Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients

Abstract

BackgroundDespite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009–2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012–2013.MethodsThe overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons.ResultsThe first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were “Unsure of the efficacy of vaccine” and “Feel not at-risk of getting influenza or its complications”. Despite recommendations, influenza vaccine uptake remains poor.ConclusionImmunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1090-x) contains supplementary material, which is available to authorized users.

Üçüncü basamak sağlık hizmeti veren hastane çalışanlarının mevsimsel grip aşısına yönelik yaklaşımları

“…Since risk perception of vaccination rates is higher in pandemics periods, Sevencan et al found the rates 36.4% whereas Ormen et al detected the rates up to 40.0% [13,14]. The reason for lower rates of vaccination in similar studies conducted worldwide is similar to the reasons detected in our country [15,16,17]. The most common reasons for rejection of the vaccination include being afraid of side effects of the vaccine, not believing the effectiveness of the vaccine and not considering the vaccine safe [18].…”

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

“…Our data are consistent with findings from several other studies in that vaccine uptake is significantly lower for nurses than physicians. 18,[27][28][29][30][31][32][33] One study determined that physicians had a higher level of knowledge about influenza and influenza vaccines were less likely to expect a severe reaction to the vaccine, and more likely to consider influenza vaccines effective than nurses. 18 Similarly, increased knowledge levels and beliefs that influenza is a serious illness and that vaccinations are safe were associated with higher uptake among nurses.…”

Can the Health Belief Model and moral responsibility explain influenza vaccination uptake among nurses?

“…Several reasons for receiving and not receiving vaccination have been identified in the literatures. For example, studies have shown that the common reasons for not receiving vaccination among nurses included low levels of risk perception, concerns about side effects, questions about vaccine's effectiveness/safety, inconvenience in accessing vaccination, fear of pain, or negative reports from media (Ajenjo et al, 2010;Clark, Cowan, & Wortley, 2009;Corace et al, 2013;Giannattasio et al, 2015;Hollmeyer, Hayden, Poland, & Buchholz, 2009;Maltezou et al, 2008;Schmid, Rauber, Betsch, Lidolt, & Denker, 2017;Wang, Lee, & Lee, 2015;Weingarten, Riedinger, Bolton, Miles, & Ault, 1989;Zhang, While, & Norman, 2011). On the other hand, the reasons for receiving vaccination among nurses included protecting oneself, patient, family members, friends and children, to avoid sick leave, recommendation/mandate by employer, perception of vaccine's effectiveness/ safety and accessibility of vaccination (Haviari et al, 2015;Hollmeyer et al, 2009;Maltezou et al, 2008;Tosh, Jacobson, & Poland, 2010;Zhang et al, 2011).…”