1
|
Álvarez Aldeán J, Álvarez García FJ, Garcés-Sánchez M, Garrote Llanos E, Iofrío de Arce A, Navarro Gómez ML, Pineda Solas V, Rivero Calle I, Ruiz-Contreras J, Salamanca de la Cueva I, Serrano Marchuet P. Vaccination against seasonal flu in childhood and adolescence. Recommendations of the Advisory Committee on Vaccines and Immunizations of the Spanish Association of Pediatrics (CAV-AEP) for the 2024-2025 season. An Pediatr (Barc) 2024; 100:438-447. [PMID: 38851979 DOI: 10.1016/j.anpede.2024.04.016] [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: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 06/10/2024] Open
Abstract
The flu is a constant threat that can sometimes cause severe forms of disease. The highest incidence rates by age group occur in children under 15 years of age, especially in those under 5 years, in whom the rate of hospitalization is also similar to the population aged 65 years and older. In addition, children are the main transmitters of the infection. In Spain, 5 influenza vaccines are authorized for the paediatric age group: three inactivated tetravalent vaccines harvested from fertilised eggs, one tetravalent inactivated vaccine obtained from cell cultures and one attenuated tetravalent vaccine for intranasal administration, which will become trivalent in the 2024-2025 season by excluding the B Yamagata lineage as recommended by the WHO. The CAV-AEP recommends systematic vaccination in children aged 6-59 months, children and adolescents belonging to risk groups, people who can transmit the flu to groups at risk of complicated flu, and household contacts or close family of infants under 6 months. From 2 years of age, the intranasal attenuated vaccine is preferred due to its greater acceptability and thus contribution to greater vaccination coverage. The CAV-AEP also considers that vaccination against influenza of healthy children and adolescents aged 5-18 years is advisable, as it provides individual protection and promotes protection at the family and community levels. It is especially important to vaccinate all health care professionals against influenza as well as pregnant women at any time during pregnancy.
Collapse
Affiliation(s)
| | | | | | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario Basurto, Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, Spain
| | | | - Marisa Luisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, CIBER ISCIII y IISGM, Madrid, Spain
| | - Valentín Pineda Solas
- Sección de Infectología Pediátrica, Hospital Universitario Parc Taulí; Universidad Autónoma de Barcelona, Sabadell, Barcelona, Spain
| | - Irene Rivero Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario de Santiago de Compostela; Sociedad Española de Infectología Pediátrica (SEIP), Grupo Genética, Vacunas, Infecciones y Pediatría (GENVIP), Spain
| | | | | | | |
Collapse
|
2
|
Townsend L, Gillespie P, McGrath J, Kenny C, Bergin C, Fleming C. Health Care Personnel Workdays Lost and Direct Health Care Salary Costs Incurred due to COVID-19 Infection in the Age of Widespread Vaccine Availability. J Infect Dis 2024:jiae223. [PMID: 38771075 DOI: 10.1093/infdis/jiae223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/27/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Vaccination against coronavirus disease 2019 (COVID-19) can mitigate the burden of health care worker (HCW) infection. We investigate the burden of HCW illness and its associated direct health care personnel costs in the setting of widespread vaccine availability and explore factors influencing these outcomes. METHODS This multicenter prospective study followed HCWs over an 8-month period from January to August 2023. Data recorded included incident COVID-19 infection, symptom burden, workdays missed, and vaccine history. Workdays lost due to illness were used to calculate direct health care personnel costs due to COVID-19 infection. Univariate analysis and multivariable regression investigated the factors associated with workdays lost and direct health care personnel. RESULTS In total, 1218 participants were enrolled and followed for 8 months, with 266 incidents of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 1191 workdays lost, and health care personnel costs of €397 974. Multivariable regression revealed that workdays lost were associated with incomplete primary COVID-19 vaccination course. Being unvaccinated, older age, and male were associated with increased health care personnel costs. CONCLUSIONS Health care workdays lost remain a significant issue and are associated with health care system burden despite vaccine availability. These can be mitigated via targeted implementation of vaccine programs. Seasonal variation in health care workdays lost should inform workforce planning to accommodate surge periods.
Collapse
Affiliation(s)
- Liam Townsend
- Department of Infectious Diseases, St James's Hospital, Dublin, Ireland
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Paddy Gillespie
- Health Economics and Policy Analysis Centre, Institute for Lifecourse and Society, University of Galway, Galway, Ireland
- CÚRAM, Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
| | - Jonathan McGrath
- Department of Infectious Diseases, St James's Hospital, Dublin, Ireland
| | - Claire Kenny
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| | - Colm Bergin
- Department of Infectious Diseases, St James's Hospital, Dublin, Ireland
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Catherine Fleming
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| |
Collapse
|
3
|
Young S, Goldin S, Dumolard L, Shendale S, McMurren B, Maltezou HC, Desai S. National vaccination policies for health workers - A cross-sectional global overview. Vaccine 2024; 42:757-769. [PMID: 37321897 DOI: 10.1016/j.vaccine.2023.04.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Immunization is essential for safeguarding health workers from vaccine-preventable diseases (VPDs) that they may encounter at work; however, information about the prevalence and scope of national policies that protect health workers through vaccination is limited. Understanding the global landscape of health worker immunization programmes can help direct resources, assist decision-making and foster partnerships as nations consider strategies for increasing vaccination uptake among health workers. METHODS A one-time supplementary survey was distributed to World Health Organization (WHO) Member States using the WHO/United Nations Children's Fund (UNICEF) Joint Reporting Form on Immunization (JRF). Respondents described their 2020 national vaccination policies for health workers - detailing VPD policies and characterising technical and funding support, monitoring and evaluation activities and provisions for vaccinating health workers in emergencies. RESULTS A total of 53 % (103/194) Member States responded and described health worker policies: 51 had a national policy for vaccinating health workers; 10 reported plans to introduce a national policy within 5 years; 20 had subnational/institutional policies; 22 had no policy for vaccinating health workers. Most national policies were integrated with occupational health and safety policies (67 %) and included public and private providers (82 %). Hepatitis B, seasonal influenza and measles were most frequently included in policies. Countries both with and without national vaccination policies reported monitoring and reporting vaccine uptake (43 countries), promoting vaccination (53 countries) and assessing vaccine demand, uptake or reasons for undervaccination (25 countries) among health workers. Mechanisms for introducing a vaccine for health workers in an emergency existed in 62 countries. CONCLUSION National policies for vaccinating health workers were complex and context specific with regional and income-level variations. Opportunities exist for developing and strengthening national health worker immunization programmes. Existing health worker immunization programmes might provide a foothold on which broader health worker vaccination policies can be built and strengthened.
Collapse
Affiliation(s)
- Stacy Young
- Independent Consultant, Chapel Hill, NC, USA
| | | | | | | | | | - Helena C Maltezou
- Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece
| | | |
Collapse
|
4
|
Wangchuk S, Prabhakaran AO, Dhakal GP, Zangmo C, Gharpure R, Dawa T, Phuntsho S, Burkhardsmeier B, Saha S, Wangmo D, Lafond KE. Introducing seasonal influenza vaccine in Bhutan: Country experience and achievements. Vaccine 2023; 41:7259-7264. [PMID: 37866993 DOI: 10.1016/j.vaccine.2023.10.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Abstract
Bhutan successfully introduced multiple vaccines since the establishment of the Vaccine Preventable Disease Program in 1979. Surveillance and subsequent introduction of influenza vaccination became a public health priority for the Ministry of Health following the influenza A(H1N1)pdm09 pandemic. Sentinel surveillance for influenza in Bhutan began in 2008, and a study of severe acute respiratory infection was conducted in 2017, which found the highest influenza burden in children aged <5 years and adults ≥50 years. Following review of surveillance and burden of disease data, the National Technical Advisory Group presented recommendations to Bhutan's Ministry of Health which approved influenza vaccine introduction for all five high-risk groups in the country. Upon the official launch of the program in June 2018, the Vaccine Preventable Disease Program began planning, budgeting, and procurement processes with technical and financial support from the Partnership for Influenza Vaccine Introduction, the United States Centers for Disease Control and Prevention, the Bhutan Health Trust Fund, and the World Health Organization. Influenza vaccination for high-risk groups was integrated into Bhutan's routine immunization services in all health care facilities beginning in November 2019 and vaccinated all populations in 2020 in response to the COVID-19 pandemic. Coverage levels between 2019 and 2022 were highest in children aged 6-24 months (62.5%-96.9%) and lowest in pregnant women (47.7%-62.5%). Bhutan maintained high coverage levels despite the COVID-19 pandemic by continued provision of influenza vaccine services at health centers during lockdowns, conducting communication and sensitization efforts, and using catch-up campaigns. Bhutan's experience with introducing and scaling up the influenza vaccine program contributed to the country's capacity to rapidly deploy its COVID-19 vaccination program in 2021.
Collapse
Affiliation(s)
- Sonam Wangchuk
- Royal Centers for Disease Control, Ministry of Health, Thimphu, Bhutan.
| | - Aslesh O Prabhakaran
- Influenza Program, US Centers for Disease Control and Prevention, New Delhi, India
| | - Guru Prasad Dhakal
- Department of Medicine, Jigme Dorji Wangchuk National Referral Hospital, Thimphu, Bhutan
| | - Cheten Zangmo
- Vaccine Preventable Disease Program, Department of Public Health, Ministry of Health, Bhutan
| | - Radhika Gharpure
- Influenza Division, United States Centers for Disease Control and Prevention, Atlanta, USA
| | - Tashi Dawa
- Vaccine Preventable Disease Program, Department of Public Health, Ministry of Health, Bhutan
| | - Sangay Phuntsho
- Vaccine Preventable Disease Program, Department of Public Health, Ministry of Health, Bhutan
| | | | - Siddhartha Saha
- Influenza Program, US Centers for Disease Control and Prevention, New Delhi, India
| | | | - Kathryn E Lafond
- Influenza Division, United States Centers for Disease Control and Prevention, Atlanta, USA
| |
Collapse
|
5
|
López-Zambrano MA, Pita CC, Escribano MF, Galán Meléndez IM, Cebrián MG, Arroyo JJG, Huerta C, Cuadrado LM, Ruiperez CM, Núñez C, Zapata AP, de la Pinta MLR, Uriz MAS, Conejo ISA, Gomila CM, Carbajo MDL, Gómez AS. Factors associated to influenza vaccination among hospital's healthcare workers in the Autonomous Community of Madrid, Spain 2021-2022. Vaccine 2023; 41:6719-6726. [PMID: 37806803 DOI: 10.1016/j.vaccine.2023.09.047] [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: 07/09/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Influenza vaccination (IV) aims primarily to protect high-risk groups against severe influenza-associated disease and death. It is recommended in Spain for high-risk groups, including Healthcare workers (HCWs). However, vaccination uptake has been consistently below desirable levels. The objective of this study were to evaluate influenza vaccination coverage using data from the regional vaccination registry, during 2021-2022 season, among HCWs in public hospitals in Autonomous Community of Madrid (CAM) and to explore factors associated with influenza vaccination. We conducted a cross-sectional study using administrative data retrieved from the Regional Department of Health data repositories. A multilevel logistic regression model was designed to estimate Level 1 (individual) and Level 2 (contextual) variables that are associated with HCẂs vaccination. The study population was HCWs from 25 public hospitals in CAM who were active during the period of the influenza 2021-2022 vaccination campaign. The global influenza vaccination coverage (IVC) was 52.1 %. All study Level 1 variables were significantly associated with vaccine uptake. Greater IVC is associated with individual characteristics: female (OR1.14; 95 %CI 1.09-1.19), older age 59-69 years old (OR1.72; 95 %CI 1.60-1.84), born in Spain, medical staff, more than one high-risk condition (OR1.24; 95 %CI 1.10-1.40; respectively) and vaccinated in two previous campaigns (OR25.64; 95 %CI 24.27-27.09). IVC was highest among HCWs celiac disease (65.5 %) followed by diabetes mellitus (65.1 %) and chronic inflammatory disease (64.3 %). The hospital where the study subject worked also showed an effect on the vaccination uptake, although Level 2 variable (hospital complexity) was not positively associated. IVC in HCWs remains suboptimal. These findings may prove useful to tailor strategies to reach specific groups. It is recommended to delve into the identification of factors associated with the HCWs workplace that may have a positive impact on IV.
Collapse
Affiliation(s)
- María Alejandra López-Zambrano
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Covadonga Caso Pita
- Servicio de Prevención de Riesgos Laborales, Hospital Clínico San Carlos, Madrid, Spain.
| | | | - Isabel Mª Galán Meléndez
- Servicio de Prevención y Salud Laboral, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Manuela García Cebrián
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de La Princesa, Hospital Infantil Universitario Niño Jesús, Hospital Universitario Santa Cristina, Madrid, Spain.
| | | | - Carmen Huerta
- Servicio de Prevención Riesgos Laborales, Hospital Universitario de Móstoles, Madrid, Spain.
| | - Luis Mazón Cuadrado
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de Fuenlabrada, Madrid, Spain.
| | - Carmen Muñoz Ruiperez
- Servicio de Medicina del Trabajo y Prevención de Riesgos Laborales, Hospital Universitario 12 de octubre, Madrid, Spain.
| | - Concha Núñez
- Servicio de Prevención Riesgos Laborales, Hospital U. La Paz-Carlos III-Cantoblanco, Madrid, Spain.
| | - Aurora Pérez Zapata
- Servicio de Prevención de Riesgos Laborales - Salud Laboral, Hospital Universitario Príncipe de Asturias, Madrid, Spain.
| | | | - Mª Angeles Sánchez Uriz
- Servicio de Prevención Mancomunado de Grupo, Hospital Universitario Infanta Leonor, Madrid, Spain.
| | | | | | - Mª Dolores Lasheras Carbajo
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Amaya Sánchez Gómez
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| |
Collapse
|
6
|
Avakian I, Dadouli K, Anagnostopoulos L, Fotiadis K, Lianos A, Mina P, Hadjichristodoulou C, Mouchtouri VA. Nationwide Survey on Seasonal Influenza Vaccination among Health Care Workers during the COVID-19 Pandemic in Greece: Determinants, Barriers and Peculiarities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6247. [PMID: 37444095 PMCID: PMC10341827 DOI: 10.3390/ijerph20136247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/10/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Seasonal influenza vaccination (SIV) of health care workers (HCWs) is critical in protecting patients' and HCWs' health. Our objective was to examine HCW SIV coverage and related determinants. METHODS AND MATERIALS A nationwide cross-sectional questionnaire survey was conducted among HCWs during the first half of 2021. The questionnaire (online or paper-based) included knowledge, attitude and practice questions regarding SIV, COVID-19 vaccines and vaccination. RESULTS Out of 6500 questionnaires administered, 2592 were completed (response rate: 39.9%). SIV coverage reached 69.4% (95% CI: 67.6-71.2%) based on self-reported vaccine uptake. Nurses and administrative staff were found to be more skeptical and have lower vaccine acceptance in comparison with physicians (aOR = 0.66 and aQR = 0.59, respectively). Other SIV hesitancy risk factors included working in secondary health care (aOR = 0.59) and working in northern Greece (aQR = 0.66). Determinants for SIV acceptance included being or living with high-risk people due to medical history (aOR = 1.84 and aOR = 1.46, respectively), positive attitudes towards routine vaccinations (aOR: 1.86), knowledge about COVID-19 vaccines (aOR = 1.53) and COVID-19 vaccine uptake (aOR = 3.45). The primary reason for SIV refusal was low risk perception (58.7%). CONCLUSIONS SIV coverage (2020/2021) was relatively high, but remained far from formal recommendations. Specific occupational groups were skeptical and low-risk perception was the main reason for vaccine refusal. Targeted policies should be developed and enforced.
Collapse
Affiliation(s)
- Ioanna Avakian
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | | | - Athanasios Lianos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 12 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (K.D.); (L.A.); (A.L.); (C.H.)
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Shi X, Zhang Y, Zhou L, Zhou L, Qiao H. Influenza vaccination coverage among health-care workers during the COVID-19 epidemic in 2020/2021 influenza season: Evidence from a web-based survey in northwestern China. Hum Vaccin Immunother 2022; 18:2102354. [PMID: 35920744 DOI: 10.1080/21645515.2022.2102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccinating health-care workers against influenza during the COVID-19 pandemic can effectively prevent and control influenza and reduce COVID-19 strain on health systems. This study was conducted to explore influenza vaccination coverage and determinants among health-care workers during the COVID-19 pandemic in 2020/2021 influenza season in Ningxia. This cross-sectional survey included demographic characteristics of health-care workers, influenza vaccination status, reasons for not getting vaccinated, and whether influenza vaccination was recommended for others. We found that influenza vaccine rate of health-care workers was 39.6%. A binary logistic regression analysis showed that health-care workers' vaccination coverage was higher when the individuals were aware of the effect of the influenza vaccine (OR = 0.624, 95% CI: 0.486-0.802). Health-care workers who from internal medicine (OR = 1.494, 95% CI: 1.146-1.948), pediatrics (OR = 2.091, 95% CI: 1.476-2.962), and surgery departments (OR = 1.373, 95% CI: 1.014-1.859) had a lower coverage than those who worked in vaccination and infectious disease departments. The main reasons that some stated for not getting vaccinated were that they felt it was unnecessary (52.22%). Health-care workers who were vaccinated against influenza were more likely to recommend influenza vaccination to their patients than health-care workers who had not been vaccinated. The incidence of influenza among health-care workers was higher than that of the general population in Ningxia. Under the policy of voluntary and self-pay influenza vaccination in Ningxia, the coverage rate of influenza vaccine among health-care workers was far below the vaccination requirements of influenza vaccine in influenza season even during the COVID-19 epidemic.
Collapse
Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China.,Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Ying Zhang
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Luping Zhou
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Liwei Zhou
- Department of Immunization Program, Ningxia Center for Disease Prevention and Control, Yinchuan, China
| | - Hui Qiao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| |
Collapse
|
9
|
Ma Y, Han X, Li W, Yang Y, Xu Y, Liu D, Yang W, Feng L, Ma L. Self-reported vaccination-related behavior patterns among healthcare workers and the association with self-directed learning frequency: A nationwide cross-sectional survey. Front Public Health 2022; 10:951818. [PMID: 36339203 PMCID: PMC9634157 DOI: 10.3389/fpubh.2022.951818] [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: 05/24/2022] [Accepted: 10/06/2022] [Indexed: 01/24/2023] Open
Abstract
Background Healthcare workers play an essential role in improving the public's vaccination uptake, but the full picture of such workers' engagement in vaccination-related behaviors has not been appropriately identified. According to the Integrated Theory of Health Behavior Change, self-directed learning may be a promising intervention for fostering engagement in vaccination-related behaviors, but the association between self-directed learning and such behaviors remains unclear. This study aimed to determine Chinese healthcare workers' level of engagement in behaviors for combatting vaccine-preventable diseases and assess the association between frequency of performing vaccine-focused SDL and engagement in vaccination-related behaviors. Materials and methods An online cross-sectional survey was conducted from January 27 to February 21, 2022, using the survey platform "wjx." Respondents were restricted to healthcare workers aged 18-65 years. A Sankey diagram and bar plots were constructed to determine patterns of engagement in a vaccination-related-behavior chain. Unconditional binary logistic regression models were fitted to determine the association between frequency of performing vaccine-focused self-directed learning and engagement in vaccination-related behaviors. Results Of the 2,248 survey respondents, data for 2,065 were analyzed. Participants who had received influenza or pneumococcal vaccination, routinely recommended vaccination to patients, tracked patients' vaccination status, and recommended efficiently accounted for 43.2%, 50.8%, 40.3%, and 36.4% of the total participants, respectively. When only considering those who routinely made such recommendations, the proportion of those who performed tracking and efficient recommendation was 28.8% and 26.2%, respectively. When compared to performing self-directed learning "never to less than once/six months," performing self-directed learning "more than once/week" was positively associated with being vaccinated (OR, 95% CI: 2.30, 1.74-3.03), routinely recommending vaccination (OR, 95% CI: 4.46, 3.30-6.04), and tracking the status of patients so recommended (OR, 95% CI: 6.18, 4.35-8.76). Conclusions Chinese healthcare workers' pattern of engagement in vaccination-related behaviors must be improved. Higher frequencies of engagement in self-directed learning are associated with more active engagement in vaccination-related behaviors, meaning raising such frequencies could be a promising intervention for fostering behavior changes in this regard and ultimately increasing vaccination coverage.
Collapse
Affiliation(s)
- Yuan Ma
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuan Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Li
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Yuan Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunshao Xu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Di Liu
- “Breath Circles” Network Platform, Beijing, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Luzhao Feng
| | - Libing Ma
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guilin Medical University, Guilin, China,Libing Ma
| |
Collapse
|
10
|
Jones RP, Ponomarenko A. Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths. Infect Dis Rep 2022; 14:710-758. [PMID: 36286197 PMCID: PMC9602062 DOI: 10.3390/idr14050076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 08/29/2023] Open
Abstract
Pathogen interference is the ability of one pathogen to alter the course and clinical outcomes of infection by another. With up to 3000 species of human pathogens the potential combinations are vast. These combinations operate within further immune complexity induced by infection with multiple persistent pathogens, and by the role which the human microbiome plays in maintaining health, immune function, and resistance to infection. All the above are further complicated by malnutrition in children and the elderly. Influenza vaccination offers a measure of protection for elderly individuals subsequently infected with influenza. However, all vaccines induce both specific and non-specific effects. The specific effects involve stimulation of humoral and cellular immunity, while the nonspecific effects are far more nuanced including changes in gene expression patterns and production of small RNAs which contribute to pathogen interference. Little is known about the outcomes of vaccinated elderly not subsequently infected with influenza but infected with multiple other non-influenza winter pathogens. In this review we propose that in certain years the specific antigen mix in the seasonal influenza vaccine inadvertently increases the risk of infection from other non-influenza pathogens. The possibility that vaccination could upset the pathogen balance, and that the timing of vaccination relative to the pathogen balance was critical to success, was proposed in 2010 but was seemingly ignored. Persons vaccinated early in the winter are more likely to experience higher pathogen interference. Implications to the estimation of vaccine effectiveness and influenza deaths are discussed.
Collapse
Affiliation(s)
- Rodney P Jones
- Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
| |
Collapse
|
11
|
Alobwede SM, Kidzeru EB, Katoto PDMC, Lumngwena EN, Cooper S, Goliath R, Jackson A, Wiysonge CS, Shey MS. Influenza Vaccination Uptake and Hesitancy among Healthcare Workers in Early 2021 at the Start of the COVID-19 Vaccine Rollout in Cape Town, South Africa. Vaccines (Basel) 2022; 10:1176. [PMID: 35893825 PMCID: PMC9332543 DOI: 10.3390/vaccines10081176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/09/2022] [Accepted: 07/10/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy toward influenza vaccines among HCWs. We adapted a questionnaire developed and validated by Betsch and colleagues and used it to conduct online and face-to-face interviews among HCWs at the start of the COVID-19 vaccine rollout. Multivariate logistic regression was used to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% were nurses, and 12.5% were physicians. A total of 54.9% were willing to accept, 20.4% were undecided, and 24.7% intended to refuse influenza vaccination. Participants who were above 25 years of age and physicians were more likely to accept the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vaccinated to protect others. Influenza vaccine hesitancy was highest in those who did not trust that influenza vaccines are safe. For future flu seasons, tailored education programs on the safety and effectiveness of flu vaccines targeting younger HCWs, could be vital to improving vaccine uptake.
Collapse
Affiliation(s)
- Samuel M. Alobwede
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Clinical Division, Department of Research and Innovation, Partners in Sexual Health, Cape Town 7500, South Africa
| | - Elvis B. Kidzeru
- Centre for Research on Health and Priority Pathologies (CRHPP), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon;
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine and Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa
- Division of Radiation Oncology, Department of Radiation Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town 7925, South Africa
| | - Patrick D. M. C. Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Evelyn N. Lumngwena
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa;
- Centre for the Study of Emerging and Re-Emerging Infections (CREMER), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon
| | - Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Rene Goliath
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Amanda Jackson
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
| | - Muki S. Shey
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
- Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| |
Collapse
|
12
|
Jędrzejek MJ, Mastalerz-Migas A. Seasonal influenza vaccination of healthcare workers: a narrative review. Int J Occup Med Environ Health 2022; 35:127-139. [PMID: 34897290 PMCID: PMC10464734 DOI: 10.13075/ijomeh.1896.01775] [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: 10/31/2020] [Accepted: 09/30/2021] [Indexed: 10/19/2022] Open
Abstract
Influenza is an acute respiratory disease caused by the influenza virus which often occurs in outbreaks and epidemics worldwide. The World Health Organization recommends annual vaccination of healthcare workers (HCWs) against influenza, because most of them are involved in the direct care of patients with a high risk of influenza-related complications. Given the significance of the disease burden, a targeted literature review was conducted to assess issues related to influenza vaccination among HCWs. The primary aim of this review was to assess the incidence of influenza among medical personnel and healthcare-associated influenza, and to outline the benefits of influenza vaccination for patients and HCWs themselves. Vaccination of HCWs seems to be an important strategy for reducing the transmission of influenza from healthcare personnel to their patients and, therefore, for reducing patient morbidity and mortality, increasing patient safety, and reducing work absenteeism among HCWs. The benefits of influenza vaccination for their patients and for HCWs themselves are addressed in literature, but the evidence is mixed and often of low-quality. Int J Occup Med Environ Health. 2022;35(2):127-39.
Collapse
|
13
|
Workplace influenza vaccination in private hospital setting: a cost-benefit analysis. Ann Occup Environ Med 2022; 34:e3. [PMID: 35425620 PMCID: PMC8980743 DOI: 10.35371/aoem.2022.34.e3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background Influenza illness causes several disruptions to the workforce. The absenteeism that often ensues has economic implications for employers. This study aimed to estimate the cost-benefit of influenza vaccination in a healthcare setting from the employer’s perspective. Methods A cross-sectional questionnaire survey was conducted in a private hospital in 2018–2019 comparing voluntary vaccinated with non-vaccinated employees with influenza vaccine. The analyses were made based on self-reporting on absenteeism and presenteeism from Influenza-like illnesses (ILIs). The costs incurred, both direct and indirect costs, were included in the study. A cost-benefit analysis was performed by measuring the cost of the vaccination program. The costs of absenteeism and reduced productivity were calculated using 3 hypothesised levels of effectiveness in the following percentage of productivity of 30%, 50%, and 70%. The costs were also calculated based on four scenarios: with and without operating income and with and without replacement. The benefits of the influenza vaccination from the employer’s perspective were analysed. The benefit to cost ratio was determined. Results A total of four hundred and twenty-one respondents participated. The influenza vaccination rate was 63.0%. The rate of ILI of 38.1% was significantly lower among vaccinated. The ILI-related absenteeism reported was also significantly lower amongst vaccinated employees at 30% compared to 70% non-vaccinated. Employers could save up to USD 18.95 per vaccinated employee when only labour cost was included or 54.0% of cost savings. The cost-saving rose to USD 155.56 when the operating income per employee was also included. The benefit to cost ratio confirmed that the net cost-benefit gained from the vaccination was more than the net cost of vaccination. Conclusions Influenza vaccination for working adults was cost-saving and cost-beneficial when translated into financial investments for the employer. A workplace vaccination demonstrates a significant cost-benefit strategy to be applied in any institutional setting.
Collapse
|
14
|
Stöckeler AM, Schuster P, Zimmermann M, Hanses F. Influenza vaccination coverage among emergency department personnel is associated with perception of vaccination and side effects, vaccination availability on site and the COVID-19 pandemic. PLoS One 2021; 16:e0260213. [PMID: 34797861 PMCID: PMC8604289 DOI: 10.1371/journal.pone.0260213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Influenza is a major concern in hospitals, including the emergency department (ED), mainly because of a high risk for ED personnel to acquire and transmit the disease. Although influenza vaccination is recommended for health care workers, vaccination coverage is low. Methods This survey was conducted in the 2016/2017 and 2020/2021 influenza seasons. Questionnaires were sent to ED personnel in 12 hospitals in Bavaria, South-Eastern Germany. The response rates were 62% and 38% in 2016/2017 and 2020/2021, respectively. Data were compared between the two seasons as well as between vaccinated and not vaccinated respondents in 2020/2021. Results Significantly more ED personnel reported having been vaccinated in the 2020/2021 season. Factors associated with vaccination coverage (or the intention to get vaccinated) were profession (physician / medical student), having been vaccinated at least twice, the availability of an influenza vaccination on site (in the ED) as well as the COVID-19 pandemic. Additionally, significant differences in the assessment and evaluation of influenza, its vaccination side effects and ethical aspects were found between vaccinated and not vaccinated ED personnel in 2020/2021. Unvaccinated respondents estimated higher frequencies of almost all potential vaccination side effects, were less likely to accept lay-offs if employees would not come to work during an influenza pandemic and more likely to agree that work attendance should be an employee´s decision. Vaccinated participants instead, rather agreed that vaccination should be mandatory and were less likely to consider job changes in case of a mandatory vaccination policy. Conclusion The COVID-19 pandemic might have contributed to a higher influenza vaccination rate among ED workers. Vaccination on site and interventions targeting the perception of influenza vaccination and its side effects may be most promising to increase the vaccination coverage among ED personnel.
Collapse
Affiliation(s)
- Anna-Maria Stöckeler
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Philipp Schuster
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Markus Zimmermann
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
| | - Frank Hanses
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
- * E-mail:
| |
Collapse
|
15
|
Hall CM, Northam H, Webster A, Strickland K. Determinants of seasonal influenza vaccination hesitancy among healthcare personnel: An integrative review. J Clin Nurs 2021; 31:2112-2124. [PMID: 34716635 DOI: 10.1111/jocn.16103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the determinants of and behaviour change models for seasonal influenza vaccination compliance among healthcare personnel. BACKGROUND COVID-19 vaccine hesitancy among healthcare personnel may be better understood by exploring determinants of seasonal influenza vaccine hesitancy. DESIGN Integrative literature review. METHODS A systematic search was conducted in accordance with PRISMA guidelines. Six thousand and forty-eight articles were screened. Seventy-eight met inclusion criteria. Due to the heterogeneity of included articles, a narrative synthesis was conducted utilising a conceptual matrix to identify thematic categories. RESULTS Six thematic categories were identified as influencing HCP SIV compliance: 'perceived vulnerability', 'trust', 'past behaviour', 'professional duty', 'access and convenience' and 'knowledge and experience'. The Health Belief Model (HBM) was the most commonly utilised health behaviour change model within the seasonal influenza vaccination context. Few studies have examined seasonal influenza vaccine acceptance and uptake within the Australian HCP context, particularly involving community care and aged care. CONCLUSIONS Factors that appear to relate to influenza vaccination compliance among HCP can be grouped according to several thematic categories, and they also appear influential in COVID-19 vaccine uptake. In particular, an emerging focus on 'trust' or the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic. Efforts to influence these domains to increase compliance, however, are likely to be impeded by a lack of a well-developed and tested behaviour change model. RELEVANCE TO CLINICAL PRACTICE Healthcare personnel (HCP) face high levels of occupational exposure to seasonal influenza every year. An emerging focus on 'trust' and the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic.
Collapse
Affiliation(s)
- Caroline M Hall
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Holly Northam
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Adrian Webster
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Health Systems Group, Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
| | - Karen Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT, Auckland, New Zealand.,Robert Gordon University, Aberdeen, Scotland
| |
Collapse
|
16
|
Li T, Qi X, Li Q, Tang W, Su K, Jia M, Yang W, Xia Y, Xiong Y, Qi L, Feng L. A Systematic Review and Meta-Analysis of Seasonal Influenza Vaccination of Health Workers. Vaccines (Basel) 2021; 9:vaccines9101104. [PMID: 34696212 PMCID: PMC8537688 DOI: 10.3390/vaccines9101104] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 01/01/2023] Open
Abstract
A systematic review and meta-analysis was conducted to estimate the pooled effect of influenza vaccinations for health workers (HWs). Nine databases were screened to identify randomized clinical trials and comparative observational studies that reported the effect of influenza vaccination among HWs. The risk ratio (RR), standardized mean difference, and 95% confidence interval (CI) were employed to study the effect size using fixed/random-effect models. Subgroup analyses and sensitivity analyses were conducted accordingly. Publication bias was examined. Sixteen studies (involving 7971 HWs from nine countries) were included after a comprehensive literature search. The combined RR regarding the incidence of laboratory-confirmed influenza was 0.36 (95% CI: 0.25 to 0.54), the incidence of influenza-like illness (ILI) was 0.69 (95% CI: 0.45 to 1.06), the absenteeism rate was 0.63 (95% CI: 0.46 to 0.86), and the integrated standardized mean difference of workdays lost was −0.18 (95% CI: −0.28 to −0.07) days/person. The subgroup analysis indicated that vaccination significantly decreases the incidence of laboratory-confirmed influenza in different countries, study populations, and average-age vaccinated groups. Influenza vaccinations could effectively reduce the incidence of laboratory-confirmed influenza, absenteeism rates, and workdays lost among HWs. It is advisable, therefore, to improve the coverage and increase the influenza vaccination count among HWs, which may benefit both workers and medical institutions.
Collapse
Affiliation(s)
- Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Xiaoling Qi
- Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing 400016, China;
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Kun Su
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China; (M.J.); (W.Y.)
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China; (M.J.); (W.Y.)
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Yu Xiong
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400016, China; (T.L.); (Q.L.); (W.T.); (K.S.); (Y.X.); (Y.X.)
- Correspondence: (L.Q.); (L.F.)
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China; (M.J.); (W.Y.)
- Correspondence: (L.Q.); (L.F.)
| |
Collapse
|
17
|
Determinants of Influenza Vaccination Coverage among Greek Health Care Workers amid COVID-19 Pandemic. Infect Dis Rep 2021; 13:757-762. [PMID: 34562996 PMCID: PMC8482201 DOI: 10.3390/idr13030071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/01/2023] Open
Abstract
In the context of the evolving current COVID-19 pandemic, influenza vaccination among the public and health care workers is of particular importance. There are sparse data on the influenza vaccination coverage among health care workers amid COVID-19 pandemic. We aimed to study possible factors associated with influenza vaccination coverage among Greek physicians, dentists, and pharmacists during the flu season 2020–2021. We formulated the hypothesis that COVID-19 pandemic exerted a positive impact on the influenza vaccination coverage of health care workers. An online survey was conducted among the members of the Larissa, (Thessaly, Central Greece) Medical, Dentists, and Pharmacists Associations. The influenza vaccination coverage was 74% (251/340). Acceptance of COVID-19 vaccination coverage was the only factor independently associated with the likelihood of influenza vaccination coverage. In conclusion, we report here a considerable improvement of the influenza vaccination coverage among HCWs and especially among physicians. Acceptance of COVID-19 vaccination was the only predictor of influenza vaccination coverage. This finding provides public health workers and policymakers with useful policy-relevant evidence in order to maintain and even further improve the gains of increased vaccination coverage achieved during the flu season 2020–2021.
Collapse
|
18
|
Gray G, Cooper J. An evaluation of influenza vaccine uptake in UK medical students. Occup Med (Lond) 2021; 71:105-108. [PMID: 33598680 DOI: 10.1093/occmed/kqab014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The annual influenza vaccination is recommended for all front-line healthcare workers in the UK and is a crucial way of reducing mortality for vulnerable patient groups. However, to date the UK government has never explicitly monitored influenza vaccine uptake in medical students. This is important to ascertain, as students regularly move between clinical areas and are both a perfect vector for the spread of influenza and at an increased risk of contracting influenza themselves. AIMS This service evaluation was designed to evaluate the effectiveness of an influenza vaccination programme in one UK medical school and make recommendations to increase vaccination rates in the future. METHODS This service evaluation collected data about medical student uptake of influenza vaccination in one UK medical school. Two hundred and fifty-one students at different course stages completed questionnaires, answering questions on vaccination status and Likert-scale 'belief' questions to assess the subjective reasons behind vaccine refusal. RESULTS There was a substantial difference between year group cohorts (~20%), with significantly higher vaccination rates in the preclinical year group. Two significant negative predictors of vaccination were found (P < 0.001), related to scepticism over the effectiveness of the vaccine and lack of convenient access to the vaccination. Results indicated that integrating information about the influenza vaccine into the curriculum would reduce lack of knowledge over the efficacy of the vaccine. The centralization of vaccination programmes at mandatory university-based learning events would mitigate against the problem of diversity of vaccination locations and lack of central accountability. CONCLUSIONS The results of this service evaluation provide significant predictors of vaccination status for medical students and potential occupational health interventions to improve vaccine uptake in this group.
Collapse
Affiliation(s)
- G Gray
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Cooper
- Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
19
|
Health Belief Model in Hospitals: Determining the Effective Factors on Influenza Vaccination. HEALTH SCOPE 2021. [DOI: 10.5812/ealthscope.113759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
: The need for extensive vaccination of health care workers (HCWs) is felt more than ever. The aim of this study was to investigate the determinants of influenza vaccination using HBM in HCWs of Jahrom hospitals. This cross-sectional study was performed by multicenter method on 614 HCWs in Jahrom, southern Iran, in 2020. Data collection tools included Demographic and researcher-made Influenza Vaccination in HCWs Based on HBM Questionnaires whose validity and reliability were measured and evaluated. Analyzes have been performed using SPSS 21. Increasing age (P < 0.001) and perceived barriers (P < 0.001) have increased influenza vaccination, but perceived benefits (P = 0.002), cues to action (P = 0.001), and self-efficacy (P < 0.001) have had a negative impact on influenza vaccination among HCWs. Perceived severity (P = 0.7) was higher in people with a history of influenza vaccination, while such a difference was not observed in perceived susceptibility. Higher mean age, previous vaccination history, and perceived barriers are predictors of influenza vaccine participation behavior.
Collapse
|
20
|
Health Belief Model in Hospitals: Determining the Effective Factors on Influenza Vaccination. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.113759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
: The need for extensive vaccination of health care workers (HCWs) is felt more than ever. The aim of this study was to investigate the determinants of influenza vaccination using HBM in HCWs of Jahrom hospitals. This cross-sectional study was performed by multicenter method on 614 HCWs in Jahrom, southern Iran, in 2020. Data collection tools included Demographic and researcher-made Influenza Vaccination in HCWs Based on HBM Questionnaires whose validity and reliability were measured and evaluated. Analyzes have been performed using SPSS 21. Increasing age (P < 0.001) and perceived barriers (P < 0.001) have increased influenza vaccination, but perceived benefits (P = 0.002), cues to action (P = 0.001), and self-efficacy (P < 0.001) have had a negative impact on influenza vaccination among HCWs. Perceived severity (P = 0.7) was higher in people with a history of influenza vaccination, while such a difference was not observed in perceived susceptibility. Higher mean age, previous vaccination history, and perceived barriers are predictors of influenza vaccine participation behavior.
Collapse
|
21
|
Samyn M, Van Hal G, Vandevijvere H, Van Damme P. The influenza vaccine for nursing and care professionals at emergency services in Flanders. Hum Vaccin Immunother 2021; 17:2719-2722. [PMID: 33844618 DOI: 10.1080/21645515.2021.1894062] [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: 10/21/2022] Open
Abstract
Background: The Belgian Superior Health Council recommends seasonal influenza vaccination for people working in the health care sector in order to reduce the risk of the influenza virus being transmitted to people at risk. The aim of this study is to provide more insight into the current vaccination rate in nurses and health care professionals in emergency services in Flanders. In addition, the influence of influenza vaccination on absenteeism will be investigated, as well as the motivation to get vaccinated or not.Methods: A quantitative multicentre, cross-sectional study was carried out in whichnurses and health care professionals in emergency services in Flanders were questioned by means of an online questionnaire.Results: The survey of nurses and health care professionals in Flanders from 2018 shows that 54% (294/548) gets vaccinated in this year. Respondents who have been vaccinated report a lower absenteeism due to influenza compared to health workers who do not get vaccinated. There is a lack of general knowledge about influenza and vaccination. Thirty-four percent of nurses and health care professionals in emergencies do not know the correct definition of influenza. The main reasons for being vaccinated are: to protect oneself (27%), family members (21.5%) and patients (16%). Reasons for not getting vaccinated are: never having had the influenza before (30%), believing you get the influenza because of the vaccination (12%), no belief or trust in the vaccine (19%). Three percent of respondents who received the influenza vaccine were absent due to flu. The absence due to influenza was higher among the respondents who were not vaccinated, namely 11%. Being vaccinated for influenza or not has been associated with being absent for influenza.Conclusions: Given that there is a lack of general knowledge about influenza and its vaccination, the vaccination campaigns should cover this knowledge gap. Efforts to convince both nursing and care professionals about the protective role of the Influenza vaccine. These efforts can improve the influenza vaccination coverage rate and consequently minimize the absenteeism.Abbreviations: WHO: World Health Organization; UZA: University Hospital of Antwerp; SPSS: Statistical Package for the Social Sciences.
Collapse
Affiliation(s)
- Matthijs Samyn
- University of Antwerp, Faculty of Medicine and Health Sciences, Master of Nursing and Midwifery, Campus Drie Eiken, Wilrijk, Belgium
| | - Guido Van Hal
- University of Antwerp, Faculty of Medicine and Health Sciences, Master of Nursing and Midwifery, Campus Drie Eiken, Wilrijk, Belgium
| | - Herman Vandevijvere
- University of Antwerp, Faculty of Medicine and Health Sciences, Master of Nursing and Midwifery, Campus Drie Eiken, Wilrijk, Belgium
| | - Pierre Van Damme
- University of Antwerp, Faculty of Medicine and Health Sciences, Master of Nursing and Midwifery, Campus Drie Eiken, Wilrijk, Belgium
| |
Collapse
|
22
|
Kindgen-Milles D, Brandenburger T, Braun JFW, Cleff C, Moussazadeh K, Mrosewski I, Timm J, Wetzchewald D. Prevalence of SARS-COV-2 positivity in 516 German intensive care and emergency physicians studied by seroprevalence of antibodies National Covid Survey Germany (NAT-COV-SURV). PLoS One 2021; 16:e0248813. [PMID: 33831032 PMCID: PMC8031427 DOI: 10.1371/journal.pone.0248813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/06/2021] [Indexed: 11/22/2022] Open
Abstract
Healthcare personnel are at risk to aquire the corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated the prevalence of SARS-CoV-2 antibodies and positive nasopharyngeal reverse transcriptase polymerase-chain reaction (RT-PCR) tests in German intensive care and emergency physicians. Physicians attending intensive care and emergency medicine training courses between June 16th and July 2nd 2020 answered a questionnaire and were screened for SARS-CoV-2 antibodies via automated electrochemiluminiscence immunoassay. We recruited 516 physicans from all parts of Germany, 445/516 (86%) worked in high risk areas, and 379/516 (73%) had treated patients with COVID-19. The overall positive rate was 18/516 (3.5%), 16/18 (89%) had antibodies against SARS-COV-2, another 2 reported previous positive RT-PCR results although antibody testing was negative. Of those positive, 7/18 (39%) were unaware of their infection. A stay abroad was stated by 173/498 (35%), mostly in Europe. 87/516 (17%) reported a febrile respiratory infection after January 1st 2020 which was related to SARS-CoV-2 in 4/87 (4.6%). Contact to COVID-19 positive relatives at home was stated by 22/502 (4.4%). This was the only significant risk factor for Covid-19 infection (Fisher´s exact test, p = 0.0005). N95 masks and eye protection devices were available for 87% and 73%, respectively. A total of 254/502 (51%) had been vaccinated against seasonal influenza. The overall SARS-CoV-2 infection rate of german physicians from intensive care and emergency medicine was low compared to reports from other countries and settings. This finding may be explained by the fact that the German health care system was not overwhelmed by the first wave of the SARS-CoV-2 pandemic.
Collapse
Affiliation(s)
- Detlef Kindgen-Milles
- Dept. of Anesthesiology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- * E-mail:
| | - Timo Brandenburger
- Dept. of Anesthesiology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Julian F. W. Braun
- Dept. of Emergency Medicine, University Witten/Herdecke, Arnsberg, Germany
| | - Corvin Cleff
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, German
| | - Kian Moussazadeh
- Dept. of Anesthesiology & Intensive Care Sana Hospital Duisburg, Duisburg, Germany
| | - Ingo Mrosewski
- Department of Laboratory Medicine, MDI Limbach Berlin GmbH, Berlin, Germany
| | - Jörg Timm
- Institute of Virology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | | |
Collapse
|
23
|
Tanner AR, Dorey RB, Brendish NJ, Clark TW. Influenza vaccination: protecting the most vulnerable. Eur Respir Rev 2021; 30:30/159/200258. [PMID: 33650528 PMCID: PMC9488965 DOI: 10.1183/16000617.0258-2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022] Open
Abstract
Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to “original antigenic sin”. Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged >65 years receive an adjuvanted trivalent inactivated vaccine and adults aged <65 years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way. To protect the elderly from influenza, multiple strategies to overcome immunosenescence need to be utilised, such as improving vaccine efficacy, indirect protection via vaccinating children and healthcare workers, and developing a universal vaccinehttps://bit.ly/30KXzYn
Collapse
Affiliation(s)
- Alex R Tanner
- Dept of Medicine for the Elderly, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
| | - Robert B Dorey
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nathan J Brendish
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Dept of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Tristan W Clark
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Dept of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
24
|
Zhang Y, Luo X, Ma ZF. Willingness of the general population to accept and pay for COVID-19 vaccination during the early stages of COVID-19 pandemic: a nationally representative survey in mainland China. Hum Vaccin Immunother 2021; 17:1622-1627. [PMID: 33606600 DOI: 10.1080/21645515.2020.1847585] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has caused negative impacts both on populations' health worldwide. COVID-19 vaccines are currently developed and tested in clinical trials. However, limited studies have investigated the willingness to get COVID-19 vaccines in populations. Therefore, the study aimed to determine the individual's willingness to accept and pay for COVID-19 vaccines, and knowledge, attitude, and perceptions (KAP) of COVID-19 vaccines, which hopefully will be available soon. Non-pregnant Chinese adults aged ≥18 years were asked to complete a self-administered KAP COVID-19 vaccine questionnaire distributed between March and May 2020. A total of 1179 participants (574 males and 605 females) were included and the mean age was 36.0 ± 11.5 years. Both the willingness to be vaccinated against COVID-19 and pay for COVID-19 vaccines were high (77.4% and 81.1%), respectively. Also, the most acceptable price range of COVID-19 vaccine was ¥501-1000 (US $ 75-149). Education and willingness to be vaccinated were significantly associated with some of the responses in KAP (P < .05). In conclusion, our study reported high willingness to be vaccinated against COVID-19 and pay for COVID-19 vaccines in Chinese population. Our findings also provided some important contributions for public health policy makers to formulate appropriate vaccination programs.
Collapse
Affiliation(s)
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| |
Collapse
|
25
|
Zürcher K, Zwahlen M, Berlin C, Egger M, Fenner L. Losing ground at the wrong time: trends in self-reported influenza vaccination uptake in Switzerland, Swiss Health Survey 2007-2017. BMJ Open 2021; 11:e041354. [PMID: 33563620 PMCID: PMC7875279 DOI: 10.1136/bmjopen-2020-041354] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES We studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged ≥65 years. DESIGN Three cross-sectional surveys. PARTICIPANTS Individuals who participated in the Swiss Health Surveys 2007, 2012 and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses. RESULTS We included 51 582 individuals in this analysis. The median age was 49 years (IQR 25-64), and 27 518 were women (53.3%). The proportion of reporting a history of influenza vaccination overall was 31.9% (95% CI 31.4 to 32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged ≥65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). In logistic regression, self-reported vaccination coverage decreased in the 65-75 years old (adjusted OR (aOR) 0.56, 95% CI 0.48 to 0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77 to 1.03 between 2012 and 2017). Uptake was positively associated with the ≥65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession and having any underlying chronic disease. CONCLUSION Influenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the influenza season 2020/2021 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.
Collapse
Affiliation(s)
- Kathrin Zürcher
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
| | - Marcel Zwahlen
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia Berlin
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
- Population Health Sciences, Bristol Medical School, University of Bristol, BristolUK
| | - Lukas Fenner
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
- Kanton Solothurn Gesundheitsamt, Solothurn, Switzerland
| |
Collapse
|
26
|
Costantino C, Ledda C, Squeri R, Restivo V, Casuccio A, Rapisarda V, Graziano G, Alba D, Cimino L, Conforto A, Costa GB, D’Amato S, Mazzitelli F, Vitale F, Genovese C. Attitudes and Perception of Healthcare Workers Concerning Influenza Vaccination during the 2019/2020 Season: A Survey of Sicilian University Hospitals. Vaccines (Basel) 2020; 8:vaccines8040686. [PMID: 33207626 PMCID: PMC7711679 DOI: 10.3390/vaccines8040686] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
Influenza is an infectious disease with a high impact on the population in terms of morbidity and mortality, but despite International and European guidelines, vaccination coverage rates among healthcare workers (HCWs) remain very low. The aim of the present study was to evaluate influenza vaccination adherence in the three Sicilian University Hospitals of Catania, Messina, and Palermo and to understand the attitudes and perceptions of vaccinated healthcare workers and the main reasons for vaccination refusal. A cross-sectional survey through a self-administered questionnaire was conducted during the 2019/2020 influenza season. Overall, 2356 vaccinated healthcare workers answered the questionnaire. The main reason reported for influenza vaccination adherence during the 2019/2020 season was to protect patients. Higher self-perceived risk of contracting influenza and a positive attitude to recommending vaccination to patients were significantly associated with influenza vaccination adherence during the last five seasons via multivariable analysis. Fear of an adverse reaction was the main reason for influenza vaccine refusal. In accordance with these findings, Public Health institutions should develop and tailor formative and informative campaigns to reduce principal barriers to the immunization process and promote influenza vaccination adherence among HCWs.
Collapse
Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (C.L.); (V.R.)
| | - Raffaele Squeri
- Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy; (R.S.); (G.B.C.); (S.D.); (F.M.)
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Alessandra Casuccio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (C.L.); (V.R.)
| | - Giorgio Graziano
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Davide Alba
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Livia Cimino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Arianna Conforto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Gaetano Bruno Costa
- Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy; (R.S.); (G.B.C.); (S.D.); (F.M.)
| | - Smeralda D’Amato
- Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy; (R.S.); (G.B.C.); (S.D.); (F.M.)
| | - Francesco Mazzitelli
- Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy; (R.S.); (G.B.C.); (S.D.); (F.M.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (V.R.); (A.C.); (G.G.); (D.A.); (L.C.); (A.C.); (F.V.)
| | - Cristina Genovese
- Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, 98124 Messina, Italy; (R.S.); (G.B.C.); (S.D.); (F.M.)
- Correspondence: ; Tel.: +39-3914868625
| |
Collapse
|
27
|
Influenza Vaccination Hesitancy among Healthcare Workers in South Al Batinah Governorate in Oman: A Cross-Sectional Study. Vaccines (Basel) 2020; 8:vaccines8040661. [PMID: 33172064 PMCID: PMC7712351 DOI: 10.3390/vaccines8040661] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/15/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background: Seasonal influenza infections are a major cause of morbidity and mortality worldwide. Healthcare workers (HCWs) are an important target group for vaccination against influenza due to their increased risk of infection and their potential to transmit the infection to their patients, families and communities. The aim of this study was to assess the potential hesitancy and its associated factors towards influenza vaccination amongst HCWs in the South Al Batinah governorate in Oman. Methods: A cross-sectional survey of 390 HCWs with direct or indirect patient contact was conducted in May and June 2019 using a self-administered questionnaire. Associations between HCW characteristics and vaccination status were examined using bivariate and multivariate analyses to identify the likelihood of vaccination against seasonal influenza among HCWs. Results: Overall, 60% of HCWs were vaccinated in the 2018/2019 season; vaccine uptake among nurses was 52% and uptake was higher among women. Self-protection and protection of the community were the most cited reasons for vaccine acceptance, with side effects being the main reason for hesitancy. Vaccinated respondents had a higher mean knowledge score (7.18; standard deviation SD: 2.14) than unvaccinated respondents (6.30; SD: 2.2). Odds of vaccination were highest among respondents who believed influenza vaccine should be mandatory for HCWs (Odds ratio (OR): 2.04 [1.30–3.18]), those working in the general medicine, emergency medicine, or intensive care units (OR: 1.92 [1.20–3.10]), nurses and doctors (OR: 1.75 [1.09–2.79]) and those who believe that HCWs should receive an influenza vaccine (OR: 1.35 [1.07–2.77]). Conclusions: The study provides valuable insights into the enablers and barriers of influenza vaccination practices among HCWs and may inform interventions to increase acceptance of vaccination.
Collapse
|
28
|
Lau LHW, Lee SS, Wong NS. The continuum of influenza vaccine hesitancy among nursing professionals in Hong Kong. Vaccine 2020; 38:6785-6793. [PMID: 32891475 DOI: 10.1016/j.vaccine.2020.08.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Influenza vaccine hesitancy among healthcare workers poses challenges to the achievement of herd immunity and causes infection risks to vulnerable patients. This study aimed to quantify the extent of influenza vaccine hesitancy among nurses in Hong Kong, to delineate its pattern, and to explore its socio-demographic, professional and personal correlates. METHOD Nurses in Hong Kong were recruited in a cross-sectional study involving the administration of an online questionnaire survey after the 2017/18 winter influenza season. Respondents' influenza vaccination behaviours, attitudes and psychological antecedents were assessed, followed by their delineation into subgroups along the hesitancy continuum through a combination of multiple correspondence analysis and K-means cluster analysis. Socio-demographic, professional and personal correlations of subgrouping were investigated using generalised ordered logistic regression. RESULTS The overall vaccination coverage of nurses for the 2017/18 influenza season was 44%. Five clusters were differentiated by the level of influenza vaccine hesitancy: "Very high hesitancy-to-complete refusal" (n = 56; 7%) characterised by outright refusal of vaccination; "High hesitancy" (n = 171; 23%) distinguished by tendency of skipping vaccination and scepticism about safety of vaccine; "Moderate hesitancy" (n = 273; 36%) with uncertainties towards vaccination, mistrust of the government's vaccine recommendations and priority concern on affordability of vaccine; "Low hesitancy" (n = 95; 13%) with cautious acceptance towards vaccination and "No-to-minimal hesitancy" (n = 158; 21%) with strong vaccine confidence and compliance greatly linked to convenience of vaccine access. Nurses having completed at least 3 years' pre-registration professional training, having most family members vaccinated against influenza, and with influenza vaccination history during studentship were less vaccine hesitant. CONCLUSION With more than half of the nurses in Hong Kong having moderate or higher level of influenza vaccine hesitancy, interventions customised to the needs of nurses as reflected from the characteristics of clusters along the vaccine hesitancy continuum could form an important strategy for improving vaccination uptake.
Collapse
Affiliation(s)
- Leonia Hiu Wan Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
29
|
Antinolfi F, Battistella C, Brunelli L, Malacarne F, Bucci FG, Celotto D, Cocconi R, Brusaferro S. Absences from work among healthcare workers: are they related to influenza shot adherence? BMC Health Serv Res 2020; 20:763. [PMID: 32811477 PMCID: PMC7433058 DOI: 10.1186/s12913-020-05585-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/27/2020] [Indexed: 11/18/2022] Open
Abstract
Background The coverage for influenza vaccination among healthcare workers (HCWs) is inadequate in many countries despite strong recommendations; is there evidence that influenza vaccination is effective in preventing absenteeism? Aim of the study is to evaluate the influenza vaccination coverage and its effects on absences from work among HCWs of an Italian academic healthcare trust during the 2017–2018 influenza season. Methods We performed a retrospective study to identify predictive characteristics for vaccination, and a retrospective cohort study to establish the effect of vaccination on absences among the vaccinated and non-vaccinated cohorts between December 2017 and May 2018. Overall absence rates over the whole observation period and sub-rates over 14-days intervals were calculated; then comparison between the two groups were conducted applying Chi-square test. Results Influenza vaccination coverage among 4419 HCWs was 14.5%. Age, university degree, medical care area and physician profile were positively associated with vaccine uptake. Globally during influenza season non-vaccinated HCWs lost 2.47/100 person-days of work compared to 1.92/100 person-days of work among vaccinated HCWs (p < 0.001); significant differences in absences rates resulted when focusing on the influenza epidemic peak. Conclusions Factors predicting influenza uptake among HCWs were male sex, working within medical care area and being a physician. Absenteeism among HCWs resulted to be negatively correlated with vaccination against influenza. These findings add evidence to the urgent need to implement better influenza vaccination strategies towards HCWs to tackle vaccine hesitancy among professionals.
Collapse
Affiliation(s)
| | - Claudio Battistella
- Department of Medicine, University of Udine, Udine, Italy.,ULSS4 Veneto Orientale Trust, San Donà di Piave, Venezia, Italy
| | - Laura Brunelli
- Department of Medicine, University of Udine, Udine, Italy.,Udine Healthcare and University Integrated Trust, Udine, Italy.,Friuli Centrale Healthcare University Trust, Udine, Italy
| | | | | | - Daniele Celotto
- Department of Medicine, University of Udine, Udine, Italy.,Giuliano Isontina Healthcare University Trust, Trieste, Italy
| | - Roberto Cocconi
- Udine Healthcare and University Integrated Trust, Udine, Italy.,Friuli Centrale Healthcare University Trust, Udine, Italy
| | | |
Collapse
|
30
|
Gianino MM, Kakaa O, Politano G, Scarmozzino A, Benso A, Zotti CM. Severe and moderate seasonal influenza epidemics among Italian healthcare workers: A comparison of the excess of absenteeism. Influenza Other Respir Viruses 2020; 15:81-90. [PMID: 32666696 PMCID: PMC7767959 DOI: 10.1111/irv.12777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background This study aims to quantify the excess of sickness absenteeism among healthcare workers (HCWs), to estimate the impact of a severe versus moderate influenza season and to determine whether the vaccination rates are associated with reduced sickness absence. Methods We investigated the excess absenteeism that occurred in a large Italian hospital, 5300 HCWs, during the severe influenza season of 2017/2018 and compared it with three moderate flu seasons (2010/2013). Data on influenza vaccinations and absenteeism were obtained from the hospital's databases. The data were split into two periods: the epidemic, from 42 to 17 weeks, and non‐epidemic, defined as 18 to 41 weeks, which was used as the baseline. We stratified the absenteeism among HCWs in multiple variables. Results Our study showed an increased absenteeism among HCWs during the epidemic period of severe season in comparison with non‐epidemic periods, the absolute increase correlated with a relative increase of 70% (from 4.05 to 6.68 days/person). Vaccinated HCWs had less excess of absenteeism in comparison with non‐vaccinated HCWs (1.74 vs 2.71 days/person). The comparison with the moderate seasons showed a stronger impact on HCW sick absenteeism in the severe season (+0.747days/person, P = .03), especially among nurses and HCWs in contact with patients (+1.53 P < .01; +1.19 P < .01). Conclusions In conclusion, a severe influenza epidemic has greater impacts on the absenteeism among HCWs than a moderate one. Although at a low rate, a positive effect of vaccination on absenteeism is present, it may support healthcare facilities to recommend vaccinations for their workers.
Collapse
Affiliation(s)
- Maria Michela Gianino
- Department of Sciences of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Omar Kakaa
- Department of Sciences of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Politecnico di Torino, Torino, Italy
| | | | - Alfredo Benso
- Department of Control and Computer Engineering, Politecnico di Torino, Torino, Italy
| | - Carla Maria Zotti
- Department of Sciences of Public Health and Pediatrics, University of Torino, Torino, Italy
| |
Collapse
|
31
|
Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections. Curr Opin Infect Dis 2020; 33:312-318. [PMID: 32657968 DOI: 10.1097/qco.0000000000000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Prevention of nosocomial transmission of respiratory viruses is a priority in all healthcare settings and often achieved with the use of personal protective equipment. Several adjunctive infection prevention methods are in common use but their effectiveness in reducing healthcare-associated respiratory viral infections is unclear. In this review, recent advances regarding the effectiveness of several adjunctive infection prevention methods to reduce healthcare-associated respiratory viral infections are discussed. RECENT FINDINGS Training and education on hand hygiene guidelines, mandatory influenza vaccination for healthcare personnel, access to paid sick leave to reduce ill presenteeism, cohorting of patients with the same infection or clinical syndrome, neuraminidase inhibitor chemoprophylaxis during influenza outbreaks, and enhanced visitor restrictions in pediatric hospitals all have shown some degree of effectiveness in observational or quasi-experimental studies. SUMMARY Most of the studies evaluating the effect of adjunctive infection prevention methods on healthcare-associated respiratory viral infections are observational or quasi-experimental and are often combined with other interventions. Therefore, it is difficult to determine the precise effectiveness or efficacy of these interventions and more controlled trials are needed. Multimodal infection prevention policies are likely to be most effective in reducing healthcare-associated respiratory viral infections.
Collapse
|
32
|
Liao Q, Ng TWY, Cowling BJ. What influenza vaccination programmes are preferred by healthcare personnel? A discrete choice experiment. Vaccine 2020; 38:4557-4563. [PMID: 32414654 PMCID: PMC7252056 DOI: 10.1016/j.vaccine.2020.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study examined the relative importance of factors relating to vaccine characteristics, social normative influence and convenience in access to vaccine for determining decision making for seasonal influenza vaccination (SIV) among healthcare personnel (HCP), aiming to optimize existing influenza vaccination programmes for HCP. METHODS A discrete choice experiment (DCE) was conducted in HCP working in public hospitals in Hong Kong. The DCE was designed to examine the relative importance of vaccine characteristics (vaccine efficacy and safety), social normative influence reflected by the proportion of HCP colleagues intending to take SIV, and convenience in access to vaccine indicated by vaccination programme duration, vaccination location, vaccination arrangement procedure and service hours in determining influenza vaccination choice among HCP. Mixed logit regression modelling was conducted to examine the preference weight (β) of factors included in the DCE for determining vaccination choice. RESULTS Vaccination probability increased with increase in vaccine efficacy (β = 0.02 for per 1% increase), vaccination location changing from "designated staff clinic" to "mobile station" (β = 0.37), vaccination arrangement procedure changing from "by appointment" to "by walk-in" (β = 0.99), but decreased with the increase in probability of mild reactions to vaccination (β = -0.05 for per 1% increase). CONCLUSION Vaccine safety was judged to be more important than vaccine efficacy for determining vaccination choice. Arranging vaccination service by walk-in and implementing mobile vaccination station should be considered in future SIV programmes to compensate for the effect of perceived low vaccination efficacy and concerns about vaccine safety to promote SIV uptake among HCP.
Collapse
Affiliation(s)
- Qiuyan Liao
- Division of Behavioural Sciences, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Tiffany W Y Ng
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
33
|
Seasonal Influenza Vaccination and Recommendation: The Difference between General Practitioners and Public Health Workers in China. Vaccines (Basel) 2020; 8:vaccines8020265. [PMID: 32486350 PMCID: PMC7350002 DOI: 10.3390/vaccines8020265] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/19/2022] Open
Abstract
Seasonal influenza vaccination for healthcare workers (HCWs) is critical to the protection of HCWs and their patients. This study examined whether the separation of public health workers and general practitioners could affect the influenza vaccine uptake and recommendation behaviors among HCWs in China. A survey was conducted from August to October 2019, and HCWs from 10 provinces in China were recruited. A self-administered and anonymous questionnaire was used to assess HCWs’ demographic information, knowledge, and attitudes toward influenza vaccination, as well as vaccine uptake and recommendation behaviors. The primary outcome was HCWs’ vaccination and recommendation status of seasonal influenza vaccine. Multivariate logistic regression models were used to identify the influence factors of influenza vaccine uptake and recommendation among HCWs. Of the 1159 HCWs in this study, 25.3% were vaccinated against influenza in the previous season. “No need to get vaccinated” was the primary reason for both unvaccinated public health workers and general practitioners. Multivariate logistic regression showed that public health workers were more likely to get vaccinated against influenza (OR = 2.20, 95% CI 1.59–3.05) and recommend influenza vaccination to children (OR = 2.10, 95% CI 1.57–2.80) and the elderly (OR = 1.69, 95% CI 1.26–2.25) than general practitioners. Besides, the knowledge and perceived risk of influenza can give rise to HCWs’ vaccination and recommendation behaviors, and HCWs who got vaccinated in the past year were more likely to recommend it to children and the elderly in their work. The influenza vaccine coverage and recommendation among HCWs are still relatively low in China, especially for general practitioners. Further efforts are needed to improve the knowledge and attitudes toward influenza and influenza vaccination among HCWs, and coherent training on immunization for both public health workers and general practitioners might be effective in the face of separated public health and clinical services in China.
Collapse
|
34
|
Kopsidas I, Tsopela GC, Maroudi-Manta S, Kourkouni E, Charalampopoulos D, Sirogianni A, Collins ME, Lourida A, Kourlaba G, Zaoutis TE, Coffin SE. Increasing healthcare workers' uptake of seasonal influenza vaccination in a tertiary-care pediatric hospital in Greece with a low-cost, tailor-made, multifaceted strategy. Vaccine 2020; 38:4609-4615. [PMID: 32430148 DOI: 10.1016/j.vaccine.2020.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/06/2020] [Accepted: 05/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Healthcare workers' (HCW) seasonal influenza vaccination (SIV) is critical to prevent nosocomial influenza. However, HCW vaccination rates remain unacceptably low in many European institutions. A two-year three-step initiative was implemented at a tertiary-care pediatric hospital with 750 beds in Athens, Greece with the aim of increasing SIV among HCW. METHODS Α cross-sectional anonymous survey of HCWs was conducted during the 2015-16 influenza season with the aim to evaluate attitudes, knowledge, and specific barriers and facilitators for SIV. Stratified analysis was used to identify factors associated with no prior history of influenza vaccination. Multifaceted interventions were implemented in the 2016-2017 season. These included 1) education around influenza disease and SIV, and 2) communication of availability and opportunity (time and place) of SIV. Interventions were designed to target HCWs with the lowest SIV rates in the previous three years. RESULTS We achieved a 67% response rate, with 363 respondents (106 doctors, 145 nurses, 101 other hospital staff; 11 did not provide their profession). Most (64%) had not been vaccinated in the previous three years; only 14% received the vaccine annually. Non-vaccination rates were significantly higher among nurses (76%) and cleaning and food-service workers (73%) compared to doctors (40%) (P < 0.001). Protection of self, family, patients and colleagues were the most common motivations. Concerns about the safety and effectiveness of the vaccine, the belief that one does not belong to a high-risk group were the most common barriers. The interventions led to an increase in SIV uptake by the HCWs in the hospital, from 19% to 31%. CONCLUSIONS In a country with very low reported rates of vaccination among HCWs, a simple, low-cost, tailor-made intervention strategy can lead to an increase in SIV uptake. Stratifying data according to vaccination history may reveal a diversity of targets for improvement that might otherwise be missed.
Collapse
Affiliation(s)
- Ioannis Kopsidas
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece.
| | | | | | - Eleni Kourkouni
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | | | | | - Madeline E Collins
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | - Athanasia Lourida
- Infection Control Committee, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgia Kourlaba
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | - Theoklis E Zaoutis
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece; Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan E Coffin
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
35
|
Kenny E, McNamara Á, Noone C, Byrne M. Barriers to seasonal influenza vaccine uptake among health care workers in long-term care facilities: A cross-sectional analysis. Br J Health Psychol 2020; 25:519-539. [PMID: 32320125 DOI: 10.1111/bjhp.12419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/14/2020] [Indexed: 11/30/2022]
Abstract
Objectives The vaccination of health care workers (HCWs) against influenza is recommended by numerous public health authorities. Despite these recommendations, the rate of vaccine uptake is poor, particularly among those working in long-term care. The current study aimed to use the theoretical domains framework to identify the barriers associated with influenza vaccine uptake among HCWs in long-term care facilities. Design The study employed a cross-sectional survey design. Methods HCWs (n = 372) at 21 long-term care facilities in the west of Ireland completed a paper-based questionnaire, which assessed the socio-demographic and psychosocial determinants associated with HCW influenza vaccine uptake. Results Findings indicated that a logistic regression using the theoretical domains framework demonstrated a strong ability to correctly classify whether or not HCWs received the influenza vaccine. Significant predictors of receiving the vaccine were past vaccination (OR = 16.16, 95% CI = 5.52-47.34), Goals (OR = 3.15, 95% CI = 1.63-6.06), Intentions (OR = 2.42, 95% CI = 1.23-4.77), Social influences (OR = 0.39, 95% CI = 0.18-0.84), and Reinforcement (OR = 0.46, 95% CI = 0.21-0.98). Conclusions This research identified the key psychological determinants associated with HCW vaccine uptake. Interventions that target the theoretical domains, Goals, Intentions, Social influences, and Reinforcement, may enhance vaccine uptake among HCW in long-term care facilities. Statement of contribution What is already known on this subject? Seasonal influenza vaccine uptake among health care workers in long-term care settings is suboptimal. Many socio-demographic, psychosocial, and organizational barriers to vaccination have been identified. However, few studies have explored the barriers to vaccination among health care workers in long-term care settings within a behaviour change theory framework. What does this study add? This is the first study to apply the theoretical domains framework to vaccination behaviour. Health care worker vaccine uptake was associated with having previously received the vaccine and the domains Goals, Intentions, Social influences, and Reinforcement. The findings suggest that interventions that target these domains may increase vaccine uptake among health care workers in long-term care facilities. Possible interventions could include vaccination action planning and promoting vaccination as a positive act rather than a professional responsibility.
Collapse
Affiliation(s)
- Eanna Kenny
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
| | - Áine McNamara
- Department of Public Health, HSE West, Merlin Park Hospital, Galway, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Ireland
| |
Collapse
|
36
|
Xu L, Zhao J, Peng Z, Ding X, Li Y, Zhang H, Feng H, Zheng J, Cao H, Ma B, Shi Y, Ma Y, Feng L. An Exploratory Study of Influenza Vaccination Coverage in Healthcare Workers in a Western Chinese City, 2018-2019: Improving Target Population Coverage Based on Policy Interventions. Vaccines (Basel) 2020; 8:E92. [PMID: 32093085 PMCID: PMC7157219 DOI: 10.3390/vaccines8010092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives: To evaluate a policy-based intervention to increase seasonal-influenza-vaccination coverage in healthcare workers in Xining, a city in Western China. Methods: From October 2018 to March 2019, we implemented a free vaccination policy in healthcare workers in Xining. A face-to-face interview with the head of the infection control department and an online survey for medical staff in four tertiary medical facilities was conducted to understand both the implementation of the free policy and influenza vaccination coverage. Possible factors for influenza vaccination among healthcare workers (physician, nurses working on the front-line, HCWs) were investigated by multivariate-logistic regression. Results: Coverage in two hospitals that implemented the free vaccination policy was 30.5% and 25.9%, respectively, which was statistically different to hospitals that did not implement the free policy (7.2% and 8.7%, respectively) (χ2 = 332.56, p < 0.0001). Among vaccinated healthcare workers, 65.5% and 48.6% reported their main reasons for vaccination were a convenient vaccination service and awareness of the free vaccination policy. The reasons for not being vaccinated among the 3389 unvaccinated healthcare workers included: the inconvenient vaccination service (33.8%), believing vaccination was unnecessary (29.7%), concerns about adverse reactions to the vaccine (28.8%), and having to pay for the vaccine (25.6%). Conclusions: Implementing the free vaccination policy, combined with improving the accessibility of the vaccination service, increased seasonal-influenza vaccination-coverage in healthcare workers in Xining.
Collapse
Affiliation(s)
- Lili Xu
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Jinhua Zhao
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Zhibin Peng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.P.); (J.Z.)
| | - Xiaojin Ding
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Yonghong Li
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Huayi Zhang
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Huaxiang Feng
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Jiandong Zheng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.P.); (J.Z.)
| | - Hailan Cao
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Binzhong Ma
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Yan Shi
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Yongcheng Ma
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai 810007, China; (L.X.); (J.Z.); (X.D.); (Y.L.); (H.Z.); (H.F.); (H.C.); (B.M.); (Y.S.)
| | - Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.P.); (J.Z.)
| |
Collapse
|
37
|
Costantino C, Casuccio A, Caracci F, Bono S, Calamusa G, Ventura G, Maida CM, Vitale F, Restivo V. Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons. Vaccines (Basel) 2019; 8:vaccines8010005. [PMID: 31878271 PMCID: PMC7158659 DOI: 10.3390/vaccines8010005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/20/2019] [Accepted: 12/22/2019] [Indexed: 11/26/2022] Open
Abstract
Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs’ awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p < 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7–50.5) to 35.9 years (95% CI: 35.0–36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work.
Collapse
|
38
|
Paoli S, Lorini C, Puggelli F, Sala A, Grazzini M, Paolini D, Bonanni P, Bonaccorsi G. Assessing Vaccine Hesitancy among Healthcare Workers: A Cross-Sectional Study at an Italian Paediatric Hospital and the Development of a Healthcare Worker's Vaccination Compliance Index. Vaccines (Basel) 2019; 7:E201. [PMID: 31795438 PMCID: PMC6963296 DOI: 10.3390/vaccines7040201] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 11/28/2019] [Indexed: 11/17/2022] Open
Abstract
Healthcare workers (HCWs) in paediatric hospitals are an important source of advice on vaccinations, but vaccine hesitancy can affect even these professionals. The aim of this study is to assess this phenomenon, measuring it by means of a scoring system. A survey was conducted in five departments of an Italian paediatric university hospital of national interest. Vaccination against influenza was considered a behavioral indicator of vaccination uptake. Using the collected data, the healthcare worker's vaccination compliance index (HVCI) was computed. The results demonstrate statistically significant differences between departments and professional profiles. Nearly 80% of the sample was not immunized against seasonal influenza. According to the HVCI scores, the most hesitant departments are the intensive care unit, emergency room, and oncohematology department, while the most hesitant professional profiles are nurses and auxiliary staff. The score of the unvaccinated is significantly lower than that of the vaccinated, and the same difference was found between those who self-perceive to be skilled versus unskilled. The HVCI score was statistically verified as a predictive parameter to assess vaccination against seasonal influenza. By means of strategic training policies, both HVCI and perceived skills could be improved, suggesting that hospital management should draw a complex intervention program to fight against hesitancy.
Collapse
Affiliation(s)
- Sonia Paoli
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Chiara Lorini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Francesco Puggelli
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Antonino Sala
- Management Department, Meyer Children’s University Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy;
| | - Maddalena Grazzini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Diana Paolini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Paolo Bonanni
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| |
Collapse
|
39
|
Jenkin DC, Mahgoub H, Morales KF, Lambach P, Nguyen-Van-Tam JS. A rapid evidence appraisal of influenza vaccination in health workers: An important policy in an area of imperfect evidence. Vaccine X 2019; 2:100036. [PMID: 31384750 PMCID: PMC6668237 DOI: 10.1016/j.jvacx.2019.100036] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The World Health Organization recommends vaccination of health workers (HWs) against influenza, but low uptake is intransigent.We conducted a Rapid Evidence Appraisal on: the risk of influenza in HWs, transmission risk from HWs to patients, the benefit of HW vaccination, and strategies for improving uptake. We aimed to capture a 'whole-of-system' perspective to consider possible benefits for HWs, employers and patients. METHODS We executed a comprehensive search of the available literature published from 2006 to 2018 in the English language. We developed search terms for seven separate questions following the PICO framework (population, intervention, comparators, outcomes) and queried nine databases. RESULTS Of 3784 publications identified, 52 met inclusion criteria. Seven addressed HW influenza risk, of which four found increased risk; 15 addressed influenza vaccine benefit to HWs or their employers, of which 10 found benefit; 11 addressed influenza transmission from HWs to patients, of which 6 found evidence for transmission; 12 unique studies addressed whether vaccinating HWs produced patient benefit, of which 9 concluded benefits accrued. Regarding the number of HWs needed to vaccinate (NNV) to deliver patient benefit, NNV estimates ranged from 3 to 36,000 but were in significant disagreement. Fourteen studies provided insights on strategies to improve uptake; the strongest evidence was for mandatory vaccination. CONCLUSIONS The evidence on most questions related to influenza vaccination in HWs is mixed and often of low-quality. Substantial heterogeneity exists in terms of study designs and settings, making comparison between studies difficult. Notwithstanding these limitations, a majority of studies suggests that influenza vaccination benefit HWs and their employers; and HWs are implicated in transmission events. The effects of vaccinating HWs on patient morbidity and mortality may include reductions in all-cause mortality and influenza-like illness (ILI). Taken together, the evidence suggests that HW vaccination is an important policy for HWs themselves, their employers, and their patients.
Collapse
Key Words
- GAVI, the global alliance for vaccines and immunization
- HW, health workers
- Health worker
- Healthcare
- ILI, influenza like illness
- Influenza
- LTCF, long-term care facility(ies)
- NNV, number needed to vaccinate
- OR, odds ratio
- Policy
- RCTs, randomised controlled trials
- RR, relative risk
- Transmission
- Vaccine
- WHO, World Health organization
- cRCTs, clustered randomised controlled trials
Collapse
Affiliation(s)
- Dawn C. Jenkin
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
| | - Hamid Mahgoub
- East of England Health Protection Team, Public Health England, United Kingdom
| | | | | | - Jonathan S. Nguyen-Van-Tam
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
| |
Collapse
|
40
|
Murti M, Otterstatter M, Orth A, Balshaw R, Halani K, Brown PD, Hejazi S, Thompson D, Allison S, Bharmal A, Dawar M, Hoyano D, Lee V, Naus M, Pollock S, Bevanda J, Coughlin S, Fitzgerald J, Keen D, Maracle M, Sprague S, Henry B. Measuring the impact of influenza vaccination on healthcare worker absenteeism in the context of a province-wide mandatory vaccinate-or-mask policy. Vaccine 2019; 37:4001-4007. [DOI: 10.1016/j.vaccine.2019.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/31/2019] [Accepted: 06/09/2019] [Indexed: 11/28/2022]
|
41
|
Pinto L, Falsaperla R, Villani A, Corsello G, Del Gado R, Mazzeo A, Lubrano R. Influenza vaccination: opinions of health care professionals working in pediatric emergency departments. Ital J Pediatr 2019; 45:47. [PMID: 30975224 PMCID: PMC6458720 DOI: 10.1186/s13052-019-0638-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/29/2019] [Indexed: 12/02/2022] Open
Abstract
Background Vaccine coverage of health care professionals against influenza is still low in Italy, as well as in other European countries. Methods Between March and May 2018, this study was performed to collect the opinions of Pediatric health care professionals, working in emergency departments, regarding the efficacy and safety of the influenza vaccine. An anonymous online survey was employed to evaluate socio-demographic and professional characteristics, knowledges, beliefs and attitudes. Results Five hundred four health care professionals completed the survey: 331 physicians, 140 nurses and 33 other health are professionals. During the 2017–18 season, 55.8% of physicians, 19.3% of nurses and 12.1% of other health care professionals had vaccinated against the influenza virus. Not vaccinated physicians and nurses with less than 40 years of age were fewer than not vaccinated physicians and nurses with more than 40 years of age. Nurses and other health care professionals were less trustworthy of the influenza vaccination, less aware of the possibility of contracting and transmitting influenza and other vaccine-preventable diseases. Conclusions Insufficient adherence to the influenza vaccination in physicians, nurses and other health care professionals is a concern for those assisting high-risk patients, especially in emergency departments. Therefore, it is vital to promote education of health care professionals and students regarding vaccinations. High vaccine coverage should be embedded in the safe hospital paradigm and should become a goal for the hospital's directors.
Collapse
Affiliation(s)
- Luciano Pinto
- Società Italiana di Medicina Emergenza Urgenza Pediatrica, Via Nevio 60, 80122, Napoli, Italy.
| | - Raffaele Falsaperla
- Policlinico-Vittorio Emanuele Università di Catania, UOC di Pediatria e Neonatologia, Catania, Italy
| | - Alberto Villani
- Ospedale Pediatrico Bambino Gesù, UOC di Pediatria Generale e Malattie Infettive, Roma, Italy
| | - Giovanni Corsello
- Università degli Studi di Palermo, Clinica Pediatrica Palermo, Palermo, Italy
| | - Roberto Del Gado
- Università degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy
| | - Adolfo Mazzeo
- Università degli Studi di Roma "La Sapienza" UOC di Pediatria e Neonatologia, Polo di Latina, Roma, Italy
| | - Riccardo Lubrano
- Università degli Studi di Roma "La Sapienza" UOC di Pediatria e Neonatologia, Polo di Latina, Roma, Italy
| |
Collapse
|
42
|
Zaffina S, Gilardi F, Rizzo C, Sannino S, Brugaletta R, Santoro A, Castelli Gattinara G, Ciofi degli Atti ML, Raponi M, Vinci MR. Seasonal influenza vaccination and absenteeism in health-care workers in two subsequent influenza seasons (2016/17 and 2017/18) in an Italian pediatric hospital. Expert Rev Vaccines 2019; 18:411-418. [DOI: 10.1080/14760584.2019.1586541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Salvatore Zaffina
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Francesco Gilardi
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Caterina Rizzo
- Unit of Innovation and Clinical Pathways, Direction of Clinical Departments, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Serena Sannino
- Health Directorate, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Rita Brugaletta
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Annapaola Santoro
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Guido Castelli Gattinara
- Vaccination Unit, University Hospital Paediatric Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | | | | |
Collapse
|
43
|
Bonaccorsi G, Pieralli F, Innocenti M, Milani C, Del Riccio M, Bechini A, Boccalini S, Bonanni P, Lorini C. Non-familial paid caregivers as potential flu carriers and cause of spread: the primary prevention of flu measured through their adhesion to flu vaccination campaigns-A Florentine experience. Hum Vaccin Immunother 2019; 15:2416-2422. [PMID: 30883258 PMCID: PMC6816408 DOI: 10.1080/21645515.2019.1593726] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Influenza vaccination is recommended for caregivers of elderly people. In a study aimed at assessing the level of health literacy (HL) in a sample non-familial caregivers in the Florence Health District (Tuscany), data were collected regarding access and adherence to the flu vaccination campaigns. Methods: The sample consists of 47 non-familial paid caregivers. We collected information regarding socio-demographic characteristics, services provided and daily work time, whether or not influenza vaccination was administered for the 2016/2017 season and in the previous three years. The level of HL was assessed through the Newest Vital Sign. Results: 63.8% of non-familial caregivers have not joined the flu campaigns over the last four years, 14.9% have been vaccinated only sometimes (in some epidemic seasons), and 21.3% have received a flu shot in all the seasons investigated. Most of the non-familial caregivers who do not get vaccinated (27.7%) do not perceive that they are in direct contact with a person at-risk; those who get the vaccine regularly (12.8%) reported they want to protect the assisted person as motivation for vaccine uptake. Vaccination was not associated with HL. Conclusion: Adhesion to anti-flu vaccination campaigns for these homecare workers has been resulted rather poor. Coverage does not seem to be related with HL level. It seems appropriate to promote extensively flu vaccination among family carers by actively offering the vaccination in appropriate forms, places and times, to avoid serious consequences on elderly people with higher risk of comorbidity and frailty.
Collapse
Affiliation(s)
| | - Francesca Pieralli
- School of Specialization in Hygiene and Public Health, University of Florence , Firenze , Italy
| | - Maddalena Innocenti
- School of Specialization in Hygiene and Public Health, University of Florence , Firenze , Italy
| | - Chiara Milani
- School of Specialization in Hygiene and Public Health, University of Florence , Firenze , Italy
| | - Marco Del Riccio
- School of Specialization in Hygiene and Public Health, University of Florence , Firenze , Italy
| | - Angela Bechini
- Department of Health Sciences, University of Florence , Firenze , Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence , Firenze , Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence , Firenze , Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence , Firenze , Italy
| |
Collapse
|
44
|
Stead M, Critchlow N, Patel R, MacKintosh AM, Sullivan F. Improving uptake of seasonal influenza vaccination by healthcare workers: Implementation differences between higher and lower uptake NHS trusts in England. Infect Dis Health 2019; 24:3-12. [DOI: 10.1016/j.idh.2018.09.082] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
|
45
|
Mandatory policies for influenza vaccination: Views of managers and healthcare workers in England. Vaccine 2019; 37:69-75. [PMID: 30470641 DOI: 10.1016/j.vaccine.2018.11.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/08/2018] [Accepted: 11/13/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Mandatory policies have the potential to increase uptake of influenza ('flu') vaccination among healthcare workers (HCWs), but concerns have been expressed about their acceptability and effectiveness. We explored views on three mandatory policies (declination forms, face masks or reduced patient contact, and mandatory vaccination) among both HCWs and flu vaccination programme managers in the National Health Service (NHS) in England. METHOD A mixed method approach was employed. An online cross-sectional survey was conducted with staff responsible for implementing influenza campaigns in NHS trusts (healthcare organisations) in England (n = 72 trusts). The survey measured perceived effectiveness of the three mandatory policies and perceived support for them among HCWs. Qualitative interviews were conducted in four trusts, with influenza campaign managers (n = 24) and with HCWs who had the opportunity to receive the influenza vaccination (n = 32). Interviews explored respondents' views of the three strategies and were analysed thematically using QSR NVivo 11 All data were collected shortly after the 2016/2017 influenza season. RESULTS In the survey, views varied on the effectiveness of the three policies and none of the interventions were thought to be strongly supported by HCWs, with particularly low levels of support perceived for mandatory vaccination and for face masks or reduced patient contact. The qualitative interviews revealed substantial concerns around the practicability and enforceability of mandatory policies and the potential discriminatory effect on HCWs who made a principled decision or had medical reasons for exemption. Additional doubts were also expressed regarding the effectiveness of face masks and their potential to worry patients, and the ethics of compelling staff to accept medical intervention. DISCUSSION Mandatory vaccination and face masks would not be strongly supported if introduced in the UK. If declination forms are adopted, they should be used in a constructive intelligence-gathering manner which avoids stigmatising HCWs.
Collapse
|
46
|
Maltezou HC, Theodoridou K, Ledda C, Rapisarda V, Theodoridou M. Vaccination of healthcare workers: is mandatory vaccination needed? Expert Rev Vaccines 2018; 18:5-13. [PMID: 30501454 DOI: 10.1080/14760584.2019.1552141] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational acquisition of vaccine-preventable diseases (VPDs) and to indirectly protect their patients and the essential healthcare infrastructure. However, outbreaks due to VPDs continue to challenge healthcare facilities and HCWs are frequently traced as sources of VPDs to vulnerable patients. In addition, HCWs were disproportionately affected during the current measles outbreak in Europe. Areas covered: We reviewed the recent published information about HCWs vaccinations with a focus on mandatory vaccination policies. Expert commentary: Although many countries have vaccination programs specifically for HCWs, their vaccination coverage remains suboptimal and a significant proportion of them remains susceptible to VPDs. The increasing vaccination hesitancy among HCWs is of concern, given their role as trusted sources of information about vaccines. Mandatory vaccinations for HCWs are implemented for specific VPDs in few countries. Mandatory influenza vaccination of HCWs was introduced in the United States a decade ago with excellent results. Mandatory vaccinations for VPDs that may cause significant morbidity and mortality should be considered. Issues of mistrust and misconceptions about vaccinations should also be addressed.
Collapse
Affiliation(s)
- Helena C Maltezou
- a Department for Interventions in Health-Care Facilities , Hellenic Center for Disease Control and Prevention , Athens , Greece
| | - Kalliopi Theodoridou
- b Department of Microbiology , Medical School of National and Kapodistrian University of Athens , Athens , Greece
| | - Caterina Ledda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Venerando Rapisarda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Maria Theodoridou
- d First Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece
| |
Collapse
|
47
|
Yao KH. [Some thoughts on influenza vaccine and regular influenza vaccination for healthcare workers]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:881-886. [PMID: 30477616 PMCID: PMC7389024 DOI: 10.7499/j.issn.1008-8830.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/20/2018] [Indexed: 06/09/2023]
Abstract
It has been 100 years since the 1918 influenza pandemic but influenza is still an uncontrolled infectious disease. In some developed countries, the coverage rate of influenza vaccine can reach as high as 60%-70%, and even up to 90% or higher in some specific population, such as the elderly and healthcare workers. The coverage rate of influenza vaccination in Chinese people, however, is very low, only about 2%-3% per year. The limitations of influenza vaccine, and the purpose and significance of influenza vaccination, the imbalance of vaccine information and the importance of inoculation for healthcare workers are discussed in this paper. The resistance to popularize influenza vaccination is explored from different perspectives. It is hoped that more people will recognize the objective epidemiological data, and get rid of misunderstandings based on their experiences. Healthcare workers in particular, and the general population, should be encouraged to have an influenza vaccination.
Collapse
Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China.
| |
Collapse
|
48
|
Yao KH. [Some thoughts on influenza vaccine and regular influenza vaccination for healthcare workers]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:881-886. [PMID: 30477616 PMCID: PMC7389024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/20/2018] [Indexed: 11/12/2023]
Abstract
It has been 100 years since the 1918 influenza pandemic but influenza is still an uncontrolled infectious disease. In some developed countries, the coverage rate of influenza vaccine can reach as high as 60%-70%, and even up to 90% or higher in some specific population, such as the elderly and healthcare workers. The coverage rate of influenza vaccination in Chinese people, however, is very low, only about 2%-3% per year. The limitations of influenza vaccine, and the purpose and significance of influenza vaccination, the imbalance of vaccine information and the importance of inoculation for healthcare workers are discussed in this paper. The resistance to popularize influenza vaccination is explored from different perspectives. It is hoped that more people will recognize the objective epidemiological data, and get rid of misunderstandings based on their experiences. Healthcare workers in particular, and the general population, should be encouraged to have an influenza vaccination.
Collapse
Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China.
| |
Collapse
|
49
|
Pereira M, Williams S, Restrick L, Cullinan P, Hopkinson NS. Response. Clin Med (Lond) 2018; 18:268-269. [PMID: 29858447 PMCID: PMC6334084 DOI: 10.7861/clinmedicine.18-3-268a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Louise Restrick
- London Respiratory Network and Whittington Health, London, UK
| | | | - Nicholas S Hopkinson
- London Respiratory Network and NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, UK
| |
Collapse
|
50
|
O'Reilly F, Noone P. Flu-related absence, a small proportion of all-cause sickness absence. Clin Med (Lond) 2018; 18:268. [PMID: 29858446 PMCID: PMC6334075 DOI: 10.7861/clinmedicine.18-3-268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|