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Maltezou HC, Tseroni M, Drositis I, Gamaletsou MN, Koukou DM, Bolikas E, Peskelidou E, Daflos C, Panagiotaki E, Ledda C, Pavli A, Moussas N, Kontogianni S, Svarna E, Ploumidis M, Spyrou A, Chini M, Adamis G, Lourida A, Hatzigeorgiou D, Gargalianos P, Syrogiannopoulos G, Sipsas NV. Vaccination coverage rates and attitudes towards mandatory vaccinations among healthcare personnel in tertiary-care hospitals in Greece. Expert Rev Vaccines 2022; 21:853-859. [PMID: 35382665 DOI: 10.1080/14760584.2022.2063118] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES : Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals. METHODS This study was a cross-sectional survey. RESULTS A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values <0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP. CONCLUSIONS Although most HCP supported mandatory vaccinations, significant vaccination gaps and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella increased the past decade, mostly because of reduction of acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP' vaccination rates is urgently needed.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, Greece
| | - Maria Tseroni
- Directorate of Epidemiological Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Ioannis Drositis
- Medical Oncology Department, Venizeleio-Pananeio General Hospital, Heraklion, Greece
| | - Maria N Gamaletsou
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Dimitra Maria Koukou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Emmanouil Bolikas
- Infection Control Committee, Venizeleio-Pananeio General Hospital, Heraklion, Greece
| | - Emmanuela Peskelidou
- COVID-19 Intensive Care Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Charalambos Daflos
- Infection Control Committee, Korgialeneio-Benakeio Red Cross General Hospital, Athens, Greece
| | | | - Caterina Ledda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Androula Pavli
- Department for Travel Medicine, National Public Health Organization, Athens, Greece
| | - Nikolaos Moussas
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, Greece
| | | | - Eftychia Svarna
- Department of Pediatrics, University of Thessaly, Larissa, Greece
| | - Michalis Ploumidis
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Andronikos Spyrou
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Maria Chini
- Third Department of Internal Medicine and Infectious Diseases Unit, Korgialeneio-Benakeio Red Cross Hospital, Athens, Greece
| | - Georgios Adamis
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Athanasia Lourida
- Infection Prevention and Control Committee, Aghia Sofia Children's Hospital, Athens, Greece
| | | | - Panagiotis Gargalianos
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, Greece
| | | | - Nikolaos V Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
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Attitudes toward Vaccinations and Vaccination Coverage Rates among Dental Students in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052879. [PMID: 35270571 PMCID: PMC8910244 DOI: 10.3390/ijerph19052879] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 01/27/2023]
Abstract
Our aim was to study attitudes toward vaccinations, full vaccination rates and susceptibility rates against vaccine-preventable diseases among students attending a University Dental School. A total of 134 students were studied. Full vaccination rates were as follows: 56.5% against measles and mumps, 70.6% against rubella, 32.3% against varicella, 44.1% against hepatitis A, 45.9% against hepatitis B, and 87.7% against COVID-19. In the past decade, 63.2% of students had received a booster shot against tetanus–diphtheria, 47.8% against pertussis, and 28.1% against poliomyelitis, while 29.4% of students had been vaccinated against influenza in the past year. Susceptibility rates were 40.4% for measles, 42.4% for mumps, 28.3% for rubella, 32.3% for varicella, 55.3% for hepatitis A, 54.1% for hepatitis B, 36.8% for tetanus–diphtheria, 52.2% for pertussis, and 71.9% for poliomyelitis. Overall, 123 (91.8%) students favored mandatory vaccinations, mainly for all dentists (88.4%), while 11.6% of students favored them only for dentists who provide care to high-risk patients. In conclusion, most dental students favored mandatory vaccinations, yet we found significant vaccination gaps and susceptibility rates against vaccine-preventable diseases. Vaccinations for dental students should be intensified. A national vaccination registry for healthcare personnel including dental students is urgently needed.
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Garlasco J, Bordino V, Marengo N, Rainero E, Scacchi A, Ditommaso S, Giacomuzzi M, Bert F, Zotti CM. Pertussis immunisation during pregnancy: Antibody levels and the impact of booster vaccine. Vaccine 2021; 39:4957-4963. [PMID: 34330557 DOI: 10.1016/j.vaccine.2021.07.052] [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: 04/09/2021] [Revised: 06/28/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Pertussis (whooping cough) is a highly infectious disease caused by Bordetella pertussis. Mothers lacking adequate immunity and contracting the disease represent the biggest risk of transmission to new-borns, for which the disease is often a threat. The aim of the study was to estimate the frequency of pertussis susceptibility among pregnant women, in order to point out the need for a vaccine recall during pregnancy, and to evaluate the antibody response in already vaccinated women. A cross-sectional observational study was conducted in the blood test centre of "St. Anna" Obstetrics and Gynaecology Hospital in Turin (Piedmont, Italy). Eligibility criteria included pregnant women coming to the centre for any blood test, aged 18 or above and with gestational age between 33 and 37 weeks at the moment of the blood draw. The data collection was carried out from May 2019 to January 2020 and the concentration of anti-Pertussis Toxin (anti-PT) IgG was measured through the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Two-hundred women (median age 35) were enrolled: 132 (66%) had received at least one dose of pertussis vaccine, 82 of which during pregnancy. Recently vaccinated women had significantly higher antibody titres (even 12-15 times as high) compared to those vaccinated more than 5 years before or never vaccinated at all (p < 0.0001). Moreover, 95.1% of recently vaccinated women had anti-PT IgG levels above 10 IU/ml, and 85.4% above 20 IU/ml, while the same proportions were as low as 37% and 21% (respectively) in the group of women not vaccinated in pregnancy. This study confirmed that the vaccination is greatly effective in ensuring high antibody titres in the first months after the booster vaccine, with considerable differences in anti-PT IgG compared to women vaccinated earlier or never vaccinated at all, and therefore vaccinating pregnant women against pertussis still represents a valuable strategy.
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Affiliation(s)
- Jacopo Garlasco
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Valerio Bordino
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Noemi Marengo
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Erika Rainero
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Alessandro Scacchi
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Savina Ditommaso
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Monica Giacomuzzi
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Fabrizio Bert
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Carla Maria Zotti
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
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Kunze U, Schweinzer H. Self-reported vaccination status and attitudes towards mandatory vaccinations for health care workers among medical students. Vaccine 2020; 38:5695-5699. [PMID: 32654904 DOI: 10.1016/j.vaccine.2020.06.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/28/2020] [Accepted: 06/16/2020] [Indexed: 11/13/2022]
Abstract
Health care workers (HCWs) are exposed to a high risk of infectious diseases at work, and of transmitting these to their patients and colleagues. Medical students constitute an important, yet neglected, group within HCW because of their contact with patients in the course of compulsory or voluntary practical training courses at health care institutions. The aim of this study was to determine the current vaccination status of medical students at the Medical University of Vienna and assess their attitudes towards occupationally indicated mandatory vaccinations for doctors and other HCW. Nearly 80% of the students considered mandatory vaccinations for doctors an appropriate measure and 88% would recommend them in settings involving immunocompromised patients. The acceptance of mandatory immunisation differs very markedly for individual vaccinations; it ranges from 82.8% for hepatitis B to 40% for influenza. The self-reported vaccination status among medical students was 90.1%, 89.9%, 88.1% and 84.4% for hepatitis B, tetanus, polio and hepatitis A, respectively. Inadequately low rates of 78%, 70.5% and 70.5%, and 28.7% were reported for MMR, varicella, pertussis and influenza (2014/15 season), respectively. CONCLUSION: The majority of medical students at the MUW had a positive attitude towards vaccinations and considered mandatory vaccinations for doctors and HCW an appropriate measure. However, the large majority of the vaccination rates are worthy of improvement.
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Affiliation(s)
- Ursula Kunze
- Department of Social and Preventive Medicine, Center for Public Health, Medical University Vienna (MUW), Kinderspitalgasse 15, A-1090 Vienna, Austria.
| | - Heike Schweinzer
- Villach District Hospital, Nikolaigasse 43, A-9500 Villach, Austria.
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Rill V, Steffen B, Wicker S. Evaluation of a vaccination seminar in regard to medical students' attitudes and their theoretical and practical vaccination-specific competencies. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc38. [PMID: 32685666 PMCID: PMC7346291 DOI: 10.3205/zma001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 02/17/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
Aim: Despite having a generally positive attitude toward vaccinations, medical students show gaps in their own immunization histories and knowledge about vaccinations. Future practicing physicians will be confronted with the need to evaluate protective immunity and make vaccination recommendations. This study aims to investigate the extent to which a seminar on the topic of vaccination can improve students' attitudes, knowledge and practical skills in interpreting vaccination certificates. Project description: Two different one-hour seminars were developed and integrated into the required clinical curriculum. A third of the students attended a theory-based seminar; the other two-thirds completed a predominantly practice-based seminar. The theoretical seminar consisted of a lecture on the principles and theoretical aspects of immunization. In the practical seminar, the curricular content was case-based and taught using fictive examples of vaccination certificates. Before the seminar was held, a voluntary and anonymous survey of the students was conducted regarding their attitudes toward and knowledge of immunization. At the conclusion of the seminar, the students' ability to understand vaccination certificates was tested. After completing the seminar, all of the participants received a link to participate in a voluntary online survey to evaluate the seminar. Results: Of the 149 seminar attendees in the 2017/18 winter semester, 148 participated in the study. Attitude: Students have a positive attitude toward vaccinations. Regardless of the type of seminar attended, the agreement with statements on vaccination could be significantly increased primarily among students who already at the start of the seminar expressed a high degree of agreement. Students vaccinated against influenza showed significantly stronger agreement than unvaccinated students. Knowledge: Regardless of teaching format, students' knowledge about vaccination topics could be increased. For those vaccinated against influenza, the mean value for agreement with the statement, "The vaccination of healthcare workers prevents nosocomial transmission of diseases," saw an increase on a five-point Likert scale from 3.97 to 4.4 (p<0.001; R=0.67). For the unvaccinated students, the mean value rose from 4.04 to 4.19 (p=0.06; R=0.29). Practical skills: The students who attended the theory-based seminar tended to score higher on interpreting vaccination certificates than those who attended the practical seminar; however, this difference was not statistically significant. Seminar evaluation: The online evaluation was completed by 18% of the participants. The theoretical seminar received the grade of 2.9 based on the conventional German academic grading scale; the practical seminar received 1.9. This difference is statistically significant (p=0.02). Conclusion: Precisely for skeptical students it was only possible to minimally change existing views with a seminar that offers very brief instruction. Attendees of the theoretical seminar tended to score somewhat higher on interpreting vaccination certificates than those who took the practical seminar. The practical seminar was rated significantly better on the course evaluation than the theoretical one. The advantage that the students attending the theoretical seminar had can be explained best by the structured review of the current vaccination recommendations as part of the seminar, which should, as a consequence, be integrated into the practical seminar.
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Affiliation(s)
- Vera Rill
- Universitätsklinikum Frankfurt, Betriebsärztlicher Dienst, Frankfurt a. M., Germany
| | - Björn Steffen
- Universitätsklinikum Frankfurt, Zentrum der Inneren Medizin, Hämatologie und Onkologie, Frankfurt a. M., Germany
| | - Sabine Wicker
- Universitätsklinikum Frankfurt, Betriebsärztlicher Dienst, Frankfurt a. M., Germany
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Vaccination coverage and immunity levels against vaccine-preventable diseases in male Air Force recruits in Greece. Vaccine 2019; 38:1181-1185. [PMID: 31761499 DOI: 10.1016/j.vaccine.2019.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/29/2019] [Accepted: 11/08/2019] [Indexed: 12/21/2022]
Abstract
AIM Data about susceptibility rates in young adults are scarce. We estimated the complete vaccination rates, timeliness of vaccinations and susceptibility rates among male military recruits in Greece. METHODS A standardized form was used to collect data. Immunity against measles, rubella, varicella, hepatitis A and hepatitis B was serologically estimated. RESULTS We studied 385 recruits with a mean age of 23.5 years (range: 18.3-29.9 years). Complete vaccination rates were 94.3% for measles, 100% for rubella, 15% for varicella, 73.9% for hepatitis A and 96.5% for hepatitis B. Only 10.8% of participants were fully vaccinated against all five diseases. Timely vaccination was 47.2% for measles, 89.3% for rubella and 48.1% for hepatitis B. Recruits >23 years had a 1.5-fold increased probability for incomplete vaccinations compared to younger recruits. Laboratory-confirmed immunity rates were 80% against measles, 85.7% against rubella, 85.2% against varicella, 69.4% against hepatitis A and 77.1% against hepatitis B. It is estimated that approximately 388,696 persons aged 18-30 years are susceptible to measles, 277,640 persons to rubella, 287,736 persons to varicella, 595,664 persons to hepatitis A and 444,224 persons to hepatitis B in Greece. CONCLUSION Our study showed that young adults have significant immunity gaps against measles, rubella, varicella, hepatitis A and hepatitis B. Complete vaccination rates were suboptimal against hepatitis A and varicella. Strategies to access young adults and increase immunity rates through catch-up vaccination services should be investigated. A third dose of MMR vaccine should be considered for young adolescents in Greece.
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Böhme M, Voigt K, Balogh E, Bergmann A, Horváth F, Kugler J, Schelling J, Schübel J, Riemenschneider H. Pertussis vaccination status and vaccine acceptance among medical students: multicenter study in Germany and Hungary. BMC Public Health 2019; 19:182. [PMID: 30755203 PMCID: PMC6373007 DOI: 10.1186/s12889-019-6516-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medical students are at risk of contracting and transmitting infectious diseases such as pertussis. Complete vaccination status is important to protect own, patient and public health. Knowing own vaccination status is elementary for following current vaccination recommendations, including boosters. We aimed to assess pertussis vaccination status and vaccination acceptance among medical students of different nationalities. METHODS A cross-sectional multicenter health survey at German and Hungarian universities enclosed international medical students in the 1st, 3rd and 5th year of study. Self-reported data from 2655 students regarding pertussis vaccination status were analyzed. Subgroup analysis enclosed data of German (n = 1217), Hungarian (n = 960) and other nationality (n = 478) students ("other"). RESULTS More Hungarians reported basic immunization (39.0% vs 15.8% Germans vs 24.3% others, p ≤ 0.05). Booster vaccination was reported more by Germans (60.5% vs 43.6% Hungarians vs 36.0% others, p ≤ 0.05). Germans were more likely to report being unvaccinated (3.7% vs 0.9% Hungarians, p ≤ 0.05). More medical students of other nationalities were unaware of their pertussis vaccination status (37.4% vs 20.0% Germans/ 16.5% Hungarians, p ≤ 0.05). 75.2% (n = 1931) rated pertussis vaccinations as absolutely necessary (86.2% Hungarians vs 69.8% Germans/ 66.1% others, p ≤ 0.05). CONCLUSIONS Positive attitudes towards vaccinations were reported but a large group reported insufficient vaccination status and being not aware of their status, especially among international students. Hungarians possibly have a better vaccination status than reported, based on mandatory vaccinations in childhood. The low awareness of vaccination status has implications for future booster vaccinations. All students should be informed about current recommendations and receive vaccination offers in frames of low-threshold medical services.
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Affiliation(s)
- Mandy Böhme
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Karen Voigt
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Erika Balogh
- Department of Public Health Medicine, University of Pécs Medical School, Sziget út 12, Pécs, 7624, Hungary
| | - Antje Bergmann
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Ferenc Horváth
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Joachim Kugler
- Department of Health Sciences /Public Health, Medical Faculty, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Jörg Schelling
- Department of General Practice and Family Medicine, Ludwig-Maximilians-Universität, München, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Jeannine Schübel
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Henna Riemenschneider
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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Riemenschneider H, Schübel J, Bergmann A, Kugler J, Voigt K. Current vaccination status regarding measles among university students in Dresden, Germany. Am J Infect Control 2015; 43:1363-5. [PMID: 26654238 DOI: 10.1016/j.ajic.2015.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/08/2015] [Accepted: 07/08/2015] [Indexed: 11/29/2022]
Abstract
Germany aimed to eliminate measles by 2015, but vaccination coverage is still insufficient, especially in respect to adolescents and young adults. A cross-sectional survey with 711 students studying a range of subjects showed a high acceptance regarding vaccination. Actual self-reported vaccination rates were lower; only 65.5% of medical students and 25.3%-39.4% of other student groups reported complete vaccination against measles. Of the students, 12.6%-45% did not know their vaccination status. Vaccination acceptance did not correlate with vaccination behavior: accessible vaccination opportunities at universities should be offered.
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Affiliation(s)
- Henna Riemenschneider
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Jeannine Schübel
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Antje Bergmann
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Joachim Kugler
- Department of Health Sciences/Public Health, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Karen Voigt
- Department of General Practice, Medical Clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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9
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Immune status of health care workers to measles virus: evaluation of protective titers in four measles IgG EIAs. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.06.095] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Black AP, Vilivong K, Nouanthong P, Souvannaso C, Hübschen JM, Muller CP. Serosurveillance of vaccine preventable diseases and hepatitis C in healthcare workers from Lao PDR. PLoS One 2015; 10:e0123647. [PMID: 25874696 PMCID: PMC4397087 DOI: 10.1371/journal.pone.0123647] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 02/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIMS Healthcare workers (HCW) have an increased risk of exposure to infectious diseases and are a potential source of infections for their patients. The Lao People's Democratic Republic (Lao PDR) has no national policy regarding HCW vaccinations and routine vaccination coverage is low within the general population. This cross-sectional serostudy determines the level of exposure and risk of infection in Lao HCW against 6 vaccine preventable diseases and hepatitis C. METHODS 1128 HCW were recruited from 3 central, 2 provincial and 8 district hospitals. Sera were tested by ELISA for the presence of antibodies and antigens to hepatitis B, hepatitis C, measles, rubella, varicella zoster, tetanus and diphtheria. RESULTS Only 53.1% of the HCW had protective anti-hepatitis B surface antigen antibodies (anti-HBs) with 48.8% having anti-hepatitis B core antibodies (anti-HBc), indicating previous exposure and 8.0% were hepatitis B surface antigen carriers. 3.9% were hepatitis C seropositive. Measles and rubella antibodies were detected in 95.4% and 86.2% of the HCW, with 11.9% of females being unprotected against rubella. Antibodies against varicella zoster, tetanus and diphtheria were detected in 95%, 78.8% and 55.3%, respectively. Seroprevalence varied according to age, gender and number of children. CONCLUSION An unacceptably high proportion of Lao HCW remain susceptible to infection with hepatitis B, diphtheria, tetanus and rubella. Furthermore, a high number of healthcare workers are chronically infected with hepatitis B and C viruses. These data emphasize the need for a robust HCW vaccination policy in addition to increased awareness within this subpopulation.
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Affiliation(s)
- Antony P. Black
- Institute of Immunology, Luxembourg Institute of Health (former Centre de Recherche Public de la Santé)/Laboratoire National de Santé, Luxembourg, Grand-Duchy of Luxembourg
- Lao-Lux Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR
| | | | | | | | - Judith M. Hübschen
- Institute of Immunology, Luxembourg Institute of Health (former Centre de Recherche Public de la Santé)/Laboratoire National de Santé, Luxembourg, Grand-Duchy of Luxembourg
- Lao-Lux Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR
| | - Claude P. Muller
- Institute of Immunology, Luxembourg Institute of Health (former Centre de Recherche Public de la Santé)/Laboratoire National de Santé, Luxembourg, Grand-Duchy of Luxembourg
- Lao-Lux Laboratory, Institut Pasteur du Laos, Vientiane, Lao PDR
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Pavlopoulou ID, Daikos GL, Tzivaras A, Bozas E, Kosmidis C, Tsournakas C, Theodoridou M. Medical and Nursing Students with Suboptimal Protective Immunity against Vaccine-Preventable Diseases. Infect Control Hosp Epidemiol 2015; 30:1006-11. [DOI: 10.1086/605923] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objectives.Medical and nursing students (hereafter referred to as “healthcare students”) are at risk of contracting and transmitting infectious diseases in a hospital Setting. The aim of our study was to evaluate the vaccination history of healthcare students and their serologic immunity against vaccine-preventable diseases.Design.Prospective cohort study.Setting.A tertiary care children's hospital in Athens, Greece, which is affiliated with the University of Athens.Methods.Healthcare students were recruited during April through November 2007. The information obtained from these students during personal interviews included demographics and whether there was a history of varicella, measles, mumps, rubella, and/or hepatitis A or B virus infection. Vaccination history and documentation of disease were abstracted from available medical records. Serum antibodies against the above-mentioned viral agents were determined by use of an enzyme-linked immunosorbent assay. Seronegative students and those with immunization gaps were referred to local vaccination clinics, and compliance was assessed 3 months later.Results.A total of 187 healthcare students were recruited, 131 (70.1%) of whom provided complete documentation of vaccination history. Adequate immunity against diphtheria and tetanus was documented for 55 (37.2%) and 73 (49.3%) of the 148 participants, respectively, whereas age-appropriate vaccination against pertussis, diphtheria, tetanus, and poliomyelitis was noted for 138 (93.2%), 147 (99.3%), 147 (99.3%), and 147 (99.3%) healthcare students, respectively. Of 185 healthcare students, 171 (92.4%) were immune to varicella. Of 182 healthcare students, 179 (98.4%) were immune to measles, 163 (89.6%) were immune to mumps, and 176 (96.7%) were immune to rubella. Of 179 healthcare students, 151 (84.4%) were immune to hepatitis B virus. Of 178 healthcare students, 26 (14.6%) were immune to hepatitis A virus. Antibodies (10 IU/L or higher) to hepatitis B surface antigen were detected for 151 (84.4%) of 179 healthcare students, and antibodies (10 IU/L or higher) to hepatitis A virus were detected for 26 (14.6%) of 178 healthcare students. Fewer than 30% of participants were in full compliance with recommended vaccinations.Conclusions.We have determined that there is a certain proportion of healthcare students who are susceptible to certain vaccine-preventable diseases. The development of an appropriate vaccination strategy is required to decrease the risk of transmission in a hospital setting.
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Fiebelkorn AP, Seward JF, Orenstein WA. A global perspective of vaccination of healthcare personnel against measles: systematic review. Vaccine 2014; 32:4823-39. [PMID: 24280280 PMCID: PMC4691996 DOI: 10.1016/j.vaccine.2013.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 10/29/2013] [Accepted: 11/01/2013] [Indexed: 10/26/2022]
Abstract
Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989-2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982-2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be disruptive and costly. Establishing policies for measles vaccination for healthcare personnel is an important strategy towards achieving measles elimination and should be a high priority for global policy setting groups, governments, and hospitals.
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Affiliation(s)
- Amy Parker Fiebelkorn
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jane F Seward
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Loulergue P, Pulcini C, Massin S, Bernhard M, Fonteneau L, Levy-Brühl D, Guthmann JP, Launay O. Validity of self-reported vaccination status among French healthcare students. Clin Microbiol Infect 2014; 20:O1152-4. [PMID: 25040583 DOI: 10.1111/1469-0691.12759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/25/2014] [Accepted: 07/02/2014] [Indexed: 11/29/2022]
Abstract
Data on validity of self-reported vaccinations are scarce. This study, performed on healthcare students in Paris (France), aimed to evaluate this validity for occupational vaccinations. The validity of self-reported vaccination status was compared with written information. A total of 432 students were enrolled. Sensitivity rates for BCG, hepatitis B and measles were over 74%. For diphtheria-tetanus-polio and pertussis, sensitivity was below 50%. Specificity was between 70 and 95% for dTP-pertussis, and below 35% for all others. Overall, the validity of self-reported information was low, meaning that checking medical records remains the preferable strategy for assessing immunization status.
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Affiliation(s)
- P Loulergue
- Paris Sorbonne Cité, Université Paris Descartes, Paris, France; Inserm CIC 1417, Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin-Hôtel Dieu-Broca, CIC Cochin-Pasteur, Paris, France
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Arbeitsbedingte Infektionen bei Mitarbeitern des Gesundheitswesens: Kinderkrankheiten. ZENTRALBLATT FUR ARBEITSMEDIZIN ARBEITSSCHUTZ UND ERGONOMIE 2014. [DOI: 10.1007/bf03344250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Maltezou HC, Katerelos P, Poufta S, Pavli A, Maragos A, Theodoridou M. Attitudes toward mandatory occupational vaccinations and vaccination coverage against vaccine-preventable diseases of health care workers in primary health care centers. Am J Infect Control 2013; 41:66-70. [PMID: 22709989 DOI: 10.1016/j.ajic.2012.01.028] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 01/18/2012] [Accepted: 01/18/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to assess the attitudes regarding mandatory occupational vaccinations and the vaccination coverage against vaccine-preventable diseases among health care workers (HCWs) working in primary health care centers in Greece. METHODS A standardized questionnaire was distributed to HCWs working in all primary health care centers in Greece (n = 185). RESULTS A total of 2,055 of 5,639 HCWs (36.4% response rate) from 152 primary health care centers participated. The self-reported completed vaccination rates were 23.3% against measles, 23.3% against mumps, 29.8% against rubella, 3% against varicella, 5.8% against hepatitis A, 55.7% against hepatitis B, and 47.3% against tetanus-diphtheria; corresponding susceptibility rates were 17%, 25%, 18.6%, 16.7%, 87.5%, 35%, and 52.6%. Mandatory vaccinations were supported by 65.1% of 1,807 respondents, with wide differences by disease. Multiple logistic regression analysis revealed higher rates of acceptance of mandatory vaccination in physicians compared with other HCW categories. CONCLUSIONS Despite the fact that two-thirds of HCWs working in primary health care centers in Greece support mandatory vaccination for HCWs, completed vaccination rates against vaccine-preventable diseases are suboptimal.
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Bolton-Maggs D, Conrad D, Keenan A, Lamden K, Ghebrehewet S, Vivancos R. Perceptions of mumps and MMR vaccination among university students in England: an online survey. Vaccine 2012; 30:5081-5. [PMID: 22705081 DOI: 10.1016/j.vaccine.2012.05.078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 05/23/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
Mumps is easily preventable through vaccination. Investigation of a number of recent mumps outbreaks in universities in the North West of England, however, found that affected students were either not vaccinated or only partially vaccinated. An online survey of students (n=2456) attending five universities in the region was undertaken during 2010 to establish MMR vaccination status, knowledge of mumps and willingness to take up vaccination if offered. Regression analysis was undertaken to identify characteristics of unimmunized students to ascertain likely target groups for future vaccination campaigns. Students least likely to be fully vaccinated with MMR included males; those not registered with a GP; first year students; mature students; and those with poor knowledge of mumps. A high proportion of students were willing to accept MMR vaccination if offered at university. Those least likely to take up vaccination included students not registered with a GP; mature students; and those who did not consider mumps to be a serious disease. The survey also highlighted that misconceptions remain about both the MMR vaccine safety and perceptions of risk/benefit of the vaccine. Encouraging registration with a GP and awareness raising should be a key part of campaigns to improve vaccination uptake among university students.
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Affiliation(s)
- Diane Bolton-Maggs
- Cheshire & Merseyside Health Protection Unit, Health Protection Agency, 5th Floor, Rail House, Lord Nelson Street, Liverpool L1 1JF, UK
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Attitudes regarding occupational vaccines and vaccination coverage against vaccine-preventable diseases among healthcare workers working in pediatric departments in Greece. Pediatr Infect Dis J 2012; 31:623-5. [PMID: 22333705 DOI: 10.1097/inf.0b013e31824ddc1e] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We studied the attitudes with regard to occupational vaccines and vaccination coverage among healthcare workers in pediatric departments. Completed vaccination rates were 33%, 33%, 41.7%, 3%, 5.8%, 69.2% and 36.3% against measles, mumps, rubella, varicella, hepatitis A, hepatitis B and tetanus-diphtheria, respectively. Susceptibility rates were 14.2%, 15.7%, 14.6%, 7.6%, 87.4%, 22.6% and 61.8% for measles, mumps, rubella, varicella, hepatitis A, hepatitis B and tetanus-diphtheria, respectively. Mandatory vaccinations were supported by 70.6% of healthcare workers, with considerable differences by target disease.
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Wicker S, Poland GA. Measles vaccination in health care personnel: Mandates, ethics, and patient safety. Vaccine 2012; 30:4407-8. [DOI: 10.1016/j.vaccine.2012.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
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Nishiura C, Hashimoto H. Screening for Measles Vaccination in Young Japanese Non‐healthcare Workers Through Self‐reported History. J Occup Health 2012; 54:154-7. [DOI: 10.1539/joh.11-0088-br] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Hideki Hashimoto
- Department of Health Economics and Epidemiology ResearchSchool of Public Health, The University of TokyoJapan
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Maltezou HC, Gargalianos P, Nikolaidis P, Katerelos P, Tedoma N, Maltezos E, Lazanas M. Attitudes towards mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers in tertiary-care hospitals. J Infect 2011; 64:319-24. [PMID: 22198739 DOI: 10.1016/j.jinf.2011.12.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 12/08/2011] [Accepted: 12/10/2011] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the attitudes about mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers (HCWs) working in tertiary-care hospitals in Greece. METHODS A questionnaire was distributed to HCWs working in four tertiary-care hospitals. RESULTS In total, 505 HCWs participated in the survey. Self-reported completed vaccination rates were 18.8% against measles, 18.8% against mumps, 22.2% against rubella, 1.9% against varicella, 3.6% against hepatitis A, 56.5% against hepatitis B, and 35.7% against tetanus-diphtheria. Younger age groups had higher completed vaccination rates against measles, mumps, rubella, varicella, and hepatitis B compared with older HCWs (p-value < 0.001). Self-reported susceptibility rates were 12.7% for measles, 18.9% for mumps, 15.8% for rubella, 15.2% for varicella, 89.9% for hepatitis A, 34.2% for hepatitis B, and 64.3% for tetanus-diphtheria. Sixty three percent of 451 HCWs who answered this question supported mandatory vaccinations for HCWs, with significant differences per target disease. Physicians more frequently supported a mandatory vaccination policy compared to nurses and other professions (72.1% versus 61.9% and 54.2%, respectively; p-value = 0.028). CONCLUSIONS Approximately two thirds of HCWs working in tertiary-care hospitals in Greece support mandatory vaccinations for HCWs, however suboptimal vaccination rates against vaccine-preventable diseases were recorded.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens, Greece.
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Koturoglu G, Kurugol Z, Turkoglu E. Seroepidemiology of varicella-zoster virus and reliability of varicella history in Turkish children, adolescents and adults. Paediatr Perinat Epidemiol 2011; 25:388-93. [PMID: 21649681 DOI: 10.1111/j.1365-3016.2010.01180.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study aimed to assess the age specific varicella-zoster virus (VZV) seroprevalence in Izmir, Turkey and to determine the reliability of a history of varicella to detect susceptible children, adolescents and adults. A questionnaire, including previous history of varicella, was completed for each participant and, in 590 of them, VZV-specific IgG was measured using an ELISA test. Overall, 28.5% of individuals were seronegative for VZV. By 5 years of age, only 25.5% of children were seropositive for VZV. Among adolescents and young adults, 18.8% and 11.7% were seronegative, respectively. The negative predictive value was 57.8%, decreasing with age (81.9% in children, 34.5% in adolescents and 8.3% in adults). In conclusion, a negative history of varicella is not a reliable predictor of varicella antibody status in adolescents and young adults. Serological testing before immunisation will be logical, rather than presumptive vaccination, for adolescents and adults with negative history of varicella.
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Affiliation(s)
- Guldane Koturoglu
- Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.
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Wicker S, Rabenau HF, Pfeilschifter JM, Gottschalk R. [Measles in 2010. Knowledge and vaccination status of medical students]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:238-42. [PMID: 21290279 DOI: 10.1007/s00103-010-1198-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In 2002, the WHO Regional Office for Europe developed a strategic plan for measles in the WHO European Region. WHO recommends that at least 95% of children receive two doses of measles vaccine. This plan targeted the elimination of measles for the year 2010 and is supported by the Federal Republic of Germany. METHODS Questionnaire survey, serological tests and check-up of the certificates of vaccination were offered to second year medical students of Goethe University Frankfurt/Main, Germany. RESULTS Only 62.3% of medical students had received two doses of measles vaccine. Serological data showed that 23.1% were not immune against measles. Important gaps of knowledge were identified in the knowledge test of the survey; less than one third of the students (n=95/324) were able to answer more than 50% of the questions correctly. DISCUSSION The suboptimum measles-vaccination coverage shows that the goal of eliminating measles will not be met across Europe by the target year 2010. Both occupational and public health measures need to make sure that vaccination programs should achieve a minimum of 95% coverage with two doses. In addition, the obligation to notify the authorities even of suspected cases serve the same purpose and measures to improve the knowledge of medical students are required. Consequent surveillance systems are necessary to investigate chains of measles infections. Healthcare workers play a decisive role in this issue.
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Affiliation(s)
- S Wicker
- Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
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Abd Elaziz KM, Sabbour SM, Dewedar SA. A measles and rubella (MR) catch-up vaccination campaign in an Egyptian University: Vaccine uptake and knowledge and attitudes of students. Vaccine 2010; 28:7563-8. [DOI: 10.1016/j.vaccine.2010.08.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Revised: 07/21/2010] [Accepted: 08/09/2010] [Indexed: 11/25/2022]
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Srichomkwun P, Apisarnthanarak A, Thongphubeth K, Yuekyen C, Mundy LM. Evidence of vaccine protection among thai medical students and implications for occupational health. Infect Control Hosp Epidemiol 2009; 30:585-8. [PMID: 19419330 DOI: 10.1086/597508] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In a cross-sectional study of Thai medical students, we compared the seroprevalence of antibody to measles virus, rubella virus, varicella zoster virus, hepatitis A virus, and hepatitis B virus with self-reports of prior infection or vaccination. Self-report predicted immunity to varicella zoster virus only. These data contribute to risk assessment and occupational health strategies in this resource-limited setting.
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Affiliation(s)
- Panudda Srichomkwun
- Division of Infectious Disease and Infection Control, Faculty of Medicine, Thammasart University Hospital, Pratumthani, Thailand
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