How to improve influenza vaccine coverage of healthcare personnel

231

220

Influenza imposes a significant burden worldwide from the healthcare and socio-economic standpoints. This is also due to suboptimal vaccination coverage among the target population, even though immunization is recommended since many years and still remains the fundamental tool for its prevention. Healthcare workers (HCWs) are at increased risk of exposure to respiratory pathogens compared with the general population, including flu, with potential threat for their health and for patients' safety. Nevertheless, despite recommendation for immunization of this work-category in most of Western Countries, inadequate flu vaccine uptake is reported during the last decade in the European area. According to recent systematic reviews on this topic, the main determinants of vaccine acceptance among HCWs have been largely investigated and include desire for self-protection and to protect family rather than absolute disease risk or desire to protect patients, among the main drivers. On the other hand, concerns regarding safety of the vaccines resulted in decreased vaccine uptake. Moreover, influenza vaccine hesitancy among HCWs was also associated with several issues such as low risk perception, denial of the social benefit of influenza vaccination, low social pressure, lack of perceived behavioral control, negative attitude toward vaccines, not having been previously vaccinated against influenza, not having previously had influenza, lack of adequate influenza-specific knowledge, lack of access to vaccination facilities, and socio-demographic variables. The topic of influenza vaccination among HCWs is challenging, full of ethical issues. Systematic reviews of randomized controlled trials (RCTs) investigating the effectiveness of interventions for improving vaccine uptake among HCWs found that combined strategies were more effective than isolate approaches. Mandatory policies are currently under debate in several countries. High quality studies would help policy-makers and stake-holders to shape evidence-based initiatives and programs to improve the control of influenza.

Section: Discussionmentioning

confidence: 99%

Influenza vaccination in healthcare workers: A comprehensive critical appraisal of the literature

Dini

Toletone

Sticchi

et al. 2017

231

220

“…10 The reasons depend both on the organizational difficulties in implementing the campaigns, but also on the personal beliefs, perceptions, and attitudes of the HCWs towards influenza disease and vaccination. 11,12 In the USA, where in many settings influenza vaccination is required by the employer, coverage rates were reported to be 78.6% during the 2016/2017 season, with 92.3% for those HCWs working in hospitals. 13 In Europe, vaccination is not mandatory, though many European countries recommend it for risk groups, such as HCWs.…”

Section: Introductionmentioning

confidence: 99%

Seasonal influenza vaccination among health-care workers: the impact of different tailored programs in four University hospitals in Rome

Tognetto

Zorzoli

Franco

et al. 2019

Seasonal influenza vaccination (SIV) of health-care workers (HCWs) is recommended in most countries to protect them and their patients from infection. Although SIV can reduce the risk of influenza complications among vulnerable patients, vaccination uptake is generally unsatisfactory. The present study aimed to assess the impact of different programs in promoting SIV uptake among HCWs during the season 2017/2018 in four teaching hospitals in Rome. A multicentric cross-sectional study was carried out, in order to describe the four different campaigns and to assess their impact by identifying and developing a set of indicators that provide information about the vaccination services, the percentage of invited HCWs, the vaccinators' workforce and the vaccination coverage rates.The hospitals organized different strategies: Hospital 1, 3 and 4 organized educational courses for HCWs and actively invited every single HCW through e-mail. All the hospitals organized a dedicated unit for influenza vaccination, and Hospital 1 added on-site vaccination sessions that required a large number of staff. Hospital 1 and hospital 4 registered a comparable vaccination coverage rate, 12.97% and 12.76%, respectively, while it was 6.88% in Hospital 2 and 4.23% in Hospital 3. Our indicators demonstrated to be effective and useful for analyzing the different SIV campaigns. The results suggest that the best practice to promote SIV among HCWs should include multiple approaches. Among those, an easy access to the vaccination site seems to play a key role in determining a higher vaccination coverage.

“…Healthcare-associated influenza increases the risk of mortality and severe morbidity among hospitalized patients. 1 Influenza vaccination among health-care workers (HCWs) reduces transmission of the disease in health-care settings, absenteeism among staff, and potentially overall health-care costs. [2][3][4][5][6] Various strategies have been adopted to encourage HCWs to consistently receive influenza vaccination.…”

Section: Introductionmentioning

confidence: 99%

“…These include mandatory influenza vaccination implemented in certain hospitals in the United States. 1,7 Other countries without such policies, such as Singapore and Australia, promote influenza vaccination uptake through annual vaccination campaigns. 8,9 Predictors of influenza vaccine uptake among HCWs are well-documented and include personal psychosocial beliefs, accessibility and availability of vaccines, and self-efficacy, which can be categorized under various constructs of the Health Belief Model.…”

Section: Introductionmentioning

confidence: 99%

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Lim

Lee

et al. 2019

Understanding the change in intention for influenza vaccine among health-care workers (HCWs) is important to increase influenza vaccination uptake. We aimed to investigate the psychosocial beliefs associated with a change in the intention for influenza vaccine. An anonymous cross-sectional survey was distributed to tertiary hospital HCWs in 2016. Of 3007 HCWs, 70% were compliant (vaccinated, with an intention to revaccinate), 8% were resistant (unvaccinated, without intention to vaccinate), 10% had positive change (unvaccinated, but with intention) and 12% had negative change (vaccinated, but without intention). Across HCW groups, medical staff had both the highest proportion receiving all influenza vaccinations in the last 5 years (101, 28.4%), as well as the highest proportion who had never received vaccination (41, 11.5%). With increasing age, HCWs were less likely to have a negative (p = .02) or positive change (p = .06) in intention, compared to the vaccine-resistant group. HCWs were more likely to be compliant or have a positive change in intention to receive influenza vaccine, if they perceived the vaccine as effective, safe, or had a higher frequency of influenza vaccination in the last 5 years (all with p < .05). HCWs who were medical staff, who believed that side effects of the vaccine were common, or had worked for 6 to 10 years (vs 5 years or less) were less likely to be compliant (all with p < .05). In conclusion, older HCWs were more likely to maintain the status quo in their behavior toward influenza vaccination. Influenza vaccination strategies should place emphasis on vaccine effectiveness and safety.