Hospital-based cluster randomised controlled trial to assess effects of a multi-faceted programme on influenza vaccine coverage among hospital healthcare workers and nosocomial influenza in the Netherlands, 2009 to 2011

Riphagen‐Dalhuisen, Josien; Burgerhof, Johannes G. M.; Frijstein, G.; Geest-Blankert, AD van der; Danhof-Pont, M.B.; Jager, Herbert J de; Bos, A.A.; Smeets, Ed; Vries, Marjan Jt de; Gallee, Pieter; Hak, Eelko

doi:10.2807/1560-7917.es2013.18.26.20512

Cited by 49 publications

(73 citation statements)

References 20 publications

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“…Therefore, it was decided to use the 4.6% for the situation where no vaccination was available. The vaccination coverage of 15.47% was lower than the median vaccination coverage reported by a European survey (25.7% in 2014‐15) but in line with a Dutch study by Gageldonk‐Lafeber et al . Mandatory vaccination policies as for example the US installed resulted in a vaccination coverage of hospital personnel of >90% .…”

Section: Discussionsupporting

confidence: 86%

“…The trial study design has been reported earlier . The study assessed the effects of a multifaceted influenza vaccination program in University Medical Centers (UMCs) in the Netherlands during two influenza seasons (2009‐2010 and 2010‐2011).…”

Section: Methodsmentioning

confidence: 99%

“…The trial study design has been reported earlier. 7 The study assessed the effects of a multifaceted influenza vaccination program in University Medical Centers (UMCs) in the Netherlands during two influenza seasons (2009-2010 and 2010-2011). In total, the hospital staff of three intervention UMCs (n = 27 900 in 2009), three control UMCs (n = 22 451), and two external non-randomized intervention UMCs (n = 16 893) participated in the trial.…”

Section: Trial Design and Participantsmentioning

confidence: 99%

“…For acute care settings, which treat patients during epidemics, the number of trials is limited. As these settings were not applicable to acute care settings, Riphagen et al performed a trial in acute care settings in the Netherlands …”

Section: Introductionmentioning

confidence: 99%

“…As these settings were not applicable to acute care settings, Riphagen et al performed a trial in acute care settings in the Netherlands. 7,23 Moreover, while influenza immunization is safe and relatively cheap, evidence on the economic benefits is not widely available for various healthcare settings, but this is an important aspect for hospital managers and policymakers to support such a program. 24 To get a better understanding of the health economic benefits of a vaccination program for healthcare workers, we performed a modeling study using as much input as possible from a clinical trial and complemented information with additional data not provided by the trial.…”

mentioning

confidence: 99%

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The potential economic value of influenza vaccination for healthcare workers in The Netherlands

Meijboom

Riphagen‐Dalhuisen

2018

Influenza Resp Viruses

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BackgroundDespite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost‐benefit model was developed using a societal perspective.Methods/PatientsThe model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff and patients admitted to the pediatrics and internal medicine departments. The model structure and parameters estimates were based on the trial and complemented with literature research, and the impact of uncertainty explored with sensitivity analyses.ResultsIn a base‐case scenario without vaccine coverage, influenza‐related annual costs were estimated at € 410 815 for an average UMC with 8000 HCWs and an average occupancy during the influenza period of 6000 hospitalized patients. Of these costs, 82% attributed to the HCWs and 18% were patient‐related. With a vaccination coverage of 15.47%, the societal program’s savings were € 2861 which corresponds to a saving of € 270.53 per extended hospitalization. Univariate sensitivity analyses show that the results are most sensitive to changes in the model parameters vaccine effectiveness in reducing influenza‐like illness (ILI) and the vaccination‐related costs.ConclusionIn addition to the decreased burden of patient morbidity among hospitalized patients, the effects of the hospital immunization program slightly outweigh the economic investments. These outcomes may support healthcare policymakers’ recommendations about the influenza vaccination program for healthcare workers.

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Trial Design and Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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The potential economic value of influenza vaccination for healthcare workers in The Netherlands

Meijboom

Riphagen‐Dalhuisen

2018

Influenza Resp Viruses

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Evaluating the Findings of the IMPACT-C Randomized Clinical Trial to Improve COVID-19 Vaccine Coverage in Skilled Nursing Facilities

et al. 2022

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Identifying successful strategies to increase COVID-19 vaccination among skilled nursing facility (SNF) residents and staff is integral to preventing future outbreaks in a continually overwhelmed system. OBJECTIVE To determine whether a multicomponent vaccine campaign would increase vaccine rates among SNF residents and staff. DESIGN, SETTING, AND PARTICIPANTS This was a cluster randomized trial with a rapid timeline (December 2020-March 2021) coinciding with the Pharmacy Partnership Program (PPP). It included 133 SNFs in 4 health care systems across 16 states: 63 and 70 facilities in the intervention and control arms, respectively, and participants included 7496 long-stay residents (>100 days) and 17 963 staff. INTERVENTIONS Multicomponent interventions were introduced at the facility level that included: (1) educational material and electronic messaging for staff; (2) town hall meetings with frontline staff (nurses, nurse aides, dietary, housekeeping); (3) messaging from community leaders; (4) gifts (eg, T-shirts) with socially concerned messaging; (5) use of a specialist to facilitate consent with residents' proxies; and (6) funds for additional COVID-19 testing of staff/residents. MAIN OUTCOMES AND MEASURESThe primary outcomes of this study were the proportion of residents (from electronic medical records) and staff (from facility logs) who received a COVID-19 vaccine (any), examined as 2 separate outcomes. Mixed-effects generalized linear models with a binomial distribution were used to compare outcomes between arms, using intent-to-treat approach. Race was examined as an effect modifier in the resident outcome model. RESULTSMost facilities were for-profit (95; 71.4%), and 1973 (26.3%) of residents were Black. Among residents, 82.5% (95% CI, 81.2%-83.7%) were vaccinated in the intervention arm, compared with 79.8% (95% CI, 78.5%-81.0%) in the usual care arm (marginal difference 0.8%; 95% CI, −1.9% to 3.7%). Among staff, 49.5% (95% CI, 48.4%-50.6%) were vaccinated in the intervention arm, compared with 47.9% (95% CI, 46.9%-48.9%) in usual care arm (marginal difference: −0.4%; 95% CI, −4.2% to 3.1%). There was no association of race with the outcome among residents. CONCLUSIONS AND RELEVANCEA multicomponent vaccine campaign did not have a significant effect on vaccination rates among SNF residents or staff. Among residents, vaccination rates were high. However, half the staff remained unvaccinated despite these efforts. Vaccination campaigns to target SNF staff will likely need to use additional approaches.

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Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions

Jefferson¹,

Lasserson

2016

Cochrane Database of Systematic Reviews

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Hospital-based cluster randomised controlled trial to assess effects of a multi-faceted programme on influenza vaccine coverage among hospital healthcare workers and nosocomial influenza in the Netherlands, 2009 to 2011

Cited by 49 publications

References 20 publications

The potential economic value of influenza vaccination for healthcare workers in The Netherlands

The potential economic value of influenza vaccination for healthcare workers in The Netherlands

Evaluating the Findings of the IMPACT-C Randomized Clinical Trial to Improve COVID-19 Vaccine Coverage in Skilled Nursing Facilities

Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions

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