1
|
Stefanizzi P, Di Lorenzo A, Capodiferro L, Moscara L, Noviello C, Vimercati L, De Maria L, Tafuri S. Increasing vaccination coverage among healthcare workers: Active call and mandatory laws. Data from a large general hospital in Southern Italy. Vaccine 2024:S0264-410X(24)00739-4. [PMID: 39013692 DOI: 10.1016/j.vaccine.2024.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/18/2024]
Abstract
Influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are respiratory pathogens which significantly impact healthcare systems. Seasonal vaccination is recommended for all healthcare workers (HCWs) to reduce the risk for both operators and patients. Puglia, a region in Southern Italy, has been enforcing since 2018 a law mandating influenza vaccination in healthcare workers. However, vaccination coverages for this category have always been suboptimal. Our study tests the effectiveness of an active recall intervention on vaccination coverage for influenza and SARS-CoV-2 in the HCWs of a large Apulian hospital (Southern Italy). During the 2023-2024 influenza vaccination season, unvaccinated HCWs of Bari's Policlinico General Hospital were contacted. The e-mail reminded them of a regional law mandating influenza vaccination to all HCWs and offered an appointment for vaccination. SARS-CoV-2 vaccination was also offered. In 2022-2023, 43.16 % of HCWs were vaccinated against influenza and 21.87 % against SARS-CoV-2. Coverage changed during the 2023-2024 season to 54.11 % and 13.58 %, respectively. A regression model showed that vaccination uptake's increase was associated with the e-mail reception and with the operator being a physician vs. non-medical personnel. On the contrary, subjects who received the e-mail did not show an increased SARS-CoV-2 vaccination uptake, which was on the contrary influenced by the worker's age, sex, job title, and area of risk. Our soft-mandate intervention was effective in increasing vaccination uptake by HCWs. Communication with a trained specialist was probably useful, and the possibility to access vaccination services with dedicated appointments increased convenience. Mandatory vaccination policies and active recall seem to synergically impact vaccination uptake.
Collapse
Affiliation(s)
| | - Antonio Di Lorenzo
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luca Capodiferro
- Bari Policlinico General University Hospital, Board of Medical Directors, Control Room Program Unit, Italy
| | - Lorenza Moscara
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Chiara Noviello
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luigi Vimercati
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Luigi De Maria
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| | - Silvio Tafuri
- Bari Aldo Moro University, Interdisciplinary Department of Medicine, Italy
| |
Collapse
|
2
|
Morgel O, Czock A, Lang P. Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study. Int J Public Health 2023; 68:1605832. [PMID: 38033764 PMCID: PMC10684700 DOI: 10.3389/ijph.2023.1605832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21. Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake.
Collapse
Affiliation(s)
- Olga Morgel
- Interdisciplinary Emergency Centre Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute at the University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Omale UI, Oka OU, Amuzie CI, Uduma VU, Adeke AS, Ikegwuonu CO, Nkwo GE, Nwali UIA, Iyare O, Ewah RL, Nnachi OO, Ukpabi OO, Okeke IM. COVID-19 vaccination acceptance (uptake, hesitancy, intention to receive and timeliness of the intention to receive) and the determinants among health workers in Ebonyi state, Nigeria: an analytical cross-sectional study. BMJ Open 2023; 13:e068668. [PMID: 37438061 DOI: 10.1136/bmjopen-2022-068668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Health workers are at particular risk of contracting the COVID-19. However, non-acceptance of COVID-19 vaccination has been a noticeable challenge the world over and in Nigeria where supply constraints have also been an issue. We evaluated COVID-19 vaccination acceptance (the uptake, hesitancy, intention to receive and timeliness of the intention to receive) and the determinants, and the predictive power of acceptance factor compared with availability/access factor, among health workers in Ebonyi state. METHODS We conducted an online-offline survey, between 12 March 2022 and 9 May 2022, among all consenting health workers (clinical/non-clinical, public/private) working/living in Ebonyi state and who were selected by convenience and snowballing techniques. Data were collected using structured self-administered questionnaire distributed via WhatsApp and interviewer-administered questionnaire in KoBoCollect installed in android devices. Data were analysed using descriptive statistics and generalised linear models. RESULTS 1276 health workers were surveyed. Uptake was 68.2% vaccinated, 47.4% fully vaccinated and 20.9% partially vaccinated. Hesitancy was 22.6% or 71.2% among the unvaccinated (76.3% of hesitancy due to refusal and 23.7% to delay). Intention to receive was 36.0% of which 55.1% gave the intended time (days) to receive with a median (IQR) of 30 days (7-133). The strongest and most important predictor of COVID-19 vaccination acceptance was COVID-19 vaccination expectations and perceptions. Other important predictors were COVID-19/COVID-19 vaccination process experiences and perceptions. Acceptance factor was a stronger predictor compared with availability/access factor. CONCLUSION The slow pace of COVID-19 vaccination coverage among the health workers in Ebonyi state/Nigeria may encounter a bottle-neck due to the high refusal rate among the unvaccinated. COVID-19 vaccination policy interventions in Nigeria and other similar settings should, in addition to sustaining availability and access, prioritise improvement of COVID-19 vaccination expectations and perceptions (regarding importance/safety/effectiveness) and COVID-19 risk communication among the health workers. TRIAL REGISTRATION NUMBER ISRCTN16735844.
Collapse
Affiliation(s)
- Ugwu I Omale
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Onyinyechukwu U Oka
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Chidinma I Amuzie
- Community Medicine, Federal Medical Centre Umuahia, Umuahia, Nigeria
| | - Victor U Uduma
- Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Azuka S Adeke
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Cordis O Ikegwuonu
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Glory E Nkwo
- Community Medicine, Federal Medical Centre Umuahia, Umuahia, Nigeria
| | - Ugochi I A Nwali
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Osarhiemen Iyare
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Richard L Ewah
- Anaesthesia, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
- Surgery (Anaesthesia Unit), Ebonyi State University, Abakaliki, Nigeria
| | - Olaedo O Nnachi
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Okechukwu O Ukpabi
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Ifeyinwa M Okeke
- Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| |
Collapse
|
4
|
Roshchina Y, Rozhkova K, Roshchin S. Between nudges and mandates: The drivers of COVID-19 vaccination intentions and subsequent uptake in Russia. Vaccine 2023:S0264-410X(23)00756-9. [PMID: 37419852 DOI: 10.1016/j.vaccine.2023.06.067] [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: 04/03/2023] [Revised: 06/10/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023]
Abstract
Despite high levels of morbidity and mortality, as well as the widespread availability of domestic vaccines, Russia demonstrated significantly low rates of vaccination throughout the COVID-19 pandemic. This research explores vaccination intentions before the start of the immunisation campaign and the consequent uptake in Russia after the introduction of mandatory vaccination policy in certain industries and proof-of-immunisation for social activities. Using a nationally representative panel dataset, we analyse factors behind individual vaccination decisions using binary and multinomial logistic regressions. Special attention is given to the effect of employment in industries with vaccine mandates and personal factors which determine individual "nudgeability" to vaccination (e.g., personality traits, beliefs, vaccine alertness, self-perceived vaccine availability etc.). Our results show that 49 per cent of the population received at least one shot of COVID-19 vaccine by autumn 2021 after the introduction of mandatory vaccination. Vaccination intentions before the rollout of the nationwide immunisation campaign are correlated with the consequent attitudes and uptake, although the prediction is not perfect. 40 percent of vaccine refusers eventually got vaccinated, while 16 percent of vaccine supporters turned into refusers, revealing the lack of promotion of vaccine safety and effectiveness. To a large extent, vaccination refusal and hesitance are explained by vaccine alertness. Vaccine mandates significantly increased the uptake in several affected industries, especially education. These results offer important insights for designing information policy, relevant for future vaccination campaigns.
Collapse
Affiliation(s)
- Yana Roshchina
- Center for Longitudinal Studies and Laboratory for Studies in Economic Sociology, Department of Sociology, National Research University Higher School of Economics, 11 Myasnitskaya street, Moscow 101000, Russian Federation.
| | - Ksenia Rozhkova
- Laboratory for Labor Market Studies, Faculty of Economic Sciences, National Research University Higher School of Economics, 11 Pokrovsky Boulevard, Moscow 109028, Russian Federation.
| | - Sergey Roshchin
- Laboratory for Labor Market Studies, Faculty of Economic Sciences, National Research University Higher School of Economics, 11 Pokrovsky Boulevard, Moscow 109028, Russian Federation.
| |
Collapse
|
5
|
Takagi MA, Hess S, Gawronski K, Haddad N, Noveloso B, Zyzanski S, Ragina N. COVID-19 Virus and Vaccination Attitudes among Healthcare Workers in Michigan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1105. [PMID: 37376494 DOI: 10.3390/vaccines11061105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Defining the characteristics of healthcare worker (HCW) attitudes toward the coronavirus disease 2019 (COVID-19) vaccine can provide insights into vaccine hesitancy. This study's goal is to determine HCWs' attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. METHODS This cross-sectional study surveyed HCWs working in institutions in Saginaw, Sanilac, and Wayne counties in Michigan (N = 120) using tipping-scale questions. Analysis of variance and t-test were used to measure HCWs' attitudes toward the COVID-19 virus and vaccines. RESULTS Most HCWs received (95.9%) and recommended (98.3%) a COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine were: (1) efficacy of the vaccine, (2) current exposure to patients with active COVID-19 infection and risk of virus spread, and (3) safety of vaccine and long-term follow-up. Female HCWs or HCWs aged 25-54 years were more concerned about contracting COVID-19. Physicians or HCWs aged 55-64 were less concerned regarding the effectiveness and side effects of the vaccine. CONCLUSIONS Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among COVID-19 attitudes. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.
Collapse
Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Samantha Hess
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Karissa Gawronski
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Nicholas Haddad
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Bernard Noveloso
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| |
Collapse
|
6
|
Wojczyk M, Niewiadomska E, Kowalska M. The Incidence Proportion of SARS-CoV-2 Infections and the Percentage of Deaths among Infected Healthcare Workers in Poland. J Clin Med 2023; 12:jcm12113714. [PMID: 37297910 DOI: 10.3390/jcm12113714] [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: 04/18/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: The incidence proportion of SARS-CoV-2 infection among healthcare workers (HCWs) in Poland is not exactly known. This study aims to present secondary epidemiological data identifying the scale of the spread of novel coronavirus infection and the estimation of vaccination coverage in selected professional groups of HCWs in Poland. (2) Methods: The secondary epidemiological data included both the number of infections and infection fatality rate (IFR) in individual occupational groups, which occurred throughout the observation period (January 2021-July 2022), both in the country and in individual voivodeship (administrative area). (3) Results: The incidence proportion of SARS-CoV-2 infections among HCWs was 16.48%. The highest percentage of infected workers concerned laboratory scientists (21.62%) and paramedics (18%). The highest frequency of infections among HCWs occurred in the province of Zachodnio-Pomorskie (18.9%). Due to COVID-19, 558 healthcare workers died during the analysed period, mostly nurses (n = 236) and doctors (n = 200). The results regarding the vaccination coverage of HCWs against COVID-19 indicate the highest percentage of vaccinated were among doctors (83.63%) and the lowest among physiotherapists (38.2%). (4) Conclusions: In general, the percentage of infections was high in Poland during the pandemic (16.48%). Significant territorial differences were observed in the frequency of infections, deaths, and percentage of vaccinated workers in individual voivodeships.
Collapse
Affiliation(s)
- Marek Wojczyk
- Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland
| | - Ewa Niewiadomska
- Department of Epidemiology and Biostatistics, Faculty of Health Science, Medical University of Silesia, 41-902 Bytom, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, Faculty of Medical Science, Medical University of Silesia, 40-055 Katowice, Poland
| |
Collapse
|
7
|
Shui X, Wang F, Li L, Liang Q. COVID-19 vaccine acceptance among healthcare workers in China: A systematic review and meta-analysis. PLoS One 2022; 17:e0273112. [PMID: 35960730 PMCID: PMC9374244 DOI: 10.1371/journal.pone.0273112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/02/2022] [Indexed: 01/09/2023] Open
Abstract
Background Since the successful development of Coronavirus Disease (COVID-19) vaccine, COVID-19 vaccination has been actively advocated all over the world. As the key population for COVID-19 vaccination, the acceptance of Healthcare Workers (HCWs) is not only related to their risk of contracting COVID-19 infection at work, but also affects the decision of the general population on COVID-19 vaccination. Currently, a series of observational studies have been conducted on the acceptance of COVID-19 vaccines among HCWs in China, but there are presently no all-inclusive reviews. Therefore, this paper reviewed to identify a reliable estimate of acceptance rate of COVID-19 vaccine among HCWs in China. Methods We conducted a search on PubMed, EMbase, The Cochrane Library, Web of Science, CNKI (Chinese National Knowledge Infrastructure), Wanfang Database, CBM (Chinese Biomedical Literature Database) and VIP database (Chinese Scientific Journal Database) from January 2020 to June 2022. The quality of included articles was estimated using the Newcastle-Ottawa Quality Assessment tool suitable for cross-sectional studies and STATA 16 was used for analysis, A random-effects model was used to calculate acceptance rate for COVID-19 vaccine, as well as subgroup analysis and sensitivity analysis. Result This review included 18 studies involving 45,760 subjects, all of which were of medium or high quality. Meta-analysis results represented that, the pooled estimated acceptance rate of COVID-19 vaccine among HCWs in China was 78% (95%CI: 73–83%), and the pooled acceptance rate in 2021 (82%, 95%CI: 78–86%) was significantly higher than that in 2020 (73%, 95%CI: 65%-81%). Subgroup analysis showed different acceptance rates for COVID-19 vaccine among HCWs with different characteristics. Conclusion The result revealed that HCWs in China generally have a high acceptance rate of COVID-19 vaccines, but the acceptance rate varies with different characteristics of the population. Therefore, corresponding training should be carried out for HCWs with different characteristics, and they should play an exemplary and leading role in COVID-19 vaccination, so as to improve the vaccination rate of the whole population and form an immune barrier at an early date.
Collapse
Affiliation(s)
- Xiaoling Shui
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Fang Wang
- Nursing Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- * E-mail:
| | - Ling Li
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Qian Liang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| |
Collapse
|
8
|
Peruch M, Toscani P, Grassi N, Zamagni G, Monasta L, Radaelli D, Livieri T, Manfredi A, D'Errico S. Did Italy Really Need Compulsory Vaccination against COVID-19 for Healthcare Workers? Results of a Survey in a Centre for Maternal and Child Health. Vaccines (Basel) 2022; 10:1293. [PMID: 36016179 PMCID: PMC9414650 DOI: 10.3390/vaccines10081293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/29/2022] [Accepted: 08/06/2022] [Indexed: 12/16/2022] Open
Abstract
Since its early spread, the COVID-19 pandemic has become a health threat globally. Due to their crucial role in the pandemic, Italy declared compulsory vaccination for healthcare workers. Vaccine hesitancy was observed among the healthcare workers and an ethical debate arose about Italian legal statement D.L. n. 44/2021. In this article, we present the results of a survey performed in an Italian center for maternal and infant care and assess the attitudes towards the COVID-19 pandemic and the mandatory COVID-19 vaccination of healthcare workers. Since March 2022, 91.5% of healthcare workers have been vaccinated with an additional dose. Only 2.3% of the respondents refused to take vaccination: the reasons behind this refusal were distrust, doubts over safety, and lack of information. Despite the high rate of response to vaccination, 17.7% of HCWs did not agree with its mandatory nature. In addition, 5.4% stated that they agreed to be vaccinated exclusively because of the sanctions provided for by the legislation. In conclusion, adequate vaccination coverage has been achieved in the hospital under consideration. However, it is still very important to continue to persuade HCWs of vaccine efficacy and safety, considering their social role.
Collapse
Affiliation(s)
- Michela Peruch
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Paola Toscani
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Nicoletta Grassi
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Giulia Zamagni
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Davide Radaelli
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Tommaso Livieri
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Alessandro Manfredi
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Stefano D'Errico
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| |
Collapse
|