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Thaivalappil A, Young I, MacKay M, Pearl DL, Papadopoulos A. A qualitative study exploring healthcare providers’ and trainees’ barriers to COVID-19 and influenza vaccine uptake. Health Psychol Behav Med 2022; 10:695-712. [PMID: 35957955 PMCID: PMC9359157 DOI: 10.1080/21642850.2022.2106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Vaccines are effective biological interventions which reduce health burdens and protect healthcare providers from vaccine-preventable diseases. However, there are concerns about varying levels of vaccination coverage of influenza and COVID-19 vaccines among those working in healthcare. The aim of this study was to identify barriers and facilitators to COVID-19 and influenza vaccinations among healthcare providers and trainees using the Theoretical Domains Framework (TDF). Methods Semi-structured interviews (n = 18) were carried out with healthcare providers and trainees in Canada. A thematic analysis approach was used to code interview transcripts and match findings to TDF domains and broader categories. Results Three overarching themes were generated from six TDF domains and three inductively generated categories: (1) making informed health decisions with an added responsibility to protect oneself and patients; (2) a pro-vaccine social network, widespread accessibility, and pursuing a sense of normalcy; and (3) seeking a more nuanced, respectful, and calculated approach to vaccine communication and policy implementation. Conclusion These findings help to identify factors associated with influenza and COVID-19 vaccine uptake among individuals in the healthcare field. Addressing these factors may improve healthcare provider sentiments surrounding vaccines, lead to better patient education, and increased uptake of vaccinations with the potential for seasonal booster doses.
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Affiliation(s)
| | - Ian Young
- School of Occupational and Public Health, Ryerson University, Toronto, Canada
| | - Melissa MacKay
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - David L. Pearl
- Department of Population Medicine, University of Guelph, Guelph, Canada
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Hämäläinen A, Patovirta RL, Mauranen E, Hämäläinen S, Koivula I. Support among healthcare workers for the new mandatory seasonal influenza vaccination policy and its effects on vaccination coverage. Ann Med 2021; 53:384-390. [PMID: 33616423 PMCID: PMC7901690 DOI: 10.1080/07853890.2021.1889022] [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] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Finland was the first European country to introduce a nation-wide mandatory seasonal influenza vaccination policy for healthcare workers (HCWs) by mandating that administrators of health care institutions only employ vaccinated HCWs. In this study, we examine the effects of the new policy and the view of HCWs on the new policy. METHODS A cross-sectional observational study was conducted in Kuopio University Hospital among HCWs working in close patient contact. The statistics on vaccination coverage were obtained from the hospital's own databases, where employees were asked to self-report their suitability for work. An anonymous survey was sent to HCWs in 2015-2016 (n = 987) and 2018-2019 (n = 821). RESULTS Vaccination coverage increased from 59.5 to 99.6%, according to the hospital's own records. Among the survey respondents, the seasonal influenza vaccination coverage of HCWs increased from 68.2 to 95.4%. 83.8% of doctors and 49.4% of nurses supported the new policy. 12.7% of doctors and 41.5% of nurses found the new mandate coercive or that it restricted their self-determination. CONCLUSIONS Our study confirms the positive effects of mandating the administrators of health care institutions to only employ vaccinated HCWs. The majority (57.9%) of all HCWs supported the new policy, with doctors being more compliant than nurses. Key messages Finland became the first European country to mandate influenza vaccination for HCWs by mandating that administrators of health care institutions only employ vaccinated HCWs. After the new act, the vaccination coverage of HCWs increased close to 100%. Most of the HCWs supported the new act and did not find it coercive.
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Affiliation(s)
- Aleksi Hämäläinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Ella Mauranen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Sari Hämäläinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Irma Koivula
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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3
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Cherif I, Kharroubi G, Bouabid L, Gharbi A, Boukthir A, Ben Alaya N, Ben Salah A, Bettaieb J. Knowledge, attitudes and uptake related to influenza vaccine among healthcare workers during the 2018-2019 influenza season in Tunisia. BMC Public Health 2021; 21:907. [PMID: 33980192 PMCID: PMC8116062 DOI: 10.1186/s12889-021-10970-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/04/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The influenza vaccine (IV) is considered the most effective strategy to prevent seasonal influenza infection and annual vaccination of healthcare workers (HCWs) is recommended by the World Health Organization given their high mixing with patients. We assessed IV uptake among HCWs in the 2018-2019 season and explored their knowledge and attitudes regarding influenza immunization. METHODS A cross-sectional study was conducted in 150 representative Tunisian health facilities from March to May 2019. We recruited 1231 HCWs with direct patient contact using self-weighted multistage sampling. Univariate and multivariate logistic regression analyses permitted to assess the factors associated with IV uptake in the 2018-2019 influenza season. RESULTS Among 1231 health professionals enrolled in this study, less than half (36.6, 95% confidence interval [CI]: 33.9-39.4) received the IV at least once in their lives and only 15.3% (CI: 13.3-17.4) were vaccinated against influenza in the 2018-2019 influenza season. High confidence regarding IV efficacy, belief about the mandatory character of influenza vaccination for HCWs, and IV uptake in the 4 years preceding the 2018-2019 influenza season were independently associated with higher IV uptake by multivariate analysis. However, participants with high educational level were less likely to receive the IV than those with the lowest educational level. CONCLUSIONS Our study revealed a low vaccination rate among Tunisian HCWs confirming the importance of tailored education programs targeting this population.
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Affiliation(s)
- Ines Cherif
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia
| | - Ghassen Kharroubi
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia
| | - Leila Bouabid
- National Observatory of New and Emerging Diseases, 5-7, Khartoum Street, Diplomat, 13th floor, Le Belvédère, 1002, Tunis, Tunisia
| | - Adel Gharbi
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia
| | - Aicha Boukthir
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia
| | - Nissaf Ben Alaya
- National Observatory of New and Emerging Diseases, 5-7, Khartoum Street, Diplomat, 13th floor, Le Belvédère, 1002, Tunis, Tunisia
| | - Afif Ben Salah
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.,Arabian Gulf University, Road 2904 Building 293, Manama, 329, Bahrain
| | - Jihene Bettaieb
- Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia. .,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Pasteur Institute of Tunis, 13, Place Pasteur, B.P.74, Belvédère, 1002, Tunis, Tunisia.
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4
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Gualano MR, Corradi A, Voglino G, Catozzi D, Olivero E, Corezzi M, Bert F, Siliquini R. Healthcare Workers' (HCWs) attitudes towards mandatory influenza vaccination: A systematic review and meta-analysis. Vaccine 2021; 39:901-914. [PMID: 33451776 DOI: 10.1016/j.vaccine.2020.12.061] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 02/08/2023]
Abstract
Influenza is a disease responsible for thousands of deaths every year. Although healthcare workers (HCWs) represent a way of contagion for patients, vaccination coverage among them is low. Mandatory vaccination has been proposed, but controversies remain. This systematic review and meta-analysis aimed to assess the acceptance of mandatory vaccination by HCWs, and to investigate associated characteristics. MEDLINE, Scopus, Embase, PsycInfo, CINAHL and Web of Science were used to search for studies assessing the topic. PRISMA statements were followed. Of the 13,457 univocal records found, 52 studies were included in the systematic review and 40 in the meta-analysis. The pooled proportion of HCWs accepting the policy was of 61% (95% CI: 53%- 68%) but with great heterogeneity between continents (from 54% in Europe to 69% in Asia) and in different professionals (from 40% in nurses to 80% in students). Vaccinated HCWs agreed more frequently with mandatory vaccination than non-vaccinated ones. More studies that consider mandatory vaccination acceptance as the main outcome are needed, but the results of this study confirm that in some settings the majority of HCWs favour mandatory vaccination. This, combined with effects that a flu epidemic could have if overlapped to pandemics with similar symptoms, requires renewed considerations on mandatory vaccination.
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Affiliation(s)
- Maria Rosaria Gualano
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Alessio Corradi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Gianluca Voglino
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy.
| | - Dario Catozzi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Elena Olivero
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Michele Corezzi
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy
| | - Fabrizio Bert
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy; AOU City of Health and Science of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Paediatric Sciences, University of Turin, Torino, Italy; AOU City of Health and Science of Turin, Turin, Italy
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Occupational Respiratory Infections. Clin Chest Med 2020; 41:739-751. [PMID: 33153691 DOI: 10.1016/j.ccm.2020.08.003] [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: 11/24/2022]
Abstract
Occupational respiratory infections can be caused by bacterial, viral, and fungal pathogens. Transmission in occupational settings can occur from other humans, animals, or the environment, and occur in various occupations and industries. In this article, we describe 4 occupationally acquired respiratory infections at the focus of NIOSH investigations over the last decade: tuberculosis (TB), influenza, psittacosis, and coccidioidomycosis. We highlight the epidemiology, clinical manifestations, occupational risk factors, and prevention measures.
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Ghandora H, Halperin DM, Isenor JE, Taylor BA, Fullsack P, Di Castri AM, Halperin SA. Knowledge, attitudes, behaviours, and beliefs of healthcare provider students regarding mandatory influenza vaccination. Hum Vaccin Immunother 2019; 15:700-709. [PMID: 30395762 DOI: 10.1080/21645515.2018.1543523] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Influenza infection poses the same risk to healthcare students as to practising clinicians. While there is substantial dialog about the benefits, risks, and ethics of mandatory influenza immunization policies in Canada, there has been little engagement of healthcare students. To explore the knowledge, attitudes, beliefs, and behaviours of healthcare students, we administered a web-based survey to students at Dalhousie University. Influenza vaccination status varied by program type, with 86.3% of medical students (n = 124) and 52.4% of nursing students (n = 96) self-reporting receipt of the influenza vaccine both in the previous and current seasons; pharmacy students' coverage fell between the two. Pharmacy students had higher mean knowledge scores (10.0 out of 13 questions) than medical (9.26) and nursing (8.88) students. Between 56.1% and 64.5% of students across disciplines were in support of a mandatory masking or vaccination policy, and between 72.6% and 82.3% of students would comply if such a policy were in place. A sense of duty to be immunized, desire to be taught more about influenza and influenza vaccine, belief that the hospital has a right to know vaccination status, support for declination policy, and willingness to accept consequences of noncompliance were all predictors of student support of mandatory policies. Medical and pharmacy students tended to hold more pro-influenza vaccination attitudes, had higher knowledge scores, and better vaccine coverage than nursing students. Based on the overall vaccination behaviour, knowledge, beliefs, and attitudes of students surveyed, this study demonstrates that mandatory influenza immunization policies are generally supported by the next generation of practitioners.
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Affiliation(s)
- Heba Ghandora
- a Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Donna M Halperin
- b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada.,c School of Nursing , St. Francis Xavier University , Antigonish , Nova Scotia , Canada
| | - Jennifer E Isenor
- b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada.,d College of Pharmacy , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Beth A Taylor
- a Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada.,e School of Nursing , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Philippe Fullsack
- b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Antonia M Di Castri
- b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Scott A Halperin
- a Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,b Canadian Center for Vaccinology , Dalhousie University , Halifax , Nova Scotia , Canada.,f Department of Microbiology and Immunology , Dalhousie University , Halifax , Nova Scotia , Canada
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7
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Agreement with employer influenza vaccination requirements among us healthcare personnel during the 2016–2017 season. Infect Control Hosp Epidemiol 2018; 39:1019-1020. [DOI: 10.1017/ice.2018.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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8
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Predictors of seasonal influenza vaccination behaviour among nurses and implications for interventions to increase vaccination uptake: A cross-sectional survey. Int J Nurs Stud 2018; 79:137-144. [DOI: 10.1016/j.ijnurstu.2017.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/02/2017] [Accepted: 12/05/2017] [Indexed: 11/17/2022]
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9
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Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness. Curr Opin Pediatr 2017; 29:606-615. [PMID: 28700416 DOI: 10.1097/mop.0000000000000527] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. RECENT FINDINGS Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season. Vaccination rates were as low as 44.9% in institutions that did not promote or offer the vaccine, compared with rates of more than 90% in institutions with mandatory vaccination policies. Policies that mandate influenza vaccination for healthcare personnel have legal and ethical justifications. Implementing such policies require multipronged approaches that include education efforts, easy access to vaccines, vaccine promotion, leadership support and consistent communication emphasizing patient safety. SUMMARY Mandatory influenza vaccination for healthcare personnel is a necessary step in protecting patients. Patients who interact with healthcare personnel are often at an elevated risk of complications from influenza. Vaccination is the best available strategy for protecting against influenza and evidence shows that institutional policies and state laws can effectively increase healthcare personnel vaccination rates, decreasing the risk of transmission in healthcare settings. There are legal and ethical precedents for institutional mandatory influenza policies and state laws, although successful implementation requires addressing both administrative and attitudinal barriers.
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10
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Access, Education and Policy Awareness: Predictors of Influenza Vaccine Acceptance Among VHA Healthcare Workers. Infect Control Hosp Epidemiol 2017. [PMID: 28641586 DOI: 10.1017/ice.2017.113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts. RESULTS The response rate was 17.4%. Of 2,502 initial respondents, 2,406 (96.2%) provided usable data. This sample includes respondents from all 140 VA hospitals. Self-reported influenza vaccination rates were highest among physicians (95.6%) and licensed independent providers (88.3%). Nonclinical staff (80.7%) reported vaccine uptake similar to other certified but nonlicensed providers (81.2%). The strongest predictor of vaccine acceptance among VHA HCWs was individual awareness of organizational policy. Vaccine acceptance was also higher among HCWs who reported more options for access to vaccination and among those in facilities with more education activities. CONCLUSIONS Influenza vaccine acceptance varied significantly by employee awareness of employer policy and on-site access to vaccine. Employer-sponsored activities to increase access continue to show positive returns across occupations. Local influenza campaign efforts to educate HCWs may have reached saturation in this target group. These results suggest that focused communications to increase HCW awareness and understanding of employer policy can drive further increase in influenza vaccination acceptance. Infect Control Hosp Epidemiol 2017;38:970-975.
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Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P. Vaccination of healthcare workers: A review. Hum Vaccin Immunother 2016; 11:2522-37. [PMID: 26291642 DOI: 10.1080/21645515.2015.1082014] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
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.
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Affiliation(s)
- Skerdi Haviari
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Thomas Bénet
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
| | - Mitra Saadatian-Elahi
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Philippe André
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Pierre Loulergue
- c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France.,d Université Paris Descartes, Sorbonne Paris Cité, INSERM, CIC 1417, Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Broca Hôtel Dieu, CIC Cochin-Pasteur ; Paris , France.,e INSERM, F-CRIN, I-REIVAC, Cochin Center ; Paris , France
| | - Philippe Vanhems
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
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12
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Luthy KE, Kohler LR, Macintosh JLB, Eden LM, Beckstrand RL, Wright EL, E Hill K. Vaccination policies of Utah family practice clinics. J Am Assoc Nurse Pract 2016; 29:77-84. [PMID: 27459709 DOI: 10.1002/2327-6924.12395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/02/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to collect information regarding healthcare worker (HCW) vaccination policies in Utah family practice clinics. METHODS The study was conducted in Utah family practice clinics in the most densely populated counties in the state and was a cross-sectional descriptive design. Data were collected from 91 family practice clinic managers. Descriptive statistics were performed, as well as a content analysis for open-ended items. CONCLUSIONS HCWs are employed in environments where infectious diseases can be easily spread from person to person, thus, vaccinations can be instrumental in protecting the health of HCWs and patients alike. In Utah, 56.8% of family practice clinics had either no vaccination policy for HCWs or had a policy with no consequences for noncompliance. Utah family practice clinics need to implement changes to create and maintain HCW vaccination policies. IMPLICATIONS FOR PRACTICE Nurse practitioners can be leaders and change agents by working with their county and state health departments to create state-wide policies that mirror the position statements from the American Nurses Association and the American Association of Nurse Practitioners.
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Affiliation(s)
- Karlen E Luthy
- College of Nursing, Brigham Young University, Provo, Utah
| | - Levi R Kohler
- College of Nursing, Brigham Young University, Provo, Utah
| | | | - Lacey M Eden
- College of Nursing, Brigham Young University, Provo, Utah
| | | | - Emily L Wright
- College of Nursing, Brigham Young University, Provo, Utah
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Abstract
The purpose of this statement is to reaffirm the American Academy of Pediatrics' support for a mandatory influenza immunization policy for all health care personnel. With an increasing number of organizations requiring influenza vaccination, coverage among health care personnel has risen to 75% in the 2013 to 2014 influenza season but still remains below the Healthy People 2020 objective of 90%. Mandatory influenza immunization for all health care personnel is ethical, just, and necessary to improve patient safety. It is a crucial step in efforts to reduce health care-associated influenza infections.
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14
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Gruben V, Siemieniuk RA, McGeer A. Health care workers, mandatory influenza vaccination policies and the law. CMAJ 2014; 186:1076-80. [PMID: 24863919 PMCID: PMC4188651 DOI: 10.1503/cmaj.140035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Vanessa Gruben
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont
| | - Reed A Siemieniuk
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont
| | - Allison McGeer
- Faculty of Common Law (Gruben), University of Ottawa, Ottawa, Ont.; Department of Internal Medicine (Siemieniuk), University of Toronto; Department of Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health (McGeer), University of Toronto, Toronto, Ont.
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15
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Wicker S, Marckmann G. Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe? Vaccine 2014; 32:4844-8. [DOI: 10.1016/j.vaccine.2013.09.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/25/2013] [Accepted: 09/26/2013] [Indexed: 01/05/2023]
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Winston L, Wagner S, Chan S. Healthcare workers under a mandated H1N1 vaccination policy with employment termination penalty: a survey to assess employee perception. Vaccine 2014; 32:4786-90. [PMID: 24996124 DOI: 10.1016/j.vaccine.2014.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 04/21/2014] [Accepted: 06/02/2014] [Indexed: 11/26/2022]
Abstract
The ethical debate over mandatory healthcare worker (HCW) influenza vaccination is a heated one. Our study hospital instituted a mandatory employee influenza vaccination policy for the 2009-2010 influenza season during the highly publicized pandemic of the H1N1 "Swine Flu." Under this mandate there was no informed declination option, and termination of employment was the consequence for noncompliance. Our objective was to examine HCW perceptions of the H1N1 influenza virus, the vaccine, and the strict mandated vaccination policy. A survey was designed, distributed, and anonymously collected. In total, 202 completed questionnaires were obtained via accidental sampling by the investigators achieving a 100% response rate. Data analysis showed that 31.7% of surveyed HCWs felt the mandate was an infringement on their rights and 3.5% of HCWs would electively seek employment elsewhere. Significantly more nurses and clerks/technicians were opposed to the mandate compared to other types of employees. 96% felt that the mandating hospital should be liable should a significant adverse effect occur from receiving the vaccine. While the mandate helped to increase HCW influenza vaccination rates dramatically, the strict consequence of employment termination created negative feelings of coercion. Adopting a policy that includes a declination option with mandatory masking during influenza season might be a more widely acceptable and still adequate approach.
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Affiliation(s)
- Lori Winston
- CEP America, Kaweah Delta Health Care District, Visalia, CA, United States; University of California at Irvine and American University of Antigua, United States.
| | - Stephanie Wagner
- Infinity Healthcare, Sacred Heart Hospital Eau Claire, WI, United States
| | - Shu Chan
- Presence Resurrection Medical Center, Chicago, IL, United States; University of Illinois at Chicago, United States
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Nowrouzi-Kia B, McGeer A. External cues to action and influenza vaccination among post-graduate trainee physicians in Toronto, Canada. Vaccine 2014; 32:3830-4. [PMID: 24837775 DOI: 10.1016/j.vaccine.2014.04.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 03/31/2014] [Accepted: 04/21/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Understanding factors affecting trainee physician choices about vaccination may permit the design of more effective vaccination programmes. METHODS To identify factors associated with seasonal and pandemic influenza vaccination, an online questionnaire based on the health belief model was sent to trainee physicians registered at the post-graduate medical education office at the University of Toronto in September 2011. RESULTS 963 complete responses were received from 1884 trainee physicians (51%); 28 (2.9%) reported an allergy to vaccine components and were excluded from further analysis. Reported seasonal influenza vaccination rates in 2008, 2009 and 2010 were 69% (648/935), 75% (708/935) and 76% (703/935), respectively; 788 (84%) reported receiving the A(H1N1)pdm09 vaccine. In multivariable analysis, number of years of post-graduate training (OR for 4+ versus 1-3 post-graduate years 2.2 (95% CL 1.3, 3.8)) was associated with receipt of the 2009 pandemic vaccine, as were four components of the health belief model: odds ratios were 4.7 (95% CL 3.0, 7.5) for perceived severity, 1.9 (95% CL 1.2, 2.9) for perceived benefits, .35 (95% CL .21, .59) for perceived barriers, and 5.8 (95% CLI 3.6, 9.1) for external cues to action. Both vaccinated and unvaccinated respondents reported that their decisions were significantly influenced by encouragement from their colleagues, families and employers. CONCLUSION Self-reported vaccination coverage among trainee physicians was high. External cues to action appear to be particularly important in trainee physician vaccination decisions: active institutional promotion may increase influenza vaccination rates in trainees.
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Affiliation(s)
| | - Allison McGeer
- Dalla Lana School of Public Health, University of Toronto, Canada; Department of Microbiology, Mount Sinai Hospital, Toronto, Canada.
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Health-Care Worker Vaccination for Influenza: Strategies and Controversies. Curr Infect Dis Rep 2012; 14:627-32. [DOI: 10.1007/s11908-012-0291-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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