Tdap Vaccination Among Healthcare Personnel, Internet Panel Survey, 2012–2014

Abstract

Introduction Healthcare personnel (HCP) are at risk for pertussis infection exposure or transmitting the disease to patients in their work settings. The Advisory Committee on Immunization Practices recommends tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination for HCP to minimize these risks. This study assessed Tdap vaccination coverage among U.S. HCP by sociodemographic and occupation-related characteristics. Methods The 2012, 2013, and 2014 Internet Panel Surveys were analyzed in 2015 to assess HCP Tdap vaccination. Effective sample sizes for 2012, 2013, and 2014 survey years were 2,038, 1613, and 1633, respectively. Missing values were assigned using multiple imputation. Multivariable logistic regression identified factors independently associated with HCP Tdap vaccination. Statistical measures were calculated with an assumption of random sampling. Results Overall, Tdap vaccination coverage among HCP was 34.8% (95% CI=30.6%, 39.0%); 40.2% (95% CI=36.1%, 44.4%); and 42.4% (95% CI=38.7%, 46.0%) in 2012, 2013, and 2014, respectively. Nurse practitioners/physician’s assistants, physicians, nurses, and HCP working in hospitals and ambulatory care settings had higher Tdap coverage. Having contact with an infant aged ≤6 months and influenza vaccination receipt were associated with increased Tdap vaccination. Non-Hispanic black race/ethnicity, having an associate/bachelor’s degree, being below poverty, non-clinical personnel status, and working in a long-term care setting were associated with decreased Tdap vaccination. Conclusions HCP Tdap vaccination coverage increased during 2012–2014; however, coverage remains low. Vaccination coverage varied widely by healthcare occupation, occupational setting, and sociodemographic characteristics. Evidence-based employer strategies used to increase HCP influenza vaccination, if applied to Tdap, may increase Tdap coverage.

Life-course immunization as a gateway to health

“…However, vaccination coverage is often low among HCPs despite vaccination recommendations being in place for more than three decades in many countries [98]. In the United States, the vaccination coverage rate among HCPs was 42% for Tdap in 2014 and 79% for seasonal influenza vaccine during the 2016-2017 season [99,100]. Notably, the most frequent reason for HCPs not receiving vaccine was fear of adverse events [101], underlining the need to better inform and educate HCPs on this matter.…”

Vaccines for Health Care Personnel

“…68 Surveys suggest US HCP vaccination rates have risen steeply from 27% in 2011 to 47% by 2014. [69][70][71] Voluntary vaccination programs have achieved variable results, with some reporting over 90% vaccination. 72 Some US hospitals have instituted Tdap requirements, with predictably high vaccination rates.…”

Adesão de profissionais de saúde do Hospital das Clínicas da FMUSP à imunização com a vacina difteria, tétano e pertussis acelular do adulto (dTpa)

“…As estratégias implementadas fazem parte da rotina do CRIE-HC, que entende que um dos seus objetivos é melhorar a cobertura vacinal dentro do Onze estudos incluídos na nossa revisão sistemática avaliaram a associação de variáveis de interesse com a vacinação de dTpa entre profissionais de saúde [28][29][30]43,[45][46][47][48][49]54,55 . Dois estudos não encontraram nenhuma associação 43,47 .…”

“…Dois estudos não encontraram nenhuma associação 43,47 . Outros estudos mostraram que ser médico (a) 30 e vacinação de influenza 28,30,54 foram associados à imunização com coqueluche entre profissionais de saúde, corroborando nossos achados. Outras variáveis positivamente associadas à vacinação com dTpa foram idade abaixo de 49 anos 28,30 , maior nível educacional 28,55 , ter maior renda 55 , ter sido hospitalizado no último ano, utilizar rotineiramente uma clínica ou centro de saúde 28,55 , ter sido imunizado para hepatite B 30,48 ou com tríplice viral 48 • A cobertura acumulada de dTpa ao término de um ano do início das estratégias foi de 41,2%.…”

“…, entendimento que influenza pode ser grave em crianças48 , ter contato com crianças menores de 6 meses de vida55 , maior volume de trabalho durante o ano30 , e ter acertado maior número de questões em um questionário sobre conhecimento sobre dTpa45 . Srivastav A et al, nos EUA, encontraram as seguintes associações negativas com a vacinação de coqueluche entre profissionais de saúde: viver abaixo da linha de pobreza e ser da raça negra54 .Dois estudos encontraram que diferentes regiões geográficas de seus países estavam associadas a diferentes coberturas com dTpa em profissionais de saúde. Nos Estados Unidos, a região oeste do país teve maiores coberturas vacinais28 enquanto que na França, trabalhadores da região da Picardia, no norte do país, tinham maior cobertura e aqueles da Provença-Alpes-Costa Azul, menor cobertura30 .…”