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Hassan MZ, Jubayer Biswas MAA, Shirin T, Rahman M, Chowdhury F, Azziz-Baumgartner E, Davis WW, Hussain M. Cost-effectiveness of seasonal influenza vaccination in WHO-defined high-risk populations in Bangladesh. J Glob Health 2024; 14:04126. [PMID: 39024624 PMCID: PMC11257706 DOI: 10.7189/jogh.14.04126] [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: 07/20/2024] Open
Abstract
Background Bangladesh carries a substantial health and economic burden of seasonal influenza, particularly among the World Health Organization (WHO)-defined high-risk populations. We implemented a modelling study to determine the cost-effectiveness of influenza vaccination in each of five high-risk groups (pregnant women, children under five years of age, adults with underlying health conditions, older adults (≥60 years), and healthcare personnel) to inform policy decisions on risk group prioritisation for influenza vaccination in Bangladesh. Methods We implemented a Markov decision-analytic model to estimate the impact of influenza vaccination for each target risk group. We obtained model inputs from hospital-based influenza surveillance data, unpublished surveys, and published literature (preferentially from studies in Bangladesh, followed by regional and global ones). We used quality-adjusted life years (QALY) as the health outcome of interest. We also estimated incremental cost-effectiveness ratios (ICERs) for each risk group by comparing the costs and QALY of vaccinating compared to not vaccinating each group, where the ICER represents the additional cost needed to achieve one year of additional QALY from a given intervention. We considered a willingness-to-pay threshold (ICER) of less than one gross domestic product (GDP) per capita as highly cost-effective and of one to three times GDP per capita as cost-effective (per WHO standard). For Bangladesh, this threshold ranges between USD 2462 and USD 7386. Results The estimated ICERs were USD -99, USD -87, USD -4, USD 792, and USD 229 per QALY gained for healthcare personnel, older adults (≥60), children aged less than five years, adults with comorbid conditions, and pregnant women, respectively. For all risk groups, ICERs were below the WHO willingness-to-pay threshold for Bangladesh. Vaccinating pregnant women and adults with comorbid conditions was highly cost-effective per additional life year gained, while vaccinating healthcare personnel, older adults (≥60), and children under five years were cost-saving per additional life year gained. Conclusions Influenza vaccination to all target risk groups in Bangladesh would be either cost-saving or cost-effective, per WHO guidelines of GDP-based thresholds.
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Affiliation(s)
- Md Zakiul Hassan
- Program for Emerging Infections, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
- Pandemic Sciences Institute, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Md Abdullah Al Jubayer Biswas
- Program for Emerging Infections, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Mahmudur Rahman
- Global Health Development the Eastern Mediterranean Public Health Network (EMPHNET), Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Program for Emerging Infections, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | | | - William W Davis
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mofakhar Hussain
- Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
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Calabrò GE, Rumi F, Ricciardi R, Cicchetti A. The economic and fiscal impact of incremental use of cell-based quadrivalent influenza vaccine for the prevention of seasonal influenza among healthcare workers in Italy. Health Res Policy Syst 2024; 22:36. [PMID: 38519969 PMCID: PMC10960473 DOI: 10.1186/s12961-024-01122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Seasonal influenza has a significant impact on public health, generating substantial direct healthcare costs, production losses and fiscal effects. Understanding these consequences is crucial to effective decision-making and the development of preventive strategies. This study aimed to evaluate the economic and the fiscal impact of implementing an incremental strategy for seasonal influenza prevention using the cell-based quadrivalent influenza vaccine (QIVc) among healthcare workers (HCWs) in Italy. METHODS To estimate the economic impact of implementing this strategy, we performed a cost analysis that considered direct healthcare costs, productivity losses and fiscal impact. The analysis considered a 3-year time horizon. A deterministic sensitivity analysis was also conducted. RESULTS Assuming a vaccination coverage rate of 30% among HCWs, the analysis considered a total of 203 018 vaccinated subjects. On analysing the overall differential impact (including direct costs, indirect costs and fiscal impact), implementing QIVc vaccination as a preventative measure against influenza among HCWs in Italy would yield societal resource savings of €23 638.78 in the first year, €47 277.56 in the second year, and €70 916.35 in the third year, resulting in total resource savings of €141 832.69. CONCLUSIONS The study demonstrated that implementing the incremental use of QIVc as part of a preventive strategy for seasonal influenza among HCWs in Italy could yield positive economic outcomes, especially in terms of indirect costs and fiscal impact. The resources saved could be utilized to fund further public health interventions. Policy-makers should consider these findings when making decisions regarding influenza prevention strategies targeting HCWs.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.Go F. Vito 1, 00168, Rome, Italy.
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Giubilini A, Savulescu J, Pugh J, Wilkinson D. Vaccine mandates for healthcare workers beyond COVID-19. JOURNAL OF MEDICAL ETHICS 2023; 49:211-220. [PMID: 35636917 PMCID: PMC9985724 DOI: 10.1136/medethics-2022-108229] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/12/2022] [Indexed: 05/06/2023]
Abstract
We provide ethical criteria to establish when vaccine mandates for healthcare workers are ethically justifiable. The relevant criteria are the utility of the vaccine for healthcare workers, the utility for patients (both in terms of prevention of transmission of infection and reduction in staff shortage), and the existence of less restrictive alternatives that can achieve comparable benefits. Healthcare workers have professional obligations to promote the interests of patients that entail exposure to greater risks or infringement of autonomy than ordinary members of the public. Thus, we argue that when vaccine mandates are justified on the basis of these criteria, they are not unfairly discriminatory and the level of coercion they involve is ethically acceptable-and indeed comparable to that already accepted in healthcare employment contracts. Such mandates might be justified even when general population mandates are not. Our conclusion is that, given current evidence, those ethical criteria justify mandates for influenza vaccination, but not COVID-19 vaccination, for healthcare workers. We extend our arguments to other vaccines.
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Affiliation(s)
- Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jonathan Pugh
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Newborn Care, John Radcliffe Hospital, Oxford, UK
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Approaches to healthcare personnel exemption requests from coronavirus disease 2019 (COVID-19) vaccination: Results of a national survey. Infect Control Hosp Epidemiol 2022; 43:1822-1827. [PMID: 35190002 PMCID: PMC8914133 DOI: 10.1017/ice.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Although a growing number of healthcare facilities are implementing healthcare personnel (HCP) coronavirus disease 2019 (COVID-19) vaccination requirements, vaccine exemption request management as a part of such programs is not well described. DESIGN Cross-sectional survey. PARTICIPANTS Infectious disease (ID) physician members of the Emerging Infections Network with infection prevention or hospital epidemiology responsibilities. METHODS Eligible persons were sent a web-based survey focused on hospital plans and practices around exemption allowances from HCP COVID-19 vaccine requirements. RESULTS Of the 695 ID physicians surveyed, 263 (38%) responded. Overall, 160 respondent institutions (92%) allowed medical exemptions, whereas 132 (76%) allowed religious exemptions. In contrast, only 14% (n = 24) allowed deeply held personal belief exemptions. The types of medical exemptions allowed varied considerably across facilities, with allergic reactions to the vaccine or its components accepted by 145 facilities (84%). For selected scenarios commonly used as the basis for religious and deeply held personal belief exemption requests, 144 institutions (83%) would not approve exemptions focused on concerns regarding right of consent or violations of freedom of personal choice, and 140 institutions (81%) would not approve exemptions focused on introducing foreign substances into one's body or the sanctity of the body. Most respondents noted plans for additional infection prevention interventions for HCP who received an exemption for COVID-19 vaccination. CONCLUSIONS Although many respondent institutions allowed exemptions from HCP COVID-19 vaccination requirements, the types of exemptions allowed and how the exemption programs were structured varied widely.
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Effect of influenza vaccination among healthcare workers on hospital-acquired influenza in short-stay hospitalized patients: A multicenter pilot study in France. Infect Control Hosp Epidemiol 2022; 43:1828-1832. [PMID: 35382916 DOI: 10.1017/ice.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs. METHODS A case-case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season. RESULTS The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21-1.29) to 0.14 (95% CI, 0.03-0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01-0.78). CONCLUSIONS Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.Trial Registration: clinicaltrials.gov identifier: NCT02198638.
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Calabrò GE, Rumi F, Fallani E, Ricciardi R, Cicchetti A. The Economic and Fiscal Impact of Influenza Vaccination for Health Care Workers in Italy. Vaccines (Basel) 2022; 10:vaccines10101707. [PMID: 36298572 PMCID: PMC9609125 DOI: 10.3390/vaccines10101707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Influenza has a significant impact on the health care system and also on production and economic systems. Vaccinated health care workers (HCWs) are more likely to have improved productivity compared to unvaccinated workers. The study aim was to estimate the economic and fiscal impact of an influenza vaccination program for HCWs in Italy. We performed a cost analysis aimed to estimate the indirect costs (productivity losses due to working days lost) and the increase in tax revenues derived from the increase in vaccination coverage among HCWs. Assuming an incremental increase in vaccination coverage of 10% per year over a period of 5 years, total savings could be obtained in terms of a reduction in productivity losses equal to −€4,475,497.16 and an increase in tax revenues of €327,158.84. This revenue could be used to finance other health interventions. Our results are fundamental in view of the sustainability of health systems and of a value-based allocation of health resources. Therefore, a complete social perspective, including the fiscal impact of flu vaccination, should be adopted to assess the economic value of influenza vaccines. Currently, health policies based on the whole value of flu vaccination are needed.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Filippo Rumi
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elettra Fallani
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Seqirus S.r.l., 53035 Monteriggioni, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Chan CP, Wong NS, Lee SS. The double-edged impacts of COVID-19 epidemic on influenza vaccination uptake in nurses in Hong Kong. Infect Dis (Lond) 2022; 54:794-803. [PMID: 35786125 DOI: 10.1080/23744235.2022.2094461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Worldwide, the COVID-19 pandemic has disrupted influenza seasonality and impacted influenza vaccination behaviours. This study examines the patterns of influenza vaccination uptake in nurses during the pre-pandemic seasons and amidst the pandemic in 2020/21 in subtropical Hong Kong. METHODS In April 2021, a cross-sectional survey was conducted in practising and student nurses. Six patterns were differentiated by their influenza vaccination status in 2020/21 and preceding five seasons: (a) resistance throughout, (b) negative change, (c) decreased tendency, (d) increased tendency (e) positive change, and (f) adherence throughout. Participants' characteristics and reasons for vaccination/non-vaccination and their associations with each vaccination pattern were explored using multivariable multinomial regression. RESULTS Among 1323 nurses (88% female with a median age of 39 years), no substantial change in vaccination uptake was noted from 2019/20 (41%) to 2020/21 (42%). Some 4% were positive-changers who were older at age of ≥50 years (aOR 4.77) and more likely to anticipate a reduced risk of severe disease with COVID-19/influenza co-infection following vaccination (aOR 8.76). Negative-changers made up 3% and were more inclined to perceive an unlikelihood of widespread influenza outbreaks amidst the pandemic (aOR 3.67). Some 26 and 43% remained adherent and resistant to influenza vaccination throughout respectively notwithstanding the COVID-19 outbreak. CONCLUSIONS In contrast to the increased uptake elsewhere, the stable influenza vaccination coverage among nurses in Hong Kong could be explained by the ubiquity of strict physical distancing regulations, which have deterred vaccination in some nurses that offsets the new uptakes induced by the mild COVID-19 outbreaks.
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Affiliation(s)
- Chin Pok Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ngai Sze Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Wong SC, Wing-Man Chan V, Kit-Ming Lam G, Lai-Ha Yuen L, Ho-Yan AuYeung C, Li FRCPath X, Hon-Kwan Chen J, Chau PH, Yuen KY, Chi-Chung Cheng V. The impact of personal coaching on influenza vaccination among healthcare workers before and during COVID-19 pandemic. Vaccine 2022; 40:4905-4910. [PMID: 35810057 PMCID: PMC9233998 DOI: 10.1016/j.vaccine.2022.06.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/26/2022]
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COVID-19 Vaccination and Intent Among Healthcare Personnel, U.S. Am J Prev Med 2022; 62:705-715. [PMID: 34965901 PMCID: PMC8710229 DOI: 10.1016/j.amepre.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/20/2021] [Accepted: 11/10/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Healthcare personnel are at increased risk for COVID-19 from workplace exposure. National estimates on COVID-19 vaccination coverage among healthcare personnel are limited. METHODS Data from an opt-in Internet panel survey of 2,434 healthcare personnel, conducted on March 30, 2021-April 15, 2021, were analyzed to assess the receipt of ≥1 dose of a COVID-19 vaccine and vaccination intent. Multivariable logistic regression was used to assess the factors associated with COVID-19 vaccination and intent for vaccination. RESULTS Overall, 68.2% of healthcare personnel reported a receipt of ≥1 dose of a COVID-19 vaccine, 9.8% would probably/definitely get vaccinated, 7.1% were unsure, and 14.9% would probably/definitely not get vaccinated. COVID-19 vaccination coverage was highest among physicians (89.0%), healthcare personnel working in hospitals (75.0%), and healthcare personnel of non-Hispanic White or other race (75.7%-77.4%). Healthcare personnel who received influenza vaccine in 2020-2021 (adjusted prevalence ratio=1.92) and those aged ≥60 years (adjusted prevalence ratio=1.37) were more likely to report a receipt of ≥1 dose of a COVID-19 vaccine. Non-Hispanic Black healthcare personnel (adjusted prevalence ratio=0.74), nurse practitioners/physician assistants (adjusted prevalence ratio=0.55), assistants/aides (adjusted prevalence ratio=0.73), and nonclinical healthcare personnel (adjusted prevalence ratio=0.79) were less likely to have received a COVID-19 vaccine. The common reasons for vaccination included protecting self (88.1%), family and friends (86.3%), and patients (69.2%) from COVID-19. The most common reason for nonvaccination was concern about side effects and safety of COVID-19 vaccine (59.7%). CONCLUSIONS Understanding vaccination status and intent among healthcare personnel is important for addressing barriers to vaccination. Addressing concerns on side effects, safety, and effectiveness of COVID-19 vaccines as well as their fast development and approval may help improve vaccination coverage among healthcare personnel.
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Jędrzejek MJ, Mastalerz-Migas A. Seasonal influenza vaccination of healthcare workers: a narrative review. Int J Occup Med Environ Health 2022; 35:127-139. [PMID: 34897290 PMCID: PMC10464734 DOI: 10.13075/ijomeh.1896.01775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 09/30/2021] [Indexed: 10/19/2022] Open
Abstract
Influenza is an acute respiratory disease caused by the influenza virus which often occurs in outbreaks and epidemics worldwide. The World Health Organization recommends annual vaccination of healthcare workers (HCWs) against influenza, because most of them are involved in the direct care of patients with a high risk of influenza-related complications. Given the significance of the disease burden, a targeted literature review was conducted to assess issues related to influenza vaccination among HCWs. The primary aim of this review was to assess the incidence of influenza among medical personnel and healthcare-associated influenza, and to outline the benefits of influenza vaccination for patients and HCWs themselves. Vaccination of HCWs seems to be an important strategy for reducing the transmission of influenza from healthcare personnel to their patients and, therefore, for reducing patient morbidity and mortality, increasing patient safety, and reducing work absenteeism among HCWs. The benefits of influenza vaccination for their patients and for HCWs themselves are addressed in literature, but the evidence is mixed and often of low-quality. Int J Occup Med Environ Health. 2022;35(2):127-39.
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Jędrzejek MJ, Mastalerz-Migas A, Janicka P. Incidence of Influenza Virus Infection among Wroclaw's Healthcare Workers in Pre-COVID-19 2019-2020 Influenza Season Using Novel Flu SensDx Device. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063159. [PMID: 35328847 PMCID: PMC8954534 DOI: 10.3390/ijerph19063159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 02/04/2023]
Abstract
Background: Healthcare workers (HCWs) are more exposed to influenza infection, and the influenza vaccination is recommended each year, to reduce the risk of influenza infection and prevent influenza transmission. This study is a cross-sectional study and the objectives were to determine the rate of influenza virus infection among HCWs in the 2019−2020 influenza season. Methods: Between January and March 2020, a survey was carried out in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). The novel point-of-care testing Flu SensDx device was used, which detects the M1 protein of the influenza virus using electrochemical impedance spectroscopy from biological material (throat/nasal swabs). Results: A total of 150 samples were collected. The majority of participating HCWs by profession were 83 physicians (55.3%) and half (51.3%) of the participating HCWs worked in PHCS. Influenza vaccination coverage was 61.3% in 2019−2020 and 46.0% in the 2018−2019 season for all participants. Of the participating HCWs, 44.0% were positive tested by the Flu SensDx device. There were no statistically significant differences among the positive tested HCWs, their influenza immunization history, and the presence of symptoms of influenza-like illness (p > 0.05). Conclusion: Although the results of the present study suggest that influenza vaccination does not reduce the frequency of influenza virus detection by Flu SensDx testing in the HCWs participants, larger studies are needed to estimate the incidence of influenza virus infection among HCWs to understand the underlying mechanism and fine-tune policies aimed at reducing nosocomial infections.
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Affiliation(s)
- Michał Jacek Jędrzejek
- Department of Family Medicine, Wroclaw Medical University, W. Syrokomli 1, 51-141 Wroclaw, Poland;
- Correspondence:
| | | | - Paulina Janicka
- Department of Pathology, Wroclaw University of Environmental and Life Sciences, Norwida 31, 50-375 Wroclaw, Poland;
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Jędrzejek MJ, Mastalerz-Migas A. Influenza Vaccination Coverage, Motivators for, and Barriers to Influenza Vaccination among Healthcare Workers in Wroclaw, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031586. [PMID: 35162609 PMCID: PMC8835710 DOI: 10.3390/ijerph19031586] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/29/2023]
Abstract
Background: Influenza vaccination, as a key element of control activities intended to prevent nosocomial influenza transmission, is recommended each year for all healthcare workers (HCWs). The objectives were to determine the rate of influenza vaccination and to identify reasons for receiving or declining the influenza vaccine among HCWs in the 2018/19 and 2019/20 influenza seasons. Methods: This study is a cross-sectional observational study carried out between January and March 2020, in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). Results: A total of 165 questionnaires were completed. The majority of participating HCWs were female—137 (83.0%), and, by profession, the majority were physicians 92 (55.8%). Influenza vaccination coverage was 61.2% in 2019/20, and 47.9% in the 2018/19 season for all participants. Participants who were male, physicians and personnel from PHCS were more frequently vaccinated in both seasons. According to the statistical analysis, physicians were more likely to receive vaccinations than nurses (p < 0.01), as were HCWs who had been vaccinated in the previous season (p < 0.001). Conclusion: The identified barriers were mainly caused by misconceptions (fear of vaccine adverse effects and perception of not being at risk/no need to get vaccinated) and an organizational barriers (lack of time). These findings may prove useful for designing immunization campaigns to tailor strategies to reach specific groups.
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Youssef D, Berry A, Youssef J, Abou-Abbas L. Vaccination against influenza among Lebanese health care workers in the era of coronavirus disease 2019. BMC Public Health 2022; 22:120. [PMID: 35039009 PMCID: PMC8763426 DOI: 10.1186/s12889-022-12501-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/03/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Health-care workers (HCWs) are at a higher occupational risk of contracting and transmitting influenza. Annual vaccination is an essential tool to prevent seasonal influenza infection. However, HCWs vaccine hesitancy remains a leading global health threat. This study aims to evaluate the flu vaccination coverage rates among Lebanese HCWs and to assess their knowledge, attitudes, practices, perceived barriers, and benefits toward the flu vaccine during the COVID-19 pandemic. In addition, we sought to identify the factors associated with flu vaccine uptake. METHODS A cross-sectional study using an online survey was conducted in Lebanon among HCWs between 14 and 28 October 2020. Multivariable logistic regression was carried out to identify the factors associated with influenza vaccine uptake. RESULTS A total of 560 HCWs participated in the survey of whom 72.9% were females, and 53.9% were aged between 30-49 years. Regarding Flu vaccination uptake, the rate has risen from 32.1% in 2019-2020 to 80.2% in 2020-2021 flu season. The majority of HCWs had a good knowledge level and a positive attitude toward flu vaccination. Regarding their practices, less than 50% of HCW were currently promoting the importance of getting the flu vaccine. The majority (83.3%) ranked the availability of a sufficient quantity of vaccines as the most significant barrier to flu vaccination. The main perceived flu vaccination benefits were enhancing patient safety, minimizing the viral reservoir in the population, decreasing hospital admission, and avoiding influenza and COVID-19 co-infection. The odds of influenza vaccine uptake was lower in unmarried compared to married HCWs (OR = 0.527, CI (0.284-0.978). However, HCWs having received the influenza vaccine in the previous season (OR = 6.812, CI (3.045-15.239)), those with good knowledge level (OR = 3.305, CI (1.155-9.457)), low perceived barriers (OR = 4.130, CI (1.827-9.334)) and high perceived level of the benefits (OR = 6.264, CI (2.919-13.442)) of the flu vaccination were found more prone to get the flu vaccine. CONCLUSION Flu vaccination uptake has increased among HCWs during the 2020-2021 flu season compared with the previous one. Continuing education as well as ensuring free, equitable, and convenient access to vaccination are still required to increase the annual flu vaccination uptake among HCWs.
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Affiliation(s)
- Dalal Youssef
- Ministry of Public Health, Lebanon, Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon.
- Institut de santé publique d'épidémiologie et de développement (ISPED), Bordeaux University, France, Bordeaux, France.
| | - Atika Berry
- Ministry of Public Health, Lebanon, Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon
| | - Janet Youssef
- Al Zahraa hospital University Medical Center, Beirut, Lebanon
| | - Linda Abou-Abbas
- Neuroscience Research Center, Faculty of medical sciences, Lebanese University, Beirut, Lebanon
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Reses HE, Jones ES, Richardson DB, Cate KM, Walker DW, Shapiro CN. COVID-19 vaccination coverage among hospital-based healthcare personnel reported through the Department of Health and Human Services Unified Hospital Data Surveillance System, United States, January 20, 2021-September 15, 2021. Am J Infect Control 2021; 49:1554-1557. [PMID: 34802705 PMCID: PMC8598683 DOI: 10.1016/j.ajic.2021.10.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022]
Abstract
To protect both patients and staff, healthcare personnel (HCP) were among the first groups in the United States recommended to receive the COVID-19 vaccine. We analyzed data reported to the U.S. Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based HCP. After vaccine introduction in December 2020, COVID-19 vaccine coverage rose steadily through April 2021, but the rate of uptake has since slowed; as of September 15, 2021, among 3,357,348 HCP in 2,086 hospitals included in this analysis, 70.0% were fully vaccinated. Additional efforts are needed to improve COVID-19 vaccine coverage among HCP.
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Affiliation(s)
| | | | | | - Kristopher M Cate
- Johns Hopkins University Applied Physics Laboratory (APL), Laurel, MD
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15
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Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel. Infect Control Hosp Epidemiol 2021; 43:3-11. [PMID: 34253266 PMCID: PMC8376851 DOI: 10.1017/ice.2021.322] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).
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16
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Talbot TR. COVID-19 Vaccination of Health Care Personnel as a Condition of Employment: A Logical Addition to Institutional Safety Programs. JAMA 2021; 326:23-24. [PMID: 34096978 DOI: 10.1001/jama.2021.8901] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
We surveyed infectious disease specialists about early coronavirus disease 2019 (COVID-19) vaccination preparedness. Almost all responding institutions rated their facility’s preparedness plan as either excellent or adequate. Vaccine hesitancy and concern about adverse reactions were the most commonly anticipated barriers to COVID-19 vaccination. Only 60% believed that COVID-19 vaccination should be mandatory.
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Hogan V, Lenehan M, Hogan M, Natin DP. Influenza vaccine uptake and attitudes of healthcare workers in Ireland. Occup Med (Lond) 2020; 69:494-499. [PMID: 31686104 DOI: 10.1093/occmed/kqz124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza vaccination uptake by Irish healthcare workers remains sub-optimal despite local initiatives to increase it. AIMS To investigate hospital workers' attitudes to influenza vaccination and how this influenced their decisions about vaccination. METHODS A questionnaire survey of Irish hospital workers, measuring uptake of and attitudes to influenza vaccination. RESULTS There were 747 responders, of whom 361 (48%) reported having received influenza vaccination. Attitudes predicting vaccination uptake included a belief that vaccination would protect family members (P < 0.0005, CI 1.191-1.739), a perception of susceptibility to 'flu (P < 0.0005, CI 1.182-1.685), a belief that all healthcare workers should be vaccinated (P < 0.005, CI 1.153-1.783), perceived ease of getting 'flu vaccination at work (P < 0.0005, CI 1.851-2.842) and encouragement by line managers (P < 0.05, CI 1.018-1.400). Attitudes negatively associated with vaccination uptake included fear of needles (P < 0.05, CI 0.663-0.985) and a belief that vaccination would cause illness (P < 0.0005, CI 0.436-0.647). Medical staff were significantly more likely to be vaccinated. Healthcare students were least likely to be vaccinated (P < 0.0005). CONCLUSION Addressing specific barriers to influenza vaccination in healthcare workers may improve uptake.
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Affiliation(s)
- V Hogan
- School of Health Sciences, NUI Galway, Galway, Ireland
| | - M Lenehan
- Department of Occupational Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Hogan
- School of Psychology, NUI Galway, Galway, Ireland
| | - D P Natin
- Mater Misericordiae University Hospital, Dublin, Ireland
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19
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Seasonal influenza vaccination coverage: a multicenter cross-sectional study among healthcare workers. ACTA ACUST UNITED AC 2020. [DOI: 10.21601/ortadogutipdergisi.658876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Abstract
Emeritus Professor Alan Glasper, from the University of Southampton, discusses government concerns about the low uptake of flu vaccination among frontline healthcare staff
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Paoli S, Lorini C, Puggelli F, Sala A, Grazzini M, Paolini D, Bonanni P, Bonaccorsi G. Assessing Vaccine Hesitancy among Healthcare Workers: A Cross-Sectional Study at an Italian Paediatric Hospital and the Development of a Healthcare Worker's Vaccination Compliance Index. Vaccines (Basel) 2019; 7:E201. [PMID: 31795438 PMCID: PMC6963296 DOI: 10.3390/vaccines7040201] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 11/28/2019] [Indexed: 11/17/2022] Open
Abstract
Healthcare workers (HCWs) in paediatric hospitals are an important source of advice on vaccinations, but vaccine hesitancy can affect even these professionals. The aim of this study is to assess this phenomenon, measuring it by means of a scoring system. A survey was conducted in five departments of an Italian paediatric university hospital of national interest. Vaccination against influenza was considered a behavioral indicator of vaccination uptake. Using the collected data, the healthcare worker's vaccination compliance index (HVCI) was computed. The results demonstrate statistically significant differences between departments and professional profiles. Nearly 80% of the sample was not immunized against seasonal influenza. According to the HVCI scores, the most hesitant departments are the intensive care unit, emergency room, and oncohematology department, while the most hesitant professional profiles are nurses and auxiliary staff. The score of the unvaccinated is significantly lower than that of the vaccinated, and the same difference was found between those who self-perceive to be skilled versus unskilled. The HVCI score was statistically verified as a predictive parameter to assess vaccination against seasonal influenza. By means of strategic training policies, both HVCI and perceived skills could be improved, suggesting that hospital management should draw a complex intervention program to fight against hesitancy.
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Affiliation(s)
- Sonia Paoli
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Chiara Lorini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Francesco Puggelli
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Antonino Sala
- Management Department, Meyer Children’s University Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy;
| | - Maddalena Grazzini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Diana Paolini
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Paolo Bonanni
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (F.P.); (M.G.); (D.P.); (P.B.); (G.B.)
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