Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens

Abstract Objective: The implementation of mandatory influenza vaccination policies among healthcare personnel (HCP) is controversial. Thus, we examined the affect of mandatory influenza vaccination policies among HCP working in outpatient settings. Setting: Four Veterans’ Affairs (VA) health systems and three non-VA medical centers. Methods: We analyzed rates of influenza and other viral causes of respiratory infections among HCP working in outpatient sites at 4 VA health systems without mandatory influenza vaccination policies and 3 non-VA health systems with mandatory influenza vaccination policies. Results: Influenza vaccination was associated with a decreased risk of influenza (odds ratio, 0.17; 95% confidence interval [CI], 0.13–0.22) but an increased risk of other respiratory viral infections (incidence rate ratio, 1.26; 95% CI, 1.02–1.57). Conclusions: Our fitted regression models suggest that if influenza vaccination rates in clinics where vaccination was not mandated had equalled those where vaccine was mandated, HCP influenza infections would have been reduced by 52.1% (95% CI, 51.3%–53.0%). These observations, their possible causes, and additional strategies to reduce influenza and other viral respiratory illnesses among HCP working in ambulatory clinics warrant further investigation.

Download Full-text

Risk Factors for Healthcare Personnel Infection With Endemic Coronaviruses (HKU1, OC43, NL63, 229E): Results from the Respiratory Protection Effectiveness Clinical Trial (ResPECT)

Clinical Infectious Diseases ◽

10.1093/cid/ciaa900 ◽

2020 ◽

Cited By ~ 1

Author(s):

Derek A T Cummings ◽

Lewis J Radonovich ◽

Geoffrey J Gorse ◽

Charlotte A Gaydos ◽

Mary T Bessesen ◽

...

Keyword(s):

Clinical Trial ◽

Respiratory Infections ◽

Cluster Randomized Trial ◽

Healthcare Personnel ◽

Respiratory Protection ◽

Increased Risk ◽

Worker Characteristics ◽

Coronavirus Infection ◽

Cluster Randomized ◽

Viral Respiratory

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents a large risk to healthcare personnel (HCP). Quantifying the risk of coronavirus infection associated with workplace activities is an urgent need. Methods We assessed the association of worker characteristics, occupational roles and behaviors, and participation in procedures with the risk of endemic coronavirus infection among HCP who participated in the Respiratory Protection Effectiveness Clinical Trial (ResPECT), a cluster randomized trial to assess personal protective equipment to prevent respiratory infections and illness conducted from 2011 to 2016. Results Among 4689 HCP seasons, we detected coronavirus infection in 387 (8%). HCP who participated in an aerosol-generating procedure (AGP) at least once during the viral respiratory season were 105% (95% confidence interval, 21%–240%) more likely to be diagnosed with a laboratory-confirmed coronavirus infection. Younger individuals, those who saw pediatric patients, and those with household members <5 years of age were at increased risk of coronavirus infection. Conclusions Our analysis suggests that the risk of HCP becoming infected with an endemic coronavirus increases approximately 2-fold with exposures to AGPs. Our findings may be relevant to the coronavirus disease 2019 (COVID-19) pandemic; however, SARS-CoV-2, the virus that causes COVID-19, may differ from endemic coronaviruses in important ways. Clinical Trials Registration NCT01249625.

Download Full-text

Immunological Aspects Related to Viral Infections in Severe Asthma and the Role of Omalizumab

Biomedicines ◽

10.3390/biomedicines9040348 ◽

2021 ◽

Vol 9 (4) ◽

pp. 348

Author(s):

Francesco Menzella ◽

Giulia Ghidoni ◽

Carla Galeone ◽

Silvia Capobelli ◽

Chiara Scelfo ◽

...

Keyword(s):

Innate Immunity ◽

Severe Asthma ◽

Viral Infections ◽

Respiratory Infections ◽

Antiviral Effect ◽

Point Of View ◽

Type I ◽

Effector Cells ◽

Viral Spread ◽

Increased Risk

Viral respiratory infections are recognized risk factors for the loss of control of allergic asthma and the induction of exacerbations, both in adults and children. Severe asthma is more susceptible to virus-induced asthma exacerbations, especially in the presence of high IgE levels. In the course of immune responses to viruses, an initial activation of innate immunity typically occurs and the production of type I and III interferons is essential in the control of viral spread. However, the Th2 inflammatory environment still appears to be protective against viral infections in general and in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections as well. As for now, literature data, although extremely limited and preliminary, show that severe asthma patients treated with biologics don’t have an increased risk of SARS-CoV-2 infection or progression to severe forms compared to the non-asthmatic population. Omalizumab, an anti-IgE monoclonal antibody, exerts a profound cellular effect, which can stabilize the effector cells, and is becoming much more efficient from the point of view of innate immunity in contrasting respiratory viral infections. In addition to the antiviral effect, clinical efficacy and safety of this biological allow a great improvement in the management of asthma.

Download Full-text

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

Infection Control and Hospital Epidemiology ◽

10.1086/670992 ◽

2013 ◽

Vol 34 (7) ◽

pp. 723-729 ◽

Cited By ~ 6

Author(s):

Kayla L. Fricke ◽

Mariella M. Gastañaduy ◽

Renee Klos ◽

Rodolfo E. Bégué

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Influenza Vaccination ◽

Vaccination Campaign ◽

Vaccination Rate ◽

Healthcare Personnel ◽

Patient Contact ◽

Hospital Type ◽

Vaccination Rates ◽

Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

Download Full-text

Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04285-4 ◽

2021 ◽

Author(s):

Timo Huber ◽

Philipp Steininger ◽

Pascal Irrgang ◽

Klaus Korn ◽

Matthias Tenbusch ◽

...

Keyword(s):

Legionella Pneumophila ◽

False Positive ◽

Bacterial Infections ◽

Viral Infections ◽

Respiratory Infections ◽

Chlamydia Psittaci ◽

Specific Flow ◽

Antibody Assays ◽

Positive Results ◽

Viral Respiratory

AbstractSARS-CoV-2 antibody assays are used for epidemiological studies and for the assessment of vaccine responses in highly vulnerable patients. So far, data on cross-reactivity of SARS-CoV-2 antibody assays is limited. Here, we compared four enzyme-linked immunosorbent assays (ELISAs; Vircell SARS-CoV-2 IgM/IgA and IgG, Euroimmun SARS-CoV-2 IgA and IgG) for detection of anti-SARS-CoV-2 antibodies in 207 patients with COVID-19, 178 patients with serological evidence of different bacterial infections, 107 patients with confirmed viral respiratory disease, and 80 controls from the pre-COVID-19 era. In COVID-19 patients, the assays showed highest sensitivity in week 3 (Vircell-IgM/A and Euroimmun-IgA: 78.9% each) and after week 7 (Vircell-IgG: 97.9%; Euroimmun-IgG: 92.1%). The antibody indices were higher in patients with fatal disease. In general, IgM/IgA assays had only limited or no benefit over IgG assays. In patients with non-SARS-CoV-2 respiratory infections, IgG assays were more specific than IgM/IgA assays, and bacterial infections were associated with more false-positive results than viral infections. The specificities in bacterial and viral infections were 68.0 and 81.3% (Vircell-IgM/IgA), 84.8 and 96.3% (Euroimmun-IgA), 97.8 and 86.0% (Vircell-IgG), and 97.8 and 99.1% (Euroimmun-IgG), respectively. Sera from patients positive for antibodies against Mycoplasma pneumoniae, Chlamydia psittaci, and Legionella pneumophila yielded particularly high rates of unspecific false-positive results in the IgM/IgA assays, which was revealed by applying a highly specific flow-cytometric assay using HEK 293 T cells expressing the SARS-CoV-2 spike protein. Positive results obtained with anti-SARS-CoV-2 IgM/IgA ELISAs require careful interpretation, especially if there is evidence for prior bacterial respiratory infections.

Download Full-text

Nasopharyngeal Type-I Interferon for Immediately Available Prophylaxis Against Emerging Respiratory Viral Infections

Frontiers in Immunology ◽

10.3389/fimmu.2021.660298 ◽

2021 ◽

Vol 12 ◽

Author(s):

Amos C. Lee ◽

Yunjin Jeong ◽

Sumin Lee ◽

Haewook Jang ◽

Allen Zheng ◽

...

Keyword(s):

Interferon Beta ◽

Viral Infections ◽

Respiratory Infections ◽

Type I ◽

Emerging Viruses ◽

Respiratory Viral Infection ◽

Respiratory Viral Infections ◽

Viral Respiratory Infections ◽

Viral Respiratory

In addition to SARS-CoV-2 and its variants, emerging viruses that cause respiratory viral infections will continue to arise. Increasing evidence suggests a delayed, possibly suppressed, type 1 interferon (IFN-I) response occurs early during COVID-19 and other viral respiratory infections such as SARS and MERS. These observations prompt considering IFN-β as a prophylactic or early intervention for respiratory viral infections. A rationale for developing and testing intranasal interferon beta (IFN-β) as an immediately available intervention for new respiratory viral infections that will arise unexpectedly in the future is presented and supported by basic and clinical trial observations. IFN-β prophylaxis could limit the spread and consequences of an emerging respiratory viral infection in at-risk individuals while specific vaccines are being developed.

Download Full-text

Abstract P271: Influenza and Herpes Zoster Vaccination in United States Stroke Survivors: A Nationwide Analysis

Stroke ◽

10.1161/str.52.suppl_1.p271 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mu Ji Hwang ◽

Setareh Salehi Omran ◽

Saad Mir ◽

Alexander E Merkler ◽

Hooman Kamel ◽

...

Keyword(s):

United States ◽

Herpes Zoster ◽

Influenza Vaccination ◽

Vaccination Rate ◽

Behavioral Risk ◽

Stroke Survivors ◽

Cross Sectional ◽

Vaccination Rates ◽

Increased Risk ◽

Prior Stroke

Introduction: Patients with stroke face an increased risk of contracting influenza and herpes zoster. We compared vaccination rates in stroke survivors versus the general United States population. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, which is an annual, nationally representative, health survey. Respondents are asked about medical conditions and care. We used the most recent years with complete data for influenza (2018) and zoster (2017). We utilized survey procedures to estimate CDC-recommended vaccination rates for influenza (annual vaccination for all) and zoster (one-time vaccination for those at least 50 years old). Multiple logistic regression was used to compare the odds of vaccination in those with and without prior stroke, while adjusting for demographics (including income and health insurance) and comorbidities that may influence vaccination rates (obesity, diabetes, heart disease, cancer, pulmonary disease, and smoking). Results: In 2018, 8,254,136 (3.4%; 95% CI, 3.3-3.5) Americans were stroke survivors. The influenza vaccination rate was 44.4% (95% CI, 42.8-46.2) in stroke survivors and 32.8% (95% CI, 32.5-33.1) otherwise. In unadjusted models, stroke survivors were more likely to have had an influenza vaccination in the past year than those without stroke (OR, 1.6; 95% CI, 1.5-1.8). In 2017, 5,839,186 (5.7%; 95% CI, 5.5-5.9) Americans over 50 years old (i.e., eligible for zoster vaccination) were stroke survivors. The zoster vaccination rate was 30.3% (95% CI, 28.8-32.0) in stroke survivors and 27.6% (95% CI, 27.3-28.0) in those without prior stroke. Stroke survivors were more likely to have had zoster vaccination than those without stroke (OR, 1.14; 95% CI, 1.06-1.23). However, after accounting for demographics and comorbidities, stroke survivors were not more likely to be vaccinated for influenza (OR, 1.01; 95% CI, 0.93-1.10) or zoster (OR, 1.00; 95% CI, 0.90-1.12). Conclusion: Stroke survivors were not vaccinated at higher rates than expected based on demographics and comorbidities, and absolute vaccination rates were low, especially for zoster. Efforts to increase vaccination after stroke may be needed.

Download Full-text

Bacteriophages: A Possible Choice for Treatment of Viral Respiratory Infections and COVID-19

Current Respiratory Medicine Reviews ◽

10.2174/1573398x17666211129102221 ◽

2021 ◽

Vol 17 ◽

Author(s):

Faezeh Abbaszadeh ◽

Narges Eslami ◽

Parisa Shiri Aghbash ◽

Hamed Ebrahimzadeh Leylabadlo ◽

Hossein Bannazadeh Baghi

Keyword(s):

Viral Infections ◽

Specific Activity ◽

Respiratory Infections ◽

Age Groups ◽

Specific Antibodies ◽

The World ◽

Microbial Infections ◽

Viral Respiratory Infections ◽

Display Technique ◽

Viral Respiratory

: Viral respiratory infections are a leading cause of illness and mortality in all age groups worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (COVID-19) has spread throughout the world, igniting the twenty-first century’s deadliest pandemic. Research has shown that phages, which are bacterial viruses, can help treat viral infections with the effect on the immune system and their antiviral activity. Phages have specific activity and affect only the target without any side effects on other parts of the human body. Human phage-related diseases have not been reported yet; therefore, phages can be a very safe treatment, especially in many viral infections. The results of clinical studies have a promising future regarding the use of phages. It is possible that the phages display technique aided in the production of SARS-CoV-2 specific antibodies against its viral protein, which prevented the virus from binding or replicating and preventing secondary microbial infections, which have been linked to many patient deaths. Furthermore, an effective antiviral vaccine can be produced by using the same technique. Given the growing number of coronaviruses cases around the world, in the present paper, we review the possible mechanisms of phages against the COVID-19 disease and the method that may be a solution to eliminate the virus.

Download Full-text

Role of Probiotics in Stimulating the Immune System in Viral Respiratory Tract Infections: A Narrative Review

Nutrients ◽

10.3390/nu12103163 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3163

Author(s):

Liisa Lehtoranta ◽

Sinikka Latvala ◽

Markus J. Lehtinen

Keyword(s):

Immune System ◽

Respiratory Tract ◽

Clinical Studies ◽

Viral Infections ◽

Narrative Review ◽

Virus Infections ◽

Respiratory Illnesses ◽

Upper Respiratory ◽

Tract Infections ◽

Viral Respiratory

Viral respiratory tract infection (RTI) is the most frequent cause of infectious illnesses including the common cold. Pharmacological solutions for treating or preventing viral RTIs are so far limited and thus several self-care products are available in the market. Some dietary supplements such as probiotics have been shown to modulate immune system function and their role in reducing the risk and the course of RTIs has been investigated extensively within the past decade. However, the mechanism of action and the efficacy of probiotics against viral RTIs remains unclear. We searched PubMed, Google Scholar, and Web of Knowledge for pre-clinical and clinical studies investigating the effect of probiotics on respiratory virus infections, immune response, and the course of upper and lower respiratory tract illness. The literature summarized in this narrative review points out that specific probiotic strains seem effective in pre-clinical models, through stimulating the immune system and inhibiting viral replication. Clinical studies indicate variable efficacy on upper respiratory illnesses and lack proof of diagnosed viral infections. However, meta-analyses of clinical studies indicate that probiotics could be beneficial in upper respiratory illnesses without specific etiology. Further studies aiming at discovering the mechanisms of action of probiotics and clinical efficacy are warranted.

Download Full-text

Impact of an influenza vaccine educational programme on healthcare personnel

Epidemiology and Infection ◽

10.1017/s0950268816000716 ◽

2016 ◽

Vol 144 (11) ◽

pp. 2290-2294 ◽

Cited By ~ 3

Author(s):

R. RODRÍGUEZ-FERNÁNDEZ ◽

A. B. MARTÍNEZ-LÓPEZ ◽

J. PÉREZ-MORENO ◽

M. I. GONZÁLEZ-SÁNCHEZ ◽

F. GONZÁLEZ-MARTÍNEZ ◽

...

Keyword(s):

High Risk ◽

Influenza Vaccination ◽

Risk Groups ◽

Educational Programme ◽

Healthcare Personnel ◽

Preventive Strategy ◽

Paediatric Hospital ◽

Vaccination Rates ◽

Question Survey ◽

Effective Preventive Strategy

SUMMARYInfluenza vaccination has been shown to be the most effective preventive strategy to reduce influenza-related morbidity and mortality in high-risk groups. Despite healthcare personnel (HCP) being considered part of such high-risk groups, their vaccination coverage is low in Europe. In January 2012, we distributed an 18-question survey regarding influenza vaccination to HCP at Gregorio Marañon Paediatric Hospital, in Madrid, Spain. After we documented that only ~30% of HCP were vaccinated an educational programme was implemented in October 2012 before the next influenza season. In January 2013, the same survey delivered again to all HCP documented a significant increase in vaccination rates (from 30% to 40%, P = 0·007) mainly among physicians and for patients' protection. In summary we found that a simple and inexpensive educational programme significantly improved the uptake of influenza vaccination in HCP in our centre. Nevertheless, vaccination rates remained low, and broader and updated campaigns are needed to overcome perception barriers.

Download Full-text