U.S. Healthcare personnel and influenza vaccination during the 2004-2005 vaccine shortage

Influenza Vaccination of Healthcare Personnel by Work Setting and Occupation-U.S., 2014

INTRODUCTION

Routine influenza vaccination of healthcare personnel (HCP) can reduce influenza-related illness and its potentially serious consequences among HCP and their patients. Influenza vaccination has been routinely recommended for HCP since 1984.

METHODS

Data from the 2013 and 2014 National Health Interview Survey were analyzed in 2015. Kaplan-Meier survival estimated the cumulative proportion of HCP reporting 2013-2014 season influenza vaccination. Vaccination coverage by work setting and occupation were assessed. Multivariable logistic regression and predictive marginal analyses identified factors independently associated with vaccination among HCP.

RESULTS

Influenza vaccination coverage was 64.9% among HCP aged ≥18 years (95% CI=60.5%, 69.3%), which was significantly higher compared with non-HCP among the same age group (41.0%, 95% CI=39.8%, 42.1%) (p<0.05). Vaccination coverage was higher among physicians (82.3%) and nurses (77.5%) than other types of HCP (range, 50.2%-65.6%). Coverage was higher among HCP working in hospitals (76.9%) versus other settings (range, 53.9%-60.2%). Characteristics independently associated with an increased likelihood of vaccination among HCP were older age, higher education, having more physician contacts, and having health insurance. Having never been married was independently associated with decreased likelihood of vaccination among HCP.

CONCLUSIONS

Influenza vaccination coverage was higher among HCP than non-HCP, but still below the national target of 90%. Vaccination coverage varied widely by occupation type, work settings, and demographic characteristics. Evidence-based interventions, such as making vaccine available at no cost in the workplace and active promotion of vaccination, are needed to increase influenza vaccination among HCP in all healthcare settings.

H1N1 and seasonal influenza vaccination of U.S. healthcare personnel, 2010

BACKGROUND

Seasonal influenza vaccination routinely has been recommended for healthcare personnel (HCP) since 1984. The influenza A (H1N1) 2009 monovalent vaccine (H1N1 vaccine) became available in the U.S. in October 2009.

PURPOSE

To assess 2009 H1N1 and seasonal influenza vaccination coverage and identify factors independently associated with vaccination among HCP in the U.S.

METHODS

Data from the 2009-2010 Behavioral Risk Factor Surveillance System (BRFSS) influenza supplemental survey were analyzed in 2011. Multivariable logistic regression and predictive marginal models were performed to identify factors independently associated with vaccination among HCP. The Kaplan-Meier survival analysis procedure was used to estimate the cumulative proportion of people vaccinated.

RESULTS

Among 16,975 HCP surveyed, 2009 H1N1, seasonal, and any-dose vaccination coverage were 34.1% (95% CI=32.7%, 35.5%); 52.4% (95% CI=50.9%, 53.9%); and 58.0% (95% CI=56.5%, 59.5%), respectively, all of which were significantly higher than those for non-HCP (19.1%, 34.9%, and 40.3%, respectively). The H1N1 vaccination coverage among HCP ranged from 18.4% in Mississippi to 56.1% in Massachusetts and seasonal influenza vaccination coverage ranged from 40.4% in Florida to 73.1% in Nebraska. Characteristics independently associated with an increased likelihood of 2009 H1N1, seasonal, and any-dose vaccinations among HCP were as follows: non-Hispanic white, higher income, having a high-risk condition, having health insurance, the ability to see a doctor if needed, and having had a routine checkup in the previous year.

CONCLUSIONS

Vaccination coverage was higher among HCP than non-HCP but still below the national health objective of 90%. Knowledge of national and state-specific H1N1 and seasonal vaccination coverage among HCP is useful for evaluating the vaccination campaign and implementing strategies for increasing yearly seasonal vaccination coverage and improving vaccination coverage among HCP in possible future pandemics.

Influenza, hepatitis B, and tetanus vaccination coverage among health care personnel in the United States

BACKGROUND

Health care personnel (HCP) are at risk for exposure to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is an essential prevention practice for HCP. We assessed the recent influenza, hepatitis B, and tetanus vaccination coverage among HCP in the United States.

METHODS

We analyzed data from the 2007 National Immunization Survey-Adult restricted to survey respondents aged 18 to 64 years. Influenza, hepatitis B, and tetanus vaccination coverage levels among HCP were assessed. Multivariable logistic regression was conducted to assess factors independently associated with receipt of vaccination among HCP.

RESULTS

Among HCP aged 18 to 64 years, 46.7% (95% confidence interval [CI]: 39.6%-53.8%) had received influenza vaccination for the 2006-2007 season, and 70.4% (95% CI: 63.9%-76.1%) received tetanus vaccination in the past 10 years; 61.7% (95% CI: 52.5%-70.2%) had received 3 or more doses of hepatitis B vaccination among HCP aged 18 to 49 years. Multiple logistic regression analysis showed that being married was associated with influenza vaccination coverage, higher education level was associated with hepatitis B vaccination coverage, and younger age was significantly associated with tetanus vaccination among HCP. Among those HCP who did not receive influenza vaccination, the most common reason reported was respondent concerns about vaccine safety and adverse effects.

CONCLUSION

By 2007, influenza and hepatitis B vaccination coverage among HCP remained well below the Healthy People 2010 objectives. Tetanus vaccination level was 70%, and this study provided a baseline data for tetanus vaccination among HCP. Innovative strategies are needed to further increase vaccination coverage among HCP.

Do vaccination strategies implemented by nursing homes narrow the racial gap in receipt of influenza vaccination in the United States?

OBJECTIVES

To determine whether the racial inequity between African Americans and Caucasians in receipt of influenza vaccine is narrower in residents of nursing homes with facility-wide vaccination strategies than in residents of facilities without vaccination strategies.

DESIGN

Secondary data analysis using the National Nursing Home Survey 2004, a nationally representative survey.

SETTING

One thousand one hundred seventy-four participating nursing homes sampled systematically with probability proportional to bed size.

PARTICIPANTS

Thirteen thousand five hundred seven randomly sampled residents of nursing homes between August and December 2004.

MEASUREMENTS

Receipt of influenza vaccine within the last year. Logistic regression was used to examine the relationship between facility-level influenza immunization strategy and racial inequity in receipt of vaccination, adjusted for characteristics at the resident, facility, state, and regional levels.

RESULTS

Overall in the United States, vaccination coverage was higher for Caucasian and African-American residents; the racial vaccination gaps were smaller (<6 percentage points) and nonsignificant in residents of homes with standing orders for influenza vaccinations (P=.14), verbal consent allowed for vaccinations(P=.39), and routine review of facility-wide vaccination rates (P=.61) than for residents of homes without these strategies. The racial vaccination gap in residents of homes without these strategies were two to three times as high (P=.009, P=.002, and P=.002, respectively).

CONCLUSION

The presence of several immunization strategies in nursing homes is associated with higher vaccination coverage for Caucasian and African-American residents, narrowing the national vaccination racial gap.

Influenza vaccination among individuals with cancer and their family members

BACKGROUND

Influenza vaccination for family members of patients with cancer lowers patients' risk of influenza and related complications.

PURPOSE

This study aims to examine the utilization of influenza vaccination among such families.

METHODS

Individuals directly or indirectly affected by cancer and a cancer-free control group were identified from the 2005 and 2006 Medical Expenditure Panel Survey: current patients (CURR-I) and their family members (CURR-F); previous patients (PREV-I) and family members (PREV-F); and individuals in families not affected by cancer (I-F). Logistic regressions with appropriate weighting algorithms for survey data were performed to compare utilization among these five groups, while controlling for confounding factors (e.g., demographics, SES).

RESULTS

The proportion of those vaccinated was substantially higher among patients with cancer. It was 58.7%, 54.7%, 43.83%, 39.73%, and 29.3% for CURR-I, PREV-I, CURR-F, PREV-F, and I-F, respectively. A similar pattern was observed in analyses stratified by age groups (18-49, 50-64, and > or =65 years). Results from logistic regressions indicated that the CURR-I group was significantly more likely to have influenza vaccine than I-F (OR [CI]=1.62 [1.10, 2.36]; 1.50 [1.11, 2.02]; and 1.42 [1.06, 1.92] for those aged 18-49, 50-64, and > or =65 years, respectively), but the differences between family members of patients with cancer and the control were not significant after controlling for the confounders. A significant difference between PREV-I and I-F was observed for only those aged > or =65 years (OR [CI]=1.47 [1.09, 1.99]).

CONCLUSIONS

Influenza vaccination was underutilized (<45%) among family members of patients with cancer. To reduce health risks for cancer survivors, prevention efforts should be extended to their family members.