Vaccinal status of healthcare students in Lille

Vaccination Coverage during Childhood and Adolescence among Undergraduate Health Science Students in Greece

High rates of vaccination coverage in childhood represent one of the most important cost-effective tools of primary prevention and have substantially reduced the incidence of and mortality from vaccine-preventable diseases globally. Vaccination coverage of young people has not been well estimated in Greece. Anonymous self-completed questionnaires and the participants’ Child Health Booklet were used to estimate complete vaccination coverage of mandatory vaccinations against vaccine-preventable diseases of undergraduate students at the University of West Attica during the academic year 2020−2021. Student’s t-tests were used to estimate mean values. Overall, 79% (95% CI: 78−81%) of study participants were fully vaccinated. This coverage was lower in males especially for vaccines that should be done during childhood (p = 0.045). High vaccination percentage (>90%) was observed for the meningococcus group A, C, W135, Y, measles-mumps-rubella, hepatitis B and meningitis C vaccine. Nevertheless, suboptimal coverage was assessed for the booster dose of tetanus, diphtheria, pertussis, for the human papillomavirus vaccine among girls, for the tuberculosis, for the meningococcus group B, for the pneumococcal, and for the seasonal influenza vaccines. In conclusion, the promotion of routine vaccination programs for young adults needs to be strengthened. An identification system for under-vaccinated students, an efficient reminder system and university campus vaccine program practices should be established, particularly among males.

Vaccination perception and coverage among healthcare students in France in 2019

BACKGROUND

Vaccine hesitancy in healthcare workers has been increasing especially in France while they are the cornerstone of vaccination programs. Greater understanding of healthcare students (HCS) vaccine knowledge, attitudes and beliefs is necessary to provide an adequate vaccination education to better equip them to promote vaccination in their future careers. The aim of this study was to assess vaccination perception (VP) (perception of benefits and risks of vaccines) and its impact on vaccination coverage (VC) for mandatory and recommended vaccines among HCS.

METHODS

A standardized, anonymous self-reporting electronic questionnaire was prospectively sent to HCS (medicine, nursing, pharmacy, midwifery, physiotherapy students and 1st year of health sciences students) of Normandy University in France between 18/03/2019 and 8/04/2019. VP was evaluated with questions regarding vaccination hesitancy, safety of vaccine and the benefit/risk balance of vaccination. Global VC (GVC) was defined as being vaccinated according to the mandatory and/or recommended vaccination schedule by national French law in 2018.

RESULTS

542 HCS took part in this survey. VC was high for mandatory (diphtheriae, poliomyelitis, tetanus 93.5%, hepatitis B virus 88.6%) and even most of recommended vaccinations (measles 95%, pertussis 88.2%). Global VC (40.4%) was not statistically different between HCS except for 1st year health sciences students who were less vaccinated (25.6%). Regarding VP, 97.8% of HCS thought that vaccine are effective. When vaccine safety and level of vaccine hesitancy were assessed (on a 0-10 scale, 0: not safe or not hesitant and 10: completely safe and strongly hesitant for vaccine), 91% of respondents stated that vaccine safety is ≥7 and in 80% the vaccine hesitancy was < 3. There was no difference among student categories. 80.6% of HCS recommended all vaccines but only 52% agreed that flu vaccination should be mandatory for HCS. In the multivariate analysis, being a 1st year health care sciences student was associated with a lower GVC (OR 95% CI = 2 [1.2-3.3], p = 0.004) than being a medical student.

CONCLUSION

HCS perceived vaccine as effective and secure. Despite the good perception of vaccines, less than half HCS are well vaccinated.

Pertussis vaccination status and vaccine acceptance among medical students: multicenter study in Germany and Hungary

BACKGROUND

Medical students are at risk of contracting and transmitting infectious diseases such as pertussis. Complete vaccination status is important to protect own, patient and public health. Knowing own vaccination status is elementary for following current vaccination recommendations, including boosters. We aimed to assess pertussis vaccination status and vaccination acceptance among medical students of different nationalities.

METHODS

A cross-sectional multicenter health survey at German and Hungarian universities enclosed international medical students in the 1st, 3rd and 5th year of study. Self-reported data from 2655 students regarding pertussis vaccination status were analyzed. Subgroup analysis enclosed data of German (n = 1217), Hungarian (n = 960) and other nationality (n = 478) students ("other").

RESULTS

More Hungarians reported basic immunization (39.0% vs 15.8% Germans vs 24.3% others, p ≤ 0.05). Booster vaccination was reported more by Germans (60.5% vs 43.6% Hungarians vs 36.0% others, p ≤ 0.05). Germans were more likely to report being unvaccinated (3.7% vs 0.9% Hungarians, p ≤ 0.05). More medical students of other nationalities were unaware of their pertussis vaccination status (37.4% vs 20.0% Germans/ 16.5% Hungarians, p ≤ 0.05). 75.2% (n = 1931) rated pertussis vaccinations as absolutely necessary (86.2% Hungarians vs 69.8% Germans/ 66.1% others, p ≤ 0.05).

CONCLUSIONS

Positive attitudes towards vaccinations were reported but a large group reported insufficient vaccination status and being not aware of their status, especially among international students. Hungarians possibly have a better vaccination status than reported, based on mandatory vaccinations in childhood. The low awareness of vaccination status has implications for future booster vaccinations. All students should be informed about current recommendations and receive vaccination offers in frames of low-threshold medical services.

Immunisation Rates of Medical Students at a Tropical Queensland University

Although medical students are at risk of contracting and transmitting communicable diseases, previous studies have demonstrated sub-optimal medical student immunity. The objective of this research was to determine the documented immunity of medical students at James Cook University to important vaccine-preventable diseases. An anonymous online survey was administered thrice in 2014, using questions with categories of immunity to determine documented evidence of immunity, as well as closed-ended questions about attitudes towards the importance of vaccination. Of the 1158 medical students targeted via survey, 289 responses were included in the study (response rate 25%), of which 19 (6.6%) had documented evidence of immunity to all of the vaccine-preventable diseases surveyed. Proof of immunity was 38.4% for seasonal influenza, 47.1% for pertussis, 52.2% for measles, 38.8% for varicella, 43.7% for hepatitis A, and 95.1% for hepatitis B (the only mandatory vaccination for this population). The vast majority of students agreed on the importance of vaccination for personal protection (98.3%) and patient protection (95.9%). In conclusion, medical students have sub-optimal evidence of immunity to important vaccine-preventable diseases. Student attitudes regarding the importance of occupational vaccination are inconsistent with their level of immunity. The findings of this study were used to prompt health service and educational providers to consider their duty of care to manage the serious risks posed by occupational communicable diseases.

Marked increase in measles vaccination coverage among young adults in Switzerland: a campaign or cohort effect?

Objectives

To evaluate the impact of the Swiss measles elimination strategy—including a mass media campaign—on vaccination coverage and awareness among young adults aged 20–29 years.

Methods

Comparison of the results of two cross-sectional population surveys in 2012 and 2015.

Results

Documented vaccination coverage increased from 77 to 88% for two doses of measles vaccine. Major determinants of complete vaccination were survey year, birth cohort, sex and the absence of prior measles disease. If birth cohort and prior history of measles disease are included as factors in a multivariate model, the difference between 2012 and 2015 vanishes.

Conclusions

The marked increase in complete measles vaccination coverage is due to a cohort effect, owing to the introduction of the second dose of vaccine in 1996. Most of the vaccinations were administered before the national strategy was implemented and vaccination catch-ups did not increase during the campaign in young adults. Nevertheless, this study provides evidence of an improvement in the awareness of measles and measles vaccination in young adults, which may result in an impact on measles vaccination coverage in the near future.

Electronic supplementary material

The online version of this article (10.1007/s00038-018-1102-x) contains supplementary material, which is available to authorized users.

Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: how much, who and why?

Background

Hepatitis B vaccination for healthcare workers (HCWs) is a key component of the WHO Hepatitis B Elimination Strategy 2016–2021. Data on current hepatitis B vaccine coverage among health care workers in Sub-Saharan Africa are scarce, but these data are vital for effective programming. We assessed the proportion of HCWs vaccinated for hepatitis B and the factors associated with adequate vaccination coverage at a national hospital in Tanzania.

Methods

A descriptive cross-sectional study was conducted among consenting healthcare workers between 30th July and 30th September 2015. Vaccination histories were obtained through self-administered questionnaires. Means and proportions were used to summarize the data. Student’s t and chi-squared tests were used as appropriate. Logistic regression was used to determine the factors associated with vaccination.

Results

A total of 348 HCWs were interviewed, of whom 198 (56.9%) had received at least one dose of hepatitis B vaccination, while only 117 (33.6%) were fully vaccinated. About half of the 81 HCWs with partial vaccination (49.4%) had missed their subsequent vaccination appointments. Among unvaccinated HCWs, 14 (9.3%) had either HBV infection or antibodies against HBV infection upon pre-vaccination screening. However, the remaining participants were not vaccinated and did not know their immune status against HBV.

Nearly all respondents (347, 99.3%) had heard about the hepatitis B viral vaccine. The following reasons for non-vaccination were given: 98 (65.3%) reported that they had not been offered the vaccine; 70 (46.7%) observed standard precautions to ensure infection prevention and 60 (41.3%) blamed a low level of awareness regarding the availability of the hepatitis B vaccine.

Conclusion

The current vaccination coverage among practicing healthcare workers at Muhimbili National Hospital is low, despite a high level of awareness and the acceptance of the vaccine. Expedited and concerted efforts to scale vaccine uptake should include improved access to the vaccine, especially for newly recruited HCWs. The extension of the study to private healthcare settings and lower-level facilities would be useful.

Les vaccins dans la prévention des infections associées aux soins

Les infections associées aux soins (IAS) constituent un véritable problème de santé publique. Escherichia coli, Staphylococcus aureus, Clostridium difficile sont les plus souvent à l’origine des IAS. L’antibiorésistance fréquente complique encore la prise en charge et des impasses thérapeutiques existent à présent. Les mesures d’hygiène hospitalière bien qu’essentielles sont insuffisantes pour diminuer drastiquement les IAS. Ainsi, des stratégies alternatives à l’antibiothérapie s’avèrent nécessaires pour prévenir et traiter les IAS. Parmi celles-ci, la vaccination et l’immunisation passive sont probablement les plus prometteuses. Nous avons fait une mise au point sur les vaccins disponibles et en développement clinique pour lutter contre les IAS, chez les patients à risque d’IAS et les soignants. L’intérêt de la vaccination grippale et rotavirus chez les patients pour prévenir ces IAS virales a été examiné. Le développement d’un vaccin anti-S. aureus, déjà émaillé de 2 échecs est complexe. Toutefois, ces échecs ont permis d’améliorer les connaissances sur l’immunité anti-S. aureus. La mise à disposition d’un vaccin préventif anti-C. difficile semble plus proche. Pour les autres bactéries gram négatif responsables d’IAS, le développement est moins avancé. La vaccination des patients à risques d’IAS pose également des problèmes de réponse vaccinale qu’il faudra résoudre pour utiliser cette stratégie. Ainsi, la vaccination des soignants, de par l’effet de groupe permet également de prévenir les IAS. Nous faisons ici le point sur l’intérêt de la vaccination des soignants contre la rougeole, la coqueluche, la grippe, la varicelle, l’hépatite B pour réduire les IAS avec des vaccins déjà disponibles.

Invasive Meningococcal Disease on the Workplaces: a systematic review

Background and aims of the work: Invasive Meningococcal Disease (IMD) represents a global health threat, and occupational settings have the potential to contribute to its spreading. Therefore, here we present the available evidences on the epidemiology of IMD on the workplaces.

METHODS

The following key words were used to explore PubMed: Neisseria meningitidis, meningococcus, meningococcal, invasive meningococcal disease, epidemiology, outbreaks, profession(al), occupation(al).

RESULTS

We identified a total of 12 IMD cases among healthcare workers (HCW), 44 involving biological laboratory workers (BLW), 8 among school personnel, and eventually 27 from other settings, including 3 large industrial working populations. Eventual prognosis of BLW, particularly the case/fatality ratio, was dismal. As clustered in time and space, data about school cases as well as industrial cases seem to reflect community rather than occupational outbreaks. In general, we identified a common pattern for HCW and BLW, i.e. the exposure to droplets or aerosol containing N meningitidis in absence of appropriate personal protective equipment (PPE) and/or microbiological safety devices (MSD) (e.g. cabinets). Post-exposure chemoprophylaxis (PEC) was rarely reported by HCW (16.7%) workers, and never by BLW. Data regarding vaccination status were available only for a case, who had failed requested boosters.

CONCLUSIONS

The risk for occupational transmission of IMD appears relatively low, possibly as a consequence of significant reporting bias, with the exception of HCW and BLW. Improved preventive measures should be implemented in these occupational groups, in order to improve the strict use of PPE and MSD, and the appropriate implementation of PEC.

Vaccination of healthcare workers: A review

Vaccine-preventable diseases are a significant cause of morbidity and mortality. As new vaccines are proving to be effective and as the incidence of some infections decreases, vaccination practices are changing. Healthcare workers (HCWs) are particularly exposed to and play a role in nosocomial transmission, which makes them an important target group for vaccination. Most vaccine-preventable diseases still carry a significant risk of resurgence and have caused outbreaks in recent years. While many professional societies favor vaccination of HCWs as well as the general population, recommendations differ from country to country. In turn, vaccination coverage varies widely for each microorganism and for each country, making hospitals and clinics vulnerable to outbreaks. Vaccine mandates and non-mandatory strategies are the subject of ongoing research and controversies. Optimal approaches to increase coverage and turn the healthcare workforce into an efficient barrier against infectious diseases are still being debated.

Hepatitis B surface antibodies in medical students from a public university in Puebla, Mexico

Although preventable with vaccination, Hepatitis B virus (HBV) infection is a major health concern, with ∼400 million people at risk of developing the chronic form of the disease worldwide. The anti-HBV vaccine consists of a recombinant HBV surface antigen (HBsAg), which induces specific anti-HBs antibodies and confers 95% protection for >20 y. The aim of the present study was to analyze the response to HBV vaccination by measuring anti-HBs antibodies in serum samples from medical students of a public university in Puebla, Mexico. HBV infection markers HBsAg and anti-HBs, were also determined. A total of 201 students were included and vaccination coverage was found at 54%. Overall seropositivity for HBsAg, anti-HBc and anti-HBs determined by ELISA was 0.5%, 1.0% and 47%, respectively. Protective levels of anti-HBs >10 mIU/mL were found in 93.2% of subjects vaccinated with 2 or 3 doses and in 40% of those vaccinated with a single dose; while only 4.8% of unvaccinated subjects were anti-HBs positive. The response to the HBV vaccine was different in each participant, despite similar vaccination scheme. A history of blood transfusion/organ transplant or more than 2 sexual partners was significantly associated with anti-HBc positivity, OR = 399 (p = 0.010) and OR = 19.9 (p = 0.044), respectively. HBV immunization coverage was low in our sample compared with reports from countries with similar HBV prevalence, but anti-HBs in vaccinated individuals were in the expected range. It is important to promote HBV vaccination and awareness among medical students, due to their exposure risk.

Low measles vaccination coverage among medical residents in Marseille, France: reasons for non-vaccination, March 2013

BACKGROUND

During 2008-12, France and Europe experienced large measles outbreaks, involving also healthcare workers (HCW). We aimed to estimate the vaccination coverage (VC) of measles among medical residents of the University of Aix/Marseille, in South-Eastern France.

METHODS

In March 2013, we conducted a cross-sectional study among all medical residents of the Medical Faculty of Aix/Marseille. We used a self-administered questionnaire to collect information on self-reported VC and reasons for vaccination and non-vaccination. We compared proportions, using the chi-squared test and prevalence ratios (PRs) with 95% confidence intervals (95% CIs).

RESULTS

Of 1152 eligible residents, 703 (61%) participated in the study and 95 (14%; 95% CI: 12-17%) reported having had measles in the past. Of all participants, 613 (93%; 95% CI: 91-95%) reported having been vaccinated against measles and 389 (76%; 95% CI: 73-80%) received two doses. Only 268 (38%) reported having visited an occupational health physician. Vaccinated individuals were more likely to report easy access to vaccination as the main motivation for measles vaccination, compared with unvaccinated residents (435; 71% and 21; 45%; P < 0.001, respectively).

CONCLUSIONS

VC among the medical residents of the University of Aix/Marseille was well below the recommended 95% coverage for two doses of measles vaccination. The majority of the study participants had not visited an occupational health doctor. Lack of easy access seems to represent major barriers to measles vaccination. We recommend that the student union, occupational health services and hospitals co-operate and address these problems in order to improve VC in this group.