1
|
Kaddour O, Ben Mabrouk A, Arfa S, Lassoued N, Berriche O, Chelli J. Knowledge and attitudes of healthcare workers about influenza vaccination. Infect Dis Health 2024; 29:203-211. [PMID: 38679564 DOI: 10.1016/j.idh.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Influenza infection is a highly contagious viral disease. It may cause several nosocomial outbreaks. This study aimed to evaluate the knowledge and attitudes of healthcare workers (HCWs) about influenza vaccination and to identify factors associated with the uptake of influenza vaccination. METHODS We conducted a cross-sectional study over 5 months between November 2021 and March 2022. Data was collected using an anonymous self-administered questionnaire. We included all HCWs at Taher Sfar University Hospital who were willing to participate in the study. RESULTS A total of 395 HCWs were included. They were mainly women (78.7%) with an average age of 27 years. The medical personnel was the largest group (67.8%). Most respondents considered the vaccination to be optional and knew that it should be renewed every year, but 97.5% of them judged the efficacy of the vaccine to be low. The influenza vaccination uptake was only 20.2%. The main reasons for accepting vaccination were to protect patients and families. However, misconceptions about the severity and the risk of influenza and the belief that barrier measures were sufficient to prevent infection were the main causes of avoiding vaccination. The factors associated with adherence to vaccination were being a medical professional, old age, longer professional experience, and considering vaccination to be mandatory for HCWs. CONCLUSION Our study showed a low adherence to influenza vaccination with misconceptions about vaccine efficacy and safety. More efforts are needed to improve the knowledge of HCW about the vaccine and boost the adherence rates.
Collapse
Affiliation(s)
- Oussama Kaddour
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Asma Ben Mabrouk
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia.
| | - Sondess Arfa
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Najoua Lassoued
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Olfa Berriche
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | - Jihene Chelli
- Internal Medicine and Endocrinology Department, Taher Sfar Hospital, Mahdia, Tunisia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Meng L, Bell J, Soe M, Edwards J, Lymon H, Barbre K, Reses H, Patel A, Wong E, Dudeck M, Huynh CV, Rowe T, Dubendris H, Benin A. Comparison of factors associated with seasonal influenza and COVID-19 booster vaccination coverage among healthcare personnel working at acute care hospitals during 2021-2022 influenza season, National Healthcare Safety Network, United States. Prev Med 2024; 179:107852. [PMID: 38211802 DOI: 10.1016/j.ypmed.2024.107852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
The simultaneous circulation of seasonal influenza virus and SARS-CoV-2 variants will likely pose unique challenges to public health during the future influenza seasons. Persons who are undergoing treatment in healthcare facilities may be particularly at risk. It is important for healthcare personnel to protect themselves and patients by receiving vaccines. The purpose of this study is to assess coverage of the seasonal influenza vaccine and COVID-19 monovalent booster among healthcare personnel working at acute care hospitals in the United States during the 2021-22 influenza season and to examine the demographic and facility characteristics associated with coverage. A total of 3260 acute care hospitals with over 7 million healthcare personnel reported vaccination data to National Healthcare Safety Network (NHSN) during the 2021-22 influenza season. Two separate negative binomial mixed models were developed to explore the factors associated with seasonal influenza coverage and COVID-19 monovalent booster coverage. At the end of the 2021-2022 influenza season, the overall pooled mean seasonal influenza coverage was 80.3%, and the pooled mean COVID-19 booster coverage was 39.5%. Several demographic and facility-level factors, such as employee type, facility ownership, and geographic region, were significantly associated with vaccination against influenza and COVID-19 among healthcare personnel working in acute care hospitals. Our findings highlight the need to increase the uptake of vaccination among healthcare personnel, particularly non-employees, those working in for-profit and non-medical school-affiliated facilities, and those residing in the South.
Collapse
Affiliation(s)
- Lu Meng
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America.
| | - Jeneita Bell
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Minn Soe
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Jonathan Edwards
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Hoody Lymon
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Kira Barbre
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America; Goldbelt C6, Chesapeake, VA, United States of America
| | - Hannah Reses
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Avni Patel
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Emily Wong
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Margaret Dudeck
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Cam-Van Huynh
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Theresa Rowe
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Heather Dubendris
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America; Lantana Consulting Group, East Thetford, Vermont, United States of America
| | - Andrea Benin
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| |
Collapse
|
4
|
Schumacher S, Salmanton-García J, Liekweg A, Rolfes M, Seidel D, Mellinghoff SC, Cornely OA. Increasing influenza vaccination coverage in healthcare workers: analysis of an intensified on-site vaccination campaign during the COVID-19 pandemic. Infection 2023; 51:1417-1429. [PMID: 36853494 PMCID: PMC9972307 DOI: 10.1007/s15010-023-02007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Influenza infections have substantial impact on healthcare institutions. While vaccination is the most effective preventive measure against influenza infection, vaccination coverage in healthcare workers is low. The study investigates the impact of an intensified influenza vaccination campaign in a maximum-care hospital on influenza vaccination coverage in healthcare workers during the COVID-19 pandemic in 2020/21. METHODS Building on findings from our previously published review Schumacher et al. (Infection 49(3): 387, 2021), an intensified influenza vaccination campaign comprising a mobile vaccination team providing on-site vaccination and vaccination at a recurring central vaccination site in addition to promotional measures was performed and analysed regarding vaccination coverage. A survey querying vaccination motivation was performed. Campaign strategies and vaccination coverage of influenza seasons between 2017/18 and 2019/20 were analysed. RESULTS The influenza vaccination campaign 2020/21 led to a significant 2.4-fold increase yielding an overall vaccination coverage of 40% among healthcare workers. A significant increase in vaccination coverage was observed across all professional fields; especially among nurses, a 2.7-fold increase, reaching a vaccination coverage of 48%, was observed. The COVID-19 pandemic positively influenced vaccination decision in 72% of first time ever or first time in over ten years influenza vaccinees. Vaccination coverage during prior vaccination campaigns focusing on educational measures did not exceed 17%. CONCLUSION A mobile vaccination team providing on-site vaccination and vaccinations at a central vaccination site in addition to promotional measures can be implemented to increase influenza vaccination coverage in healthcare workers. Our concept can inform influenza and other vaccination campaigns for healthcare workers.
Collapse
Affiliation(s)
- Sofie Schumacher
- Department of Anaesthesiology and Intensive Care Medicine, St. Elisabeth Hospital, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Andrea Liekweg
- Pharmacy Department, University Hospital Cologne, Cologne, Germany
| | - Muriel Rolfes
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Danila Seidel
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
| | - Sibylle C Mellinghoff
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany.
| |
Collapse
|
5
|
Rubinstein EB, Rayel H, Crawford EC, Larson M. Using a rapid ethnographic assessment to explore vaccine hesitancy on a public university campus in the Upper Midwest. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37399535 DOI: 10.1080/07448481.2023.2225628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023]
Abstract
Objective: This exploratory study examined campus attitudes toward vaccines to guide subsequent development of context-relevant interventions for increasing vaccine acceptance and uptake. Participants: We gathered ethnographic data on a convenience sample of campus community members (students, faculty, staff) at a public university over six weeks in spring 2022. Methods: Student researchers conducted a rapid ethnographic assessment across campus locations. Weekly team debriefs enabled ongoing, iterative refinement of instruments and supplemented observational fieldnotes. Data analysis was inductive and oriented toward practical recommendations for intervention development. Results: Four themes, and attendant recommendations, emerged: 1) social identities and social roles influence health-related beliefs, including vaccination; 2) vaccine knowledge influences vaccination behaviors; 3) language surrounding vaccines (sometimes) matters; 4) vaccines aren't considered part of general health and wellness and can't be forced. Conclusions: Findings highlight the need to address individual, social, and institutional contexts when designing campus-based behavioral interventions for vaccine uptake.
Collapse
Affiliation(s)
- Ellen B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA
| | - Hannah Rayel
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
| | - Elizabeth C Crawford
- Department of Communication, North Dakota State University, Fargo, North Dakota, USA
| | - Mary Larson
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
| |
Collapse
|
6
|
Moyce S, Ruff J, Galloway A, Shannon S. Implementation of a COVID-19 Mass Vaccination Clinic to College Students in Montana. Am J Public Health 2021; 111:1776-1779. [PMID: 34499538 PMCID: PMC8561196 DOI: 10.2105/ajph.2021.306435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 11/04/2022]
Abstract
We describe a large-scale collaborative intervention of practice measures and COVID-19 vaccine administration to college students in the priority 1b group, which included Black or Indigenous persons and other persons of color. In February 2021, at this decentralized vaccine distribution site at Montana State University in Bozeman, we administered 806 first doses and 776 second doses by implementing an interprofessional effort with personnel from relevant university units, including facilities management, student health, communications, administration, and academic units (e.g., nursing, medicine, medical assistant program, and engineering). (Am J Public Health. Published online ahead of print September 9, 2021:1776-1779. https://doi.org/10.2105/AJPH.2021.306435).
Collapse
Affiliation(s)
- Sally Moyce
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Julie Ruff
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Ann Galloway
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Sarah Shannon
- All authors are with the College of Nursing, Montana State University, Bozeman
| |
Collapse
|
7
|
Influenza vaccination among healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2021; 43:1303-1305. [PMID: 34105448 DOI: 10.1017/ice.2021.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
8
|
Suryadevara M. Vaccine Confidence and Vaccine Hesitancy. Vaccines (Basel) 2021. [DOI: 10.1007/978-3-030-58414-6_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
9
|
Increasing influenza vaccination coverage in healthcare workers: a review on campaign strategies and their effect. Infection 2020; 49:387-399. [PMID: 33284427 PMCID: PMC7720031 DOI: 10.1007/s15010-020-01555-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022]
Abstract
Purpose Increasing influenza vaccination coverage in healthcare workers is a challenge. Especially during the ongoing COVID-19 pandemic, high vaccination coverage should be attained. This review analyzed strategies to increase influenza vaccination coverage in healthcare workers. Methods A literature search using PubMed was conducted and 32 publications on influenza vaccination campaigns for healthcare workers were reviewed for key interventions and resulting vaccination coverage. Results Among key interventions analyzed, mandatory vaccination policies or multifaceted campaigns including a vaccinate-or-wear-a-mask policy as well as mandatory declination reached vaccination coverage in healthcare workers of over 90%. Although campaigns solely based on education and promotion or on-site-vaccination did not regularly exceed an absolute vaccination coverage of 40%, a substantial relative increase in vaccination coverage was reached by implementation of these strategies. Conclusion Mandatory vaccination policies are effective measures to achieve high overall vaccination coverage. In clinics where policies are infeasible, multifaceted campaigns comprising on-site vaccination, vaccination stands and educational and promotional campaigns as well as incentives should be implemented. Lessons learned from influenza campaigns could be implemented in future SARS-CoV-2 vaccination campaigns.
Collapse
|
10
|
Occupational Respiratory Infections. Clin Chest Med 2020; 41:739-751. [PMID: 33153691 DOI: 10.1016/j.ccm.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Occupational respiratory infections can be caused by bacterial, viral, and fungal pathogens. Transmission in occupational settings can occur from other humans, animals, or the environment, and occur in various occupations and industries. In this article, we describe 4 occupationally acquired respiratory infections at the focus of NIOSH investigations over the last decade: tuberculosis (TB), influenza, psittacosis, and coccidioidomycosis. We highlight the epidemiology, clinical manifestations, occupational risk factors, and prevention measures.
Collapse
|
11
|
The role of alternative and complementary medical practices in vaccine hesitancy among nurses: A cross-sectional survey in Brittany. Infect Dis Now 2020; 52:159-163. [PMID: 33039553 DOI: 10.1016/j.medmal.2020.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 09/28/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Given today's increasing calling into question of vaccination, we have studied possible connections between alternative and complementary medical practices (CAM) and vaccine hesitancy (VH) among nurses. METHOD Ours was a cross-sectional study by self-administered online questionnaire addressed to a panel of nurses in Brittany. After adjustment for other proximal and distal determinants of VH, we examined the impact of CAM use. RESULTS Multivariate logistic regressions confirmed the existence of a link between CAM and VH. While trust in medical institutions seems to have an important role, CAM use appears largely independent of VH. CONCLUSION Association between CAM and VH in nurses raises the question not only of their training with respect to these alternative practices, but also of the role of medical institutions in the training of practitioners availing themselves of the latter.
Collapse
|
12
|
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.
Collapse
|
13
|
Gallagher MC, Haessler S, Babcock HM. Influenza Vaccination and Healthcare Personnel Compliance. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020; 12:71-76. [PMID: 32435160 PMCID: PMC7223640 DOI: 10.1007/s40506-020-00211-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of Review We reviewed the benefit of influenza vaccination in healthcare personnel (HCP), rates of vaccine coverage, and practices used to try to boost vaccine coverage among HCP. Recent Findings Influenza vaccination in HCP provides benefits to both HCP and patients, including reductions in patient morbidity and mortality and decreases in HCP absenteeism. Despite these benefits, influenza vaccine coverage among HCP still falls short of the Healthy People 2020 goal of 90%. As a result, healthcare institutions have used various practices to boost vaccination, including mandatory vaccine policies and requiring non-immunized HCP to wear masks during the influenza season. All of these efforts have been successful at increasing vaccination rates, and employer vaccination requirements have led to rates that meet the Healthy People 2020 goal. Rates of mandatory vaccine policies have increased over time, and several states now have influenza vaccine requirements. However, additional study into how these policies improve patient outcomes is needed. Summary Continued effort is needed to boost influenza vaccination rates among HCP, and mandatory vaccine policies may be used if other methods have not been effective in adequately raising vaccination rates. Future research should focus on how mandatory vaccine policies can improve patient outcomes.
Collapse
Affiliation(s)
- Megan C Gallagher
- 1Division of Infectious Disease, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Sarah Haessler
- 1Division of Infectious Disease, University of Massachusetts Medical School-Baystate, Springfield, MA USA
| | - Hilary M Babcock
- 2Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO USA
| |
Collapse
|
14
|
Yue M, Wang Y, Low CK, Yoong JSY, Cook AR. Optimal Design of Population-Level Financial Incentives of Influenza Vaccination for the Elderly. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:200-208. [PMID: 32113625 DOI: 10.1016/j.jval.2019.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To identify how monetary incentives affect influenza vaccination uptake rate using a randomized control experiment and to subsequently design an optimal incentive program in Singapore, a high-income country with a market-based healthcare system. METHODS 4000 people aged ≥65 were randomly assigned to 4 treatment groups (1000 each) and were offered a monetary incentive (in shopping vouchers) if they chose to participate. The baseline group was invited to complete a questionnaire with incentives of 10 Singapore dollars (SGD; where 1 SGD ≈ 0.73 USD), whereas the other three groups were invited to complete the questionnaire and be vaccinated against influenza at their own cost of around 32 SGD, in return for incentives of 10, 20, or 30 SGD. RESULTS Increasing the total incentive for vaccination and reporting from 10 to 20 SGD increased participation in vaccination from 4.5% to 7.5% (P < .001). Increasing the total incentive from 20 to 30 SGD increased the participation rate to 9.2%, but this was not statistically significantly different from a 20-SGD incentive. The group of nonworking elderly were more sensitive to changes in incentives than those who worked. In addition to working status, the effects of increasing incentives on influenza vaccination rates differed by ethnicity, socio-economic status, household size, and a measure of social resilience. There were no significant differential effects by age group, gender, or education, however. The cost of the program per completed vaccination under a 20-SGD incentive is 36.80 SGD, which was the lowest among the three intervention arms. For a hypothetical population-level financial incentive program to promote influenza vaccination among the elderly, accounting for transmission dynamics, an incentive between 10 and 20 SGD minimizes the cost per completed vaccination from both governmental and health system perspectives. CONCLUSIONS Appropriate monetary incentives can boost influenza vaccination rates. Increasing monetary incentives for vaccination from 10 to 20 SGD can improve the influenza vaccination uptake rate, but further increasing the monetary incentive to 30 SGD results in no additional gains. A partial incentive may therefore be considered to improve vaccination coverage in this high-risk group.
Collapse
Affiliation(s)
- Mu Yue
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yi Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chng Kiat Low
- Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | - Joanne Su-Yin Yoong
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore; Duke-NUS Medical School Singapore, Singapore.
| |
Collapse
|
15
|
McConeghy KW, Huang SS, Miller LG, McKinnell JA, Shireman TI, Mor V, Gravenstein S. Hospital Influenza Admissions as a Harbinger for Nursing Home Influenza Cases. J Am Med Dir Assoc 2019; 21:121-126. [PMID: 31445924 DOI: 10.1016/j.jamda.2019.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/22/2019] [Accepted: 06/24/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine temporal associations of local measures of influenza morbidity and mortality by the Centers for Disease Control and Prevention (CDC) with influenza hospitalizations in nursing home residents. DESIGN Retrospective, longitudinal panel study. SETTING AND PARTICIPANTS Long-stay nursing home residents, aged 65 years or older in 823 nursing homes from 2011 to 2015. MEASURES CDC-reported rates of influenza and pneumonia mortality and laboratory-confirmed influenza hospitalizations. We compared the CDC measures to nursing home resident hospitalizations due to (1) all-cause, (2) a primary diagnosis of respiratory or circulatory illness, and (3) a primary diagnosis of pneumonia or influenza based on Medicare Part A Claims data. RESULTS Our final sample included 273,743 unique residents in 819 nursing homes in 108 cities. National laboratory-confirmed influenza-associated hospitalizations for the group aged 65 and older occurred 0 to 1 week prior to nursing home resident influenza-related hospitalizations (Spearman ρ = 0.54). CDC-reported influenza hospitalizations occurred 3 weeks prior to CDC-reported influenza deaths (ρ = 0.59). Nursing home resident influenza hospitalizations occurred 2 weeks before local CDC-reported pneumonia and influenza deaths occurred (ρ = 0.44). CONCLUSIONS/IMPLICATIONS Publicly reported CDC measures correlate well with nursing home hospitalizations for pneumonia and influenza. Rates of laboratory-confirmed influenza hospitalizations (as reported by the CDC) may be a useful surrogate for nursing home influenza outbreaks but should be considered along with local indicators of disease outbreaks. Early community signals could be clinically leveraged as a trigger for increased infection control measures in nursing homes.
Collapse
Affiliation(s)
- Kevin W McConeghy
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI.
| | - Susan S Huang
- Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA
| | - Loren G Miller
- Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA
| | - James A McKinnell
- Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA
| | - Theresa I Shireman
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI
| | - Vincent Mor
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI
| | - Stefan Gravenstein
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Medicine, Warren-Alpert School of Medicine, Brown University, Providence, RI
| |
Collapse
|
16
|
Perl TM, Talbot TR. Universal Influenza Vaccination Among Healthcare Personnel: Yes We Should. Open Forum Infect Dis 2019; 6:ofz096. [PMID: 31012441 PMCID: PMC6468130 DOI: 10.1093/ofid/ofz096] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/22/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Trish M Perl
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Thomas R Talbot
- Departments of Medicine and Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee
| |
Collapse
|
17
|
Halpin C, Reid B. Attitudes and beliefs of healthcare workers about influenza vaccination. Nurs Older People 2019; 31:32-39. [PMID: 31468782 DOI: 10.7748/nop.2019.e1154] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND Annual influenza vaccination is recommended for all healthcare workers (HCWs) to help reduce the risk of contracting the virus and transmitting it to vulnerable people, especially older adults in residential care facilities. Vaccination uptake among HCWs remains low. AIM To investigate HCWs' attitudes towards, and beliefs about, seasonal influenza vaccination in a residential care facility for older adults in the Republic of Ireland. METHOD Data were collected using a self-administered questionnaire. RESULTS A total of 95 questionnaires were distributed, and 35 (37%) HCWs completed and returned them. During the 2016-17 flu season, 20 (57%) respondents were vaccinated. Primary predictors of vaccination acceptance were the belief that being healthy should not mitigate against requiring the vaccine ( r =0.7, P =0.01), protection of self and family ( r =0.67, P =0.01), protection of patients ( r =0.592, P =0.01) and agreement with mandatory vaccination ( r =0.351, P =0.039). Reasons for vaccination avoidance were misconceptions about the need for vaccination among healthy HCWs (67%), efficacy of the vaccine (60%), lack of trust in the vaccine (47%) and a belief that the vaccine may cause flu (47%). CONCLUSION Addressing HCWs' beliefs relating to the personal benefits of vaccination while simultaneously correcting misconceptions may help to increase uptake among those working in residential care settings for older adults.
Collapse
Affiliation(s)
- Carmel Halpin
- Health Service Executive Dublin North East, Dublin, Republic of Ireland
| | - Bernie Reid
- School of Nursing, University of Ulster, Northern Ireland
| |
Collapse
|
18
|
Trilla A, Aldea M. La vacunación de la gripe en el personal sanitario: auctoritas y potestas. Med Clin (Barc) 2019; 152:59-61. [DOI: 10.1016/j.medcli.2018.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
|
19
|
Agreement with employer influenza vaccination requirements among us healthcare personnel during the 2016–2017 season. Infect Control Hosp Epidemiol 2018; 39:1019-1020. [DOI: 10.1017/ice.2018.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
20
|
Lytras T, Kopsachilis F, Mouratidou E, Papamichail D, Bonovas S. Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis. Hum Vaccin Immunother 2017; 12:671-81. [PMID: 26619125 DOI: 10.1080/21645515.2015.1106656] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Influenza vaccination is recommended for healthcare workers (HCWs), but coverage is often low. We reviewed studies evaluating interventions to increase seasonal influenza vaccination coverage in HCWs, including a meta-regression analysis to quantify the effect of each component. Fourty-six eligible studies were identified. Domains conferring a high risk of bias were identified in most studies. Mandatory vaccination was the most effective intervention component (Risk Ratio of being unvaccinated [RRunvacc] = 0.18, 95% CI: 0.08-0.45), followed by "soft" mandates such as declination statements (RRunvacc = 0.64, 95% CI: 0.45-0.92), increased awareness (RRunvacc = 0.83, 95% CI: 0.71-0.97) and increased access (RRunvacc = 0.88, 95% CI: 0.78-1.00). For incentives the difference was not significant, while for education no effect was observed. Heterogeneity was substantial (τ(2) = 0.083). These results indicate that effective alternatives to mandatory HCWs influenza vaccination do exist, and need to be further explored in future studies.
Collapse
Affiliation(s)
- Theodore Lytras
- a Department of Epidemiological Surveillance and Intervention , Hellenic Centre for Disease Control and Prevention , Athens , Greece.,b Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain.,c Department of Experimental and Health Sciences , Universitat Pompeu Fabra (UPF) , Barcelona , Spain
| | - Frixos Kopsachilis
- d Department of Occupational and Industrial Hygiene , National School of Public Health , Athens , Greece
| | - Elisavet Mouratidou
- a Department of Epidemiological Surveillance and Intervention , Hellenic Centre for Disease Control and Prevention , Athens , Greece
| | - Dimitris Papamichail
- e Department of Child Health , National School of Public Health , Athens , Greece
| | - Stefanos Bonovas
- f Humanitas Clinical and Research Center , Rozzano , Milan , Italy
| |
Collapse
|
21
|
Swift MD, Aliyu MH, Byrne DW, Qian K, McGown P, Kinman PO, Hanson KL, Culpepper D, Cooley TJ, Yarbrough MI. Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination. Am J Public Health 2017; 107:S168-S176. [PMID: 28892449 PMCID: PMC5594393 DOI: 10.2105/ajph.2017.303953] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. METHODS We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. RESULTS A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. CONCLUSIONS Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the "Flulapalooza method" as a best practice model to enhance efficiency.
Collapse
Affiliation(s)
- Melanie D Swift
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Muktar H Aliyu
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Daniel W Byrne
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Keqin Qian
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Paula McGown
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Patricia O Kinman
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Katherine Louise Hanson
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Demoyne Culpepper
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Tamara J Cooley
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| | - Mary I Yarbrough
- Melanie D. Swift, Katherine Louise Hanson, and Mary I. Yarbrough are with Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Muktar H. Aliyu is with the Department of Health Policy, Vanderbilt University School of Medicine. Daniel W. Byrne is with the Department of Biostatistics, Vanderbilt University School of Medicine. Keqin Qian, and Patricia O. Kinman are with the Occupational Health Clinic, VUMC. Paula McGown, Demoyne Culpepper are with Faculty/Staff Health and Wellness, VUMC. Tamara J. Cooley is with Environmental Health and Safety, VUMC
| |
Collapse
|
22
|
Stepwise intervention including 1-on-1 counseling is highly effective in increasing influenza vaccination among health care workers. Am J Infect Control 2017; 45:635-641. [PMID: 28063732 DOI: 10.1016/j.ajic.2016.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/11/2016] [Accepted: 11/11/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The influenza vaccination rate among health care workers (HCWs) remains suboptimal. We attempted to increase vaccine uptake in HCWs by nonmandatory measures, including 1-on-1 counseling. METHODS In 2015 we used a stepwise approach including (1) text messaging on the last day of the vaccination period, (2) extending the vaccination period by 3 days, (3) education for the low uptake group, and (4) 1-on-1 counseling for unvaccinated HCWs after the 3 interventions. RESULTS There were 1,433 HCWs included. By the end of the initial 3 days, the uptake rate was 80.0% (1,146/1,433). During an extension for a further 3 days, 33 additional HCWs received the vaccine. One month after starting the vaccination, 90.1% (1,291/1,433) of the HCWs were vaccinated, but this included only 76.1% (210/276) of the doctors (lowest among HCWs). After 3 educational presentations targeted at the unvaccinated doctors, no additional individuals were vaccinated in the following 2 weeks. After 1-on-1 counseling for unvaccinated HCWs, the overall vaccination rate increased to 94.7% (1,357/1,433) in 2015, higher than in the previous year (82.5%, P < .001). Of the unvaccinated doctors, 63.2% (43/68) were vaccinated, therefore achieving 92.4% (255/276) compliance, higher than the 56.5% in the previous year (152/269, P < .001). CONCLUSIONS Stepwise intervention including 1-on-1 counseling is effective in increasing influenza vaccination rates among HCWs.
Collapse
|
23
|
Gallone MS, Gallone MF, Cappelli MG, Fortunato F, Martinelli D, Quarto M, Prato R, Tafuri S. Medical students' attitude toward influenza vaccination: Results of a survey in the University of Bari (Italy). Hum Vaccin Immunother 2017; 13:1937-1941. [PMID: 28463582 DOI: 10.1080/21645515.2017.1320462] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Influenza vaccination is strongly recommended for Italian healthcare professionals, but vaccine coverage is low. Since 2012, vaccination is also offered to medical students as part of the National Immunization Plan; however, few Medical Schools has implemented the plan so far. To study determinants of vaccination compliance, we conducted a survey among medical students at the University of Bari, where influenza vaccination has been actively offered since 2013. Information was obtained by means of an online anonymous questionnaire administered in April 2014. We enrolled 669 students, 383 (57%) vaccinated; 54% were female and the average age was 23.9 ± 4.9 y. Determinants of getting vaccinated were analyzed in a multivariate logistic model. Receiving invitation from the University (aOR = 3.8; 95%CI = 1.2-12.3; p = 0.026), the opinion that vaccine is safe (aOR = 2.8; 95%CI = 1.5-5.0; p = 0.001) and useful (aOR = 3.4; 95%CI = 1.7-6.7; p<0.0001), a specific training about influenza vaccination during the course (aOR = 1.5; 95%CI = 1.1-2.1; p = 0.043), and considering himself as at a major risk of influenza complication (aOR = 1.8; 95% CI = 1.1-2.9; p = 0.001) were significantly associated with vaccine acceptance. Active invitation and training are confirmed as key actions (as in children vaccination strategies) and, according to our results, they could be routinely used to promote vaccination in hard-to-reach groups such as healthcare workers.
Collapse
Affiliation(s)
- Maria Serena Gallone
- a Department of Biomedical Sciences and Human Oncology , University of Bari Aldo Moro , Bari , Italy
| | - Maria Filomena Gallone
- a Department of Biomedical Sciences and Human Oncology , University of Bari Aldo Moro , Bari , Italy
| | | | - Francesca Fortunato
- b Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Domenico Martinelli
- b Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Michele Quarto
- a Department of Biomedical Sciences and Human Oncology , University of Bari Aldo Moro , Bari , Italy
| | - Rosa Prato
- b Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Silvio Tafuri
- a Department of Biomedical Sciences and Human Oncology , University of Bari Aldo Moro , Bari , Italy
| |
Collapse
|
24
|
Leung VKY, Carolan LA, Worth LJ, Harper SA, Peck H, Tilmanis D, Laurie KL, Slavin MA, Sullivan SG. Influenza vaccination responses: Evaluating impact of repeat vaccination among health care workers. Vaccine 2017; 35:2558-2568. [PMID: 28385605 DOI: 10.1016/j.vaccine.2017.03.063] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/16/2017] [Accepted: 03/20/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To compare the antibody response to influenza between health care workers (HCWs) who have received multiple vaccinations (high vaccination group) and those who have received fewer vaccinations (low vaccination group). DESIGN Prospective serosurvey. SETTING Tertiary referral hospital. PARTICIPANTS Healthcare workers. METHODS Healthcare workers were vaccinated with the 2015 southern hemisphere trivalent influenza vaccine. Influenza antibody titres were measured pre-vaccination, 21-28days post-vaccination and 6months post-vaccination. Antibody titres were measured using the haemagglutination inhibition assay. Levels of seropositivity and estimated geometric mean titres were calculated. RESULTS Of the 202 HCWs enrolled, 182 completed the study (143 high vaccination and 39 low vaccination). Both vaccination groups demonstrated increases in post-vaccination geometric mean titres, with greater gains in the low vaccination group. Seropositivity remained high in both high and low vaccination groups post-vaccination. The highest fold rise was observed among HCWs in the low vaccination group against the H3N2 component of the vaccine. CONCLUSIONS Both high and low vaccination groups in our study demonstrated protective antibody titres post-vaccination. The findings from the current study are suggestive of decreased serological response among highly vaccinated HCWs. More studies with larger sample sizes and a greater number of people in the vaccine-naïve and once-vaccinated groups are required to confirm or refute these findings before making any policy changes.
Collapse
Affiliation(s)
- Vivian K Y Leung
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Department of Infectious Diseases/Infection Prevention, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia
| | - Louise A Carolan
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia
| | - Leon J Worth
- Department of Infectious Diseases/Infection Prevention, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia
| | - Susan A Harper
- Department of Infectious Diseases/Infection Prevention, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia
| | - Heidi Peck
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia
| | - Danielle Tilmanis
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia
| | - Karen L Laurie
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia
| | - Monica A Slavin
- Department of Infectious Diseases/Infection Prevention, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Fielding School of Public Health, University of California, Los Angeles, USA; School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| |
Collapse
|
25
|
Haridi HK, Salman KA, Basaif EA, Al-Skaibi DK. Influenza vaccine uptake, determinants, motivators, and barriers of the vaccine receipt among healthcare workers in a tertiary care hospital in Saudi Arabia. J Hosp Infect 2017; 96:268-275. [PMID: 28283372 DOI: 10.1016/j.jhin.2017.02.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/05/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Influenza vaccination of healthcare workers (HCWs) is essential for patient safety, their own safety, and hospital operation. However, despite its strong recommendation, studies indicates a low rate of vaccine uptake. AIM To assess rates of, and factors affecting, influenza vaccine uptake among HCWs. METHODS A cross-sectional survey was carried out during October 1st to 16th, 2015, among HCWs in King Abdullah Medical City in Makkah, Saudi Arabia. A self-administered, anonymous questionnaire was distributed to HCWs; this included questions on demographic characteristics, vaccine uptake, and knowledge, beliefs, attitude, and concern about influenza vaccine. FINDINGS Out of 500 HCWs approached, 447 returned valid self-reported questionnaires with response rate 89.4%. Overall, 88.3% of the participants reported receiving vaccination during the 2014/15 season, higher than during the 2013/14 (61.2%) and 2012/13 (54.5%) seasons. Self-protection (81.5%) was the main reason for vaccination, whereas 73.4% of HCWs reported vaccination to protect patients. The main reasons for vaccination avoidance were misconception that the vaccine causes influenza (38.5%) and concern about vaccine efficacy (32.7%). Logistic regression analysis revealed that the following were independently associated with vaccine receipt among HCWs: awareness of vaccine guidelines; intention to receive the vaccine next season; nurses and other HCWs compared to physicians; longer practice; and age >40 years. CONCLUSION A good uptake of influenza vaccine was achieved during the 2014/15 season following adoption of mandatory vaccination policy. Awareness programmes are needed to correct HCWs' misconceptions about the vaccine. Efforts need to focus especially on physicians, younger staff and new recruits.
Collapse
Affiliation(s)
- H K Haridi
- General Directorate of Health Affairs, Hail Region, Saudi Arabia; King Abdulla Medical City, Makkah, Saudi Arabia.
| | - K A Salman
- King Abdulla Medical City, Makkah, Saudi Arabia
| | - E A Basaif
- King Abdulla Medical City, Makkah, Saudi Arabia
| | - D K Al-Skaibi
- General Directorate of Health Affairs, Hail Region, Saudi Arabia
| |
Collapse
|
26
|
Pless A, Shaw D, McLennan S, Elger BS. Nurses' attitudes towards enforced measures to increase influenza vaccination: A qualitative study. Influenza Other Respir Viruses 2017; 11:247-253. [PMID: 27943585 PMCID: PMC5410727 DOI: 10.1111/irv.12441] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Despite studies demonstrating that the annual influenza vaccination of healthcare workers reduces morbidity and mortality among vulnerable patients, vaccination rates remain very low, particularly in nursing staff. Educational programmes have failed to improve rates, which has led to a diverse range of enforced approaches being advocated and implemented. OBJECTIVES To examine the attitudes of non-vaccinated nursing staff towards various enforced measures aimed at increasing rates of influenza vaccination. METHODS Semi-structured qualitative interviews with a purposive sample of 18 non-vaccinated nurses, working in units with high-risk patients at two hospitals in Switzerland. Analysis of interviews was done using conventional content analysis. RESULTS Nurses were critical of enforced measures. However, measures that include an element of choice were perceived as more acceptable. Declination forms and mandatory vaccinations as part of the employment requirements were found to be the most accepted measures. CONCLUSION The perception of choice is crucial to the acceptance of a measure. Respect for choice and autonomy has a positive effect on behavioural change. Mandatory influenza vaccination as a condition of new (and perhaps ongoing) employment could be a feasible, effective and ethical measure to increase vaccination rates among nurses who oppose vaccination.
Collapse
Affiliation(s)
- Anina Pless
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - David Shaw
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Stuart McLennan
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Institute for History, Ethics and Philosophy of Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
27
|
Student-centered interventions the key to student health care worker influenza vaccination. Infect Dis Health 2016. [DOI: 10.1016/j.idh.2016.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
28
|
Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P. Vaccination of healthcare workers: A review. Hum Vaccin Immunother 2016; 11:2522-37. [PMID: 26291642 DOI: 10.1080/21645515.2015.1082014] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Vaccine-preventable diseases are a significant cause of morbidity and mortality. As new vaccines are proving to be effective and as the incidence of some infections decreases, vaccination practices are changing. Healthcare workers (HCWs) are particularly exposed to and play a role in nosocomial transmission, which makes them an important target group for vaccination. Most vaccine-preventable diseases still carry a significant risk of resurgence and have caused outbreaks in recent years. While many professional societies favor vaccination of HCWs as well as the general population, recommendations differ from country to country. In turn, vaccination coverage varies widely for each microorganism and for each country, making hospitals and clinics vulnerable to outbreaks. Vaccine mandates and non-mandatory strategies are the subject of ongoing research and controversies. Optimal approaches to increase coverage and turn the healthcare workforce into an efficient barrier against infectious diseases are still being debated.
Collapse
Affiliation(s)
- Skerdi Haviari
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Thomas Bénet
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
| | - Mitra Saadatian-Elahi
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Philippe André
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Pierre Loulergue
- c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France.,d Université Paris Descartes, Sorbonne Paris Cité, INSERM, CIC 1417, Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Broca Hôtel Dieu, CIC Cochin-Pasteur ; Paris , France.,e INSERM, F-CRIN, I-REIVAC, Cochin Center ; Paris , France
| | - Philippe Vanhems
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
| |
Collapse
|
29
|
To KW, Lai A, Lee KCK, Koh D, Lee SS. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions. J Hosp Infect 2016; 94:133-42. [PMID: 27546456 DOI: 10.1016/j.jhin.2016.07.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from <5% to >90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.
Collapse
Affiliation(s)
- K W To
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - A Lai
- Occupational Health Division, Ministry of Health, Negara Brunei Darussalam
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Negara Brunei Darussalam; SSH School of Public Health, National University of Singapore, Singapore
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
| |
Collapse
|
30
|
Lin CJ, Nowalk MP, Raymund M, Sweeney PM, Zimmerman RK. Association of State Laws and Healthcare Workers’ Influenza Vaccination Rates. J Natl Med Assoc 2016; 108:99-102. [DOI: 10.1016/j.jnma.2015.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
31
|
Recommended Health Care Personnel Immunization: Exploring Immunization Rates, Motivators, and Barriers to Immunization in Health Care Personnel. J Dr Nurs Pract 2016; 9:38-44. [PMID: 32751001 DOI: 10.1891/2380-9418.9.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Immunization rates among health care personnel (HCP) have remained low despite advances in vaccine development with reported rates ranging from 27% to 72% for commonly recommended vaccines. Within the United States, HCP are placing patients, families, and themselves at considerable risk for vaccine-preventable diseases. A significant source of infection, HCP are carriers of infectious agents and often unknowingly transmit these contagious diseases while experiencing minimal or no symptoms. This study examined the current immunization rates of HCP for influenza, tetanus, diphtheria, and pertussis (Tdap), and hepatitis B in Nebraska, as well as identified motivators and barriers to vaccination. Nebraska HCP surveyed included physicians, physician assistants, nurse practitioners, registered nurses, licensed practical nurses, medical assistants, nursing assistants, and clerical or administrative staff of nonrestricted ethnic backgrounds age 19 years and older. Nebraska HCP immunization rates were statistically above the national rates. Motivators and barriers were also identified for each vaccine.
Collapse
|
32
|
Guanche Gacell H, Villanueva Arias A, Guilarte García E, Rubiera Jiménez R, Nonato Alfonso R. A Successful Strategy for Improving the Influenza Immunization Rates of Health Care Workers without a Mandatory Policy. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2015; 6:184-6. [PMID: 26174995 PMCID: PMC6977052 DOI: 10.15171/ijoem.2015.595] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 05/23/2015] [Indexed: 11/17/2022]
|
33
|
Abstract
The purpose of this statement is to reaffirm the American Academy of Pediatrics' support for a mandatory influenza immunization policy for all health care personnel. With an increasing number of organizations requiring influenza vaccination, coverage among health care personnel has risen to 75% in the 2013 to 2014 influenza season but still remains below the Healthy People 2020 objective of 90%. Mandatory influenza immunization for all health care personnel is ethical, just, and necessary to improve patient safety. It is a crucial step in efforts to reduce health care-associated influenza infections.
Collapse
|
34
|
Jarrett C, Wilson R, O'Leary M, Eckersberger E, Larson HJ. Strategies for addressing vaccine hesitancy - A systematic review. Vaccine 2015; 33:4180-90. [PMID: 25896377 DOI: 10.1016/j.vaccine.2015.04.040] [Citation(s) in RCA: 626] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts. METHODS A systematic review of peer reviewed (January 2007-October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager. RESULTS Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
Collapse
Affiliation(s)
- Caitlin Jarrett
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rose Wilson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maureen O'Leary
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Elisabeth Eckersberger
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | | |
Collapse
|
35
|
Honda H, Sato Y, Yamazaki A, Padival S, Kumagai A, Babcock H. A Successful Strategy for Increasing the Influenza Vaccination Rate of Healthcare Workers without a Mandatory Policy Outside of the United States: A Multifaceted Intervention in a Japanese Tertiary Care Center. Infect Control Hosp Epidemiol 2015; 34:1194-200. [DOI: 10.1086/673452] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.Although mandatory vaccination programs have been effective in improving the vaccination rate among healthcare workers, implementing this type of program can be challenging because of varied reasons for vaccine refusal. The purpose of our study is to measure improvement in the influenza vaccination rate from a multifaceted intervention at a Japanese tertiary care center where implementing a mandatory vaccination program is difficult.Design.Before-and-after trial.Participants and Setting.Healthcare workers at a 550-bed, tertiary care, academic medical center in Sapporo, Japan.Interventions.We performed a multifaceted intervention including (1) use of a declination form, (2) free vaccination, (3) hospital-wide announcements during the vaccination period, (4) prospective audit and real-time telephone interview for healthcare workers who did not receive the vaccine, (5) medical interview with the hospital executive for noncompliant (no vaccine, no declination form) healthcare workers during the vaccination period, and (6) mandatory submission of a vaccination document if vaccinated outside of the study institution.Results.With the new multifaceted intervention, the vaccination rate in the 2012-2013 season increased substantially, up to 97%. This rate is similar to that reported in studies with a mandatory vaccination program. Improved vaccination acceptance, particularly among physicians, likely contributed to the overall increase in the vaccination rate reported in the study.Conclusions.Implementation of comprehensive strategies with strong leadership can lead to substantial improvements in vaccine uptake among healthcare workers even without a mandatory vaccination policy. The concept is especially important for institutions where implementing mandatory vaccination programs is challenging.
Collapse
|
36
|
Quan KA, Cousins SM, Hizon DA, Heck KK, Samuelson P, Garcia F, Huang SS. Electronic solutions to enhance tracking and compliance with mandatory influenza vaccination for all hospital staff. Infect Control Hosp Epidemiol 2014; 35:1421-4. [PMID: 25333440 DOI: 10.1086/678415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In implementing a hospital mandatory influenza vaccination policy, we developed an automated, real-time tracking and reminder system. Of 6,957 policy-covered individuals automatically identified, automated reminders left only 5 requiring counseling. This decreased Occupational Health workload in contacting noncompliant individuals and hosting vaccination events while simultaneously facilitating a 96% vaccination rate.
Collapse
Affiliation(s)
- Kathleen A Quan
- Epidemiology and Infection Prevention Program, University of California Irvine Health, Orange, California
| | | | | | | | | | | | | |
Collapse
|
37
|
Lindley MC, Dube D, Kalayil EJ, Kim H, Paiva K, Raymond P. Qualitative evaluation of Rhode Island's healthcare worker influenza vaccination regulations. Vaccine 2014; 32:5962-6. [PMID: 25192807 DOI: 10.1016/j.vaccine.2014.08.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 08/22/2014] [Accepted: 08/25/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate Rhode Island's revised vaccination regulations requiring healthcare workers (HCWs) to receive annual influenza vaccination or wear a mask during patient care when influenza is widespread. DESIGN Semi-structured telephone interviews conducted in a random sample of healthcare facilities. SETTING Rhode Island healthcare facilities covered by the HCW regulations, including hospitals, nursing homes, community health centers, nursing service agencies, and home nursing care providers. Participants Staff responsible for collecting and/or reporting facility-level HCW influenza vaccination data to comply with Rhode Island HCW regulations. METHODS Interviews were transcribed and individually coded by interviewers to identify themes; consensus on coding differences was reached through discussion. Common themes and illustrative quotes are presented. RESULTS Many facilities perceived the revised regulations as extending their existing influenza vaccination policies and practices. Despite variations in implementation, nearly all facilities implemented policies that complied with the minimum requirements of the regulations. The primary barrier to implementing the HCW regulations was enforcement of masking among unvaccinated HCWs, which required timely tracking of vaccination status and additional time and effort by supervisors. Factors facilitating implementation included early and regular communication from the state health department and facilities' ability to adapt existing influenza vaccination programs to incorporate provisions of the revised regulations. CONCLUSIONS Overall, facilities successfully implemented the revised HCW regulations during the 2012-2013 influenza season. Continued maintenance of the regulations is likely to reduce transmission of influenza and resulting morbidity and mortality in Rhode Island's healthcare facilities.
Collapse
Affiliation(s)
- Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road N.E., Atlanta, GA 30333, USA.
| | - Donna Dube
- Independent Healthcare Consultant, Providence, RI USA
| | - Elizabeth J Kalayil
- Carter Consulting, Inc., 2310 Parklake Dr. NE, Suite 535, Atlanta, GA 30345, USA
| | - Hanna Kim
- Division of Community, Family Health, and Equity, Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908, USA
| | - Kristi Paiva
- Division of Community, Family Health, and Equity, Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908, USA
| | - Patricia Raymond
- Division of Community, Family Health, and Equity, Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908, USA
| |
Collapse
|
38
|
Update on immunizations for healthcare personnel in the United States. Vaccine 2014; 32:4869-75. [DOI: 10.1016/j.vaccine.2013.10.090] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 10/18/2013] [Accepted: 10/29/2013] [Indexed: 11/23/2022]
|
39
|
Theodoridou M. Professional and ethical responsibilities of health-care workers in regard to vaccinations. Vaccine 2014; 32:4866-8. [PMID: 24951862 DOI: 10.1016/j.vaccine.2014.05.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Maria Theodoridou
- First University Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Greece.
| |
Collapse
|
40
|
Kao CM, Schneyer RJ, Bocchini JA. Child and adolescent immunizations: selected review of recent US recommendations and literature. Curr Opin Pediatr 2014; 26:383-95. [PMID: 24722457 DOI: 10.1097/mop.0000000000000093] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To provide a clinically relevant summary of the latest research and recommendations regarding childhood and adolescent immunizations. RECENT FINDINGS Childhood vaccination has dramatically reduced pediatric morbidity and mortality in the United States. Recent research on childhood and adolescent immunizations has focused on expanding the use of current vaccines for additional subpopulations as well as the development of new vaccines. In particular, data confirming the safety and immunogenicity of vaccines in various groups of children have shaped national guidelines. Furthermore, studies on vaccine uptake, cost-effectiveness, and impact of vaccination have reinforced the importance of adhering to these guidelines. More work needs to be done by providers and parents to increase vaccination coverage rates to better protect children and adolescents from these serious diseases. In this article, selected recent publications and recommendations on the following vaccines are reviewed: influenza, meningococcal conjugate, childhood and adolescent/adult formulations of diphtheria and tetanus toxoids and acellular pertussis, pneumococcal conjugate, and human papillomavirus. SUMMARY Research on childhood and adolescent vaccinations continues to shape future guidelines. Through this work, we can learn how to optimize the protection of all children and adolescents against vaccine-preventable diseases.
Collapse
Affiliation(s)
- Carol M Kao
- aDivision of General Pediatrics, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York bDepartment of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | | | | |
Collapse
|
41
|
Hines L, Rees E, Pavelchak N. Respiratory protection policies and practices among the health care workforce exposed to influenza in New York State: evaluating emergency preparedness for the next pandemic. Am J Infect Control 2014; 42:240-5. [PMID: 24457143 PMCID: PMC7115259 DOI: 10.1016/j.ajic.2013.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/06/2013] [Accepted: 09/06/2013] [Indexed: 11/01/2022]
Abstract
BACKGROUND New York State hospitals are required to implement a respiratory protection program (RPP) consistent with the Occupational Safety and Health Administration respirator standard. Guidance provided during the 2009 novel H1N1 pandemic expanded on earlier recommendations, emphasizing the need to keep staff in all health care settings healthy to maintain services. METHODS New York State hospitals with emergency departments having more than 1,000 visits annually were invited to participate; 23 hospitals participated. Health care workers, unit managers, and hospital managers were interviewed regarding knowledge, beliefs, and practices of respiratory protection. Interviewees were observed donning and doffing an N-95 respirator as they normally would during patient care. Written RPPs for each hospital were evaluated. RESULTS The majority of the hospitals surveyed had implemented an RPP, although unawareness of the policies and practices, as well as inadequacies in education and training exist among health care workers. CONCLUSION Health care workers and other hospital employees may be unnecessarily exposed to airborne infectious diseases. Having an RPP ensures safe and effective use of N-95 respirators and will help prevent avoidable exposure to disease during a pandemic, protecting the health care workforce and patients alike.
Collapse
Affiliation(s)
- Leah Hines
- Bureau of Occupational Health and Injury Prevention, Center for Environmental Health, New York State Department of Health, Albany, NY.
| | - Elizabeth Rees
- Bureau of Occupational Health and Injury Prevention, Center for Environmental Health, New York State Department of Health, Albany, NY
| | - Nicholas Pavelchak
- Bureau of Occupational Health and Injury Prevention, Center for Environmental Health, New York State Department of Health, Albany, NY
| |
Collapse
|
42
|
Jaiyeoba O, Villers M, Soper DE, Korte J, Salgado CD. Association between health care workers' knowledge of influenza vaccine and vaccine uptake. Am J Infect Control 2014; 42:69-70. [PMID: 24176601 DOI: 10.1016/j.ajic.2013.06.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/25/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
Immunization is the most effective measure available to prevent influenza and its complications, and health care workers (HCWs) play a pivotal role. We conducted a cross-sectional survey study to determine HCWs knowledge and opinions regarding influenza vaccine and its acceptance at our institution. The most important reason for vaccine uptake was because it required formal declination (33%); physicians were more likely to be vaccinated because of patient care, whereas nurses were more likely to be vaccinated because it required formal declination.
Collapse
|
43
|
Garcell HG, Ramirez EC. Influenza immunization coverage for healthcare workers in a community hospital in Qatar (2011-2012 and 2012-2013 seasons). J Infect Public Health 2013; 7:70-2. [PMID: 24284023 DOI: 10.1016/j.jiph.2013.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/01/2013] [Accepted: 06/17/2013] [Indexed: 02/06/2023] Open
Abstract
Influenza vaccination is recommended for all healthcare workers (HCW) to prevent transmission within healthcare facilities. We conducted a descriptive study on influenza vaccination coverage during 2011-2012 and 2012-2013 campaigns in a community hospital in Qatar. 61.7% of the HCW were immunized in the first campaign, with an increase of up to 71.1% (p<0.05) in the second one, which was mainly due to better compliance of doctors (46.9% and 69.2%, respectively). Our results show proper coverage rates according US standards and highlight the need to implement additional strategies to improve health workers adherence of influenza, vaccination.
Collapse
|
44
|
Zimmerman RK. Ethical analyses of institutional measures to increase health care worker influenza vaccination rates. Vaccine 2013; 31:6172-6. [PMID: 24188752 DOI: 10.1016/j.vaccine.2013.10.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/18/2013] [Accepted: 10/22/2013] [Indexed: 10/26/2022]
Abstract
Health care worker (HCW) influenza vaccination rates are modest. This paper provides a detailed ethical analysis of the major options to increase HCW vaccination rates, comparing how major ethical theories would address the options. The main categories of interventions to raise rates include education, incentives, easy access, competition with rewards, assessment and feedback, declination, mandates with alternative infection control measures, and mandates with administrative action as consequences. The aforementioned interventions, except mandates, arouse little ethical controversy. However, these efforts are time and work intensive and rarely achieve vaccination rates higher than about 70%. The primary concerns voiced about mandates are loss of autonomy, injustice, lack of due process, and subsuming the individual for institutional ends. Proponents of mandates argue that they are ethical based on beneficence, non-maleficence, and duty. A number of professional associations support mandates. Arguments by analogy can be made by mandates for HCW vaccination against other diseases. The ethical systems used in the analyses include evolutionary ethics, utilitarianism, principalism (autonomy, beneficence, non-maleficence, and justice), Kantism, and altruism. Across these systems, the most commonly preferred options are easy access, assessment and feedback, declinations, and mandates with infection control measures as consequences for non-compliance. Given the ethical imperatives of non-maleficence and beneficence, the limited success of lower intensive interventions, and the need for putting patient safety ahead of HCW convenience, mandates with additional infection control measures as consequences for non-compliance are preferred. For those who opt out of vaccination due to conscience concerns, such mandates provide a means to remain employed but not put patient safety at risk.
Collapse
Affiliation(s)
- Richard K Zimmerman
- Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh, 3518 Fifth Avenue, Pittsburgh, PA 15261, United States.
| |
Collapse
|
45
|
Vaccination policies for healthcare workers in Europe. Vaccine 2013; 32:4876-80. [PMID: 24161573 DOI: 10.1016/j.vaccine.2013.10.046] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 01/05/2023]
Abstract
Health-care workers (HCWs) are at increased risk for acquisition of vaccine-preventable diseases (VPDs) and vaccination is justified in order to protect them from occupational exposure and to prevent the spread of VPDs that pose a threat to susceptible patients. Review of European vaccination policies for HCWs revealed significant differences between countries in terms of recommended vaccines, implementation frame (mandatory or recommendation), target HCW groups and health-care settings. Further, the few published studies available identified indicate significant immunity gaps among HCWs against VPDs in Europe. In order to achieve higher vaccination coverage against VPDs stronger recommendations are needed. The issue of mandatory vaccination should be considered for diseases that can be transmitted to susceptible patients (influenza, measles, mumps, rubella, hepatitis B, pertussis, varicella). The acceptance of vaccinations and of mandatory vaccinations by HCWs is a challenge and appears to be VPD-specific.
Collapse
|
46
|
Nowalk MP, Lin CJ, Raymund M, Bialor J, Zimmerman RK. Impact of hospital policies on health care workers' influenza vaccination rates. Am J Infect Control 2013; 41:697-701. [PMID: 23422232 DOI: 10.1016/j.ajic.2012.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/02/2012] [Accepted: 11/02/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Overall annual influenza vaccination rate has slowly increased among health care workers but still remains below the national goal of 90%. METHODS To compare hospitals that mandate annual health care worker (HCW) influenza vaccination with and without consequences for noncompliance, a 34-item survey was mailed to an infection control professional in 964 hospitals across the United States in 4 waves. Respondents were grouped by presence of a hospital policy that required annual influenza vaccination of HCWs with and without consequences for noncompliance. Combined with hospital characteristics from the American Hospital Association, data were analyzed using χ(2) or Fisher exact tests for categorical variables and t tests for continuous variables. RESULTS One hundred fifty hospitals required influenza vaccination, 84 with consequences (wear a mask, termination, education, restriction from patient care duties, unpaid leave) and 66 without consequences for noncompliance. Hospitals whose mandates have consequences for noncompliance included a broader range of personnel, were less likely to allow personal belief exemptions, or to require formal declination. The change in vaccination rates in hospitals with mandates with consequences (19.5%) was nearly double that of the hospitals with mandates without consequences (11%; P=.002). Presence of a state law regulating HCW influenza vaccination was associated with an increase in rates for mandates with consequences nearly 3 times the increase for mandates without consequences. CONCLUSION Hospital mandates for HCW influenza vaccination with consequences for noncompliance are associated with larger increases in HCW influenza vaccination rates than mandates without such consequences.
Collapse
|
47
|
A Time Off Incentive Was Not Associated with Influenza Vaccination Acceptance among Healthcare Workers. INFLUENZA RESEARCH AND TREATMENT 2013; 2013:209491. [PMID: 23878733 PMCID: PMC3710596 DOI: 10.1155/2013/209491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/31/2013] [Accepted: 06/13/2013] [Indexed: 11/29/2022]
Abstract
Objectives. The national influenza vaccination rate among healthcare workers (HCWs) remains low despite clear benefits to patients, coworkers, and families. We sought to evaluate formally the effect of a one-hour time off incentive on attitudes towards influenza vaccination during the 2011-2012 influenza season. Methods. All HCWs at the Philadelphia Veterans Affairs (VA) Medical Center were invited to complete an anonymous web-based survey. We described respondents' characteristics and attitudes toward influenza vaccination and determined the relationship of specific attitudes with respondents' acceptance of influenza vaccination, using a 5-point Likert scale. Results. We analyzed survey responses from 154 HCWs employed at the Philadelphia VA Medical Center, with a response rate of 8%. Among 121 respondents who reported receiving influenza vaccination, 34 (28%, 95% CI 20–37%) reported agreement with the statement that the time off incentive made a difference in their decision to accept influenza vaccination. Conclusions. Our study provides evidence that modest incentives such as one-hour paid time off will be unlikely to promote influenza vaccination rates within medical facilities. More potent interventions that include mandatory vaccination combined with penalties for noncompliance will likely provide the only means to achieve near-universal influenza vaccination among HCWs.
Collapse
|
48
|
Fricke KL, Gastañaduy MM, Klos R, Bégué RE. Correlates of improved influenza vaccination of healthcare personnel: a survey of hospitals in Louisiana. Infect Control Hosp Epidemiol 2013; 34:723-9. [PMID: 23739077 DOI: 10.1086/670992] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates. DESIGN Survey. PARTICIPANTS Volunteer sample of hospitals in Louisiana. METHODS All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate. RESULTS Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%-91%). CONCLUSIONS The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.
Collapse
|
49
|
Leung VKY, Harper SE, Slavin MA. Influenza vaccination uptake in an Australian hospital: time to make it mandatory for health care workers? Med J Aust 2012; 197:552. [DOI: 10.5694/mja12.11199] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Vivian K Y Leung
- Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, Melbourne, VIC
| | - Susan E Harper
- Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, Melbourne, VIC
| | - Monica A Slavin
- Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, Melbourne, VIC
| |
Collapse
|
50
|
Seale H, Kaur R, MacIntyre CR. Understanding Australian healthcare workers' uptake of influenza vaccination: examination of public hospital policies and procedures. BMC Health Serv Res 2012; 12:325. [PMID: 22992333 PMCID: PMC3507749 DOI: 10.1186/1472-6963-12-325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 09/17/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Australia, whether to provide free influenza vaccine to health care workers (HCWs) is a policy decision for each hospital or jurisdiction, and is therefore not uniform across the country. This study explored hospital policies and practices regarding occupational influenza vaccination of HCWs in Australia. METHODS A study using qualitative methodology, which included semi-structured interviews, was undertaken with hospital staff involved with the delivery of occupational influenza vaccination from three states in Australia. RESULTS The 29 participants were responsible for vaccinating staff in 82 hospitals. Major themes in the responses were the lack of resources and the difficulties participants faced in procuring any additional support or funding from their institutions. All study sites provided vaccine free of charge to employees via on-site clinics or mobile carts, and used multiple strategies to inform and educate their staff. In some instances, declination forms had been adopted, however their use was associated with resourcing issues, animosity, and other problems. Participants who were responsible for multiple sites were more likely to recount lower vaccination coverage figures at their hospitals. CONCLUSIONS From these interviews, it is clear that hospitals are implementing multiple strategies to educate, promote, and deliver the vaccine to staff. However, resources and support are not always available to assist with the vaccination campaign. The reality for many hospitals is that there is limited capacity to implement the vaccination campaigns at the levels high enough to raise compliance rates. Further research needs to be conducted to quantify the factors contributing to higher uptake in the Australian hospital setting.
Collapse
Affiliation(s)
- Holly Seale
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, New South Wales, Australia
| | - Rajneesh Kaur
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, New South Wales, Australia
| | - C Raina MacIntyre
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, New South Wales, Australia
- National Centre for Immunization Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children’s Hospital at Westmead, New South Wales, Australia
| |
Collapse
|