1. Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: A 2010 survey
Abstract
“Our objectives were to describe the vaccine coverage (VC1) for some occupational vaccines (hepatitis B, pertussis, seasonal and pandemic influenza) among French General Practitioners (GPs2) and to study the factors associated with being vaccinated for each of these four diseases. We surveyed a representative national sample of 1431 self-employed GPs in France. Self-reported VC was 76.9% for 2009/10 seasonal influenza, 73.0% for hepatitis B, 63.9% for pertussis and 60.8% for A/H1N1 pandemic influenza. The factors associated with reporting being vaccinated were quite different from one vaccine to another. For some or all four vaccines, we found a significant positive association (p < 0.05) with the following factors in the multivariate analysis: GP’s male gender, high volume of activity, no particular mode of exercise (e.g. homoeopathy), no use of Internet at the practice, Continuing Medical Education sessions, discussing the benefits and risks of vaccination with the patients and performing prevention investigations for oneself (lipid profile). Being vaccinated for one vaccine also increased the VC for some or all three other studied vaccines. All these findings argue for public health campaigns using messages adapted to each vaccine.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/23806242
Citation
Pulcini, CÃoline, Sophie Massin, Odile Launay, and Pierre Verger. "Factors Associated with Vaccination for Hepatitis B, Pertussis, Seasonal and Pandemic Influenza among French General Practitioners: A 2010 Survey." Vaccine 31.37 (2013): 3943-949.
“Our objectives were to describe the vaccine coverage (VC1) for some occupational vaccines (hepatitis B, pertussis, seasonal and pandemic influenza) among French General Practitioners (GPs2) and to study the factors associated with being vaccinated for each of these four diseases. We surveyed a representative national sample of 1431 self-employed GPs in France. Self-reported VC was 76.9% for 2009/10 seasonal influenza, 73.0% for hepatitis B, 63.9% for pertussis and 60.8% for A/H1N1 pandemic influenza. The factors associated with reporting being vaccinated were quite different from one vaccine to another. For some or all four vaccines, we found a significant positive association (p < 0.05) with the following factors in the multivariate analysis: GP’s male gender, high volume of activity, no particular mode of exercise (e.g. homoeopathy), no use of Internet at the practice, Continuing Medical Education sessions, discussing the benefits and risks of vaccination with the patients and performing prevention investigations for oneself (lipid profile). Being vaccinated for one vaccine also increased the VC for some or all three other studied vaccines. All these findings argue for public health campaigns using messages adapted to each vaccine.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/23806242
Citation
Pulcini, CÃoline, Sophie Massin, Odile Launay, and Pierre Verger. "Factors Associated with Vaccination for Hepatitis B, Pertussis, Seasonal and Pandemic Influenza among French General Practitioners: A 2010 Survey." Vaccine 31.37 (2013): 3943-949.
2. Influenza vaccination among healthcare workers in Italy The experience of a large tertiary acute-care teaching hospital
Abstract
“Influenza vaccination is a fundamental tool for the prevention of influenza in healthcare settings and its administration to healthcare workers (HC Ws) is recommended in more than 40 countries including United States of America and many countries of the European Union. Despite these recommendations, the compliance of HCWs to influenza vaccination is largely inadequate in Italy. Since 2005/06 season, a comprehensive multifaceted intervention project aimed at increasing the seasonal influenza vaccination coverage rates among HCWs was performed at the IRCCS AOU San Martino IST teaching hospital in Genoa, Italy, the regional tertiary adult acute-care reference center with a 1300 bed capacity. Despite almost a decade of efforts, the vaccination coverage rates registered at our hospital steadily remain unsatisfactory and very distant by the minimum objective of 75% defined by the Italian Ministry of Health. During the last influenza season (2013/14), vaccination coverage rates by occupation type resulted 30% among physicians, 11% among nurses and 9% among other clinical personnel. Further efforts are necessary to prevent the transmission of influenza to patient and novel strategies need to be identified and implemented in order to increase the compliance of HCWs, particularly nurses, with the seasonal influenza vaccination”
Links
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514208/
Citation
“Alicino, Cristiano, Rocco Iudici, Ilaria Barberis, Chiara Paganino, Roberto Cacciani, Monica Zacconi, Angela Battistini, Dorotea Bellina, Anna Maria Di Bella, Antonella Talamini, Laura Sticchi, Alessandra Morando, Filippo Ansaldi, and Paolo Durando. "Influenza Vaccination among Healthcare Workers in Italy." Human Vaccines & Immunotherapeutics 11.1 (2014)”
“Influenza vaccination is a fundamental tool for the prevention of influenza in healthcare settings and its administration to healthcare workers (HC Ws) is recommended in more than 40 countries including United States of America and many countries of the European Union. Despite these recommendations, the compliance of HCWs to influenza vaccination is largely inadequate in Italy. Since 2005/06 season, a comprehensive multifaceted intervention project aimed at increasing the seasonal influenza vaccination coverage rates among HCWs was performed at the IRCCS AOU San Martino IST teaching hospital in Genoa, Italy, the regional tertiary adult acute-care reference center with a 1300 bed capacity. Despite almost a decade of efforts, the vaccination coverage rates registered at our hospital steadily remain unsatisfactory and very distant by the minimum objective of 75% defined by the Italian Ministry of Health. During the last influenza season (2013/14), vaccination coverage rates by occupation type resulted 30% among physicians, 11% among nurses and 9% among other clinical personnel. Further efforts are necessary to prevent the transmission of influenza to patient and novel strategies need to be identified and implemented in order to increase the compliance of HCWs, particularly nurses, with the seasonal influenza vaccination”
Links
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514208/
Citation
“Alicino, Cristiano, Rocco Iudici, Ilaria Barberis, Chiara Paganino, Roberto Cacciani, Monica Zacconi, Angela Battistini, Dorotea Bellina, Anna Maria Di Bella, Antonella Talamini, Laura Sticchi, Alessandra Morando, Filippo Ansaldi, and Paolo Durando. "Influenza Vaccination among Healthcare Workers in Italy." Human Vaccines & Immunotherapeutics 11.1 (2014)”
3. Influenza vaccination in paediatric nurses: Cross-sectional study of coverage, refusal, and factors in acceptance
Abstract
“Background:
Influenza vaccination among health-care workers is poor, and the effectiveness of hospital vaccination programs remains unclear. Little is known about the effectiveness of intensive evidence-based vaccination programs in nursing staff. We determined whether the recommended vaccination rate could be achieved among paediatric nurses during an intensive promotional program for influenza vaccination. We also sought to identify the reasons for which nurses refuse the influenza vaccine and predictors of future vaccination intent.
Methods:
We offered influenza vaccination to nursing staff during an influenza season through a multicomponent program that included intensive promotional activities. We analysed vaccination data to determine uptake rates. In a cross-sectional survey, self-administered questionnaires were distributed to all nurses with patient contact during that season. The questionnaire evaluated their vaccine use, site of work, absenteeism and physician visits due to respiratory illness, vaccination intent for the subsequent influenza season, and other items. We surveyed vaccinated nurses regarding their program experiences and the frequency and severity of adverse reactions. Unvaccinated nurses were asked their reasons for refusing vaccination. Multiple logistic-regression analysis was conducted to identify variables that predicted the likelihood of future vaccine acceptance.
Results:
More than 75% (895/1182) of applicable nurses were vaccinated in the program. The questionnaire response rate was nearly 48% (585/1230). Vaccination in the program during the current season (odds ratio [OR] 101.99, 95% confidence interval [CI] 52.54–197.98), program convenience (OR 199.19, 95% CI 98.01–404.11), and a physician visit for respiratory illness (OR 2.44, 95% CI 1.29–4.61) were found to be independent predictors of intent to receive the vaccine the following season. A lack of perceived personal need was the most common reason for vaccine refusal, given in 30% (77/258) of unvaccinated respondents.
Conclusions:
Adequate coverage of nurses is achievable during an intensive voluntary immunisation program against influenza, using best-known practices. Perceived lack of personal benefit is a major deterrent, while program convenience and previous vaccination strongly predict future vaccine acceptance. Our findings support interventions that improve the convenience of hospital immunisation programs for influenza, particularly those that are aimed at nurses and that promote vaccine efficacy and benefits.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/18448210
Citation
Norton, Seamus P., David W. Scheifele, Julie A. Bettinger, and Robert M. West. "Influenza Vaccination in Paediatric Nurses: Cross-sectional Study of Coverage, Refusal, and Factors in Acceptance." Vaccine 26.23 (2008): 2942-948.
“Background:
Influenza vaccination among health-care workers is poor, and the effectiveness of hospital vaccination programs remains unclear. Little is known about the effectiveness of intensive evidence-based vaccination programs in nursing staff. We determined whether the recommended vaccination rate could be achieved among paediatric nurses during an intensive promotional program for influenza vaccination. We also sought to identify the reasons for which nurses refuse the influenza vaccine and predictors of future vaccination intent.
Methods:
We offered influenza vaccination to nursing staff during an influenza season through a multicomponent program that included intensive promotional activities. We analysed vaccination data to determine uptake rates. In a cross-sectional survey, self-administered questionnaires were distributed to all nurses with patient contact during that season. The questionnaire evaluated their vaccine use, site of work, absenteeism and physician visits due to respiratory illness, vaccination intent for the subsequent influenza season, and other items. We surveyed vaccinated nurses regarding their program experiences and the frequency and severity of adverse reactions. Unvaccinated nurses were asked their reasons for refusing vaccination. Multiple logistic-regression analysis was conducted to identify variables that predicted the likelihood of future vaccine acceptance.
Results:
More than 75% (895/1182) of applicable nurses were vaccinated in the program. The questionnaire response rate was nearly 48% (585/1230). Vaccination in the program during the current season (odds ratio [OR] 101.99, 95% confidence interval [CI] 52.54–197.98), program convenience (OR 199.19, 95% CI 98.01–404.11), and a physician visit for respiratory illness (OR 2.44, 95% CI 1.29–4.61) were found to be independent predictors of intent to receive the vaccine the following season. A lack of perceived personal need was the most common reason for vaccine refusal, given in 30% (77/258) of unvaccinated respondents.
Conclusions:
Adequate coverage of nurses is achievable during an intensive voluntary immunisation program against influenza, using best-known practices. Perceived lack of personal benefit is a major deterrent, while program convenience and previous vaccination strongly predict future vaccine acceptance. Our findings support interventions that improve the convenience of hospital immunisation programs for influenza, particularly those that are aimed at nurses and that promote vaccine efficacy and benefits.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/18448210
Citation
Norton, Seamus P., David W. Scheifele, Julie A. Bettinger, and Robert M. West. "Influenza Vaccination in Paediatric Nurses: Cross-sectional Study of Coverage, Refusal, and Factors in Acceptance." Vaccine 26.23 (2008): 2942-948.
4. Mothers and vaccination: knowledge, attitudes, and behavior in Italy
Abstract
“The study evaluates knowledge, attitudes, and behavior of mothers regarding the immunization of 841 infants who attended public kindergarten in Cassino and Crotone, Italy. Overall, 57.8% of mothers were aware about all four mandatory vaccinations for infants (poliomyelitis, tetanus, diphtheria, hepatitis B). The results of a multiple logistic regression analysis showed that this knowledge was significantly greater among mothers with a higher education level and among those who were older at the time of the child's birth. Respondents' attitudes towards the utility of vaccinations for preventing infectious diseases were very favourable. Almost all children (94.4%) were vaccinated with all three doses of diphtheria-tetanus (DT), oral poliovirus vaccine (OPV), and hepatitis B. The proportion of children vaccinated who received all three doses of OPV, DT or diphtheria-tetanus-pertussis (DTP), and hepatitis B vaccines within 1 month of becoming age-eligible ranged from 56.6% for the third dose of hepatitis B to 95.7% for the first dose of OPV. Results of the regression analysis performed on the responses of mothers who had adhered to the schedule for all mandatory vaccinations indicated that birth order significantly predicted vaccination nonadherence, since children who had at least one older sibling in the household were significantly less likely to be age-appropriately vaccinated. The coverage for the optional vaccines was only 22.5% and 31% for measles-mumps-rubella and for all three doses against pertussis, respectively. Education programmes promoting paediatric immunization, accessibility, and follow-up should be targeted to the entire population.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/10212512
Citation
“Angelillo IF, Ricciardi G, Rossi P, Pantisano P, Langiano E, Pavia M. Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bulletin of the World Health Organization. 1999;77(3):224-229.”
“The study evaluates knowledge, attitudes, and behavior of mothers regarding the immunization of 841 infants who attended public kindergarten in Cassino and Crotone, Italy. Overall, 57.8% of mothers were aware about all four mandatory vaccinations for infants (poliomyelitis, tetanus, diphtheria, hepatitis B). The results of a multiple logistic regression analysis showed that this knowledge was significantly greater among mothers with a higher education level and among those who were older at the time of the child's birth. Respondents' attitudes towards the utility of vaccinations for preventing infectious diseases were very favourable. Almost all children (94.4%) were vaccinated with all three doses of diphtheria-tetanus (DT), oral poliovirus vaccine (OPV), and hepatitis B. The proportion of children vaccinated who received all three doses of OPV, DT or diphtheria-tetanus-pertussis (DTP), and hepatitis B vaccines within 1 month of becoming age-eligible ranged from 56.6% for the third dose of hepatitis B to 95.7% for the first dose of OPV. Results of the regression analysis performed on the responses of mothers who had adhered to the schedule for all mandatory vaccinations indicated that birth order significantly predicted vaccination nonadherence, since children who had at least one older sibling in the household were significantly less likely to be age-appropriately vaccinated. The coverage for the optional vaccines was only 22.5% and 31% for measles-mumps-rubella and for all three doses against pertussis, respectively. Education programmes promoting paediatric immunization, accessibility, and follow-up should be targeted to the entire population.”
Links
https://www.ncbi.nlm.nih.gov/pubmed/10212512
Citation
“Angelillo IF, Ricciardi G, Rossi P, Pantisano P, Langiano E, Pavia M. Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bulletin of the World Health Organization. 1999;77(3):224-229.”
5. Vaccinating health care workers during an influenza pandemic
Abstract
“In response to the 2009 H1N1 influenza pandemic, health care workers (HCWs) were offered immunization with H1N1 vaccine in addition to seasonal flu vaccine. Previously, low rates of influenza vaccine uptake in HCWs have been attributed to concerns about vaccine clinical effectiveness, side effects and access difficulties.
AIMS:
To explore H1N1 influenza vaccination of HCWs in London during 2009-10 and examine reasons for vaccine refusal.
METHODS:
An online questionnaire survey of doctors and nurses working in two primary care trust (PCT) areas and one acute trust area was carried out in London.
RESULTS:
Only 59% of the 221 respondents had been immunized with H1N1 influenza vaccine and 43% with seasonal influenza vaccine. The commonest reasons for remaining unvaccinated were 'side effects', 'swine flu not severe' and 'concerns about clinical effectiveness of the vaccine'. Respondents who had been vaccinated that season gave positive feedback on their experience.
CONCLUSIONS:
While uptake among HCWs was greater for the pandemic vaccine than is usually seen with seasonal influenza vaccine, this survey suggests that in this area of London during the 2009 pandemic, HCWs refused H1N1 vaccination due to concerns about clinical effectiveness, side effects and perceptions that H1N1 infection was not generally severe. We found no evidence to suggest poor access was a barrier to H1N1 vaccination of HCWs. If good access is maintained, the key barrier to improving seasonal flu vaccine uptake lies with informing the personal risk assessment made by the HCW.“
Links
https://www.ncbi.nlm.nih.gov/pubmed/22773657
Citation
Head, S., S. Atkin, K. Allan, C. Ferguson, S. Lutchmun, and R. Cordery. "Vaccinating Health Care Workers during an Influenza Pandemic." Occupational Medicine 62.8 (2012): 651-54.
“In response to the 2009 H1N1 influenza pandemic, health care workers (HCWs) were offered immunization with H1N1 vaccine in addition to seasonal flu vaccine. Previously, low rates of influenza vaccine uptake in HCWs have been attributed to concerns about vaccine clinical effectiveness, side effects and access difficulties.
AIMS:
To explore H1N1 influenza vaccination of HCWs in London during 2009-10 and examine reasons for vaccine refusal.
METHODS:
An online questionnaire survey of doctors and nurses working in two primary care trust (PCT) areas and one acute trust area was carried out in London.
RESULTS:
Only 59% of the 221 respondents had been immunized with H1N1 influenza vaccine and 43% with seasonal influenza vaccine. The commonest reasons for remaining unvaccinated were 'side effects', 'swine flu not severe' and 'concerns about clinical effectiveness of the vaccine'. Respondents who had been vaccinated that season gave positive feedback on their experience.
CONCLUSIONS:
While uptake among HCWs was greater for the pandemic vaccine than is usually seen with seasonal influenza vaccine, this survey suggests that in this area of London during the 2009 pandemic, HCWs refused H1N1 vaccination due to concerns about clinical effectiveness, side effects and perceptions that H1N1 infection was not generally severe. We found no evidence to suggest poor access was a barrier to H1N1 vaccination of HCWs. If good access is maintained, the key barrier to improving seasonal flu vaccine uptake lies with informing the personal risk assessment made by the HCW.“
Links
https://www.ncbi.nlm.nih.gov/pubmed/22773657
Citation
Head, S., S. Atkin, K. Allan, C. Ferguson, S. Lutchmun, and R. Cordery. "Vaccinating Health Care Workers during an Influenza Pandemic." Occupational Medicine 62.8 (2012): 651-54.
6. Vaccination practices among physicians and their children
Abstract
“The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 members of the Academy of Pediatrics in 2009. Two categories of questions included 1) how physicians with children vaccinated them in the past, and 2) how all respondents would vaccinate a child in 2009. A comparison was made between the answers of general and specialty pediatricians. 582 valid questionnaires were received (58.2% response rate) of which 431 were general pediatricians and 151 subspecialists. No statistical difference was found between general and specialty pediatricians on how they vaccinated their children up until 2009 (95% vs 93%). When asked about vaccinating a future child, a significant proportion of respondents would deviate from CDC guidelines, specialists more than general pediatricians (21% vs 9%). Generalists were more likely to give a future child Hepatitis A (OR: 3.6; 95% CI 1.3 - 10.4), Rotavirus (OR: 2.2; 95% CI 1.1 - 4.4), Meningococcal (OR: 9.9; 95% CI 3.3 - 29.9), and influenza (OR: 5.4; 95% CI 1.1 - 26.7) vaccines. Specialists were more likely to postpone MMR vaccinetion (OR: 4.4 95% CI 2.3 - 8.6). Safety was listed by both groups as the most common reason for altering the recommended immunization schedule. Until 2009, general pediatricians and pediatric specialists have largely adhered to ACIP recommendations, but due to vaccine safety and other concerns, both groups, albeit a higher percentage of specialists, reported greater numbers willing to diverge from these recommendations.”
Links
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=22932
Citation
Martin, Michael, and Vahe Badalyan. "Vaccination Practices among Physicians and Their Children." Open Journal of Pediatrics 02.03 (2012): 228-35.
“The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 members of the Academy of Pediatrics in 2009. Two categories of questions included 1) how physicians with children vaccinated them in the past, and 2) how all respondents would vaccinate a child in 2009. A comparison was made between the answers of general and specialty pediatricians. 582 valid questionnaires were received (58.2% response rate) of which 431 were general pediatricians and 151 subspecialists. No statistical difference was found between general and specialty pediatricians on how they vaccinated their children up until 2009 (95% vs 93%). When asked about vaccinating a future child, a significant proportion of respondents would deviate from CDC guidelines, specialists more than general pediatricians (21% vs 9%). Generalists were more likely to give a future child Hepatitis A (OR: 3.6; 95% CI 1.3 - 10.4), Rotavirus (OR: 2.2; 95% CI 1.1 - 4.4), Meningococcal (OR: 9.9; 95% CI 3.3 - 29.9), and influenza (OR: 5.4; 95% CI 1.1 - 26.7) vaccines. Specialists were more likely to postpone MMR vaccinetion (OR: 4.4 95% CI 2.3 - 8.6). Safety was listed by both groups as the most common reason for altering the recommended immunization schedule. Until 2009, general pediatricians and pediatric specialists have largely adhered to ACIP recommendations, but due to vaccine safety and other concerns, both groups, albeit a higher percentage of specialists, reported greater numbers willing to diverge from these recommendations.”
Links
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=22932
Citation
Martin, Michael, and Vahe Badalyan. "Vaccination Practices among Physicians and Their Children." Open Journal of Pediatrics 02.03 (2012): 228-35.