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Akmatova R, Ebama MS, Temirbekov S, Alymkulova V, Otorbaeva D. A comparative analysis of knowledge, attitude, and practice (KAP) towards influenza and influenza vaccination among healthcare workers in Kyrgyzstan prior to and during the COVID-19 pandemic. Vaccine 2024:S0264-410X(24)00420-1. [PMID: 38594119 DOI: 10.1016/j.vaccine.2024.04.008] [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: 02/22/2024] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Influenza, a globally significant respiratory illness with pandemic potential, affects around 1 billion individuals annually, leading to increased risk for severe illness and mortality. Despite recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and MoH prioritization, influenza vaccination coverage rate among HCWs in Kyrgyzstan remains low, ranging between 16 % and 46 % over the past five years. Understanding the Knowledge, Attitudes, and Practices (KAP) dynamics of HCWs regarding influenza vaccinations, both before and during the COVID-19 pandemic is crucial for refining national strategies and institutional approaches to enhance vaccination coverage rates in this important risk group. METHOD This study employed cross sectional investigations aimed at assessing KAPs among HCWs regarding influenza disease and vaccination. Conducted prior to and during the initial phase of the COVID-19 pandemic, the project involved 2400 participants from diverse medical disciplines. EPI Info was utilized to run biostatistical analyses, with descriptive and logistic regression models, to elucidate the dynamics of KAP over time. RESULTS The findings indicate that HCWs with over 5 years of experience were more likely to get vaccinated or recommend it to patients (p = 0.000). Low confidence in vaccine effectiveness influenced on recommendations of influenza vaccination in pre-pandemic time, where insufficient (95 %CI 0.08-0.6; p = 0.003) or uncertain assurance in vaccine effectiveness (95 %CI 0.007-0.18; p = 0.000) was a barrier for vaccine promotion during the pandemic. The study underscores to consider mandatory influenza vaccination for HCWs which may impact on likelihood of flu vaccination (p = 0.001). Priority groups for influenza vaccination shifted during the COVID-19 period, emphasizing older adults, individuals with existing conditions, and HCWs, compared to the pre-pandemic focus on HCWs, children, and patients with pre-existing conditions. CONCLUSION Our investigation provides valuable insights into HCWs KAP concerning influenza vaccination in Kyrgyzstan, highlighting the need for targeted interventions addressing factors influencing vaccine acceptance. The study suggests policy implications, advocating for the revision of national strategies to strengthen capacity building for medical staff.
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Affiliation(s)
- Rakhat Akmatova
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Malembe S Ebama
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Sanjar Temirbekov
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Venera Alymkulova
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Dinara Otorbaeva
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan.
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Flanagan P, Dowling M, Sezgin D, Mereckiene J, Murphy L, Giltenane M, Carr P, Gethin G. The effectiveness of interventions to improve the seasonal influenza vaccination uptake among nurses: A systematic review. J Infect Prev 2023; 24:268-277. [PMID: 37969468 PMCID: PMC10638950 DOI: 10.1177/17571774231208115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 09/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background Seasonal influenza is a significant cause of mortality and morbidity worldwide. Despite annual recommendations, influenza vaccination uptake rates are disproportionately lower among nurses compared to other health care professionals, especially when compared to physicians. Nurses have an additional risk of exposure to influenza infection due to the nature of their work. Aim To determine the effectiveness of interventions in increasing seasonal influenza vaccination uptake among nurses. Methods Evidence on the effectiveness of interventions to improve seasonal influenza vaccination uptake among nurses was systematically reviewed. A comprehensive search of six electronic databases and grey literature was undertaken. A minimum of two reviewers completed study selection, data extraction and risk of bias assessment independently. Results One hundred and thirty-four studies were identified of which one cluster randomised trial met the inclusion criteria. The results of the included study found the implementation of an intervention with multiple components increased nurses' seasonal influenza vaccination rates during a single influenza season in geriatric healthcare settings in France. As the evidence in this review was very limited, it was not possible to make recommendations regarding which interventions were effective at increasing the seasonal influenza vaccination rate for nurses. Conclusion This systematic review highlights a lack of high-quality studies that assessed interventions to improve the seasonal influenza vaccination of nurses. In view of the likelihood of influenza and the coronavirus (COVID-19) pandemic occurring together, it is imperative to have evidence on effective interventions for the nursing workforce and for policy decision makers.
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Affiliation(s)
- Paula Flanagan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | | | - Louise Murphy
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Martina Giltenane
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Peter Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Georgina Gethin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Alsaif F, Twigg M, Scott S, Blyth A, Wright D, Patel A. A systematic review of barriers and enablers associated with uptake of influenza vaccine among care home staff. Vaccine 2023; 41:6156-6173. [PMID: 37673716 DOI: 10.1016/j.vaccine.2023.08.082] [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: 06/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
Barriers and enablers to vaccination of care home (CH) staff should be identified in order to develop interventions to address them that increase uptake and protect residents. We aimed to synthesis the evidence describing the barriers and enablers that affect the influenza vaccination uptake of care home (CH) staff. METHOD We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, IBSS, SCOPUS to identify quantitative, qualitative or mixed-method studies. Data related to health or social care workers in CHs reported barriers or enablers were extracted and mapped to the Theoretical Domains Framework (TDF); the data within each domain were grouped and categorized into key factors affecting influenza vaccine uptake among CH staff. RESULTS We screened 4025 studies; 42 studies met our inclusion criteria. Thirty-four (81 %) were surveys. Five theoretical domains were frequently reported as mediators of influenza vaccine uptake: Beliefs about consequences (32 studies), Environmental context and resources (30 studies), Emotions (26 studies), Social influences (25 studies), Knowledge (22 studies). The low acceptance rate of the influenza vaccine among CH staff can be attributed to multiple factors, including insufficient understanding of the vaccine, its efficacy, or misconceptions about the vaccine (knowledge), perceiving the vaccine as ineffective and unsafe (beliefs about consequences), fear of influenza vaccine and its side effects (emotions), and experiencing limited accessibility to the vaccine (environmental context and resources). CONCLUSION Interventions aimed at increasing influenza vaccine uptake among CH staff should focus on addressing the barriers identified in this review. These interventions should include components such as enhancing knowledge by providing accurate information about vaccine benefits and safety, addressing negative beliefs by challenging misconceptions, managing concerns and fears through open communication, and improving accessibility to the vaccine through convenient on-site options. This review provides a foundation for the development of tailored Interventions to improve influenza vaccine uptake among CH staff.
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Affiliation(s)
- Faisal Alsaif
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Michael Twigg
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Sion Scott
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Annie Blyth
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
| | - David Wright
- School of Healthcare, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Amrish Patel
- School of Economics, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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Boyer J, König E, Friedl H, Pux C, Uhlmann M, Schippinger W, Krause R, Zollner-Schwetz I. Sustained Increase in Very Low Influenza Vaccination Coverage in Residents and Healthcare Workers of Long-Term Care Facilities in Austria after Educational Interventions. Vaccines (Basel) 2023; 11:1066. [PMID: 37376455 DOI: 10.3390/vaccines11061066] [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: 04/24/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Residents of long-term care facilities (LTCFs) are particularly at risk for influenza infections. We aimed to improve influenza vaccination coverage among residents and healthcare workers (HCWs) in four LTCFs by implementing educational programs and enhanced vaccination services. We compared vaccination coverage before and after the interventions (2017/18 and 2018/19 seasons). Data on vaccination adherence were recorded during a four-year observational period (2019/20 to 2022/23 seasons). Following the interventions, vaccination coverage increased significantly from 5.8% (22/377) to 19.1% (71/371) in residents and from 1.3% (3/234) to 19.7% (46/233) in HCWs (p < 0.001). During the observational period (2019/20 to 2022/23 seasons), vaccination coverage remained high in residents but decreased in HCWs. Vaccination adherence was significantly higher in residents and HCWs in LTCF 1 compared to the other three LTCFs. Our study suggests that a bundle of educational interventions and enhanced vaccination services can be an effective method for improving influenza vaccination coverage in LTCFs in both residents and HCWs. However, vaccination rates are still well below the recommended targets and further efforts are needed to increase vaccine coverage in our LTCFs.
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Affiliation(s)
- Johannes Boyer
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Elisabeth König
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Herwig Friedl
- Institute of Statistics, Graz University of Technology, 8010 Graz, Austria
| | - Christian Pux
- Geriatric Health Centers of the City of Graz, 8020 Graz, Austria
| | - Michael Uhlmann
- Geriatric Health Centers of the City of Graz, 8020 Graz, Austria
| | | | - Robert Krause
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Ines Zollner-Schwetz
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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Lohiniva AL, Hussein I, Lehtinen JM, Sivelä J, Hyökki S, Nohynek H, Nuorti P, Lyytikäinen O. Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland. Vaccines (Basel) 2023; 11:530. [PMID: 36992113 PMCID: PMC10056830 DOI: 10.3390/vaccines11030530] [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: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff's intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.
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Affiliation(s)
- Anna-Leena Lohiniva
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Idil Hussein
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jaana-Marija Lehtinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Suvi Hyökki
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Kalevankatu 4, 33520 Tampere, Finland
| | - Outi Lyytikäinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
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Langer R, Thanner M. Pharmacists' attitudes toward influenza vaccination: does the COVID-19 pandemic make a difference? EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100235. [PMID: 36816546 PMCID: PMC9925413 DOI: 10.1016/j.rcsop.2023.100235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Background Influenza vaccine uptake in most European countries remains low, despite the World Health Organization's target of 75%. Community pharmacists play a vital role in promoting vaccination; however, they have been reported to be vaccine-hesitant. This study aimed to investigate changes in pharmacists' attitudes toward influenza vaccination since the onset of the COVID-19 pandemic, as well as their COVID-19 vaccination intentions. Methods In December 2020, all members of the Swiss Association of Pharmacists were invited to participate in an online, cross-sectional survey. This study assessed pharmacists' attitudes toward influenza vaccination by surveying influenza vaccine uptake during the 2019-20 influenza season and possible reasons for their decision(s), in addition to their intention to receive COVID-19 and seasonal influenza vaccination(s) during the 2020-21 influenza season. Descriptive analysis and multinomial logistic regression were used to assess predictors of vaccine uptake and intention. Results Of 5900 Swiss pharmacists, 569 (9.6%) completed the survey. The self-reported influenza vaccination coverage among pharmacists during the 2019-20 season was 48.0%. The primary reason for vaccine uptake was the belief that all healthcare workers should be vaccinated, whereas the main reason for refusal was a lack of concern about contracting influenza. The proportions of participants who intend to accept influenza and COVID-19 vaccinations in the 2020-2021 season, when available, were 63.3% and 66.5%, respectively. The most important predictor of high willingness to be vaccinated against influenza in 2020-21 was vaccination history (OR = 3.73; 95% CI = 1.47-9.50), while the most critical predictor of willingness to be vaccinated against COVID-19 was the intention to be vaccinated against influenza (OR = 3.45; 95% CI = 1.74-6.84). Conclusions Findings indicated that although pharmacists' readiness to accept seasonal influenza vaccination significantly increased during the COVID-19 pandemic, influenza vaccine uptake among them remains suboptimal. This is consistent with what has been reported in the literature.
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Affiliation(s)
- Roland Langer
- Department of Medical Sciences, Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein,Corresponding author.
| | - Mirjam Thanner
- Frauenklinik, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Best practices to reduce COVID-19 in group homes for individuals with serious mental illness and intellectual and developmental disabilities: Protocol for a hybrid type 1 effectiveness-implementation cluster randomized trial. Contemp Clin Trials 2023; 125:107053. [PMID: 36539061 PMCID: PMC9758744 DOI: 10.1016/j.cct.2022.107053] [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: 08/25/2022] [Revised: 11/29/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND People with serious mental illness (SMI) and intellectual disabilities and/or developmental disabilities (ID/DD) living in group homes (GHs) and residential staff are at higher risk for COVID-19 infection, hospitalization, and death compared with the general population. METHODS We describe a hybrid type 1 effectiveness-implementation cluster randomized trial to assess evidence-based infection prevention practices to prevent COVID-19 for residents with SMI or ID/DD and the staff in GHs. The trial will use a cluster randomized design in 400 state-funded GHs in Massachusetts for adults with SMI or ID/DD to compare effectiveness and implementation of "Tailored Best Practices" (TBP) consisting of evidence-based COVID-19 infection prevention practices adapted for residents with SMI and ID/DD and GH staff; to "General Best Practices" (GBP), consisting of required standard of care reflecting state and federal standard general guidelines for COVID-19 prevention in GHs. External (i.e., community-based research staff) and internal (i.e., GH staff leadership) personnel will facilitate implementation of TBP. The primary effectiveness outcome is incident SARS-CoV-2 infection and secondary effectiveness outcomes include COVID-19-related hospitalizations and mortality in GHs. The primary implementation outcomes are fidelity to TBP and rates of COVID-19 vaccination. Secondary implementation outcomes are adoption, adaptation, reach, and maintenance. Outcomes will be assessed at baseline, 3-, 6-, 9-, 12-, and 15-months post-randomization. CONCLUSIONS This study will advance knowledge on comparative effectiveness and implementation of two different strategies to prevent COVID-19-related infection, morbidity, and mortality and promote fidelity and adoption of these interventions in high-risk GHs for residents with SMI or ID/DD and staff. CLINICAL TRIAL REGISTRATION NUMBER NCT04726371.
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Patel A, Sims E, Blacklock J, Birt L, Bion V, Clark A, Griffiths A, Guillard C, Hammond A, Holland R, Jones A, Jones L, Katangwe-Chigamba T, Pitcher J, Ruby P, Scott S, Wagner AP, Ahmed S, Baqir W, Cook L, Dean T, Wright D. Cluster randomised control trial protocol for estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates compared to usual practice (FLUCARE). Trials 2022; 23:989. [PMID: 36494824 PMCID: PMC9733011 DOI: 10.1186/s13063-022-06925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022] Open
Abstract
The care home staff influenza vaccination rate in England is significantly lower than the 75% World Health Organisation recommendation. This represents a substantial potential for resident harm. Barriers to staff vaccination stem from individual and organisational levels. Existing interventions address some but not all barriers and are not underpinned by behavioural science theory. This study aims to estimate the effectiveness and cost-effectiveness of a theory-informed intervention to improve care home staff vaccination rates compared to routine practice.Set in care homes with both nursing and residential focus, and a range of ownership status, only homes providing long stay care to older people with a staff vaccination rate below 40% are eligible to participate. Participation expressions of interest will be sought using a variety of approaches prior to seeking consent.The primary outcome measure is the proportion of staff vaccinated at 6 months, with secondary outcome measures being proportion vaccinated at 3 months, numbers of staff sick days, general practitioner and nurse visits to care home, care home resident hospitalisations and mortality.Based on the assumptions that the mean cluster (care home) size is 54 staff, a coefficient of variation of 0.48, control vaccination rate is 55%, intervention 75%, intra-cluster correlation coefficient of 0.2 and with 90% power, and 20% attrition, we require 39 care homes per arm.Blocked randomisation will be at the level of care home, stratified by the proportion of non-white care home staff, and implemented by Norwich Clinical Trials Unit.The intervention comprises co-designed information videos and posters, provision of in-house staff vaccination clinics, and incentive scheme and monthly data collection on trial outcomes. Beyond usual practice, the control arm will additionally contribute monthly data.Data will be collected at the start, monthly and at 6 months, and analysis will be blind to allocation. Statistical analysis will use the intention-to-treat principle with the difference in vaccination rates between groups compared using a random effect logistic regression model at the staff-level.This will be the first study to use a theory-informed intervention designed to comprehensively address identified barriers to care home staff influenza vaccination.Trial registration: ISRCTN ISRCTN22729870 . Registered on 24 August 22. Secondary identifiers: R209939, IRAS 316820, CPMS 53812.
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Affiliation(s)
- Amrish Patel
- grid.8273.e0000 0001 1092 7967School of Economics, University of East Anglia, Norwich, UK
| | - Erika Sims
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Jeanette Blacklock
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
| | - Linda Birt
- grid.9918.90000 0004 1936 8411LOROS Associate Professor in Palliative Care and Frailty, University of Leicester, Leicester, UK
| | - Veronica Bion
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Allan Clark
- grid.8273.e0000 0001 1092 7967School of Medicine, University of East Anglia, Norwich, UK
| | - Alys Griffiths
- grid.10025.360000 0004 1936 8470Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Cecile Guillard
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Amber Hammond
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Richard Holland
- grid.9918.90000 0004 1936 8411Leicester Medical School, University of Leicester, Leicester, UK
| | - Andy Jones
- grid.8273.e0000 0001 1092 7967School of Medicine, University of East Anglia, Norwich, UK
| | - Liz Jones
- grid.10025.360000 0004 1936 8470Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Thando Katangwe-Chigamba
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Jennifer Pitcher
- grid.8273.e0000 0001 1092 7967School of Economics, University of East Anglia, Norwich, UK
| | - Po Ruby
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Sion Scott
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
| | - Adam P. Wagner
- grid.8273.e0000 0001 1092 7967Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England (EoE), Cambridge, UK
| | - Saiqa Ahmed
- Patient and Public Involvement Representative, NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK
| | - Wasim Baqir
- grid.451052.70000 0004 0581 2008Pharmacy Integration Programme, NHS England and Improvement, London, UK
| | - Luke Cook
- Askham Village Community, Doddington, UK
| | - Tony Dean
- Norfolk Local Pharmaceutical Committee, Great Bircham, UK
| | - David Wright
- grid.9918.90000 0004 1936 8411School of Healthcare, University of Leicester, Leicester, UK
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COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review. Vaccines (Basel) 2022; 10:vaccines10060948. [PMID: 35746556 PMCID: PMC9227837 DOI: 10.3390/vaccines10060948] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.
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Flanagan P, Dowling M, Gethin G. Mandatory vaccination for seasonal influenza: what are nurses' views? ACTA ACUST UNITED AC 2020; 29:1186-1191. [PMID: 33180612 DOI: 10.12968/bjon.2020.29.20.1186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Preventing seasonal influenza is a public health priority but, although the benefits of vaccinating healthcare workers (HCWs) are emphasised, seasonal influenza vaccine uptake rates remain low. Voluntary vaccination policies have been less successful in achieving high vaccine uptake when compared to mandatory policies and the persistently low vaccine uptake among HCWs has fuelled debate on whether mandatory vaccination programmes should be implemented in the interest of patient safety. AIM This study explored nurses' views on mandatory vaccination policy for seasonal influenza. METHODS A self-selected sample (n=35) of qualified nurses working in two large hospital sites in Ireland participated in five focus groups. Data were analysed using Braun and Clarke's framework. FINDINGS Two themes were identified: (1) mixed views on mandatory vaccination and (2) leave nurses to make their own choice on vaccination. CONCLUSION This study provides an understanding of nurses' views regarding mandatory vaccination policy for seasonal influenza and highlights that individual choice and autonomy are crucial for vaccine acceptance.
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Affiliation(s)
- Paula Flanagan
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Republic of Ireland
| | - Maura Dowling
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, Republic of Ireland
| | - Georgina Gethin
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, Adjunct Associate Professor School of Nursing, Monash University, Australia, and Director, Alliance for Research and Innovation in Wounds, National University of Ireland, Galway, Republic of Ireland
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11
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Promoting Influenza Vaccination among Staff of Nursing Homes According to Behavioral Insights: Analyzing the Choice Architecture during a Nudge-Based Intervention. Vaccines (Basel) 2020; 8:vaccines8040600. [PMID: 33053868 PMCID: PMC7712811 DOI: 10.3390/vaccines8040600] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Influenza vaccination uptake in nursing home (NH) workers is uncommon. The aim of this study was to understand the choice architecture of influenza vaccination acceptance or refusal among them and to promote vaccination acceptance using the nudge approach. (2) Methods: In autumn 2019, a nudge intervention with a contextual qualitative analysis of choice architecture of vaccination was performed among the staff of eight Tuscan NHs. In summer 2020, a cross-sectional study including the staff of 111 NHs (8 in the nudge, 103 in the comparison group) was conducted to assess the impact of the nudge intervention in promoting vaccination uptake. (3) Results: Macro-categories of motivations for vaccination uptake that emerged from the qualitative analysis were risk perception, value dimension, and trust, while those regarding refusal were risk perception, distrust, value dimension, and reasons related to one’s health. Considering the cross-sectional study, influenza vaccination uptake in the 2018–2019 season was similar in the two groups (23.6% vs. 22.2% respectively, in the nudge and comparison group), but significantly different in the 2019–2020 season: 28% in the nudge vs. 20% in the comparison group. Also, the intention to get the vaccine in the 2020–2021 season was significantly different in the two groups: 37.9% in the nudge and 30.8% in the comparison group. (4) Conclusions: Nudge interventions-simple, fast, low cost-could be effective in promoting vaccination acceptance among NH workers and the analysis of choice architecture could be useful in improving tailored, new nudge interventions aimed at modifying irrational biased and cognitive errors.
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Bechini A, Ninci A, Del Riccio M, Biondi I, Bianchi J, Bonanni P, Mannucci E, Monami M. Impact of Influenza Vaccination on All-Cause Mortality and Hospitalization for Pneumonia in Adults and the Elderly with Diabetes: A Meta-Analysis of Observational Studies. Vaccines (Basel) 2020; 8:vaccines8020263. [PMID: 32486233 PMCID: PMC7349976 DOI: 10.3390/vaccines8020263] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/17/2020] [Accepted: 05/29/2020] [Indexed: 11/16/2022] Open
Abstract
Diabetes is a chronic condition that can be worsened by complications such as seasonal influenza virus infections. The aim of the present meta-analysis is the systematic retrieval and analysis of all available evidence on the effects of an influenza vaccine on diabetic patients. We conducted a systematic review and meta-analysis by searching MEDLINE, Embase and the Cochrane databases from inception until April 2019. We included all types of studies reporting on the effectiveness of influenza vaccination in adult and elderly patients with type 1 and type 2 diabetes. The Newcastle-Ottawa scale was used to assess risk of bias, the GRADE methodology was used to assess the evidence for each outcome. A total of 2261 studies were identified, of those, 6 studies completely fulfilled the inclusion criteria. In the 6 studies included in the analysis, influenza vaccination was associated with a lower mortality rate (Mantel Haenszel Odds Ratio (MH-OR), 95% CI: 0.54 (0.40; 0.74), p < 0.001). Patients who received influenza vaccination showed a lower risk of hospitalization for pneumonia (MH-OR, 95% CI: 0.89; (0.80; 0.98), p = 0.18). A sensitivity analysis using fixed effect model confirmed the results (MH-OR, 95% CI: 0.91; (0.87; 0.96); p = 0.001). The results of this meta-analysis are clinically relevant and support the recommendation for all persons with diabetes to receive influenza vaccination.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
| | - Alessandra Ninci
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
- Correspondence:
| | - Ilaria Biondi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
| | - Jacopo Bianchi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (A.B.); (A.N.); (I.B.); (J.B.); (P.B.)
| | - Edoardo Mannucci
- Diabetology, Careggi Hospital and University of Florence, 50134 Florence, Italy; (E.M.); (M.M.)
| | - Matteo Monami
- Diabetology, Careggi Hospital and University of Florence, 50134 Florence, Italy; (E.M.); (M.M.)
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