, Marte M, Serruto P, La Torre G. Flu Vaccination among Healthcare Professionals in Times of COVID-19: Knowledge, Attitudes, and Behavior. Vaccines (Basel) 2022; 10:vaccines10081341. [PMID: 36016229 PMCID: PMC9414714 DOI: 10.3390/vaccines10081341] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022] Open
Abstract
The seasonal flu vaccine is the most important way to prevent influenza epidemics, so it is useful to increase the awareness of health professionals. The aim of our study is to evaluate knowledge, attitudes, and behavior about flu vaccination among healthcare professionals in times of COVID-19. Methods: A cross sectional study was carried out between November 2020 and April 2021. Participants were recruited in teaching hospital ‘Policlinico Umberto I’ of Rome. A survey of 24 questions about flu vaccination was administered, evaluating their knowledge, attitude, and practice about this topic. Results: 872 healthcare professionals were involved in the study (36.9% men, 63.1% women). More than 90% of the HCWs, especially physicians, recognize the importance of getting influenza vaccination: The main reasons for not getting vaccinated were fear of vaccine side effects (20.3%) and fear of the needle (6.4%). Nevertheless, 40.7% of the healthcare providers consider mandatory vaccination as unethical, especially if they work in low-intensity wards. Conclusion: a high percentage of healthcare workers agree with the importance of influenza vaccination and only a small percentage is still opposed. It is therefore important to continue to promote the influenza vaccination through communication and health education programs.
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Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1289-1300. [PMID: 35757890 DOI: 10.1080/14760584.2022.2093723] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs). AREAS COVERED To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Nazario Brescia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
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9
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Flu and COVID-19 Vaccination: What Happens to the Flu Shot When the Campaigns Overlap? Experience from a Large Italian Research Hospital. Vaccines (Basel) 2022; 10:vaccines10060976. [PMID: 35746583 PMCID: PMC9228127 DOI: 10.3390/vaccines10060976] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/14/2022] Open
Abstract
Influenza represents a threat to global health and health care workers (HCWs) have an increased risk of contracting the influenza virus in the workplace. The COVID-19 pandemic has brought back the importance of influenza vaccination, as the influenza virus can circulate together with SARS-CoV-2. The aim of this report is to describe the actual flu vaccination coverage among healthcare workers of a research hospital and the trend changes, with respect to the past flu vaccination campaigns, in light of the present pandemic and COVID-19 vaccination. A Pearson’s χ2 test was used to test the correlation of flu vaccination coverage, across all professional categories, between the last two years. A linear regression model was adopted to predict the total vaccination coverage of this year. A statistically significant decrease (p < 0.01) was observed in vaccination coverage among all the professional categories with a 50% reduction in vaccination trends between the last two years. Analyzing the data from the previous six flu vaccination campaigns, the expected value, according to the linear regression model, was estimated to be 38.5% while the observed value was 24%. The decrease in vaccination coverage may be due to the fear of the pandemic situation and especially to the uncertainty related to the consequences of a concurrent administration which may overload the immune system or may be more reactogenic. The COVID-19 pandemic represents an opportunity to promote and support large-scale influenza vaccination among HCWs through structured programs, adequate funding, and tailored communication strategies.
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COVID-19 and Influenza Vaccination Campaign in a Research and University Hospital in Milan, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116500. [PMID: 35682083 PMCID: PMC9180437 DOI: 10.3390/ijerph19116500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023]
Abstract
Background: Healthcare workers (HCWs) are a historical key target of influenza vaccination programs. For the 2021–2022 season, WHO considered the coadministration of a flu and a COVID-19 vaccine as acceptable and recommended it to allow for higher uptake of both vaccines. The aim of this study was to investigate demographic and occupational features of vaccinated HCWs, reasons behind flu vaccine acceptance and a possible effect of the coadministration of a COVID-19 vaccine, in order to potentially draw general conclusions on HCWs’ attitude towards flu vaccination and inform further strategies for consistent improvement of vaccine acceptance. Methods: a promotional and educational campaign, a gaming strategy, and vaccination delivery through both a large central hub and on-site ambulatories, were the implemented strategies. In the central hub, the flu/COVID-19 vaccine coadministration was offered. Statistical descriptive analysis, multiple correspondence analysis (MCA) and logistic regression models were performed. Results: 2381 HCWs received the flu vaccine, prompting a vaccination coverage rate (VCR) of 52.0% versus 43.1% in the 2020–2021 campaign. Furthermore, 50.6% vaccinated HCWs belonged to the 18–39 years-old age group. The most expressed reasons for vaccine uptake were “Vaccination is the most effective strategy of prevention” (n = 1928, 81.0%), “As HCW it’s my duty to get vaccinated to protect my patients” (n = 766, 32.2%), and the group of COVID-19-related reasons (n = 586, 24.6%). In addition, 23.3% HCWs received the flu vaccine in the current campaign but not in the previous one (newly vaccinated) and the flu/COVID-19 vaccine coadministration was more frequent in this group. A total of 51.0% HCWs were hesitant towards the coadministration, while residents and nurses showed the highest propensity to receive it. Conclusions: in the second year of the COVID-19 pandemic, the Fondazione’s influenza VCR continued to increase, with the greatest participation among HCWs aged 18–39 years. A potential propelling role of the COVID-19 vaccine coadministration was highlighted.
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Perrone PM, Biganzoli G, Lecce M, Campagnoli EM, Castrofino A, Cinnirella A, Fornaro F, Gallana C, Grosso FM, Maffeo M, Shishmintseva V, Pariani E, Castaldi S. Influenza Vaccination Campaign during the COVID-19 Pandemic: The Experience of a Research and Teaching Hospital in Milan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115874. [PMID: 34070763 PMCID: PMC8198860 DOI: 10.3390/ijerph18115874] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year’s in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04–1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24–1.69) and newborn workers (PR: 1.41; 95% CI: 1.20–1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.
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Affiliation(s)
- Pier Mario Perrone
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
- Correspondence: ; Tel.: +39-3463063408
| | - Giacomo Biganzoli
- Pharmacogenomics & Precision Therapeutics Master Degree, University of Milan, 20142 Milan, Italy;
| | - Maurizio Lecce
- Quality Unit Fondazione IRCCS Ca’ Granda OMP, 20122 Milan, Italy;
| | - Emanuela Maria Campagnoli
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Ambra Castrofino
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Andrea Cinnirella
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Federica Fornaro
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Claudia Gallana
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Francesca Maria Grosso
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Manuel Maffeo
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Viktoriia Shishmintseva
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Elena Pariani
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
| | - Silvana Castaldi
- Department Biomedical Sciences for Health, Postgraduate School in Public Health, University of Milano, 20136 Milan, Italy; (E.M.C.); (A.C.); (A.C.); (F.F.); (C.G.); (F.M.G.); (M.M.); (V.S.); (E.P.); (S.C.)
- Quality Unit Fondazione IRCCS Ca’ Granda OMP, 20122 Milan, Italy;
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De Sarro C, Papadopoli R, Cautela V, Nobile CGA, Pileggi C, Pavia M. Vaccination coverage among health-care workers: pre-post intervention study to assess impact of an on-site vaccination-dedicated clinic. Expert Rev Vaccines 2021; 20:753-759. [PMID: 33896347 DOI: 10.1080/14760584.2021.1915776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Several studies have revealed low vaccinations coverage among health-care workers (HCWs) for all vaccinations. The aim of our study was to evaluate the impact of the implementation of an on-site vaccination-dedicated clinic on the vaccination coverage rates of HCWs. RESEARCH DESIGN AND METHODS A quasi-experimental pre-post intervention study was carried out among undergraduate and postgraduate students attending medical and health-care professions schools. RESULTS We enrolled 804 students, 404 in the control and 400 in the experimental group. A significantly higher increase of vaccination coverage in the experimental group than in the control group for all the investigated vaccinations (p < 0.001) was found. The odds of adherence to vaccinations in the experimental group, compared to the control group, ranged from 6.9-fold (95% CI 3.51-13.44) to 18.9-fold (95% CI 10.85-32.96). The increase in the coverage rate in the control group was between 2.5% and 3.5%, whereas in the experimental group, higher increases were found, ranging from 34.8% to 71%. CONCLUSIONS The extraordinary increase in the adherence to HCWs recommended vaccinations found in the study seems to indicate a significant role of enabling factors in the complex process of decision-making and implementation of health-related behaviors.
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Affiliation(s)
- Caterina De Sarro
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro (Italy)
| | - Rosa Papadopoli
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro (Italy)
| | - Vincenza Cautela
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro (Italy)
| | | | - Claudia Pileggi
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro (Italy)
| | - Maria Pavia
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples (Italy)
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13
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Bruno S, Carducci B, Quaranta G, Beccia V, Di Pilla A, La Milia DI, Di Pumpo M, Carini E, Masini L, Tamburrini E, Spadea A, Damiani G, Lanzone A, Laurenti P. Enhancement of Vaccination Attitude and Flu Vaccination Coverage among Pregnant Women Attending Birthing Preparation Course. Vaccines (Basel) 2021; 9:183. [PMID: 33670085 PMCID: PMC7926478 DOI: 10.3390/vaccines9020183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/17/2022] Open
Abstract
Most vaccinations are recommended within the 15th month of life, in order to reduce risks and to protect children from the initial stages of their lives. A vaccination training session was carried out during the birthing preparation course, aimed at increasing the attitude toward vaccination in maternal-child age. A questionnaire on vaccination awareness was administered before and after the training session and on-site flu vaccination was offered to women and their companions. The percentage of participants who consider the preparatory course a useful tool to obtain information about vaccines increases significantly from 30.34% at pre-intervention to 64.56% at post-intervention (p < 0.001). There is a significant increase in the mean number of vaccinations that the participants want their children to get. The number of participants believing that there is no relationship between vaccination and autism rose from 41.05 to 72.97% (p < 0.001). In total, 48 out of 119 (40.34%) pregnant women participating in the course and 39 companions were vaccinated for influenza. Vaccination knowledge and attitude significantly increased after a training session dedicated to vaccination as a part of the pregnant pre-birth course, whose aim can be therefore extended to the management of the health of the child, well beyond the period of pregnancy, according to the life-course approach to health.
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Affiliation(s)
- Stefania Bruno
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Brigida Carducci
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Gianluigi Quaranta
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Viria Beccia
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Andrea Di Pilla
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Daniele Ignazio La Milia
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
| | - Marcello Di Pumpo
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Elettra Carini
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Lucia Masini
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Enrica Tamburrini
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | | | - Gianfranco Damiani
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Antonio Lanzone
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
| | - Patrizia Laurenti
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (B.C.); (G.Q.); (D.I.L.M.); (L.M.); (E.T.); (G.D.); (A.L.); (P.L.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (V.B.); (M.D.P.); (E.C.)
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14
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A Wide Range of Strategies to Cope with Healthcare Workers' Vaccine Hesitancy in A North-Eastern Italian Region: Are They Enough? Healthcare (Basel) 2020; 9:healthcare9010004. [PMID: 33374510 PMCID: PMC7822214 DOI: 10.3390/healthcare9010004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 01/01/2023] Open
Abstract
The recent pandemic reminded the world of the high risk of healthcare workers (HCWs) and patient contagiousness along with the healthcare services disruption related to nosocomial outbreaks. This study aims at describing vaccination campaigns within healthcare institutions of a North-Italian Region and comparing their effectiveness in term of vaccination coverage. In December 2019, we surveyed all healthcare institutions of Friuli Venezia Giulia Region throughout an email questionnaire with 15 questions investigating strategies adopted for the vaccination of HCWs against influenza and other vaccine-preventable diseases (VPDs), along with actions put in place in case of a VPD exposure. We found a strong heterogeneity in VPDs prevention and control policy and practice for HCWs, along with responsibility attribution ranging among different stakeholders. Strategies adopted to promote vaccination included a wide range of methods, but HCWs' influenza vaccination coverage still ranged from 17.0 to 33.3%. Contact tracing after a VPD exposure did not always include medical residents and students and visitors/caregivers/extra personnel as possible contacts. Even if knowledge and complacency gaps among HCWs could be faced with education activities, more efforts should be done in identifying and implementing effective vaccination strategies, and mandatory vaccination for HCWs could be introduced to achieve host, herd, and healthcare immunity preventing possible hospital outbreaks.
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15
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Serino L, Maurici M, D’Alò GL, Amadori F, Terracciano E, Zaratti L, Franco E. Healthcare Workers Training Courses on Vaccinations: A Flexible Format Easily Adaptable to Different Healthcare Settings. Vaccines (Basel) 2020; 8:vaccines8030514. [PMID: 32911808 PMCID: PMC7563464 DOI: 10.3390/vaccines8030514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 12/28/2022] Open
Abstract
Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non-mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services.
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Affiliation(s)
- Laura Serino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.S.); (M.M.); (G.L.D.); (L.Z.)
- Department of Prevention, Local Health Unit Roma 1, 00173 Rome, Italy
| | - Massimo Maurici
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.S.); (M.M.); (G.L.D.); (L.Z.)
| | - Gian Loreto D’Alò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.S.); (M.M.); (G.L.D.); (L.Z.)
- Department of Prevention, Local Health Unit Roma 1, 00173 Rome, Italy
| | - Fabiana Amadori
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (F.A.); (E.T.)
| | - Elisa Terracciano
- Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (F.A.); (E.T.)
| | - Laura Zaratti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.S.); (M.M.); (G.L.D.); (L.Z.)
| | - Elisabetta Franco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.S.); (M.M.); (G.L.D.); (L.Z.)
- Correspondence:
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16
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Bert F, Thomas R, Lo Moro G, Scarmozzino A, Silvestre C, Zotti CM, Siliquini R. A new strategy to promote flu vaccination among health care workers: Molinette Hospital's experience. J Eval Clin Pract 2020; 26:1205-1211. [PMID: 31697012 DOI: 10.1111/jep.13295] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Seasonal flu represents a major public health issue, especially for health care workers (HCWs). WHO highlights the need of higher awareness and flu vaccine coverage among HCWs. In Europe the coverage is less than 30-40%. Italy reports some of the lowest rates. The paper aims to illustrate the 2017/2018 flu vaccination campaign within Molinette, the third Italian hospital for dimensions, to provide inputs about strategies for increasing HCWs coverage. The campaign objective was to increase the administered doses at least of 30%. METHODS The intervention included informational material, direct educational sessions for workers, extension of the access time to Occupational Medicine Service, elimination of the reservation requirement, composition of "moving vaccination units" (MVUs), and organisation of vaccination sessions within departments. RESULTS In 2017/2018, 593 doses were administered. The doses percentage change between 2017/2018 and 2016/2017 vaccination seasons was +46.06%, while it was +84.74% compared with the previous 5-year period mean. The majority was administered by Occupational Medicine Service, while 6.75% by MVUs. Among the total doses, 72.68% were administered to workers, 13.49% to residents, 6.75% to students, and 7.08% to "other". So, 7.68% of total workforce was vaccinated. Only 0.3% of vaccinated people presented mild adverse reactions. CONCLUSIONS A combined campaign, that includes actions for education, increase of awareness, improved access to facilities and active offers to workers has potentiality but there is still work to do. The vaccination increase was determined mostly by the re-organization of the occupational medicine, while the MVUs were useful to HCWs of detached offices.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Torino, Turin, Italy.,Molinette Hospital, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - Robin Thomas
- Department of Public Health Sciences, University of Torino, Turin, Italy
| | - Giuseppina Lo Moro
- Department of Public Health Sciences, University of Torino, Turin, Italy
| | - Antonio Scarmozzino
- Molinette Hospital, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - Carlo Silvestre
- Molinette Hospital, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - Carla Maria Zotti
- Department of Public Health Sciences, University of Torino, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Torino, Turin, Italy.,Molinette Hospital, A.O.U. City of Health and Science of Turin, Turin, Italy
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Viruses of Respiratory Tract: an Observational Retrospective Study on Hospitalized Patients in Rome, Italy. Microorganisms 2020; 8:microorganisms8040501. [PMID: 32244685 PMCID: PMC7232519 DOI: 10.3390/microorganisms8040501] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022] Open
Abstract
Respiratory tract infections account for high morbidity and mortality around the world. Fragile patients are at high risk of developing complications such as pneumonia and may die from it. Limited information is available on the extent of the circulation of respiratory viruses in the hospital setting. Most knowledge relates to influenza viruses (FLU) but several other viruses produce flu-like illness. The study was conducted at the University Hospital Policlinico Tor Vergata, Rome, Italy. Clinical and laboratory data from hospitalized patients with respiratory tract infections during the period October 2016-March 2019 were analysed. The retrospective analysis included 17 viral agents detected by FilmArray test and clinical data from medical records and hospital discharge sheets. Models were adjusted for relevant confounders such as clinical severity and risk of death, socio-demographic characteristics and surgical procedures. From a total of 539 specimens analysed, 180 (33.39%) were positive for one or more respiratory viruses. Among them, 83 (46.1 %) were positive for influenza viruses (FLU), 36 (20%) rhino/enteroviruses (RHV/EV), 17 (9.44%) human coronaviruses (HCOV-229E, -HKU1, -NL63, and -OC43), 17 (9.44%) respiratory syncytial virus, 15 (8.33%) human metapneumovirus (HMPV), 8 (4.44%) parainfluenza viruses (PIV) and 4 (2.22%) adenoviruses (ADV). The distribution of viral agents varied across age groups and month of detection. The positive specimens were from 168 patients [102 M, 66 F; median age (range): 64 years (19-93)]. Overall, 40% of them had a high-grade clinical severity and a 27% risk of death; 27 patients died and 22 of them (81.5%) had received a clinical diagnosis of pneumonia. Respiratory viral infections may have a severe course and a poor prognosis in hospitalized patients, due to underlying comorbidities. Monitoring the circulation of respiratory viruses in hospital settings is important to improve diagnosis, prevention and treatment.
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Strategies to Increase Flu Vaccination Coverage among Healthcare Workers: A 4 Years Study in a Large Italian Teaching Hospital. Vaccines (Basel) 2020; 8:vaccines8010085. [PMID: 32069869 PMCID: PMC7157643 DOI: 10.3390/vaccines8010085] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
Flu vaccination is recommended among healthcare workers (HCWs). The low vaccination coverage registered in our hospital among HCWs called for new engaging approaches to improve flu vaccination coverage. The aim of this study was to evaluate the efficacy of different strategies implemented during the last four years (2015-2019). A quasi-experimental study was conducted, involving almost 4000 HCWs each year. Starting from the 2015-2016 campaign, new evidence-based strategies were progressively implemented. At the end of each campaign, an evaluation of the vaccination coverage rate reached was performed. Moreover, during the last three campaigns, differences in coverage among job category, wards involved or not in on-site vaccination (OSV) intervention, age classes and gender were analyzed. An increasing flu vaccination coverage rate was registered, from 6% in 2015-2016 to almost 22% at the end of 2018-2019. The overall number of vaccinated HCWs increased, especially at younger ages. OSV strategy always leads to better results, and physicians always show a higher vaccination coverage than nurses and other HCWs. The implemented strategies were effective in achieving higher flu vaccination coverage among HCWs in our hospital and therefore can be considered valuable examples of good prevention practices in hospital settings.
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