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Green-McKenzie J, Shofer FS, Kruse G, Momplaisir F, Brennan PJ, Kuter BJ. COVID-19 vaccine uptake before and after a vaccine mandate at a major academic hospital: Trends by race/ethnicity and level of patient contact. Vaccine 2023; 41:5441-5446. [PMID: 37517911 DOI: 10.1016/j.vaccine.2023.07.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To assess vaccine coverage rates before and after implementation of a COVID-19 vaccine mandate among Health care Personnel (HCP) and demographic characteristics associated with vaccine uptake Design, Setting, and Participants: Cohort study conducted among 10,889 hospital employees followed from Dec 16, 2020 - October 31, 2021, at a large academic hospital in Philadelphia. MAIN OUTCOME AND MEASURES Time to COVID-19 vaccination and vaccine series completion rates before and after implementation of a COVID-19 vaccine mandate based on age, gender, race/ethnicity, and level of patient contact/occupational group. RESULTS The vaccination series completion rate was 86.0% prior to mandate announcement, and increased to 98.7% after mandate implementation. Rates before mandate announcement were highest among Asians (96.2%), Whites (94.0%), males (89.7%), employees ≥ 65 years of age (95.2%), and employees with direct patient care (physicians, 99.0%, and nurses, 93.3%). Hospital educational initiatives (including Town Halls and discussions with Black and Hispanic employees with the lowest vaccination rates) appeared to improve uptake. The largest increase in series completion after mandate announcement occurred among Blacks, those of other/multiracial backgrounds, and Hispanics (35.6%, 22.4%, and 10.8%, respectively) as well as those with some or no direct patient contact (24.5% and 18.3%, respectively). Medical or religious exemptions were approved for 64 (<0.6%) employees and 38 (<0.4%) left their positions (8 voluntary, 30 involuntary) specifically due to the COVID-19 vaccine mandate. No clinically meaningful differences by age, gender, or race/ethnicity for those who were vaccinated under the mandate versus those who left their positions were noted. CONCLUSIONS AND RELEVANCE These results suggest that while mandates may be challenging to institutions and enforcement unpopular, they play an important role in reducing hesitancy and securing high vaccination rates among HCP, a group at high risk of COVID-19 given their employment and who can be a source of disease transmission to patients.
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Affiliation(s)
- Judith Green-McKenzie
- Professor & Chief, Division of Occupational Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; Leonard Davis Institute, University of Pennsylvania Perelman School of Medicine, United States.
| | - Frances S Shofer
- Director & Adjunct Professor of Epidemiology & Biostatistics, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States
| | - Gregory Kruse
- Associate Vice President of Strategic Operations, University of Pennsylvania Perelman School of Medicine, United States
| | - Florence Momplaisir
- Leonard Davis Institute, University of Pennsylvania Perelman School of Medicine, United States; Assistant Professor, University of Pennsylvania, Perelman School of Medicine, Department of Medicine, Division of Infectious Diseases, United States
| | - Patrick J Brennan
- Chief Medical Officer and Senior Vice President, University of Pennsylvania Health System, United States
| | - Barbara J Kuter
- Visiting Research Scientist, Vaccine Education Center, Children's Hospital of Philadelphia, United States
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Rubinstein EB, Rayel H, Crawford EC, Larson M. Using a rapid ethnographic assessment to explore vaccine hesitancy on a public university campus in the Upper Midwest. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37399535 DOI: 10.1080/07448481.2023.2225628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023]
Abstract
Objective: This exploratory study examined campus attitudes toward vaccines to guide subsequent development of context-relevant interventions for increasing vaccine acceptance and uptake. Participants: We gathered ethnographic data on a convenience sample of campus community members (students, faculty, staff) at a public university over six weeks in spring 2022. Methods: Student researchers conducted a rapid ethnographic assessment across campus locations. Weekly team debriefs enabled ongoing, iterative refinement of instruments and supplemented observational fieldnotes. Data analysis was inductive and oriented toward practical recommendations for intervention development. Results: Four themes, and attendant recommendations, emerged: 1) social identities and social roles influence health-related beliefs, including vaccination; 2) vaccine knowledge influences vaccination behaviors; 3) language surrounding vaccines (sometimes) matters; 4) vaccines aren't considered part of general health and wellness and can't be forced. Conclusions: Findings highlight the need to address individual, social, and institutional contexts when designing campus-based behavioral interventions for vaccine uptake.
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Affiliation(s)
- Ellen B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA
| | - Hannah Rayel
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
| | - Elizabeth C Crawford
- Department of Communication, North Dakota State University, Fargo, North Dakota, USA
| | - Mary Larson
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
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3
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Rubenstein BL, Amiel PJ, Ternier A, Helmy H, Lim S, Chokshi DA, Zucker JR. Increases In COVID-19 Vaccination Among NYC Municipal Employees After Implementation Of Vaccination Requirements. Health Aff (Millwood) 2023; 42:357-365. [PMID: 36877900 PMCID: PMC10917388 DOI: 10.1377/hlthaff.2022.00809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
In July 2021 New York City (NYC) instituted a requirement for all municipal employees to be vaccinated against COVID-19 or undergo weekly testing. The city eliminated the testing option November 1 of that year. We used general linear regression to compare changes in weekly primary vaccination series completion among NYC municipal employees ages 18-64 living in the city and a comparison group of all other NYC residents in this age group during May-December 2021. The rate of change in vaccination prevalence among NYC municipal employees was greater than that of the comparison group only after the testing option was eliminated (employee slope = 12.0; comparison slope = 5.3). Among racial and ethnic groups, the rate of change in vaccination prevalence among municipal employees was higher than the comparison group for Black and White people. The requirements were associated with narrowing the gap in vaccination prevalence between municipal employees and the comparison group overall and between Black municipal employees and employees from other racial and ethnic groups. Workplace requirements are a promising strategy for increasing vaccination among adults and reducing racial and ethnic disparities in vaccination uptake.
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Affiliation(s)
- Beth L Rubenstein
- Beth L. Rubenstein , New York City Department of Health and Mental Hygiene, Queens, New York; and Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pierre J Amiel
- Pierre J. Amiel, NYC Department of Health and Mental Hygiene; and CDC Foundation, Atlanta, Georgia
| | | | - Hannah Helmy
- Hannah Helmy, NYC Department of Health and Mental Hygiene
| | - Sungwoo Lim
- Sungwoo Lim, NYC Department of Health and Mental Hygiene
| | - Dave A Chokshi
- Dave A. Chokshi, City University of New York and New York University, New York, New York
| | - Jane R Zucker
- Jane R. Zucker, NYC Department of Health and Mental Hygiene; and CDC
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Lee JT, Sean Hu S, Zhou T, Bonner KE, Kriss JL, Wilhelm E, Carter RJ, Holmes C, de Perio MA, Lu PJ, Nguyen KH, Brewer NT, Singleton JA. Employer requirements and COVID-19 vaccination and attitudes among healthcare personnel in the U.S.: Findings from National Immunization Survey Adult COVID Module, August - September 2021. Vaccine 2022; 40:7476-7482. [PMID: 35941037 PMCID: PMC9234000 DOI: 10.1016/j.vaccine.2022.06.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Employer vaccination requirements have been used to increase vaccination uptake among healthcare personnel (HCP). In summer 2021, HCP were the group most likely to have employer requirements for COVID-19 vaccinations as healthcare facilities led the implementation of such requirements. This study examined the association between employer requirements and HCP's COVID-19 vaccination status and attitudes about the vaccine. METHODS Participants were a national representative sample of United States (US) adults who completed the National Immunization Survey Adult COVID Module (NIS-ACM) during August-September 2021. Respondents were asked about COVID-19 vaccination and intent, requirements for vaccination, place of work, attitudes surrounding vaccinations, and sociodemographic variables. This analysis focused on HCP respondents. We first calculated the weighted proportion reporting COVID-19 vaccination for HCP by sociodemographic variables. Then we computed unadjusted and adjusted prevalence ratios for vaccination coverage and key indicators on vaccine attitudes, comparing HCP based on individual self-report of vaccination requirements. RESULTS Of 12,875 HCP respondents, 41.5% reported COVID-19 vaccination employer requirements. Among HCP with vaccination requirements, 90.5% had been vaccinated against COVID-19, as compared to 73.3% of HCP without vaccination requirements-a pattern consistent across sociodemographic groups. Notably, the greatest differences in uptake between HCP with and without employee requirements were seen in sociodemographic subgroups with the lowest vaccination uptake, e.g., HCP aged 18-29 years, HCP with high school or less education, HCP living below poverty, and uninsured HCP. In every sociodemographic subgroup examined, vaccine uptake was more equitable among HCP with vaccination requirements than in HCP without. Finally, HCP with vaccination requirements were also more likely to express confidence in the vaccine's safety (68.3% vs. 60.1%) and importance (89.6% vs 79.6%). CONCLUSION In a large national US sample, employer requirements were associated with higher and more equitable HCP vaccination uptake across all sociodemographic groups examined. Our findings suggest that employer requirements can contribute to improving COVID-19 vaccination coverage, similar to patterns seen for other vaccines.
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Affiliation(s)
- James T. Lee
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA,Corresponding author
| | - S. Sean Hu
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Tianyi Zhou
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA,Leidos Inc, 2295 Parklake Dr NE Suite 300, Atlanta, GA 30345, USA
| | - Kimberly E. Bonner
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA,Epidemic Intelligence Service, CDC, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | | | | | | | - Carissa Holmes
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | | | - Peng-jun Lu
- CDC COVID-19 Response, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | | | - Noel T. Brewer
- UNC Gillings School of Global Public Health, 325 Rosenau Hall CB #7440 Chapel Hill, NC 27599, USA
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Regan AK, Wesley MG, Gaglani M, Kim SS, Edwards LJ, Murthy K, Jeddy Z, Naleway AL, Flannery B, Dawood FS, Groom H. Consistency of self-reported and documented historical influenza vaccination status of US healthcare workers. Influenza Other Respir Viruses 2022; 16:881-890. [PMID: 35415884 PMCID: PMC9343323 DOI: 10.1111/irv.12988] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Healthcare personnel (HCP) are a priority group for annual influenza vaccination. Few studies have assessed the validity of recall of prior influenza vaccination status among HCP, especially for more than one preceding season. METHODS Using data from a randomized controlled trial of influenza vaccination among 947 HCP from two US healthcare systems, we assessed agreement between participant self-report and administrative record documentation of influenza vaccination status during the preceding five influenza seasons; kappa coefficients and sensitivity values were calculated. Administrative record documentation was considered the gold standard. Documented vaccination sources included electronic medical records, employee health records, outside immunization providers, and the state immunization information system. RESULTS Among 683 HCP with prior influenza immunization information, 89.7% (95% CI: 87.2%, 91.9%) of HCP were able to self-report their vaccination status for the season preceding the survey. By the fifth preceding season, 82.6% (95% CI: 79.5%, 85.3%) of HCP were able to self-report. Among HCP who self-reported their vaccination status, agreement between self-report and documented vaccination status ranged from 81.9% (95% CI: 77.2%, 86.7%) for the fifth season to 90.5% (95% CI: 87.2%, 93.9%) for the season preceding interview. HCP who received vaccine for only some of the preceding five seasons (18.3%) more commonly had ≥2 errors in their recall compared with those vaccinated all five preceding seasons (55.7% vs. 4.3%). CONCLUSIONS Self-reported vaccination status is a reliable source for historical influenza vaccination information among HCP who are consistently vaccinated but less reliable for those with a history of inconsistent vaccination.
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Affiliation(s)
- Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, Orange, California, USA.,Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia.,School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Meredith G Wesley
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Abt Associates, Atlanta, Georgia, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, Texas, USA.,Texas A&M University College of Medicine, College Station, Texas, USA
| | - Sara S Kim
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | - Allison L Naleway
- The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fatimah S Dawood
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Holly Groom
- The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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Eltvedt AK, Poulsen A, Winther TN, Von Linstow ML. Barriers for vaccination of healthcare workers. Hum Vaccin Immunother 2021; 17:3073-3076. [PMID: 33905303 DOI: 10.1080/21645515.2021.1904760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Outbreaks of vaccine preventable diseases (VPDs) in hospital settings remain a challenge even in countries with established (childhood-) vaccination programs. Healthcare workers (HCWs) with an updated vaccination card play an important role in reducing the risk of nosocomial spread of VPDs. Yet, in many places, HCWs report their immunization status to be unknown or not updated. In times of a global pandemic, the debate on vaccination of HCWs is as hot as ever; do HCWs have an increased responsibility to get vaccinated against VPDs? If so, how do we increase vaccination uptake rates among HCWs? Mandatory vaccination against VPDs for HCWs has been introduced in some countries, but it may cause ethical dilemmas and not be culturally acceptable everywhere. We looked at vaccination policies and HCWs' attitudes toward immunization against VPDs. We found that missing vaccine policies and lack of knowledge of VPDs, vaccination benefits, as well as inadequate organization around HCWs' immunizations were important barriers to have a complete vaccination record. A systematic approach to employees providing information of VPDs and vaccinations, going through their vaccination cards and offering antibody testing where appropriate or a shot of a missing vaccine could support staff to adhere to vaccination schemes.
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Affiliation(s)
- Anna Korsgaard Eltvedt
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thilde Nordmann Winther
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - Marie-Louise Von Linstow
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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7
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Use of a comprehensive program to review religious and personal seasonal influenza vaccination exemption requests by healthcare personnel. Infect Control Hosp Epidemiol 2020; 42:507-512. [PMID: 33118915 DOI: 10.1017/ice.2020.1260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Vanderbilt University Medical Center (VUMC) requires that all faculty and staff receive the seasonal influenza vaccine annually or receive an approved vaccine exemption, either for a medical or deeply held religious or personal belief. We sought to understand the underlying principles behind these exemption requests and their interaction with a multidisciplinary exemption review process. DESIGN All of the personal and religious exemption requests at VUMC for 3 consecutive influenza seasons from 2015 to 2018 were analyzed, categorizing these requests by 1 of 12 standardized employee categories and 1 of 18 unique reasons for vaccine exemption. SETTING Tertiary-care academic medical center. PARTICIPANTS Healthcare personnel (HCP). RESULTS Among the 3 influenza seasons, 1.1%-2.1% of all VUMC HCP requested religious or personal exemption from vaccination. The frequency of religious and personal exemption approval increased annually from 296 of 452 (65.5%) to 196 of 248 (80.2%) to 283 of 323 (87.6%) over the 3 seasons, representing a statistically significant increase each year. Of the 5 most common reasons against vaccination, 4 were explicitly religious in nature; the most common reason was that the "body is a temple or sacred." Nonclinical staff submitted the most religious and personal exemption requests of any job category, submitting approximately one-third of all requests every year. CONCLUSIONS These results demonstrate how detailed the personal or religious convictions behind vaccine avoidance can be among HCP and how vaccine avoidance stems from much more than simple misinformation regarding vaccination. The intersection between misinformation and personal or religious beliefs provides a unique opportunity to address HCP opinions toward vaccination in an exemption and appeals process like the one described here.
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Waheed A, Waheeb Y, Hassan A, Fahim A. Seasonal influenza vaccination coverage and barriers among healthcare workers in an Egyptian Province. LA MEDICINA DEL LAVORO 2020; 111:449-456. [PMID: 33311420 PMCID: PMC7809988 DOI: 10.23749/mdl.v111i6.9489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022]
Abstract
Background: Influenza vaccination uptake by Egyptian healthcare workers remains sub-optimal despite local initiatives and infection control programs to increase it. Objective: To assess vaccination coverage and investigate health care workers’ barriers and also motivators toward seasonal influenza vaccination. Methods: An interview questionnaire survey and focus group sessions were conducted to measure uptake and assess barriers to seasonal influenza vaccination among HCWs in main hospitals and primary care centers in Ismailia city. Results: There were 980 participants, of whom 131 (13.4%) reported having received influenza vaccination in last season 2018/2019. Females were 76.8% of participants, and nurses were the main occupational category of study sample (80.4%). The most commonly reported motivator (97.7%) was “protection of oneself and family members” among the vaccinated participants. The top barriers among non-vaccinated ranked by their Relative Importance Index (RII), included lack of instruction by supervisors RII=0.82, lack of awareness about vaccine benefits RII=0.79 and lack of awareness from where to get the vaccine RII=0.71. Predictors of non-vaccination included belief that the vaccine itself may induce influenza (OR: 1.9 p<0.05, CI, 1.3-2.8) and the perception that vaccination is ineffective (OR: 2.8 p<0.05, CI, 1.5-5.2), and lack of knowledge about the vaccinations recommended for health care workers (OR: 1.9 p<0.05, CI, 1.2-2.8). Conclusions: Addressing specific barriers to influenza vaccination uptake among healthcare workers may improve vaccination rate. Targeted evidence-based promotion campaigns and programs should be established to overcome identified barriers.
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Affiliation(s)
- Amani Waheed
- Department of Community Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Youssef Waheeb
- Department of Community Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Adel Hassan
- Department of Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Ayman Fahim
- Department of Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
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9
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Petek D, Kamnik-Jug K. Motivators and barriers to vaccination of health professionals against seasonal influenza in primary healthcare. BMC Health Serv Res 2018; 18:853. [PMID: 30428886 PMCID: PMC6234642 DOI: 10.1186/s12913-018-3659-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the last decade, the vaccination rates amongst the general population in Slovenia were declining. According to the World Health Organisation, the vaccination rates amongst healthcare workers are also low throughout Europe. The aim of this study was to evaluate vaccination rates for seasonal flu amongst healthcare workers on the primary care level in the Koroška region and to find motivators and barriers for vaccination. METHODS In a cross-sectional study, an anonymous questionnaire was distributed to all health centres, nursing homes and private contractors, who agreed to participate. Out of 334 distributed questionnaires, 250 (74.8%) were analysed. Bivariate and multivariable statistical analyses were conducted. RESULTS Only 12% of included health professionals were vaccinated in the 2014/15 season. The main motivators for vaccination coverage were: awareness of high risk of infection at the workplace, self-protection and protection of family members and co-workers. The main barriers for vaccination were doubt in the effectiveness of the vaccine, fear of side effects and the belief that health professionals are not at high risk of influenza infection. In the multivariable model, a positive association was found between the vaccination, older age and belief in the effectiveness against influenza, while a negative association was found between the nurses' profession and vaccination. CONCLUSION The trend of declining rates for seasonal influenza vaccination is continuing. Protection of the patients was not among the most important reasons for vaccination. This especially endangers clients of nursing homes. The recognized motivators, barriers and other factors that were important for vaccination coverage/hesitancy could be used for designing strategies and educational programmes for health professionals to improve the vaccination coverage rates. The strategy should include the specifics of health profession groups.
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Affiliation(s)
- Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000, Ljubljana, Slovenia.
| | - Kristina Kamnik-Jug
- Primary Health Care Centre Slovenj Gradec, Partizanska pot 16, 2380, Slovenj Gradec, Slovenia
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10
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Seale H. Don't forget healthcare workers are required to have other mandatory immunizations, so why isn't the influenza vaccination included? Expert Rev Respir Med 2018; 12:805-807. [PMID: 30106607 DOI: 10.1080/17476348.2018.1512410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Holly Seale
- a School of Public Health and Community Medicine , UNSW Australia , Sydney , Australia
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11
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Babcock HM. Continuing to Move the Needle on Health Care Personnel Influenza Vaccination Rates. JAMA Netw Open 2018; 1:e180144. [PMID: 30646059 DOI: 10.1001/jamanetworkopen.2018.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hilary M Babcock
- Washington University School of Medicine, St Louis, Missouri
- Infection Prevention and Epidemiology Consortium, BJC HealthCare, St Louis, Missouri
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12
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Fernández-Villa T, Molina AJ, Torner N, Castilla J, Astray J, García-Gutiérrez S, Mayoral JM, Tamames S, Domínguez Á, Martín V. Factors associated with acceptance of pandemic flu vaccine by healthcare professionals in Spain, 2009-2010. Res Nurs Health 2017; 40:435-443. [PMID: 28805243 DOI: 10.1002/nur.21815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/29/2017] [Indexed: 11/11/2022]
Abstract
The A(H1N1)pdm09 influenza virus reached pandemic level in Spain in 2009, prompting a national vaccination campaign. To avoid transmission to patients, healthcare professionals' vaccination against pandemic influenza is crucial. The main objective of this study was to analyze factors associated with the failure by healthcare professionals to accept the pandemic vaccination in 2009. A cross-sectional survey was conducted of healthcare professionals in seven of Spain's autonomous regions. A questionnaire was used to collect information about personal and professional details, the respondents' flu vaccination status in the 2008-2009 and 2009-2010 seasons (seasonal and pandemic vaccines), and their knowledge and attitudes. A total of 1,661 professionals completed the survey. In the 2009-2010 season, 38.2% had both the seasonal and the pandemic vaccine, 22.1% had had only the seasonal, and 4.7% only the pandemic vaccine. The strongest predictor of not receiving the pandemic vaccine was not having had seasonal vaccinations in that year or the previous year. Those who had not received the pandemic vaccine were more often female; nurses; under 45; denied contact with at-risk groups; and had negative beliefs about the vaccine effectiveness and little concern for getting the disease, being infected at work, or passing it on to patients. It would be prudent to direct preventive campaigns not only at individuals at risk of catching flu but also at health professionals with a negative view of flu vaccine, with a particular focus on nurses, who have a key role in recommending flu vaccine.
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Affiliation(s)
- Tania Fernández-Villa
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Antonio J Molina
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Nuria Torner
- Agencia de Salud Pública de Cataluña, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jesus Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | | | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | | | - Vicente Martín
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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13
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Elias C, Fournier A, Vasiliu A, Beix N, Demillac R, Tillaut H, Guillois Y, Eyebe S, Mollo B, Crépey P. Seasonal influenza vaccination coverage and its determinants among nursing homes personnel in western France. BMC Public Health 2017; 17:634. [PMID: 28687075 PMCID: PMC5501011 DOI: 10.1186/s12889-017-4556-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 06/29/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Influenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide. Vaccination coverage among residents is high but poorly effective due to immunosenescence. Hence, vaccination of personnel is an efficient way to protect residents. Our objective was to quantify the seasonal influenza vaccination (IV) coverage among NH for elderly workers and identify its determinants in France. METHODS We conducted a cross-sectional study in March 2016 in a randomized sample of NHs of the Ille-et-Vilaine department of Brittany, in western France. A standardized questionnaire was administered to a randomized sample of NH workers for face-to-face interviews. General data about the establishment was also collected. RESULTS Among the 33 NHs surveyed, IV coverage for the 2015-2016 season among permanent workers was estimated at 20% (95% Confidence Interval (CI) 15.3%-26.4%) ranging from 0% to 69% depending on the establishments surveyed. Moreover, IV was associated with having previously experienced a "severe" influenza episode in the past (Prevalence Ratio 1.48, 95% CI 1.01-2.17), and varied by professional categories (p < 0.004) with better coverage among administrative staff. Better knowledge about influenza prevention tools was also correlated (p < 0.001) with a higher IV coverage. Individual perceptions of vaccination benefits had a significant influence on the IV coverage (p < 0.001). Although IV coverage did not reach a high rate, our study showed that personnel considered themselves sufficiently informed about IV. CONCLUSIONS IV coverage remains low in the NH worker population in Ille-et-Vilaine and also possibly in France. Strong variations of IV coverage among NHs suggest that management and working environment play an important role. To overcome vaccine "hesitancy", specific communication tools may be required to be adapted to the various NH professionals to improve influenza prevention.
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Affiliation(s)
- Christelle Elias
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Anna Fournier
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Anca Vasiliu
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Nicolas Beix
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Rémi Demillac
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Epiter, F-94415 Saint-Maurice, France
| | - Hélène Tillaut
- Santé publique France, Cellule d’intervention en région Bretagne, F-94415 Saint-Maurice, France
| | - Yvonnick Guillois
- Santé publique France, Cellule d’intervention en région Bretagne, F-94415 Saint-Maurice, France
| | - Serge Eyebe
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Bastien Mollo
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Pascal Crépey
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- UMR “Emergence des Pathologies Virales”, Aix-Marseille University - IRD 190 - Inserm 1207 - EHESP, Marseille, France
- EA 7449 Reperes, EHESP - Université de Rennes 1, Rennes, France
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14
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Haridi HK, Salman KA, Basaif EA, Al-Skaibi DK. Influenza vaccine uptake, determinants, motivators, and barriers of the vaccine receipt among healthcare workers in a tertiary care hospital in Saudi Arabia. J Hosp Infect 2017; 96:268-275. [PMID: 28283372 DOI: 10.1016/j.jhin.2017.02.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/05/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Influenza vaccination of healthcare workers (HCWs) is essential for patient safety, their own safety, and hospital operation. However, despite its strong recommendation, studies indicates a low rate of vaccine uptake. AIM To assess rates of, and factors affecting, influenza vaccine uptake among HCWs. METHODS A cross-sectional survey was carried out during October 1st to 16th, 2015, among HCWs in King Abdullah Medical City in Makkah, Saudi Arabia. A self-administered, anonymous questionnaire was distributed to HCWs; this included questions on demographic characteristics, vaccine uptake, and knowledge, beliefs, attitude, and concern about influenza vaccine. FINDINGS Out of 500 HCWs approached, 447 returned valid self-reported questionnaires with response rate 89.4%. Overall, 88.3% of the participants reported receiving vaccination during the 2014/15 season, higher than during the 2013/14 (61.2%) and 2012/13 (54.5%) seasons. Self-protection (81.5%) was the main reason for vaccination, whereas 73.4% of HCWs reported vaccination to protect patients. The main reasons for vaccination avoidance were misconception that the vaccine causes influenza (38.5%) and concern about vaccine efficacy (32.7%). Logistic regression analysis revealed that the following were independently associated with vaccine receipt among HCWs: awareness of vaccine guidelines; intention to receive the vaccine next season; nurses and other HCWs compared to physicians; longer practice; and age >40 years. CONCLUSION A good uptake of influenza vaccine was achieved during the 2014/15 season following adoption of mandatory vaccination policy. Awareness programmes are needed to correct HCWs' misconceptions about the vaccine. Efforts need to focus especially on physicians, younger staff and new recruits.
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Affiliation(s)
- H K Haridi
- General Directorate of Health Affairs, Hail Region, Saudi Arabia; King Abdulla Medical City, Makkah, Saudi Arabia.
| | - K A Salman
- King Abdulla Medical City, Makkah, Saudi Arabia
| | - E A Basaif
- King Abdulla Medical City, Makkah, Saudi Arabia
| | - D K Al-Skaibi
- General Directorate of Health Affairs, Hail Region, Saudi Arabia
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15
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Lin CJ, Nowalk MP, Raymund M, Sweeney PM, Zimmerman RK. Association of State Laws and Healthcare Workers’ Influenza Vaccination Rates. J Natl Med Assoc 2016; 108:99-102. [DOI: 10.1016/j.jnma.2015.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Borggreve SJ, Timen A. Barriers encountered during the implementation of a policy guideline on the vaccination of health care workers during the 2013-2014 measles outbreak in the Netherlands: a qualitative study. BMC Res Notes 2015; 8:780. [PMID: 26667824 PMCID: PMC4678470 DOI: 10.1186/s13104-015-1756-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/26/2015] [Indexed: 11/13/2022] Open
Abstract
Background In 2013 the Netherlands faced a measles epidemic, during which more than 2600 individuals were infected, including 19 health care workers (HCW). Vaccinating health care workers can lead to benefits on both the individual and public health level, underscoring the need for HCW vaccination. In June of 2013 the Dutch National Institute for Public Health and the Environment (RIVM) developed a measles guideline (MG) that advised Dutch hospitals to strengthen their policies concerning measles vaccination of HCWs. A key problem with guidelines, however, is adherence, which can be due to several barriers. The objective of this research was to identify the barriers that Dutch hospital professionals encountered during the implementation of this policy guideline, in order to improve the implementation of similar policies in the future. Methods In-depth interviews (n = 9) were conducted with 12 hospital health care professionals involved with prevention and control of communicable diseases. These participants represented ten different Dutch hospitals located in eight of the twelve different provinces. Participants were asked about their experiences during the 2013–2014 measles epidemic regarding infection prevention measures, including vaccination of HCWs, with a specific focus on barriers to the implementation of the RIVM guideline. Results The implementation of the MG was impeded by several (types of) barriers. First, barriers were found related to knowledge and attitude, and included lack of agreement, barriers associated with leadership and issues related to evidence-based decision making. Second, barriers related to characteristics of the guideline, mostly related to unclear or missing guideline content. Finally, contextual and social factors such as human and financial resources, belief systems, physical facilities and technical support, and national views on vaccination policies also play an important role in policy implementation. Conclusions This study has provided valuable insights into the barriers infection prevention specialists encounter during the implementation of new policies concerning vaccination of HCWs in times of a major outbreak. Moreover, this study exposed the complexity and breadth of barriers that are of importance when implementing vaccination policies in the hospital setting. In order to improve the implementation of similar policies in the future, guideline developers and health care providers and administrators alike should aim to eliminate or minimise these identified barriers by taking into account the suggestions made by the authors.
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Affiliation(s)
- Stephanie Jessica Borggreve
- Rijksinstituut voor Volksgezondheid en Milieu, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
| | - Aura Timen
- Rijksinstituut voor Volksgezondheid en Milieu, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
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Podczervinski S, Stednick Z, Helbert L, Davies J, Jagels B, Gooley T, Casper C, Pergam SA. Employee influenza vaccination in a large cancer center with high baseline compliance rates: comparison of carrot versus stick approaches. Am J Infect Control 2015; 43:228-33. [PMID: 25728148 DOI: 10.1016/j.ajic.2014.11.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Influenza is a major complication in patients with cancer and hematopoietic cell transplant recipients. We set out to maximize influenza vaccination rates in health care personnel at our large ambulatory cancer center with high baseline compliance and to assess alternatives to mandatory policies. METHODS Baseline influenza vaccine compliance rates at our center were >85%. During 2011 an incentive-based "carrot" campaign was implemented, and in 2012 a penalty-based "stick" approach to declining staff was required. Yearly approaches were compared using Kaplan-Meier survival estimates. RESULTS Both the incentive and penalty approaches significantly improved the baseline rates of vaccination (2010 vs 2011 P = .0001 and 2010 vs 2012 P < .0001), and 2012 significantly improved over 2011 (P < .0001). Staff with direct patient contact had significantly higher rates of vaccination compared with those with indirect and minimal contact in every campaign year, except in the penalty-driven campaign from 2012 (P < .001, P < .001, and P = .24 and P < .001, P < .001, and P = .17, respectively). CONCLUSIONS A multifaceted staff vaccination program that included education, training, and active declination was more effective than a program offering incentives. Improvements in vaccination rates in the penalty-driven campaign were driven by staff without direct care responsibilities. High compliance with systemwide influenza vaccination was achieved without requiring mandatory vaccination.
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18
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Esolen LM, Kilheeney KL. Sustaining high influenza vaccination compliance with a mandatory masking program. Infect Control Hosp Epidemiol 2014; 35:603-4. [PMID: 24709741 DOI: 10.1086/675846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Lisa M Esolen
- Department of Infection Prevention and Control, Geisinger Health System, Danville, Pennsylvania
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19
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Workplace-based influenza vaccination promotion practices among large employers in the United States. J Occup Environ Med 2014; 56:397-402. [PMID: 24492538 DOI: 10.1097/jom.0000000000000115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Influenza vaccination levels in the working-age population are low. Workplace promotion practices can increase employee vaccination levels, but the extent of employers' use of these practices is unknown. We aimed to estimate the prevalence of employers' use of evidence-based practices for promoting influenza vaccination in the workplace. METHODS We conducted a telephone survey of large employers across the United States regarding their use of evidence-based practices to promote vaccination. RESULTS Eighty-four percent of 583 employers surveyed offered on-site vaccination. Use of four promotion practices was high (75% or more), but the remaining four practices were used by only a minority of employers. There is particular room for improvement in the use of practices that increase physical access to vaccination. CONCLUSIONS Employers are highly engaged in basic influenza vaccination promotion practices, but there is potential to increase levels of use.
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20
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Fiebelkorn AP, Seward JF, Orenstein WA. A global perspective of vaccination of healthcare personnel against measles: systematic review. Vaccine 2014; 32:4823-39. [PMID: 24280280 PMCID: PMC4691996 DOI: 10.1016/j.vaccine.2013.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 10/29/2013] [Accepted: 11/01/2013] [Indexed: 10/26/2022]
Abstract
Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989-2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982-2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be disruptive and costly. Establishing policies for measles vaccination for healthcare personnel is an important strategy towards achieving measles elimination and should be a high priority for global policy setting groups, governments, and hospitals.
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Affiliation(s)
- Amy Parker Fiebelkorn
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jane F Seward
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Update on immunizations for healthcare personnel in the United States. Vaccine 2014; 32:4869-75. [DOI: 10.1016/j.vaccine.2013.10.090] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 10/18/2013] [Accepted: 10/29/2013] [Indexed: 11/23/2022]
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Betsch C, Wicker S. Personal attitudes and misconceptions, not official recommendations guide occupational physicians' vaccination decisions. Vaccine 2014; 32:4478-4484. [PMID: 24962759 DOI: 10.1016/j.vaccine.2014.06.046] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/25/2014] [Accepted: 06/11/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Healthcare personnel (HCP) are often under-vaccinated. The aim of this study was to evaluate occupational physicians' potential role by assessing relations between their knowledge and attitudes regarding HCP vaccination and the extent to which official vaccination recommendations are communicated. METHODS Cross-sectional survey, n=135 occupational physicians. RESULTS Occupational physicians who treat HCP recommend vaccinations more often to HCP when they have better knowledge of official vaccination recommendations and a more positive attitude towards vaccination compared to physicians with less such knowledge or a more negative attitude. The attitude towards vaccination most strongly affects whether occupational physicians recommend the measles, mumps, and rubella (MMR) vaccination: physicians with less positive attitudes recommend MMR to HCP in a more restricted way. A more positive attitude towards vaccination also relates to fewer misconceptions. Occupational physicians' knowledge and attitude further influence the extent to which pregnant HCP receive vaccinations against influenza. Knowledge about official recommendations does not influence the recommendation of influenza vaccination for pregnant women. CONCLUSIONS Reasons for vaccination gaps in HCP might have their roots in occupational physicians' incomplete knowledge of vaccination recommendations. Attitudes, which are related to misperceptions, also influence which vaccinations are recommended to HCP. Official recommendations, and not personal attitudes and misconceptions, should guide occupational vaccination behavior.
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Affiliation(s)
- Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences University of Erfurt, Nordhäuserstrasse 63, 99089 Erfurt, Germany.
| | - Sabine Wicker
- Occupational Health Service, University Hospital Frankfurt, Goethe-University Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
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Apenteng BA, Opoku ST. Employee influenza vaccination in residential care facilities. Am J Infect Control 2014; 42:294-9. [PMID: 24581019 DOI: 10.1016/j.ajic.2013.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 09/16/2013] [Accepted: 09/17/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities. METHODS The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study's objectives. RESULTS Facility size, director's educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates. CONCLUSION Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies.
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Affiliation(s)
- Bettye A Apenteng
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA.
| | - Samuel T Opoku
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE
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Parent and provider perspectives on immunization: are providers overestimating parental concerns? Vaccine 2013; 32:579-84. [PMID: 24315883 DOI: 10.1016/j.vaccine.2013.11.076] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/25/2013] [Accepted: 11/21/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Data are limited on whether providers understand parental attitudes to recommended childhood immunizations. We determined parental attitudes and assessed how accurately providers estimated parental opinions. METHODS Survey of parents and providers (pediatricians, nurses, medical assistants) in randomly selected practices in Houston, Texas. Surveys assessed demographics, perceptions of immunization importance, safety and efficacy, and acceptability of vaccine delivery. Providers estimated parental responses. RESULTS 401 parents (82% mothers, 12% fathers, 6% other) and 105 providers participated. Parents thought vaccines were important for health (median score 9.5; 0=not important, 10=extremely important) but also were concerned regarding vaccine safety and side effects (8.9 on 0-10 scale). 309 (77%) agreed that vaccines effectively prevent disease. Route of administration mattered to 147 (37%), who preferred injection (9.0) over oral (7.3) or intranasal (4.8) routes. Although parents would prefer three or fewer injections per visit, preventing more diseases (189 [47.6%]) was more important than number of injections (167 [42.3%]) when deciding the number of vaccines allowed per visit. White parents rated vaccines less important in preventing some illnesses than did non-white (P≤0.006 for meningitis, hepatitis, HPV, influenza and rotavirus) and rated number of injections per visit more important than number of diseases prevented (51.6% white versus 34.2% non-white; P 0.002). Providers underestimated parental attitudes toward vaccine importance (particularly influenza and HPV), and overestimated the proportion of parents who thought route of administration mattered (63%) and that number of injections per visit was the most important factor (76%) around parental vaccine decisions (P<0.001 for parent-provider mismatch). CONCLUSIONS Most surveyed parents believe vaccines are important for child health and rate disease prevention higher than number of injections entailed. Providers underestimate the importance of some vaccines to parents and overestimate parental concerns regarding route of administration. Future research should focus on how this mismatch impacts parental vaccine decisions.
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Lim YC, Seale H. Examining the views of key stakeholders regarding the provision of occupational influenza vaccination for healthcare workers in Australia. Vaccine 2013; 32:606-10. [PMID: 24291538 DOI: 10.1016/j.vaccine.2013.11.063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/06/2013] [Accepted: 11/15/2013] [Indexed: 11/29/2022]
Abstract
Annual vaccination of hospital healthcare workers (HCWs) may be an effective measure to reduce the transmission of healthcare associated influenza. However, vaccine coverage rates among HCWs in most public Australian hospitals are below satisfactory for a number of reasons. This study aimed to examine the opinions of key health stakeholders on current issues regarding HCW influenza vaccination. A qualitative study involving semi-structured interviews was undertaken with key Australian health stakeholders representing different organizations and sectors involved in influenza vaccination and policy. Amongst the participants, there was overwhelming support for HCW influenza vaccination. They viewed vaccination as one of the most important preventive measures for healthcare associated influenza and generally agreed that vaccination of HCWs reduces the overall risk of transmission to patients. However, there were contradictory attitudes regarding the evidence available for justifying the impact of vaccinating HCWs against influenza. Amongst the stakeholders interviewed, there was support for continuing to promote influenza vaccination for HCWs via the conventional framework. Participants recommended that hospitals continue to use conventional, voluntary strategies to increase vaccine coverage such as education and mobile carts. Given that the World Health Organization has included HCWs as a target group for influenza vaccination, Australian hospitals may need to start considering the use of mandatory policies in the near future.
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Affiliation(s)
- Yi Chen Lim
- UNSW Medicine, University of New South Wales, New South Wales, Australia.
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, New South Wales, Australia.
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