Mandatory influenza immunisation of health-care workers

Abstract

Seasonal influenza imposes an enormous but poorly defined burden of excess deaths, hospital admissions, and health-care costs, and often spreads within health-care facilities. Hospital patients with influenza are a potential source of infection for health-care workers that are not immunised, with attack rates among health-care workers of 18–24%.1 Unfortunately, health-care workers infected with influenza often continue to work, despite symptoms, with potentially devastating consequences for high-risk patients, including those who are very young, elderly, or immunocompromised—for example, patients receiving bone-marrow transplants have a high risk of pneumonia and death from influenza.2\ud Trivalent subunit influenza vaccines are 70–90% effective3 and safe, with mild side-effects in less than 10% of recipients.4 Immunisation of health-care workers can reduce exposure to, and illness and death from, influenza among patients in long-term care facilities5 even with modest uptake rates6 (at an estimated cost of £51–405 per life-year saved), as well as reducing infection and absenteeism among health-care workers that have been immunised (with estimated savings of £12 per vaccinee).5 In a bone-marrow-transplant unit in the USA, increasing immunisation uptake from 12% to 58% among health-care workers, was associated with a reduction in nosocomial influenza infections from 14 to 4 cases per 10 000 patients days.7\ud Despite this evidence and recommendations by major health authorities for yearly immunisation of health-care workers,8 uptake is often poor (less than 30%). Immunisation uptake rarely exceeds 60%, even when vaccine is free and easily accessible,5 and 9 which is inadequate to protect the most vulnerable patients, many of whom are unimmunised because of immunosuppression or comorbidities. Uptake can be increased by various interventions, including staff education, active promotion, incentives, declination forms, clinical leadership, and provision of free vaccine at convenient locations, such as mobile carts,8 and 10 but increases are often modest and difficult to sustain over successive seasonsveli

Influenza vaccination among nursing professionals: reality and challenges

“…Thus, we can say that knowledge does not necessarily affects the action. Other authors (20)(21)(22)(23) have also shown that the benefits of vaccination related to patients were little considered by some professionals, and which in this study also does not appear as the main motivators for vaccination. These data can be interpreted as a limited understanding of the benefits generated by vaccination in health professionalpresent, more intensely in those who have not adhered to this practice.…”

“…In another study, the authors used different intervention strategies related to accessibility, including the training of workers to act vaccinating their colleagues in the workplace, prolongingvaccination time beyond the routine, mass vaccination day,mobile vaccinators moving aroud workplece which, combined with educational measures and diverse dissemination, obtained an increase of 77.0% to 84.7% in coverage of the institution (26) . It is also important to remember that facilitating access to vaccination through measures such as increasing the number of days of the campaign, making it available within the various work shifts and leaving the option for the professional to vaccinate in the workplace or go to a fixed location with easy access are important strategies for acquiring adequate coverage (15,21,23) . Nevertheless, isolated measures in campaigns involving only education or only promotionhave little impact on increasing adherence to vaccination.…”

Niedrige Influenzaimpfquoten bei Mitarbeitern im Gesundheitswesen

“…Da medizinisches Personal aufgrund seiner beruflichen Tätigkeit ein erhöhtes Expositionsrisiko gegenüber Influenzaerkrankten hat, dient die Impfung einerseits dem individuellen Schutz der Beschäftigten, andererseits können dadurch Infektionsübertragungen auf Patienten vermieden werden [12]. Allerdings lässt sich nur ungefähr jeder fünfte Beschäftige aus dem Gesundheitswesen in Deutschland gegen Influenza impfen.…”

“…Impfungen für medizinisches Personal werden meist als etwas betrachtet, das man akzeptieren oder auch ablehnen kann. Die Wahlfreiheit hängt aber auch davon ab, inwieweit die eigene Entscheidung andere Personen beeinträch-tigen kann [12]. Die ethische Pflicht, anderen nicht zu schaden, das heißt in diesem Kontext, keine Influenzainfektion zu übertragen, überwiegt nach unserem Ermessen der relativ geringen Gefahr, aufgrund der Influenzaimpfung relevante Nebenwirkungen zu erleiden [18,38,41,42,43,44,45,46,47].…”

Seasonal flu vaccination for healthcare workers?

“…There is no consensus on whether mandatory influenza immunisation policies for healthcare workers should be instituted 45–49. Recently, the Society for Healthcare Epidemiology of America has endorsed a policy in which annual influenza vaccination is a condition of both initial and continued healthcare worker employment and/or professional privileges 50.…”