Factors Associated with Increased Healthcare Worker Influenza Vaccination
                  Rates: Results from a National Survey of University Hospitals and Medical
                  Centers

Objective. To ascertain which components of healthcare worker (HCW) influenza vaccination programs are associated with higher vaccination rates. Design. Survey. Setting. University-affiliated hospitals. Methods. Participating hospitals were surveyed with regard to their institutional HCW influenza vaccination program for the 2007-2008 influenza season. Topics assessed included vaccination adherence and availability, use of declination statements, education methods, accountability, and data reporting. Factors associated with higher vaccination rates were ascertained. Results. Fifty hospitals representing 368,696 HCWs participated in the project. The median vaccination rate was 55.0% (range, 25.6%-80.6%); however, the types of HCWs targeted by vaccination programs varied. Programs with the following components had significantly higher vaccination rates: weekend provision of vaccine (58.8% in those with this feature vs 43.9% in those without; P = .01), train-the-trainer programs (59.5% vs 46.5%; P = .005), report of vaccination rates to administrators (57.2% vs 48.1%; P = .04) or to the board of trustees (63.9% vs 53.4%; P = .01), a letter sent to employees emphasizing the importance of vaccination (59.3% vs 47%; P = .01), and any form of visible leadership support (57.9% vs 36.9%; P = .01). Vaccination rates were not significantly different between facilities that did and those that did not require a signed declination form for HCWs who refused vaccination (56.9% vs 55.1%; P = .68), although the precise content of such statements varied. Conclusions. Vaccination programs that emphasized accountability to the highest levels of the organization, provided weekend access to vaccination, and used train-the-trainer programs had higher vaccination coverage. Of concern, the types of HCWs targeted by vaccination programs differed, and uniform definitions will be essential in the event of public reporting of vaccination rates.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v2 ◽

2020 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Protective Effect ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background: To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018. Methods: Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates. Results: Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, no statistically significant association was observed between vaccination coverage and nosocomial influenza incidence rate although a protective effect was suggested (IRR 0.89, 95%CI:0.69-1.15, p =0.37). Conclusion: No significant association was observed between influenza vaccination rates and nosocomial influenza incidence rates, although a protective effect was suggested. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v3 ◽

2020 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Protective Effect ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background: To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018. Methods: Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates.Results: Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, no statistically significant association was observed between vaccination coverage and nosocomial influenza incidence rate although a protective effect was suggested (IRR 0.89, 95%CI:0.69-1.15, p=0.37). Conclusion: No significant association was observed between influenza vaccination rates and nosocomial influenza incidence rates, although a protective effect was suggested. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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Improving Influenza Vaccination of Healthcare Workers by Means of Quality Improvement Tools

Infection Control and Hospital Epidemiology ◽

10.1086/660198 ◽

2011 ◽

Vol 32 (6) ◽

pp. 616-618 ◽

Cited By ~ 13

Author(s):

Jose Cadena ◽

Teresa Prigmore ◽

Jason Bowling ◽

Beth Ann Ayala ◽

Leni Kirkman ◽

...

Keyword(s):

Quality Improvement ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Seasonal Influenza ◽

Vaccination Rate ◽

Improvement Project ◽

Vaccination Rates ◽

Grand Rounds ◽

Voluntary Vaccination

For a healthcare worker seasonal influenza vaccination quality improvement project, interventions included support of leadership, distribution of vaccine kits, grand rounds, an influenza website, a Screensaver, e-mails, phone messages, and audit feedback. Vaccination rates increased from 58.8% to 76.6% (P < .01). Quality improvement increased the voluntary vaccination rate but did not achieve a rate more than 80%.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v1 ◽

2019 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Statistical Significance ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018.Methods Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates.Results Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, 10% increase in vaccination coverage corresponded to 11% decrease in nosocomial influenza incidence rate (IRR 0.89, 95%CI:0.69-1.15, p =0.37).Conclusion We observed a negative association between influenza vaccination rates and nosocomial influenza incidence rates, although statistical significance was not reached. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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Determinants of influenza vaccination uptake in pregnancy: a large single-Centre cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2628-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Stéphanie Bartolo ◽

Emilie Deliege ◽

Ophélie Mancel ◽

Philippe Dufour ◽

Sophie Vanderstichele ◽

...

Keyword(s):

Influenza Vaccination ◽

Pregnant Women ◽

Healthcare Worker ◽

First Trimester ◽

Vaccination Rate ◽

Free Access ◽

Vaccination Rates ◽

Vaccination Uptake ◽

Vaccination Recommendations ◽

In Pregnancy

Abstract Background Although vaccination of pregnant women against influenza is recommended, the vaccination rate remains low. We conducted a study to identify determinants of influenza vaccination uptake in pregnancy in order to identify strategies to improve seasonal influenza vaccination rates. Methods Prospective observational hospital-based study in the French hospital performing the highest number of deliveries, located in the city of Lille, among all women who had given birth during the 2014–2015 influenza season. Data were collected through a self-completed questionnaire and from medical files. The vaccination uptake was self-reported. Determinants of vaccination uptake were identified using logistic regression analysis. Results Of the 2045 women included in the study, 35.5% reported that they had been vaccinated against influenza during their pregnancy. The principal factors significantly associated with greater vaccination uptake were previous influenza vaccination (50.9% vs 20.2%, OR 4.1, 95% CI 3.1–5.5), nulliparity (41.0% vs 31.3%, OR 2.5, 95% CI 1.7–3.7), history of preterm delivery < 34 weeks (43.4% vs 30.3%, OR 2.3, 95% CI 1.1–4.9), the mother’s perception that the frequency of vaccine complications for babies is very low (54.6% vs 20.6%, OR 1.1, 95% CI 0.5–2.2), the mother’s good knowledge of influenza and its vaccine (61.7% vs 24.4%, OR 3.1, 95% CI 2.2–4.4), hospital-based prenatal care in their first trimester of pregnancy (55.0% vs 30.2%, OR 2.1, 95% CI 1.2–3.7), vaccination recommendations during pregnancy by a healthcare worker (47.0% vs 2.7%, OR 18.8, 95% CI 10.0–35.8), receipt of a vaccine reimbursement form (52.4% vs 18.6%, OR 2.0, 95% CI 1.5–2.7), and information from at least one healthcare worker about the vaccine (43.8% vs 19.1%, OR 1.8, 95% CI 1.3–2.6). Conclusions Our findings suggest that in order to increase flu vaccination compliance among pregnant women, future public health programmes must ensure cost-free access to vaccination, and incorporate education about the risks of influenza and the efficacy/safety of vaccination and clear recommendations from healthcare professionals into routine antenatal care.

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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.

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Influenza vaccine uptake among adults living with young children

Journal of Epidemiological Research ◽

10.5430/jer.v4n1p41 ◽

2018 ◽

Vol 4 (1) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Nirma Khatri Vadlamudi ◽

Fawziah Marra

Keyword(s):

Young Children ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Perceived Health ◽

Canadian Community Health Survey ◽

Demographic Characteristics ◽

Vaccine Uptake ◽

Vaccination Programs ◽

Vaccination Rates ◽

Vaccination Uptake

Background: Many studies report vaccine uptake among young adults aged 18 to 49 years is low. In Canada, the National Advisory Committee on Immunization (NACI) recommends influenza vaccination for adults in contact with young children, however vaccination rates for this specific population are missing. An estimate is required to identify appropriate public health interventions. The objective of this study was to describe recent trends in influenza vaccination uptake among Canadian adults aged 18 to 49 years old living with or without young children.Methods: The Canadian Community Health Survey (2013-2014) dataset, available for public use was used after grouping individuals by influenza vaccination uptake within the past year in adults aged 18 to 49 years. The relationship between living in a household with young children and influenza vaccination uptake was examined using a multivariable logistic regression model.Results: Among Canadian adults aged 18 to 49 years, the influenza vaccination uptake was 24.1% in adult household contacts with young children compared to 18.2% in those without young children (p<.0001). After adjusting for socio-demographic characteristics and self-perceived health, we determined that vaccine uptake was associated with living in a household with young children (adjusted OR: 1.30 [95%CI: 1.17-1.44]). While socio-demographic characteristics and self-perceived health greatly influenced influenza vaccination uptake, we also found marital status was a strong influencer of influenza vaccine uptake (adjusted OR: 1.31 [95%CI: 1.16-1.48]). Conclusion: Overall, influenza vaccination uptake among caregiving adults is low. Increased vaccine uptake was associated with living in a household with one or more young children. Targeted education and vaccination programs are required to improve uptake of the influenza vaccine in this age group.

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Use Of A Mobile Cart Influenza Program For Vaccination Of Hospital Employees

Infection Control and Hospital Epidemiology ◽

10.1086/502320 ◽

2004 ◽

Vol 25 (11) ◽

pp. 918-922 ◽

Cited By ~ 99

Author(s):

Catherine Sartor ◽

Herve Tissot-Dupont ◽

Christine Zandotti ◽

Francoise Martin ◽

Pierre Roques ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Rate ◽

Associate Professor ◽

University Hospital ◽

Vaccination Program ◽

Vaccination Rates ◽

Vaccination Acceptance ◽

The Impact ◽

Haenszel Test

AbstractObjective:Rates of annual influenza vaccination of healthcare workers (HCWs) remained low in our university hospital. This study was conducted to evaluate the impact of a mobile cart influenza vaccination program on HCW vaccination.Methods:From 2000 to 2002, the employee health service continued its annual influenza vaccination program and the mobile cart program was implemented throughout the institution. This program offered influenza vaccination to all employees directly on the units. Each employee completed a questionnaire. Vaccination rates were analyzed using the Mantel–Haenszel test.Results:The program proposed vaccination to 50% to 56% of the employees. Among the nonvaccinated employees, 52% to 53% agreed to be vaccinated. The compliance with vaccination varied from 61% to 77% among physicians and medical students and from 38% to 55% among nurses and other employees. Vaccination of the chief or associate professor of the unit was associated with a higher vaccination rate of the medical staff (P < .01). Altogether, the vaccination program led to an increase in influenza vaccination among employees from 6% in 1998 and 7% in 1999 before the mobile cart program to 32% in 2000, 35% in 2001, and 32% in 2002 (P < .001).Conclusions:The mobile cart program was associated with a significantly increased vaccination acceptance. Our study was able to identify HCW groups for which the mobile cart was effective and highlight the role of the unit head in its success.

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Factors That Influenced Rates of Influenza Vaccination Among Employees of Wisconsin Acute Care Hospitals and Nursing Homes During the 2005-2006 Influenza Season

Infection Control and Hospital Epidemiology ◽

10.1086/523866 ◽

2007 ◽

Vol 28 (12) ◽

pp. 1398-1400 ◽

Cited By ~ 20

Author(s):

Gwen Borlaug ◽

Alexandra Newman ◽

John Pfister ◽

Jeffrey P. Davis

Keyword(s):

Nursing Homes ◽

Influenza Vaccination ◽

Acute Care ◽

Influenza Season ◽

Acute Care Hospitals ◽

Vaccination Programs ◽

Vaccination Rates

Hospitals and nursing homes were surveyed in 2006 to obtain information on employee influenza vaccination programs and baseline rates of influenza vaccination among employees. Results were used to make recommendations for improving employees' 2007 influenza vaccination rates. Facilities should continue to provide convenient and free vaccination programs, offer education to promote vaccination, and use signed declination forms.

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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.

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