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Challenger A, Sumner P, Powell E, Bott L. Identifying reasons for non-acceptance of influenza vaccine in healthcare workers: an observational study using declination form data. BMC Health Serv Res 2023; 23:1167. [PMID: 37891521 PMCID: PMC10604813 DOI: 10.1186/s12913-023-10141-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Healthcare workers are sometimes required to complete a declination form if they choose not to accept the influenza vaccine. We analysed the declination data with the goal of identifying barriers to vaccination uptake across seasons, staff groups, and pre- and post- arrival of COVID-19. METHODS Reasons for declining the vaccine were gathered from N = 2230 declination forms, collected over four influenza seasons, 2017/2018, 2018/2019, 2019/2020 and 2020/2021, from a single health board in the UK. Reasons were classified according to ten categories and the resulting distribution analysed across year and staff groups. A further analysis considered the two most prevalent categories in more detail. RESULTS Fear of adverse reactions and Lack of perception of own risk were identified as primary reasons for not accepting the vaccine across time and across staff groups. However, there was no evidence that Lack of concern with influenza, or Doubts about vaccine efficacy was prevalent, contrary to previous findings. Overall, reasons fitted a pattern of underestimating risk associated with influenza and overestimating risk of minor adverse reactions. There were also differences across years, χ2(24) = 123, p < .001. In particular, there were relatively fewer Lack of perception of own risk responses post-COVID-19 arrival than before, χ2(8) = 28.93, p = .002. CONCLUSION This study shows that data collected from declination forms yields sensible information concerning vaccine non-acceptance without the difficulties of retrospective or pre-emptive reasoning suffered by questionnaires. Our findings will aid messaging campaigns designed to encourage uptake of the influenza vaccine in healthcare workers. In particular, we argue for an approach focused on risk perception rather than correction of straightforward misconceptions.
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Affiliation(s)
- Aimee Challenger
- World Health Organization Collaborating Centre On Investment for Health and Wellbeing, Public Health Wales, Cardiff, Wales, UK
| | - Petroc Sumner
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, Wales, UK
| | - Eryl Powell
- Aneurin Bevan Gwent Public Health Team, Aneurin Bevan University Health Board, Wales, UK
| | - Lewis Bott
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, Wales, UK.
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2
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Ballalai I, Dawson R, Horn M, Smith V, Bekkat-Berkani R, Soumahoro L, Vicic N. Understanding barriers to vaccination against invasive meningococcal disease: a survey of the knowledge gap and potential solutions. Expert Rev Vaccines 2023; 22:457-467. [PMID: 37144283 DOI: 10.1080/14760584.2023.2211163] [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: 05/06/2023]
Abstract
INTRODUCTION Invasive meningococcal disease (IMD) is a leading cause of life-threatening bacterial meningitis and septicemia. Evidence points to a knowledge gap among parents, teenagers, and healthcare providers (HCPs) regarding IMD and available vaccines, including those against the highly prevalent serogroup B. AREAS COVERED An online survey was conducted between March 27 and April 12, 2019, to gather insights into the knowledge that parents/guardians have about IMD vaccines. The children were aged 2 months-10 years in Australia, Brazil, Germany, Greece, Italy, and Spain, 5-20 years in the UK, and 16-23 years in the US. The findings were discussed in the context of the available literature and solutions were proposed to minimize the knowledge gap and the barriers to vaccination against IMD. EXPERT OPINION The survey demonstrated that parents have a good understanding of IMD but a limited understanding of the different serogroups and vaccines. The available literature highlighted multiple barriers to IMD vaccine uptake; these may be reduced through education of HCPs, clear recommendations to parents by HCPs, the use of technology, and disease-awareness initiatives that engage parents through physical and digital channels. Further studies are warranted to assess the impact of the COVID-19 pandemic on IMD vaccination.
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Affiliation(s)
| | - Rob Dawson
- Meningitis Research Foundation, Bristol, UK
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de Lusignan S, Ashraf M, Ferreira F, Tripathy M, Yonova I, Rafi I, Kassianos G, Joy M. Impact of General Practitioner Education on Acceptance of an Adjuvanted Seasonal Influenza Vaccine among Older Adults in England. Behav Sci (Basel) 2023; 13:bs13020130. [PMID: 36829359 PMCID: PMC9952828 DOI: 10.3390/bs13020130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/06/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Seasonal vaccination against influenza and in-pandemic COVID-19 vaccination are top public health priorities; vaccines are the primary means of reducing infections and also controlling pressures on health systems. During the 2018-2019 influenza season, we conducted a study of the knowledge, attitudes, and behaviours of 159 general practitioners (GPs) and 189 patients aged ≥65 years in England using a combination of qualitative and quantitative approaches to document beliefs about seasonal influenza and seasonal influenza vaccine. GPs were surveyed before and after a continuing medical education (CME) module on influenza disease and vaccination with an adjuvanted trivalent influenza vaccine (aTIV) designed for patients aged ≥65 years, and patients were surveyed before and after a routine visit with a GP who participated in the CME portion of the study. The CME course was associated with significantly increased GP confidence in their ability to address patients' questions and concerns about influenza disease and vaccination (p < 0.001). Patients reported significantly increased confidence in the effectiveness and safety of aTIV after meeting their GP. Overall, 82.2% of the study population were vaccinated against influenza (including 137 patients vaccinated during the GP visit and 15 patients who had been previously vaccinated), a rate higher than the English national average vaccine uptake of 72.0% that season. These findings support the value of GP-patient interactions to foster vaccine acceptance.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
- Correspondence: ; Tel.: +44-01865-617-283 (ext. 17-283)
| | | | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Manasa Tripathy
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Ivelina Yonova
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Imran Rafi
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
- Institute for Medical and Biomedical Education, St George’s University of London, London SW17 0RE, UK
| | - George Kassianos
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
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Ashraf M, Rajaram S, English PM. How the COVID 19 pandemic will shape influenza public health initiatives: the UK experience. Hum Vaccin Immunother 2022; 18:2056399. [PMID: 35435806 PMCID: PMC9255027 DOI: 10.1080/21645515.2022.2056399] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although caused by different pathogens, COVID-19 and influenza share many clinical features, as well as the potential for inflammatory, cardiovascular, and other long-term complications. During the 2020–2021 influenza season, COVID-19 mitigation efforts and a robust influenza vaccination campaign led to an unprecedented reduction in influenza cases. The lack of exposure to influenza, along with antigenic changes, may have reduced population immunity to influenza and set the stage for a high severity influenza season in 2021–2022. For the second consecutive season, the UK Department of Health and Social Care has expanded influenza vaccine eligibility to mitigate the impact of both COVID-19 and influenza. Continuation of clear policy decisions, as well as ongoing coordination between manufacturers, distributors, health authorities, and healthcare providers, is key to reducing the burden of influenza and COVID-19 and preventing large numbers of severe cases that can overwhelm the healthcare system.
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Gesser-Edelsburg A, Badarna Keywan H. Physicians' Perspective on Vaccine-Hesitancy at the Beginning of Israel's COVID-19 Vaccination Campaign and Public's Perceptions of Physicians' Knowledge When Recommending the Vaccine to Their Patients: A Cross-Sectional Study. Front Public Health 2022; 10:855468. [PMID: 35356022 PMCID: PMC8960033 DOI: 10.3389/fpubh.2022.855468] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/07/2022] [Indexed: 02/06/2023] Open
Abstract
Because public healthcare workers (HCWs) are at the forefront of the battle against COVID-19, they must be able to provide vaccination information to their patients and respond to their anxieties and concerns. This research objectives were to (1) examine physicians' perceptions of how they received information about the Pfizer COVID-19 vaccine, their attitudes toward hesitant colleagues, and their own knowledge and self-efficacy in communicating information to their patients, and (2) to examine the public's perceptions of physicians' knowledge when recommending the COVID-19 vaccine to their patients. At the beginning of the vaccination campaign, a survey examined the attitudes of physicians in the Israeli public healthcare system (n = 295) regarding the Pfizer vaccine. In addition, the attitudes of a representative sample (n = 500) of the Israeli adult population (age 18+) were examined through interviews. Most of the participating physicians (81%) reported they had already been vaccinated or intended to be vaccinated. When asked about their reasons for vaccine hesitancy, 27% cited concerns about long-term side effects and doubts about the vaccine's effectiveness in preventing contagion. They cited system pressure and departmental norms as explanations for their eventual compliance. Moreover, they saw the system as less tolerant of hesitant physicians, while they themselves tend to be more tolerant. The results of the survey of the public showed that mostly young people (under 44) who tend to be critical believe that physicians do not have sufficient knowledge to make recommendations about the COVID-19 vaccine. The findings indicate that the health system should employ complete transparency in conveying the advantages and disadvantages of the COVID-19 vaccine to physicians. The system should be more tolerant of physicians' worries and concerns and grant legitimacy to their reservations and misgivings. Moreover, medical studies should reinforce physicians' immunological knowledge regarding vaccinations so they can help their patients make informed decisions.
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Gesser-Edelsburg A. How to Make Health and Risk Communication on Social Media More "Social" During COVID-19. Risk Manag Healthc Policy 2021; 14:3523-3540. [PMID: 34471393 PMCID: PMC8403670 DOI: 10.2147/rmhp.s317517] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/13/2021] [Indexed: 12/14/2022] Open
Abstract
Social media have changed the way citizens participate in and express opinions about government policy. Social media serve organizations in achieving four main goals: interacting with citizens; fostering citizen participation; furthering open government; and analyzing/monitoring public opinion and activities. We contend that despite the importance of social media, international and local health organizations have been slow to adopt to them, primarily due to the discrepancy between intraorganizational discourse modes and the type of discourse suitable for dialogue with the public. In this perspective paper, we recommend strategies for such public dialogue based on understanding the challenges faced by organizations on the road to becoming more “social” in their social media presence and in their health and risk communication. Subsequently, we propose an integrative approach that combines three complementary paths: (1) putting the “social” back into health organizations’ culture by inserting more “social” content into the internal organizational discourse through consultation with experts from different fields, including those who diverge from the scientific consensus. (2) Using strategies to enable health organizations to respond to the public on social networks, based on health communications research and studies on emerging infectious disease (EID) communication. (3) Engaging the public on social media based on the participatory approach, which considers the public as a partner that understands science and can work with the organizations to develop an open and innovative pandemic realm by using crowdsourcing to solve complex global health problems. For each path, we define the current challenges, among which are (1) overcoming organizational groupthink and hidden profiles, (2) treating all unofficial information as misleading, and (3) insufficient public engagement in solving complex global problems. We then offer recommendations for dealing with each challenge.
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Affiliation(s)
- Anat Gesser-Edelsburg
- School of Public Health and the Health and Risk Communication Research Center, University of Haifa, Haifa, 3498838, Israel
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7
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Gray G, Cooper J. An evaluation of influenza vaccine uptake in UK medical students. Occup Med (Lond) 2021; 71:105-108. [PMID: 33598680 DOI: 10.1093/occmed/kqab014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The annual influenza vaccination is recommended for all front-line healthcare workers in the UK and is a crucial way of reducing mortality for vulnerable patient groups. However, to date the UK government has never explicitly monitored influenza vaccine uptake in medical students. This is important to ascertain, as students regularly move between clinical areas and are both a perfect vector for the spread of influenza and at an increased risk of contracting influenza themselves. AIMS This service evaluation was designed to evaluate the effectiveness of an influenza vaccination programme in one UK medical school and make recommendations to increase vaccination rates in the future. METHODS This service evaluation collected data about medical student uptake of influenza vaccination in one UK medical school. Two hundred and fifty-one students at different course stages completed questionnaires, answering questions on vaccination status and Likert-scale 'belief' questions to assess the subjective reasons behind vaccine refusal. RESULTS There was a substantial difference between year group cohorts (~20%), with significantly higher vaccination rates in the preclinical year group. Two significant negative predictors of vaccination were found (P < 0.001), related to scepticism over the effectiveness of the vaccine and lack of convenient access to the vaccination. Results indicated that integrating information about the influenza vaccine into the curriculum would reduce lack of knowledge over the efficacy of the vaccine. The centralization of vaccination programmes at mandatory university-based learning events would mitigate against the problem of diversity of vaccination locations and lack of central accountability. CONCLUSIONS The results of this service evaluation provide significant predictors of vaccination status for medical students and potential occupational health interventions to improve vaccine uptake in this group.
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Affiliation(s)
- G Gray
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Cooper
- Warwick Medical School, University of Warwick, Coventry, UK
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8
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Bhugra P, Grandhi GR, Mszar R, Satish P, Singh R, Blaha M, Blankstein R, Virani SS, Cainzos-Achirica M, Nasir K. Determinants of Influenza Vaccine Uptake in Patients With Cardiovascular Disease and Strategies for Improvement. J Am Heart Assoc 2021; 10:e019671. [PMID: 34315229 PMCID: PMC8475658 DOI: 10.1161/jaha.120.019671] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Influenza infection is associated with an increased risk of cardiovascular events (myocardial infarction, stroke, and heart failure exacerbation) and mortality, and all‐cause mortality in patients with CVD. Infection with influenza leads to a systemic inflammatory and thrombogenic response in the host body, which further causes destabilization of atherosclerotic plaques. Influenza vaccination has been shown to be protective against cardiovascular and cerebrovascular events in several observational and prospective studies of at‐risk populations. Hence, many international guidelines recommend influenza vaccination for adults of all ages, especially for individuals with high‐risk conditions such as CVD. Despite these long‐standing recommendations, influenza vaccine uptake among US adults with CVD remains suboptimal. Specifically, vaccination uptake is strikingly low among patients aged <65 years, non‐Hispanic Black individuals, those without health insurance, and those with diminished access to healthcare services. Behavioral factors such as perceived vaccine efficacy, vaccine safety, and attitudes towards vaccination play an important role in vaccine acceptance at the individual and community levels. With the ongoing COVID‐19 pandemic, there is a potential threat of a concurrent epidemic with influenza. This would be devastating for vulnerable populations such as adults with CVD, further stressing the need for ensuring adequate influenza vaccination coverage. In this review, we describe a variety of strategies to improve the uptake of influenza vaccination in patients with CVD through improved understanding of key sociodemographic determinants and behaviors that are associated with vaccination, or the lack thereof. We further discuss the potential use of relevant strategies for COVID‐19 vaccine uptake among those with CVD.
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Affiliation(s)
| | | | - Reed Mszar
- Center for Outcomes Research and EvaluationYale New Haven Health New Haven CT
| | - Priyanka Satish
- Department of CardiologyHouston Methodist Hospital Houston TX
| | - Rahul Singh
- Department of Internal Medicine Houston Methodist Hospital Houston TX
| | - Michael Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD
| | - Ron Blankstein
- Cardiovascular Imaging Program, Cardiovascular Division and Department of Radiology Brigham and Women's Hospital Boston MA
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX.,Baylor College of Medicine Houston TX
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness Department of CardiologyHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Outcomes Research Yale University New Haven CT
| | - Khurram Nasir
- Division Health Equity & Disparities Research Center for Outcomes Research Houston Methodist Hospital Houston TX.,Division of Cardiovascular Prevention and Wellness Department of Cardiovascular MedicineHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Cardiovascular Computational & Precision Health (C3-PH) Department of Cardiovascular Medicine Houston Methodist DeBakey Heart & Vascular Center Houston TX.,Division of Cardiology Yale University New Haven CT
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9
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Parimalanathan V, Joy M, Van Dam PJ, Fan X, de Lusignan S. Association between Influenza Vaccine Administration and Primary Care Consultations for Respiratory Infections: Sentinel Network Study of Five Seasons (2014/2015-2018/2019) in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020523. [PMID: 33435229 PMCID: PMC7827078 DOI: 10.3390/ijerph18020523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/25/2022]
Abstract
Influenza, a vaccine preventable disease, is a serious global public health concern which results in a considerable burden on the healthcare system. However, vaccine hesitancy is increasingly becoming a global problem. One prevalent misconception is that influenza vaccinations can cause the flu. We carried out this study to determine whether people undertaking influenza vaccination presented less with acute respiratory tract infection (ARTI) and influenza-like-illness (ILI) following vaccination. We utilised the Oxford Royal College of General Practitioners Research and Surveillance Centre sentinel database to examine English patients who received vaccination between 2014/2015 and 2018/2019. Of the 3,841,700 influenza vaccinations identified, vaccination details and primary care respiratory consultation counts were extracted to calculate the relative incidence (RI) per exposure risk period using the self-controlled case series methodology. Results showed a significant increase in the RI of respiratory consultation rates within fourteen days of vaccination across all five years. Less than 6.2% of vaccinations led to consultations for ARTI or ILI in primary care (crude consultation rate 6196 per 100,000). These findings, particularly if confirmed in further research, may reduce the risk of cross-infection between waiting patients and increase uptake of influenza vaccine.
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Affiliation(s)
- Vaishnavi Parimalanathan
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (V.P.); (P.J.V.D.)
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
- Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
| | - Pieter Jan Van Dam
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (V.P.); (P.J.V.D.)
| | - Xuejuan Fan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
- Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK
- Correspondence: ; Tel.: +44-1865-617-283
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10
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Baj-Rogowska A. Mapping of the Covid-19 Vaccine Uptake Determinants From Mining Twitter Data. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2021; 9:134929-134944. [PMID: 34786320 PMCID: PMC8545202 DOI: 10.1109/access.2021.3115554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 05/12/2023]
Abstract
Opinion polls on vaccine uptake clearly show that Covid-19 vaccine hesitancy is increasing worldwide. Thus, reaching herd immunity not only depends on the efficacy of the vaccine itself, but also on overcoming this hesitancy of uptake in the population. In this study, we revealed the determinants regarding vaccination directly from people's opinions on Twitter, based on the framework of the 6As taxonomy. Covid-19 vaccine acceptance depends mostly on the characteristics of new vaccines (i.e. their safety, side effects, effectiveness, etc.), and the national vaccination strategy (i.e. immunization schedules, quantities of vaccination points and their localization, etc.), which should focus on increasing citizens' awareness, among various other factors. The results of this study point to areas for potentially improving mass campaigns of Covid-19 immunization to increase vaccine uptake and its coverage and also provide insight into possible directions of future research.
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Affiliation(s)
- Anna Baj-Rogowska
- Department of Informatics in ManagementGdañsk University of Technology 80-233 Gdañsk Poland
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11
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O' Leary F, O' Donovan J. Attitudes of elite athletes and their support staff to the influenza vaccine. Ir J Med Sci 2020; 190:1231-1236. [PMID: 33111253 DOI: 10.1007/s11845-020-02408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Influenza is an important public health issue, even amongst healthy adults. Uptake rates of the influenza vaccine amongst elite athletes vary and can depend on the attitudes of their coaches, fellow athletes and support staff. International studies have documented a fear amongst elite athletes to the potential side effects of the vaccine. AIMS Determine the influenza vaccine uptake rates in elite Irish athletes and their support staff along with attitudes, fears and barriers to receiving it. METHODS A cross-sectional survey was performed in the Sport Ireland Institute. Elite athletes and support staff from the 2019 database were invited to participate via an anonymous online survey. The database included a variety of sports, e.g. athletics, boxing, cycling, rowing, swimming and para-athletics. RESULTS From 218 athletes and staff invited, 39% (n = 87 [43 male, 44 female]) responded to the online survey. Fifty-nine percent (n = 51) of participants received the influenza vaccine during the 2018/2019 season. Forty-six percent (n = 40) completely agree that the influenza vaccine is safe. Fourteen percent (n = 12) of participants believe the vaccine causes influenza. "Getting sick" from the vaccine was the biggest fear for participants. Athletes were least likely to recommend the influenza vaccine to others and most likely to fear missing time from training or work as a result of it. CONCLUSIONS Elite Irish athletes are vulnerable to contracting influenza annually, despite free access to immunisation. Barriers to receiving the vaccine include location access, education and fear of side effects.
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Affiliation(s)
- Frank O' Leary
- Sport Ireland Institute, National Sports Campus, Abbotstown, Dublin 15, Ireland.
| | - James O' Donovan
- Sport Ireland Institute, National Sports Campus, Abbotstown, Dublin 15, Ireland
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12
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Karnaki P, Baka A, Petralias A, Veloudaki A, Zota D, Linos A. Immunization related behaviour among healthcare workers in Europe: Results of the HProImmune survey. Cent Eur J Public Health 2019; 27:204-211. [PMID: 31580555 DOI: 10.21101/cejph.a5514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 07/26/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Vaccine preventable diseases (VPDs) continue to pose a significant threat to healthcare workers (HCWs) while immunization among this group remains low. HCWs' behaviours as well as facilitators and barriers towards their vaccination for a number of VPDs were explored through an EU-wide survey. METHODS HCWs across the EU answered online survey that explored attitudes and behaviours towards vaccination for a number of VPDs. Response data were adjusted based on weights estimated by HCWs' country and working profession according to WHO statistics. The survey was delivered between October 2012 and April 2014. RESULTS Analysis was based on responses from 5,424 HCWs from 14 European countries. The majority (86.7%) had a positive attitude regarding immunizations. HCWs considered influenza (86.4%), viral hepatitis type B (71.9%) and tuberculosis (59.1%) as higher risk diseases for occupational exposure in the workplace. However, 43.8% reported not receiving a seasonal influenza vaccine in the last 10 years and 65.6% reported not receiving the pandemic influenza vaccine in 2009. Main enablers towards immunizations included believing in vaccine protection and easy, free of charge access to vaccines in the workplace. Barriers to up-to-date immunizations differed according to disease but included concerns about short- and long-term effects. CONCLUSION Although the concept of mandatory vaccination seems to be favoured by many health professionals in Europe, it remains a controversial subject both among HCWs' profession categories and also among different countries. Interventions to increase vaccination among HCWs would benefit by tailoring their approach according to disease and target group.
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Affiliation(s)
- Pania Karnaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece
| | - Agoritsa Baka
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece.,Hellenic Centre for Disease Control and Prevention, Attika, Greece
| | - Athanassios Petralias
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Afroditi Veloudaki
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dina Zota
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athena Linos
- Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, Greece.,Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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13
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Gesser-Edelsburg A, Abed Elhadi Shahbari N, Cohen R, Mir Halavi A, Hijazi R, Paz-Yaakobovitch G, Birman Y. Differences in Perceptions of Health Information Between the Public and Health Care Professionals: Nonprobability Sampling Questionnaire Survey. J Med Internet Res 2019; 21:e14105. [PMID: 31271145 PMCID: PMC6639070 DOI: 10.2196/14105] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 02/03/2023] Open
Abstract
Background In the new media age, the public searches for information both online and offline. Many studies have examined how the public reads and understands this information but very few investigate how people assess the quality of journalistic articles as opposed to information generated by health professionals. Objective The aim of this study was to examine how public health care workers (HCWs) and the general public seek, read, and understand health information and to investigate the criteria by which they assess the quality of journalistic articles. Methods A Web-based nonprobability sampling questionnaire survey was distributed to Israeli HCWs and members of the public via 3 social media outlets: Facebook, WhatsApp, and Instagram. A total of 979 respondents participated in the online survey via the Qualtrics XM platform. Results The findings indicate that HCWs find academic articles more reliable than do members of the general public (44.4% and 28.4%, respectively, P<.001). Within each group, we found disparities between the places where people search for information and the sources they consider reliable. HCWs consider academic articles to be the most reliable, yet these are not their main information sources. In addition, HCWs often use social networks to search for information (18.2%, P<.001), despite considering them very unreliable (only 2.2% found them reliable, P<.001). The same paradoxes were found among the general public, where 37.5% (P<.001) seek information via social networks yet only 8.4% (P<.001) find them reliable. Out of 6 quality criteria, 4 were important both to HCWs and to the general public. Conclusions In the new media age where information is accessible to all, the quality of articles about health is of critical importance. It is important that the criteria examined in this research become the norm in health writing for all stakeholders who write about health, whether they are professional journalists or citizen journalists writing in the new media.
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Affiliation(s)
- Anat Gesser-Edelsburg
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
| | | | - Ricky Cohen
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
| | - Adva Mir Halavi
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
| | - Rana Hijazi
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
| | - Galit Paz-Yaakobovitch
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
| | - Yael Birman
- Health and Risk Communication Research Center and School of Public Health, Haifa, Israel
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14
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Zaffina S, Gilardi F, Rizzo C, Sannino S, Brugaletta R, Santoro A, Castelli Gattinara G, Ciofi degli Atti ML, Raponi M, Vinci MR. Seasonal influenza vaccination and absenteeism in health-care workers in two subsequent influenza seasons (2016/17 and 2017/18) in an Italian pediatric hospital. Expert Rev Vaccines 2019; 18:411-418. [DOI: 10.1080/14760584.2019.1586541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Salvatore Zaffina
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Francesco Gilardi
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Caterina Rizzo
- Unit of Innovation and Clinical Pathways, Direction of Clinical Departments, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Serena Sannino
- Health Directorate, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Rita Brugaletta
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Annapaola Santoro
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Guido Castelli Gattinara
- Vaccination Unit, University Hospital Paediatric Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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15
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Boey L, Bral C, Roelants M, De Schryver A, Godderis L, Hoppenbrouwers K, Vandermeulen C. Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers - A cross-sectional survey. Vaccine 2018; 36:3351-3358. [PMID: 29716777 DOI: 10.1016/j.vaccine.2018.04.044] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Seasonal influenza threatens hospitalised patients and residents of nursing homes annually. Due to age and chronic disease their protection following immunisation is diminished. Additional immunisation of direct contacts and in particular healthcare workers (HCWs) has proven added value. As vaccination coverage in HCWs remains low, we aimed to gain insight in the factors behind the demotivation for influenza vaccination. METHODS Attitudes and believes towards influenza vaccination and socio-demographic and professional determinants were surveyed in 5141 Belgian HCWs from 13 hospitals and 14 nursing homes. Additionally, influenza campaign coordinators of the participating healthcare institutions were interviewed about the factors of success/failure in their campaigns. RESULTS The mean vaccination coverage registered by the participating healthcare institutions was 40.4% in the hospitals and 45.3% in the nursing homes. Overall, up to 90% of HCWs found it important not to infect their patients. However, only 20% of non-vaccinated HCWs considered influenza vaccination a duty to not harm their patients. Up to 40% of unvaccinated staff believed they could get influenza after vaccination and that vaccination weakens their immune system. Also, only about 20% of unvaccinated staff thought to have a high chance of getting influenza. Reasons for unvaccinated staff to get vaccinated in the future are self-protection and protection of family members. Factors that positively influenced vaccination coverage are encouragement by supervisors (OR, hospitals: 7.1, p < 0.001; nursing homes: 7.5, p < 0.001) and well-organized vaccination campaigns with on-site vaccination. Factors that negatively affected vaccination coverage are misconceptions about influenza and its vaccine (OR, range 0.1-0.7, p < 0.001 for most misconceptions) and underestimation of the risk of contracting influenza by patients or HCWs (OR of perceived susceptibility, range 2.1-5.1, p < 0.001 for most factors). CONCLUSION There is a need for guidance for the organization of seasonal influenza campaigns, in which education, communication and easy accessible vaccination are promoted.
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Affiliation(s)
- Lise Boey
- Leuven University Vaccinology Center, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium.
| | - Charlotte Bral
- Leuven University Vaccinology Center, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
| | - Mathieu Roelants
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Antoon De Schryver
- Department of Epidemiology and Social Medicine, University of Antwerp, Belgium; IDEWE Occupational Health Services, Heverlee-Leuven, Belgium
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Belgium; IDEWE Occupational Health Services, Heverlee-Leuven, Belgium
| | - Karel Hoppenbrouwers
- Leuven University Vaccinology Center, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium; Environment and Health, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Corinne Vandermeulen
- Leuven University Vaccinology Center, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
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16
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Hussain H, McGeer A, McNeil S, Katz K, Loeb M, Simor A, Powis J, Langley J, Muller M, Coleman BL. Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada. Influenza Other Respir Viruses 2018; 12:319-325. [PMID: 29430860 PMCID: PMC5907810 DOI: 10.1111/irv.12545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Influenza vaccine coverage rates among healthcare workers (HCWs) in acute care facilities in Canada remain below national targets. OBJECTIVE To determine factors associated with influenza vaccine uptake among HCWs. METHODS This secondary analysis of a prospective cohort study included HCWs aged 18-69 years, working ≥20 h/wk in a Canadian acute care hospital. Questionnaires were administered to participants in the fall of the season of participation (2011/12-2013/14) which captured demographic/household characteristics, medical histories, occupational, behavioural and risk factors for influenza. Generalized estimating equation logistic regression was used to determine factors associated with vaccine uptake in the season of participation. RESULTS The adjusted odds ratio for influenza vaccination in the current season was highest for those vaccinated in 3 of 3 previous seasons (OR 156; 95% CI 98, 248) followed by those vaccinated in 2 of 3 and 1 of 3 previous seasons when compared with those not vaccinated. Compared with nurses, physicians (OR 4.2; 95% CI 1.4, 13.2) and support services staff (OR 1.8; 95% CI 1.3, 2.4) had higher odds ratios for vaccine uptake. Conversely, HCWs identifying as Black had lower odds of uptake compared with those with European ancestry (OR 0.44, 95% CI 0.26-0.75) when adjusted for other factors in the model. CONCLUSION Healthcare workers differ in their annual uptake of influenza vaccine based on their past vaccination history, occupation and ethnicity. These findings indicate a need to determine whether there are other vaccine-hesitant groups within healthcare settings and learn which approaches are successful in increasing their uptake of influenza vaccines.
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Affiliation(s)
| | - Allison McGeer
- Mount Sinai Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Shelly McNeil
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada.,Dalhousie University, Halifax, NS, Canada.,Nova Scotia Health Authority, Halifax, NS, Canada
| | - Kevin Katz
- University of Toronto, Toronto, ON, Canada.,North York General Hospital, Toronto, ON, Canada
| | - Mark Loeb
- Hamilton Health Sciences, Hamilton, ON, Canada.,McMaster University, Hamilton, ON, Canada
| | - Andrew Simor
- University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jeff Powis
- University of Toronto, Toronto, ON, Canada.,Michael Garron Hospital, Toronto, ON, Canada
| | - Joanne Langley
- Dalhousie University, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| | - Matthew Muller
- University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada
| | | | - Brenda L Coleman
- Mount Sinai Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
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17
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Pereira M, Williams S, Restrick L, Cullinan P, Hopkinson NS. Healthcare worker influenza vaccination and sickness absence - an ecological study. Clin Med (Lond) 2017; 17:484-489. [PMID: 29196347 PMCID: PMC6297706 DOI: 10.7861/clinmedicine.17-6-484] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although Influenza vaccination is recommended for healthcare workers, vaccination rates in UK healthcare workers are only around 50%. We investigated the association between NHS sickness absence rates (using data from Health and Social Care Information Centre quarterly reports), staff vaccination rates and influenza vaccine efficacy (from Public Health England), influenza deaths (from the Office of National Statistics) and staff satisfaction (from www.NHSstaffsurveys.com). Data from 223 healthcare trusts covered approximately 800,000 staff in each of four influenza seasons from 2011; overall staff sickness rate was roughly 4.5%. Annual vaccination rates varied between 44% and 54%. Higher NHS trust vaccination rates were associated with reduced sickness absence (β = -0.425 [95% CI -0.658 to -0.192], p<0.001). Thus, a 10% increase in vaccination rate would be associated with a 10% fall in sickness absence rate. Influenza vaccination for NHS staff is associated with reduced sickness absence rates.
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Affiliation(s)
| | | | - Louise Restrick
- London Respiratory Network and Whittington Health, London, UK
| | | | - Nicholas S Hopkinson
- London Respiratory Network and NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, UK
| | - on behalf of the London Respiratory Network
- National Heart and Lung Institute, London, UK
- London Respiratory Network, London, UK
- London Respiratory Network and Whittington Health, London, UK
- National Heart and Lung Institute, London, UK
- London Respiratory Network and NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, UK
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18
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Edge R, Goodwin D, Isba R, Keegan T. Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors. QUALITATIVE HEALTH RESEARCH 2017; 27:1982-1993. [PMID: 28737075 PMCID: PMC5669255 DOI: 10.1177/1049732317720664] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.
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Affiliation(s)
- Rhiannon Edge
- Lancaster University, Bailrigg, Lancaster, United Kingdom
| | - Dawn Goodwin
- Lancaster University, Bailrigg, Lancaster, United Kingdom
| | - Rachel Isba
- Lancaster University, Bailrigg, Lancaster, United Kingdom
| | - Thomas Keegan
- Lancaster University, Bailrigg, Lancaster, United Kingdom
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19
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Karafillakis E, Larson HJ. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017; 35:4840-4850. [PMID: 28760616 DOI: 10.1016/j.vaccine.2017.07.061] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The success of vaccination strategies depends in part on population perceptions of benefits and risks of vaccines and related confidence in vaccination. Better knowledge of public concerns about vaccines and what is driving them is needed to inform vaccination strategies and communications. This literature reviewer examined studies on vaccine and vaccination risk perceptions and concerns across European populations. METHODS A systematic literature review was conducted to identify studies published between 2004 and 2014 in Europe. A descriptive analysis was performed. FINDINGS A total of 145 articles were selected, most of which were conducted in the UK, the Netherlands and France and studied seasonal influenza, HPV and pandemic influenza vaccination. Across all countries and vaccines, the primary area of concern was vaccine safety, followed by perceptions of low likelihood of contracting vaccine-preventable diseases (VPDs), perceived low severity of VPDs, beliefs that vaccines do not work, and overall lack of information. Concerns were found to be vaccine-, country- and population-specific. CONCLUSION In addition to identifying concerns about vaccination in Europe, this study confirmed the notion that individuals have many safety concerns about vaccination and often believe that the risks of vaccination outweigh their benefits. More research needs to be conducted to explore the impact of different types of communication strategies, which would frame the benefits of vaccination as well as risks of not vaccinating. Strategies to better inform public perceptions of vaccines should include the provision of unbiased, comprehensive information tailored to population information needs, and delivered using multiple and new communication technologies such as social media.
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Affiliation(s)
- Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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20
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Abstract
The experience of nurses who work in the residential elderly care setting regarding the seasonal influenza vaccine is often overlooked, with a paucity of published qualitative studies. The aim of this study is to present an insight into the issues concerning nurses with regard to the seasonal influenza vaccine. The study purposively sampled registered nurses (n=11) working in a large long-term care facility for older people (n=142) in Ireland. Using a broad qualitative research approach, data were collected through interviews, transcribed, analysed and grouped into the following themes: knowing: the seasonal influenza vaccine; mandatory vaccination: balancing autonomy and control; and meaningful education. This study reveals the complexity of issues and concerns for nurses when it comes to the seasonal influenza vaccine. These issues and concerns include influences such as family, friends, peers, the media and how nurses inform themselves. The position of nurses within the organisation and recommendations for meaningful nurse education are also discussed. The findings of this study provide an insight that could inform future influenza policy and education, which should be explored before the introduction of any mandatory influenza campaigns.
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Affiliation(s)
- Gemma Quinn
- Infection Prevention & Control Manager, Mid West Primary, Community and Continuing Care, Ireland
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21
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Thomson A, Robinson K, Vallée-Tourangeau G. The 5As: A practical taxonomy for the determinants of vaccine uptake. Vaccine 2015; 34:1018-24. [PMID: 26672676 DOI: 10.1016/j.vaccine.2015.11.065] [Citation(s) in RCA: 247] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
Suboptimal vaccine uptake in both childhood and adult immunisation programs limits their full potential impact on global health. A recent progress review of the Global Vaccine Action Plan stated that "countries should urgently identify barriers and bottlenecks and implement targeted approaches to increase and sustain coverage". However, vaccination coverage may be determined by a complex mix of demographic, structural, social and behavioral factors. To develop a practical taxonomy to organise the myriad possible root causes of a gap in vaccination coverage rates, we performed a narrative review of the literature and tested whether all non-socio-demographic determinants of coverage could be organised into 4 dimensions: Access, Affordability, Awareness and Acceptance. Forty-three studies were reviewed, from which we identified 23 primary determinants of vaccination uptake. We identified a fifth domain, Activation, which captured interventions such as SMS reminders which effectively nudge people towards getting vaccinated. The 5As taxonomy captured all identified determinants of vaccine uptake. This intuitive taxonomy has already facilitated mutual understanding of the primary determinants of suboptimal coverage within inter-sectorial working groups, a first step towards them developing targeted and effective solutions.
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Affiliation(s)
| | - Karis Robinson
- Department of Psychology, Kingston University, Kingston upon Thames, UK
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22
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Edge R, Heath J, Rowlingson B, Keegan TJ, Isba R. Seasonal Influenza Vaccination amongst Medical Students: A Social Network Analysis Based on a Cross-Sectional Study. PLoS One 2015; 10:e0140085. [PMID: 26452223 PMCID: PMC4599893 DOI: 10.1371/journal.pone.0140085] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/21/2015] [Indexed: 01/25/2023] Open
Abstract
Introduction The Chief Medical Officer for England recommends that healthcare workers have a seasonal influenza vaccination in an attempt to protect both patients and NHS staff. Despite this, many healthcare workers do not have a seasonal influenza vaccination. Social network analysis is a well-established research approach that looks at individuals in the context of their social connections. We examine the effects of social networks on influenza vaccination decision and disease dynamics. Methods We used a social network analysis approach to look at vaccination distribution within the network of the Lancaster Medical School students and combined these data with the students’ beliefs about vaccination behaviours. We then developed a model which simulated influenza outbreaks to study the effects of preferentially vaccinating individuals within this network. Results Of the 253 eligible students, 217 (86%) provided relational data, and 65% of responders had received a seasonal influenza vaccination. Students who were vaccinated were more likely to think other medical students were vaccinated. However, there was no clustering of vaccinated individuals within the medical student social network. The influenza simulation model demonstrated that vaccination of well-connected individuals may have a disproportional effect on disease dynamics. Conclusions This medical student population exhibited vaccination coverage levels similar to those seen in other healthcare groups but below recommendations. However, in this population, a lack of vaccination clustering might provide natural protection from influenza outbreaks. An individual student’s perception of the vaccination coverage amongst their peers appears to correlate with their own decision to vaccinate, but the directionality of this relationship is not clear. When looking at the spread of disease within a population it is important to include social structures alongside vaccination data. Social networks influence disease epidemiology and vaccination campaigns designed with information from social networks could be a future target for policy makers.
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Affiliation(s)
- Rhiannon Edge
- Department of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom
- * E-mail:
| | - Joseph Heath
- Department of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom
| | - Barry Rowlingson
- Department of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom
| | - Thomas J. Keegan
- Department of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom
| | - Rachel Isba
- Department of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom
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23
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Domínguez A, Godoy P, Castilla J, María Mayoral J, Soldevila N, Torner N, Toledo D, Astray J, Tamames S, García-Gutiérrez S, González-Candelas F, Martín V, Díaz J. Knowledge of and attitudes to influenza in unvaccinated primary care physicians and nurses. Hum Vaccin Immunother 2015; 10:2378-86. [PMID: 25424945 PMCID: PMC4896788 DOI: 10.4161/hv.29142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Primary healthcare workers, especially nurses, are exposed to the vast majority of patients with influenza and play an important role in vaccinating patients. Healthcare workers’ misconceptions about influenza and influenza vaccination have been reported as possible factors associated with lack of vaccination. The objective of this study was to compare the characteristics of unvaccinated physicians and unvaccinated nurses in the 2011–2012 influenza season. We performed an anonymous web survey of Spanish primary healthcare workers in 2012. Information was collected on vaccination and knowledge of and attitudes to the influenza vaccine. Multivariate analysis was performed using unconditional logistic regression. We included 461 unvaccinated physicians and 402 unvaccinated nurses. Compared with unvaccinated nurses, unvaccinated physicians had more frequently received seasonal influenza vaccination in the preceding seasons (aOR 1.58; 95% CI 1.11–2.25), and more frequently believed that vaccination of high risk individuals is effective in reducing complications (aOR 2.53; 95% CI 1.30–4.95) and that influenza can be a serious illness (aOR 1.65; 95% CI 1.17–2.32). In contrast, unvaccinated physicians were less concerned about infecting patients (aOR 0.62; 95% CI 0.40–0.96). Unvaccinated nurses had more misconceptions than physicians about influenza and the influenza vaccine and more doubts about the severity of annual influenza epidemics in patients with high risk conditions and the prevention of complications by means of the influenza vaccination. For unvaccinated physicians, strategies to improve vaccination coverage should stress the importance of physicians as a possible source of infection of their patients. The effectiveness of influenza vaccination of high risk persons should be emphasized in nurses.
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Affiliation(s)
- Angela Domínguez
- a Departament de Salut Pública; Universitat de Barcelona; Barcelona, Spain
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24
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Little K, Goodridge S, Lewis H, Lingard S, Din S, Tidley M, Roberts R, Williams N, Hayes S. Occupational vaccination of health care workers: uptake, attitudes and potential solutions. Public Health 2015; 129:755-62. [DOI: 10.1016/j.puhe.2015.02.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 12/31/2014] [Accepted: 02/22/2015] [Indexed: 01/05/2023]
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25
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Larson HJ, Jarrett C, Schulz WS, Chaudhuri M, Zhou Y, Dube E, Schuster M, MacDonald NE, Wilson R. Measuring vaccine hesitancy: The development of a survey tool. Vaccine 2015; 33:4165-75. [PMID: 25896384 DOI: 10.1016/j.vaccine.2015.04.037] [Citation(s) in RCA: 503] [Impact Index Per Article: 55.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop tools to measure and address the nature and scale of hesitancy in settings where it is becoming more evident. The definition of vaccine hesitancy and a matrix of determinants guided the development of a survey tool to assess the nature and scale of hesitancy issues. Additionally, vaccine hesitancy questions were piloted in the annual WHO-UNICEF joint reporting form, completed by National Immunization Managers globally. The objective of characterizing the nature and scale of vaccine hesitancy issues is to better inform the development of appropriate strategies and policies to address the concerns expressed, and to sustain confidence in vaccination. The Working Group developed a matrix of the determinants of vaccine hesitancy informed by a systematic review of peer reviewed and grey literature, and by the expertise of the working group. The matrix mapped the key factors influencing the decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine-specific. These categories framed the menu of survey questions presented in this paper to help diagnose and address vaccine hesitancy.
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Affiliation(s)
- Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom and Department of Global Health, University of Washington, Seattle, USA.
| | - Caitlin Jarrett
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom and Department of Global Health, University of Washington, Seattle, USA
| | - William S Schulz
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom and Department of Global Health, University of Washington, Seattle, USA
| | | | | | - Eve Dube
- Institut National de Santé Publique du Québec, Canada
| | | | - Noni E MacDonald
- Department of Paediatrics, Dalhousie University, Canadian Centre for Vaccinology, IWK Health Centre, Halifax, Canada
| | - Rose Wilson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom and Department of Global Health, University of Washington, Seattle, USA
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26
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Bonaccorsi G, Santomauro F, Porchia BR, Niccolai G, Pellegrino E, Bonanni P, Lorini C. Beliefs and Opinions of Health Care Workers and Students Regarding Influenza and Influenza Vaccination in Tuscany, Central Italy. Vaccines (Basel) 2015; 3:137-47. [PMID: 26344950 PMCID: PMC4494245 DOI: 10.3390/vaccines3010137] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/16/2015] [Accepted: 02/12/2015] [Indexed: 11/16/2022] Open
Abstract
Immunization of health care workers (HCWs) against influenza has been associated with improvements in patient safety. The aim of this study is to assess the beliefs, attitudes, and knowledge of HCWs and health profession students regarding influenza. An anonymous questionnaire was distributed to HCWs in three local Florentine healthcare units, at Careggi University Teaching Hospital, and to students in health profession degree programs. A total of 2576 questionnaires were fully completed. A total of 12.3% of subjects responded that they were "always vaccinated" in all three of the seasonal vaccination campaigns studied (2007-2008 to 2009-2010), 13.1% had been vaccinated once or twice, and 74.6% had not received vaccinations. Although the enrolled subjects tended to respond that they were "never vaccinated," they considered influenza to be a serious illness and believed that the influenza vaccine is effective. The subjects who refused vaccination more frequently believed that the vaccine could cause influenza and that it could have serious side effects. More than 60% of the "always vaccinated" group completely agreed that HCWs should be vaccinated. Self-protection and protecting family members or other people close to the respondent from being infected and representing potential sources of influenza infection can be considered motivating factors for vaccination. The results highlight the importance of improving vaccination rates among all HCWs through multi-component interventions. Knowledge of influenza should be reinforced.
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Affiliation(s)
- Guglielmo Bonaccorsi
- Department of Clinical and Experimental Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Francesca Santomauro
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Barbara Rita Porchia
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Giuditta Niccolai
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Elettra Pellegrino
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Paolo Bonanni
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
| | - Chiara Lorini
- Department of Health Science, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy.
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Mavrodaris A, Sibal B, McKerr C, Hawker JI. Outbreak of acute respiratory infection in a care home for the vulnerable elderly: investigation, management and challenges. Public Health 2014; 128:944-7. [PMID: 25301701 DOI: 10.1016/j.puhe.2014.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 05/22/2014] [Accepted: 07/21/2014] [Indexed: 11/15/2022]
Affiliation(s)
- A Mavrodaris
- Health Sciences Research Division, B-162, Warwick Medical School, University of Warwick, CV4 7AL, UK.
| | - B Sibal
- Public Health England, Birmingham, UK
| | - C McKerr
- Public Health England, Birmingham, UK
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Gesser-Edelsburg A, Walter N, Green MS. Health care workers--part of the system or part of the public? Ambivalent risk perception in health care workers. Am J Infect Control 2014; 42:829-33. [PMID: 24939516 DOI: 10.1016/j.ajic.2014.04.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 04/17/2014] [Accepted: 04/17/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND The emergence of the avian influenza A (H7N9) in China during 2013 illustrates the importance of health care professionals as a mediating channel between health agencies and the public. Our study examined health care professionals' risk perceptions considering their unique position as representing the health care system and yet also being part of the public, hence a risk group. Recent studies have examined the role of health professionals' personal risk perceptions and attitudes regarding compliance of the general public with vaccination. Our study examined how risk perception affects their risk analysis. METHODS We employed an online survey of Israeli health care professionals and the general public in Israel (N = 240). RESULTS When risk perception is relatively low, health care professionals tend to base their attitudes toward vaccines on analytical knowledge (Rc = 0.315; P < .05), whereas in situations with high risk perception, the results did not indicate any significant difference between Israeli health professionals and the Israeli general public, hence both groups base their attitudes more on emotions and personal experience than on analytical knowledge. CONCLUSIONS Public health organizations must consider the fact that health professionals are a group that cannot be automatically treated as an extension of the organization. When the risk is tangible and relevant, health care workers behave and act like everybody else. Our study contributes to understanding health care professionals' perceptions about vaccines and the thinking processes underlying such perceptions.
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Affiliation(s)
| | - Nathan Walter
- Department of Communication, University of Haifa, Haifa, Israel
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29
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Bentele H, Bergsaker MR, Hauge SH, Bjørnholt JV. Vaccination coverage for seasonal influenza among residents and health care workers in Norwegian nursing homes during the 2012/13 season, a cross-sectional study. BMC Public Health 2014; 14:434. [PMID: 24885662 PMCID: PMC4049507 DOI: 10.1186/1471-2458-14-434] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 04/30/2014] [Indexed: 02/03/2023] Open
Abstract
Background WHO has set a goal of 75% vaccination coverage (VC) for seasonal influenza for residents and also recommends immunization for all healthcare workers (HCWs) in nursing homes (NHs). We conducted a cross-sectional study to estimate the VC for seasonal influenza vaccination in Norwegian NHs in 2012/2013 since the VC in NHs and HCWs is unknown. Methods We gathered information from NHs concerning VC for residents and HCWs, and vaccination costs for HCWs, using a web-based questionnaire. We calculated VC among NH residents by dividing the number of residents vaccinated by the total number of residents for each NH. VC among HCWs was similarly calculated by dividing the number of HCWs vaccinated by the total number of HCWs for each NH. The association between VC and possible demographic variables were explored. Results Of 910 NHs, 354 (38.9%) responded. Median VC per NH was 71.7% (range 0-100) among residents and 0% (range 0-100) among HCWs, with 214 (60%) NHs reporting that none of their HCWs was vaccinated. Median VC for HCWs in NHs with an annual vaccination campaign was 0% (range 0-53), compared to when they did not have an annual vaccination campaign 0% (range 0-12); the distributions in the two groups differed significantly (Mann–Whitney U, P = 0.006 two tailed). Conclusion Median influenza VC in Norwegian NHs was marginally lower than recommended among residents and exceptionally low among HCWs. The VC in HCWs was significantly higher when NHs had an annual vaccination campaign. We recommend that NHs implement measures to increase VC among residents and HCWs, including vaccination campaigns and studies to identify potential barriers to vaccination.
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Affiliation(s)
- Horst Bentele
- Department of Infection Control Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
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30
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Lehmann BA, Ruiter RAC, Wicker S, van Dam D, Kok G. "I don't see an added value for myself": a qualitative study exploring the social cognitive variables associated with influenza vaccination of Belgian, Dutch and German healthcare personnel. BMC Public Health 2014; 14:407. [PMID: 24775096 PMCID: PMC4021212 DOI: 10.1186/1471-2458-14-407] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 04/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health Authorities recommend influenza vaccination of healthcare personnel (HCP) to decrease the transmission of influenza to vulnerable patients. Recent studies have almost exclusively used quantitative questionnaires in order to identify determinants of vaccination behaviour. Interviews enable HCP to express freely why they think they are (not) willing to get vaccinated against influenza. METHODS By means of semi-structured one-on-one interviews with 123 Belgian, Dutch and German HCP, reasons for and against vaccination, experiences with influenza vaccination, intention to get vaccinated and possible barriers, as well as willingness to advice influenza vaccination to patients were investigated. Data were processed with QSR NVivo 8.0 and analysed using a combination of a deductive and a general inductive approach. RESULTS Across countries, self-protection, patient protection, and protection of family members were reported as most important reasons to get vaccinated against influenza. Reasons to not get vaccinated against influenza were fear of side effects caused by the vaccine, a low risk-perception, the disbelief in the effectiveness of influenza vaccination, organizational barriers, misconceptions, and undefined negative emotions. CONCLUSIONS The social cognitive variables underlying the decision of HCP to get vaccinated against influenza (or not) seem to be similar in Belgium, Germany, and the Netherlands, even though some differences surfaced. A quantitative investigation of those social cognitive variables is needed in order to determine the importance of the social cognitive variables in explaining the intention to get vaccinated and the importance of the similarities and differences between countries that have been found in this study.
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Affiliation(s)
- Birthe A Lehmann
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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31
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Bellia C, Setbon M, Zylberman P, Flahault A. Healthcare worker compliance with seasonal and pandemic influenza vaccination. Influenza Other Respir Viruses 2014; 7 Suppl 2:97-104. [PMID: 24034493 DOI: 10.1111/irv.12088] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Healthcare workers (HCWs) can be an important source of transmission of influenza to patients and family members, and their well-being is fundamental to the maintenance of healthcare services during influenza outbreaks and pandemics. Unfortunately, studies have shown consistently low levels of compliance with influenza vaccination among HCWs, a finding that became particularly pronounced during recent pandemic vaccination campaigns. Among the variables associated with vaccine acceptance in this group are demographic factors, fears and concerns over vaccine safety and efficacy, perceptions of risk and personal vulnerability, past vaccination behaviours and experience with influenza illness, as well as certain situational and organisational constructs. We report the findings of a review of the literature on these factors and highlight some important challenges in interpreting the data. In particular, we point out the need for longitudinal study designs, as well as focused research and interventions that are adapted to the most resistant HCW groups. Multi-pronged strategies are an important step forward in ensuring that future influenza vaccination campaigns, whether directed at seasonal or pandemic strains, will be successful in ensuring broad coverage among HCWs.
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Affiliation(s)
- Claire Bellia
- Ecole des Hautes Etudes en Sante Publique (EHESP), Paris, France
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Lewthwaite P, Campion K, Blackburn B, Kemp E, Major D, Sarangi K. Healthcare workers' attitude towards influenza vaccination after the 2009 pandemic. Occup Med (Lond) 2014; 64:348-51. [DOI: 10.1093/occmed/kqu048] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Domínguez A, Godoy P, Castilla J, Soldevila N, Toledo D, Astray J, Mayoral JM, Tamames S, García-Gutiérrez S, González-Candelas F, Martín V, Díaz J, Torner N. Knowledge of and attitudes to influenza vaccination in healthy primary healthcare workers in Spain, 2011-2012. PLoS One 2013; 8:e81200. [PMID: 24260560 PMCID: PMC3832596 DOI: 10.1371/journal.pone.0081200] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/09/2013] [Indexed: 01/08/2023] Open
Abstract
Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011–2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72–6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83–3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56–3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine.
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Affiliation(s)
- Angela Domínguez
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- * E-mail:
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | | | | | - Vicente Martín
- Instituto de Biomedicina, Universidad de León, León, Spain
| | - José Díaz
- Servicio Andaluz de Salud, Sevilla, Spain
| | - Nuria Torner
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
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Buxton JA, McIntyre CC, Tu AW, Eadie BD, Remple VP, Halperin B, Pielak KL. Who knows more about immunization?: Survey of public health nurses and physicians. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2013; 59:e514-e521. [PMID: 24235210 PMCID: PMC3828113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To report the findings of a knowledge survey of nurse and physician immunization providers. DESIGN Cross-sectional postal survey assessing demographic characteristics and vaccine knowledge. SETTING British Columbia (BC). PARTICIPANTS Nurse and physician immunization providers in BC. MAIN OUTCOME MEASURES Knowledge of vaccine-preventable diseases, vaccines in general, and vaccine administration and handling practices. RESULTS Survey responses were received from 256 nurses and 292 physicians (response rates of 48.6% and 18.3%, respectively). Most nurses (98.4%) reported receiving immunization training outside of the academic setting compared with 55.6% of physicians. Overall, nurse immunizers scored significantly higher than physician immunizers on all 3 domains of immunization knowledge (83.7% vs 72.8%, respectively; P < .001). Physicians scored highest on the vaccine-preventable disease domain and least well on the general vaccine domain. Nurses with more experience as health care providers scored higher. Physicians scored higher if they were female, served patient populations predominantly younger than 5 years, or received immunization training outside of academic settings. CONCLUSION In BC, nurse immunizers appear to have higher overall immunization knowledge than physicians and are more likely to receive immunization training when in practice. Physician immunizers might benefit most from further training on vaccines and vaccine administration and handling.
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Wicker S, Rabenau HF, von Gierke L, François G, Hambach R, De Schryver A. Hepatitis B and influenza vaccines: Important occupational vaccines differently perceived among medical students. Vaccine 2013; 31:5111-7. [DOI: 10.1016/j.vaccine.2013.08.070] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/23/2013] [Accepted: 08/07/2013] [Indexed: 10/26/2022]
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Llupià A, Mena G, Olivé V, Quesada S, Aldea M, Sequera VG, Ríos J, García-Basteiro AL, Varela P, Bayas JM, Trilla A. Evaluating influenza vaccination campaigns beyond coverage: a before-after study among health care workers. Am J Infect Control 2013; 41:674-8. [PMID: 23896285 DOI: 10.1016/j.ajic.2013.04.006] [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: 01/19/2013] [Revised: 04/02/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Influenza vaccination campaigns based on educational interventions do not seem to increase coverage in the hospital setting, and their impact on educational goals is not usually evaluated. This study describes the campaign implemented in a university hospital and assesses the achievement of the strategic objectives, which were to increase health care workers (HCW) perceptions of the risk of influenza and of their role as promoters of influenza vaccination among their colleagues and to increase knowledge about influenza. METHODS A before-after study was conducted using a self-administered survey in a randomized sample of HCW during the 2010-2011 influenza vaccination campaign. The Wilcoxon paired measures test was used to assess attainment of the strategic objectives. RESULTS The campaign had a positive impact on the strategic objectives (Wilcoxon test, P value <.05 in all cases). The reach of the campaign was high (91.9%), and HCW rated it as positive (7.19 [standard deviation, 2.3] out of 10) but did not achieve increased coverage (34%; 95% confidence interval: 33.8-36.4). CONCLUSION Evaluation of the campaign shows that its effect responded to the strategic objectives. However, it seems that increasing the information provided to HCW and heightening their risk perception do not necessarily lead to greater acceptance of influenza vaccination.
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Mytton OT, O'Moore EM, Sparkes T, Baxi R, Abid M. Knowledge, attitudes and beliefs of health care workers towards influenza vaccination. Occup Med (Lond) 2013; 63:189-95. [PMID: 23447033 DOI: 10.1093/occmed/kqt002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza vaccination is routinely offered to health care workers in the U.K. to prevent nosocomial spread to patients and illness among health care workers. Despite its importance uptake has been low in the U.K. AIMS To describe the knowledge, attitudes and behaviour of health care workers towards influenza vaccination offered as part of occupational health and to understand their relative importance in promoting uptake of influenza vaccine. We also sought to make comparisons with other vaccines more readily accepted as part of occupational health. METHODS An online survey was distributed by e-mail to health care workers in the South Central Strategic Health Authority. The questionnaire included the following: demographic characteristics; vaccination status; and knowledge, attitudes and behaviour towards influenza, MMR and hepatitis B vaccination. We used logistic regression to identify the independent predictors of receipt of influenza vaccine. RESULTS The survey was completed by 998 health care workers representing just over 1% of health care workers in the region. Of those, 69% thought that overall benefits of influenza vaccination were greater than the risks and inconvenience (versus 92% for hepatitis B and 86% for MMR). The following predicted receipt of influenza vaccine: belief that influenza poses a risk to one's own health (OR 3.74; 95% CI 2.45-5.71); belief that influenza vaccine is harmful (OR 0.25; 95% CI 0.16-0.37); and belief that influenza vaccine will protect patients (OR 2.96; 95% CI 1.89-4.62). CONCLUSIONS Staff knowledge, attitudes and beliefs concerning influenza and its vaccine are an important predictor of uptake and should be a target for campaigns to promote uptake.
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Affiliation(s)
- O T Mytton
- Department of Public Health, University of Oxford, Oxford OX3 7LF, UK
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38
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Ishola DA, Permalloo N, Cordery RJ, Anderson SR. Midwives' influenza vaccine uptake and their views on vaccination of pregnant women. J Public Health (Oxf) 2013; 35:570-7. [PMID: 23365262 DOI: 10.1093/pubmed/fds109] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pregnant women in England are now offered seasonal influenza vaccine. Midwives could be influential in promoting this, but specific information on their views on the policy and their role in its implementation is lacking. METHODS London midwives were surveyed for their views on the new policy and their own vaccine uptake, using an anonymously self-completed semi-structured online survey via a convenience sampling approach. RESULTS In total, 266 midwives responded. Sixty-nine percent agreed with the policy of vaccinating all pregnant women. Seventy-six percent agreed that midwives should routinely advise pregnant women on vaccination, but only 25% felt adequately prepared for this role. Just 28% wished to be vaccinators, due to concerns about increased workload and inadequate training. Forty-three percent received seasonal influenza vaccine themselves. Major reasons for non-uptake were doubts about vaccine necessity (34%), safety (25%) and effectiveness (10%); and poor arrangements for vaccination (11%). Suggested strategies for improving their own uptake included better access to evidence of effectiveness (67%) and improved work-based vaccination (45%). CONCLUSIONS London midwives support influenza vaccination of pregnant women, but are more willing to give advice on, than to administer, the vaccine. Midwives' own influenza vaccine uptake could improve with more information and easier access to vaccination in their workplace.
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Affiliation(s)
- D A Ishola
- Health Protection Agency, London Regional Epidemiology Unit, 151 Buckingham Palace Road, London SW1W 9SZ, UK
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39
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Estudio de actitudes y conocimientos sobre la vacunación antigripal en personal sanitario de atención primaria. Temporada 2011-2012. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.vacun.2013.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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40
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Head S, Atkin S, Allan K, Ferguson C, Lutchmun S, Cordery R. Vaccinating health care workers during an influenza pandemic. Occup Med (Lond) 2012; 62:651-4. [DOI: 10.1093/occmed/kqs098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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41
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Mak KK, Yiu YF, Ko KL, Hui KSH, Mak KM, Mak LY, To WP, Wu KH, Yeung F, Lee PPW. Attitudes and perceptions of influenza vaccination among Hong Kong doctors and medical students before the 2009 pandemic. Eur J Public Health 2012; 23:257-62. [PMID: 22383477 DOI: 10.1093/eurpub/cks014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vaccination is an important preventive measure for preparing against the influenza pandemics. This study investigated the attitudes and perceptions of influenza vaccination among doctors and medical students in Hong Kong. METHODS A cross-sectional survey was conducted among 204 doctors and 242 medical students in a teaching hospital in 2009. Participants' demographic and job characteristics, and influenza experience and vaccination in the previous year were assessed in the questionnaire. Logistic regression models were used to examine the associations between uptake of influenza vaccination and the perceived benefits. RESULTS Medical students were more likely to have receive an influenza vaccination in the previous year (66.9 vs. 39.7%) and acknowledged the related benefits than doctors. Moreover, uptake of influenza vaccine was associated with perceived benefits of vaccination in both doctors and medical students. CONCLUSIONS The perceived benefits of influenza vaccination are an important factor in vaccine uptake for both doctors and medical students in Hong Kong, and should be reinforced in the professional training.
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Affiliation(s)
- Kwok Kei Mak
- Department of Community Medicine and School of Public Health, Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
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Couto CR, Pannuti CS, Paz JP, Fink MCD, Machado AA, de Marchi M, Machado CM. Fighting misconceptions to improve compliance with influenza vaccination among health care workers: an educational project. PLoS One 2012; 7:e30670. [PMID: 22328920 PMCID: PMC3273463 DOI: 10.1371/journal.pone.0030670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 12/23/2011] [Indexed: 11/18/2022] Open
Abstract
The compliance with influenza vaccination is poor among health care workers (HCWs) due to misconceptions about safety and effectiveness of influenza vaccine. We proposed an educational prospective study to demonstrate to HCWs that influenza vaccine is safe and that other respiratory viruses (RV) are the cause of respiratory symptoms in the months following influenza vaccination. 398 HCWs were surveyed for adverse events (AE) occurring within 48 h of vaccination. AE were reported by 30% of the HCWs. No severe AE was observed. A subset of 337 HCWs was followed up during four months, twice a week, for the detection of respiratory symptoms. RV was diagnosed by direct immunofluorescent assay (DFA) and real time PCR in symptomatic HCWs. Influenza A was detected in five episodes of respiratory symptoms (5.3%) and other RV in 26 (27.9%) episodes. The incidence density of influenza and other RV was 4.3 and 10.8 episodes per 100 HCW-month, respectively. The educational nature of the present study may persuade HCWs to develop a more positive attitude to influenza vaccination.
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Affiliation(s)
- Carla R. Couto
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Cláudio S. Pannuti
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - José P. Paz
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria C. D. Fink
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Alessandra A. Machado
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Michela de Marchi
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Clarisse M. Machado
- Virology Laboratory (LIM 52 - HCFMUSP), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Intradermal vaccination to protect against yellow fever and influenza. Curr Top Microbiol Immunol 2011; 351:159-79. [PMID: 21416266 DOI: 10.1007/82_2011_124] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The viral infections yellow fever and influenza can lead to large epidemics, which may deplete limited vaccine supplies. The intradermal vaccination route of yellow fever and influenza vaccines has received renewed attention, because it allows dose reduction without loss of efficacy. In this chapter, we review these two vaccines, the history of vaccine development, correlates of protection, immune response to vaccination and current knowledge concerning intradermal vaccination, including the immunological background, both in healthy subjects and immunocompromized individuals.
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44
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Crystal YG, Robert JW. The Role of Health System Pharmacy in Improving Influenza Vaccination Rates among Health Care Workers. Hosp Pharm 2011. [DOI: 10.1310/hpj4611-901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Director's Forum series is written and edited by Robert J. Weber and Scott M. Mark and is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. During the autumn months, health care professions and the media will advocate for immunizing all patients to prevent the occurrence and spread of influenza. A potential source of influenza in hospitalized patients is health care workers (HCWs) who have not been vaccinated. Pharmacists have long served as vaccine immunizers, advocates, and educators and may play an active role in improving vaccination rates among HCWs. Pharmacy directors should consider their department's role in influenza vaccination by becoming active partners in influenza prevention. By actively participating in making vaccines available in a variety of ways to HCWs, pharmacy directors can maximize the benefits of a hospital's employee vaccination program.
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Affiliation(s)
- Y. Girardot Crystal
- Department of Pharmacy Services, Orlando Regional Medical Center, Orlando, Florida
| | - J. Weber Robert
- The Ohio State University Medical Center, and Medical Center Affairs, The Ohio State University College of Pharmacy, Columbus, Ohio
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45
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Kok G, van Essen GA, Wicker S, Llupià A, Mena G, Correia R, Ruiter RAC. Planning for influenza vaccination in health care workers: an Intervention Mapping approach. Vaccine 2011; 29:8512-9. [PMID: 21939722 DOI: 10.1016/j.vaccine.2011.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 08/26/2011] [Accepted: 09/06/2011] [Indexed: 11/30/2022]
Abstract
Influenza vaccination uptake by health care workers (HCWs) decreases the transmission of influenza to vulnerable patients and prevents influenza-related absenteeism. Vaccination is effective, easy, and generally without serious side-effects. However, vaccination rates of HCWs are too low. This paper's objective is to apply Intervention Mapping (IM), a planning process for the systematic theory- and evidence-based development of health promotion interventions, to the development of voluntary educational interventions to promote influenza vaccination in HCWs. IM consists of the following six steps: needs assessment, program objectives, methods and applications, program development, planning for program implementation, and planning for program evaluation. Examples are provided to illustrate the activities associated with these steps. It is concluded that applying IM in the (influenza) vaccination field may help the development of effective behavior change interventions.
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Affiliation(s)
- Gerjo Kok
- Work & Social Psychology, Maastricht University, the Netherlands.
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Sato H, Tomio J, Tanaka Y, Iwasaki E. The public acceptance of smallpox vaccination to fight bioterrorism in Japan: results of a large-scale opinion survey in Japan. Environ Health Prev Med 2011; 16:290-8. [PMID: 21431787 PMCID: PMC3156840 DOI: 10.1007/s12199-010-0199-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study examines the public acceptance of smallpox vaccinations in the event of a terrorist attack using smallpox. The article also provides public health professionals with the information necessary for such smallpox management. METHODS A questionnaire survey was conducted in a city in Japan asking about prospective action when smallpox vaccination is advised after a terrorist attack and factors that could influence individual decisions about such vaccination. RESULTS Only a tiny fraction of people (0.12%) expressed their rejection of vaccination. Of the respondents, 63.6% showed their intent to be vaccinated promptly when such a measure was required; 28.6% wanted to decide for themselves, having some reservations. Those in the younger age group, those suffering from hypertension/cardiac diseases, and those who considered the threat of smallpox terrorism less seriously were likely to reserve their vaccination decisions until after examining information. CONCLUSIONS Communication programs regarding smallpox vaccination should be well planned beforehand and should especially target those people who reserve their decisions at such times. Health professionals should also be well equipped with all information necessary for appropriate and effective smallpox management in the face of such a bioterrorism attack or the strong potential of one.
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Affiliation(s)
- Hajime Sato
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Japan.
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Parry HM, Damery S, Fergusson A, Draper H, Bion J, Low AE. Pandemic influenza A (H1N1) 2009 in a critical care and theatre setting: beliefs and attitudes towards staff vaccination. J Hosp Infect 2011; 78:302-7. [PMID: 21481491 DOI: 10.1016/j.jhin.2011.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
West Midlands was particularly affected by the 2009 H1N1 influenza A (pH1N1) pandemic. Vaccination of frontline healthcare professionals (HCPs) aimed to prevent spread to vulnerable patients, minimise service disruption and protect staff. HCPs involved in upper airway management are particularly at risk of aerosol exposure. We assessed the attitudes of these HCPs towards pandemic influenza A (H1N1) 2009 vaccination uptake: primary reasons for acceptance, barriers to vaccination, and knowledge surrounding pH1N1 influenza. We performed a voluntary, anonymous questionnaire survey based in two West Midlands National Health Service Trusts, one month after introduction of the vaccine. In all, 187 useable responses were received (60.5% response rate); 43.8% (N=82) had/intended to receive vaccination. Concern over long term side-effects was the main deterrent (37.4%, N=70). Primary reasons for potentially accepting vaccination were: to protect themselves (36.9%, N=69), to protect family (35.3%, N=66), and to protect patients (10.2%, N=19). Of responders, 76.5% were unsure that the vaccines had undergone suitably rigorous clinical trials to ensure safety; 20.9% correctly identified reported vaccine efficacy. We conclude that pH1N1 vaccination uptake among high risk HCPs remained low, although twice that of peak seasonal influenza vaccination rates. HCPs' knowledge of vaccine efficacy is poor. Barriers to vaccination include concerns over safety profile given the short chronological time-span between the pandemic being declared and vaccine introduction. Side-effects, both acute and chronic, are a significant barrier to vaccination. Further reassurance/education surrounding vaccine safety/efficacy at the time of any future pandemic may improve uptake rates.
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Affiliation(s)
- H M Parry
- Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK.
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Kaboli F, Astrakianakis G, Li G, Guzman J, Donovan T, Naus M. Influenza vaccination and intention to receive the pandemic H1N1 influenza vaccine among healthcare workers of British Columbia, Canada: a cross-sectional study. Infect Control Hosp Epidemiol 2011; 31:1017-24. [PMID: 20707670 DOI: 10.1086/655465] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess healthcare workers' attitudes and concerns regarding seasonal and pandemic influenza vaccines in order to improve vaccination campaign communications. DESIGN Cross-sectional survey. SETTING All 6 health authorities in British Columbia, Canada. METHODS An anonymous, self-administered online survey was conducted from August 30 through September 30, 2009. Question topics included demographic characteristics, factors influencing acceptance of seasonal influenza vaccine, factors influencing intentions to accept pandemic H1N1 influenza vaccine, and knowledge and concerns regarding the effect of the influenza pandemic. PARTICIPANTS All 96,217 British Columbia healthcare workers were eligible to participate. RESULTS A volunteer sample of 4,046 healthcare workers returned the survey; 3,563 (88%) were women, 58% were under 50 years old (mean age + or - standard deviation, 45.3 + or - 10.9 years), 3,152 of 4,023 (79%) had 5 or more years of experience in their profession, 1,853 of 4,023 (46%) were nurses, and 2,833 (70%) had been vaccinated against seasonal influenza the previous year. Two thousand eight hundred (69%) respondents reported intending to receive the pandemic H1N1 vaccine. The most important predictor of this intention was having received the seasonal vaccine the previous year (odds ratio [OR], 6.25 [95% confidence interval {CI}, 5.39-7.26]). Worry about making loved ones ill was the only attitude associated with intention to receive the pandemic H1N1 vaccine (adjusted OR, 1.38 [95% CI, 1.27-1.50]). Concerns with vaccine safety (adjusted OR, 0.31 [95% CI, 0.25-0.39]) and belief "that H1N1 is not severe enough" (adjusted OR, 0.29 [95% CI, 0.26-0.32]) were independently associated with the intention to reject the pandemic H1N1 vaccine. CONCLUSIONS Vaccination campaigns for pandemic H1N1 vaccine should use messages that emphasize the risk of illness among younger people and the opportunity to protect loved ones by getting the vaccine and should address concerns about the safety and effectiveness of the vaccine.
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Affiliation(s)
- Fariba Kaboli
- Disease Prevention, Vancouver, British Columbia, Canada
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Hopman CE, Riphagen-Dalhuisen J, Looijmans-van den Akker I, Frijstein G, Van der Geest-Blankert ADJ, Danhof-Pont MB, De Jager HJ, Bos AA, Smeets E, De Vries MJT, Gallee PMM, Lenderink AF, Hak E. Determination of factors required to increase uptake of influenza vaccination among hospital-based healthcare workers. J Hosp Infect 2011; 77:327-31. [PMID: 21316803 DOI: 10.1016/j.jhin.2010.10.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 10/07/2010] [Indexed: 11/25/2022]
Abstract
A questionnaire study was performed in all eight University Medical Centers in The Netherlands to determine the predictors of influenza vaccination compliance in hospital-based healthcare workers (HCWs). Demographical, behavioural and organisational determinants were assessed based on behavioural and implementation models. Multivariable regression analysis was applied to assess the independent predictors for influenza vaccine uptake. Age >40 years, the presence of a chronic illness, awareness of personal risk and awareness of risk of infecting patients, trust in the effectiveness of the vaccine to reduce the risk of infecting patients, the HCWs' duty to do no harm and their duty to ensure continuity of care, finding vaccination useful despite the constant flow of visitors and having knowledge of the Health Council's advice, social influence and convenient time for vaccination were all independently associated with vaccine uptake. The accuracy of the prediction model was very high (area under the receiver operating curve: 0.95). Intervention programmes to increase influenza vaccine uptake among HCWs should target the relevant determinants identified in this study.
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Affiliation(s)
- C E Hopman
- University of Groningen, Groningen Research Institute of Pharmacy, Unit Pharmacoepidemiology and Pharmacoeconomics, Groningen, The Netherlands
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Chen H, Ng S, King ME, Fong C, Ng W, Szeto K, Ho S, Leung J, Lam C, Chan S, Chan W, Wong T. Promotion of seasonal influenza vaccination among staff in residential care homes for elderly in Hong Kong. HEALTHCARE INFECTION 2010; 15:121-125. [PMID: 32288838 PMCID: PMC7129256 DOI: 10.1071/hi10023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 09/06/2010] [Indexed: 11/23/2022]
Abstract
Annual influenza epidemics continue to cause worldwide morbidity, mortality and societal disruption, especially among the aged residents of residential care homes for the elderly (RCHEs). Vaccination remains the most effective measure to prevent influenza and its associated complications. The seasonal influenza vaccine uptake rates among RCHE staff were much lower than that among residents. In order to increase uptake of influenza vaccination among RCHE staff in Hong Kong, this study developed and evaluated amultimodal vaccine promotion program (VPP) based on identified factors affecting vaccination acceptance or refusal within the Hong Kong Chinese context. Vaccine acceptance was found to be significantly associated with belief in vaccine efficacy, duration of service, staff group and providing direct care to residents. The focus group study revealed that RCHE staff's belief in the efficacy and safety of the vaccine played a major role in vaccine acceptance. VPP effectiveness was evaluated with a cluster randomised controlled trial among RCHEs with staff vaccination rates below 50%. Compared with 2008/09, the 2009/10 mean staff vaccination rates increased significantly in both the intervention (39.4% to 59.6% (P < 0.001)) and control groups (36.3% to 47.6% (P = 0.008)). RCHE staff in the intervention group had a higher vaccination rate than in the control group (59.6% versus 47.6%, P = 0.072). This program reinforces the importance of a comprehensive and culturally sensitive approach to promote influenza vaccination for RCHE staff.
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Affiliation(s)
- H. Chen
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - Sammy Ng
- Elderly Health Service (EHS) of the Department of Health, Room 3502-4, 35th Floor, Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong SAR
| | - Mark E. King
- Faculty of Education, Pofulam Road, The University of Hong Kong, Hong Kong SAR
| | - Carol Fong
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - W.P. Ng
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - K.H. Szeto
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - Sara Ho
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - Jane Leung
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
| | - C.K. Lam
- Elderly Health Service (EHS) of the Department of Health, Room 3502-4, 35th Floor, Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong SAR
| | - Shelley Chan
- Elderly Health Service (EHS) of the Department of Health, Room 3502-4, 35th Floor, Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong SAR
| | - W.M. Chan
- Elderly Health Service (EHS) of the Department of Health, Room 3502-4, 35th Floor, Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong SAR
| | - T.Y. Wong
- Infection Control Branch, Centre for Health Protection, 147C, Argyle Street, Kowloon, Hong Kong SAR
- Corresponding author.
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