Measles Immunization Status of Health Care Workers: A Cross-Sectional Study Exploring Factors Associated with Lack of Immunization According to the Health Belief Model

Measles vaccination coverage and immunization status of nurses: An interventional study in Türkiye

INTRODUCTION

Healthcare workers are more likely to contract measles than the general population. Our study aimed to assess measles vaccination and immunization levels among nurses, examine the influencing factors and implement an intervention program to increase immunization coverage.

MATERIALS AND METHODS

Our study was conducted in a university hospital in Türkiye. The study included 1012 nurses. It was an intervention study, continued between 01/11/2021 and 30/10/2023. Measles IgG and vaccination status of the participants were evaluated. Participants with negative measles IgG results who had not been vaccinated against measles or received a single dose of the vaccine were invited to the outpatient clinic to receive two doses. Participants who had received two doses of the measles vaccine and had negative measles IgG results were invited to the outpatient clinic for one dose of the measles vaccine. Nine hundred seventy-eight people participated in our study. The access frequency was 96.6%.

RESULTS

Among the participants aged 21-30, 68.4 % were Measles IgG (+). Measles IgG (+) prevalence was higher in women than men (85.3 % vs. 61.0 %). The department with the lowest measles IgG positivity was intensive care (75.8 %). Measles IgG (+) prevalence became higher as the duration of employment increased. The measles seropositivity in total population rose from 83.1 % before the intervention to 94.3 % after, to 91.8 % in the 21-30 age group, and to 90.2 % in male. Sixteen people had never received measles vaccination. Of the 37 participants who had previously received two doses of measles vaccine, 22 received a single dose and after the intervention 16 (72.7 %) were positive. Only 1 person was found to have vaccine refusal during the intervention.

CONCLUSION

Expanding the immunization scope in hospitals by screening for measles antibodies among healthcare personnel and vaccinating those who are seronegative can be considered an effective public health strategy.

Impact of Actively Offering Influenza Vaccination to Frail People during Hospitalisation: A Pilot Study in Italy

Despite the worldwide recommendations for influenza immunisation, vaccination coverage for patients exposed to the highest risk of severe complications is still far from the optimal target. The need to take advantage of alternative methods to provide vaccination is essential. This study presents a hospital-based strategy which offers influenza vaccination to inpatients at discharge. This study was conducted during the 2022-2023 influenza season at the University Hospital of Palermo. A questionnaire was administered to identify the determinants for the acceptance of influenza vaccination in the frail population. Overall, 248 hospitalised patients were enrolled, of which 56.1% were female and 52.0% were over 65 years of age. The proportion of patients vaccinated against influenza during hospitalisation was 62.5%, an increase of 16% in influenza vaccination uptake among frail people in comparison with the previous influenza season (46.8% vaccinated during the 2021-22 influenza season). Factors significantly associated with vaccination acceptance were the following: to have received influenza vaccine advice from hospital healthcare workers (OR = 3.57, p = 0.001), to have been previously vaccinated for influenza (OR = 3.16 p = 0.005), and to have had a low level of education (OR = 3.56, p = 0.014). This study showed that offering influenza vaccination to hospitalised patients could be an effective strategy to increase vaccination coverage in the most vulnerable population, and these findings could be useful for planning and improving future influenza vaccination campaigns.

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings

BACKGROUND

Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting.

AIMS

To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine.

METHODS

We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL.

RESULTS

The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis (p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%).

CONCLUSIONS

Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators.