scholarly journals What, in Fact, Is the Evidence That Vaccinating Healthcare Workers against Seasonal Influenza Protects Their Patients? A Critical Review

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Zvi Howard Abramson
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Relevant Literature ◽  
Vaccination Rates ◽  
Personal Benefit ◽  
Health Authorities ◽  
Published Evidence ◽  
Patient Morbidity ◽  
The Individual ◽  
Self Protection

Background and Methods. Vaccination of all healthcare workers is widely recommended by health authorities and medical institutions and support for mandatory vaccination is increasing. This paper presents the relevant literature and examines the evidence for patient benefit from healthcare worker vaccination. Articles identified by Medline searches and citation lists were inspected for internal and external validity. Emphasis was put on RCTs. The literature on self-protection from vaccination is also presented. Results. Published research shows that personal benefit from vaccinating healthy nonelderly adults is small and there is no evidence that it is any different for HCWs. The studies aiming to prove the widespread belief that healthcare worker vaccination decreases patient morbidity and mortality are heavily flawed and the recommendations for vaccination biased. No reliable published evidence shows that healthcare workers' vaccination has substantial benefit for their patients—not in reducing patient morbidity or mortality and not even in increasing patient vaccination rates. Conclusion. The arguments for uniform healthcare worker influenza vaccination are not supported by existing literature. The decision whether to get vaccinated should, except possibly in extreme situations, be that of the individual healthcare worker, without legal, institutional, or peer coercion.

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

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.

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

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.

Factors Associated with Healthcare Worker Acceptance of Vaccination: A Systematic Review and Meta-analysis

2014 ◽  
Vol 35 (6) ◽  
pp. 699-708 ◽  
Author(s):  
Marija Vasilevska ◽  
Jennifer Ku ◽  
David N. Fisman
Keyword(s):  
Systematic Review ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
Disease Risk ◽  
Meta Analysis ◽  
Vaccine Uptake ◽  
Future Research ◽  
Vaccine Acceptance ◽  
Factors Influencing ◽  
Self Protection

Background and objective.Healthcare workers experience occupational risk of infection and may transmit infections to patients. Vaccination provides an efficient means of protecting workers and patients, but uptake may be low. We sought to identify factors influencing vaccine acceptance by healthcare workers in order to obtain insights leading to more effective vaccination programs in this population.Design.Systematic review and meta-analysis.Methods.We searched Medline, Embase, and CINAHL databases to identify studies published up to May 2012. Factors influencing vaccination acceptance were devised a priori. Random-effects meta-analysis was performed to generate summary estimates of effect. Heterogeneity and publication bias were explored using statistical tools.Results.Thirty-seven studies evaluating a variety of vaccines (against influenza, pertussis, smallpox, anthrax, and hepatitis B) were included. Homogeneous effects on vaccine acceptance were identified with desire for self-protection (odds ratio [OR], 3.42 [95% confidence interval (CI), 2.42–4.82]) and desire to protect family and friends (OR, 3.28 [95% CI, 1.10–9.75]). Concern that vaccine transmits the illness it was meant to prevent decreased acceptance (OR, 0.42 [95% CI, 0.30–0.58]). Differences in physician and nurse acceptance of immunization were seen between Asian and non-Asian studies.Conclusions.Consideration of self-protection (rather than absolute disease risk or protection of patients) appears the strongest and most consistent driver of healthcare workers’ decisions to accept vaccination, though other factors may also be impactful, and reasons for between-study divergence in effects is an important area for future research. This finding has important implications for the design of programs to enhance healthcare worker vaccine uptake.Infect Control Hosp Epidemiol2014;35(6):699–708

scholarly journals Influenza vaccination: a multi-modal approach to increase compliance in an italian teaching hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Celotto ◽  
F Malacarne ◽  
C Battistella ◽  
F G Bucci ◽  
F Antinolfi ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Medical Doctor ◽  
University Hospital ◽  
Intervention Programme ◽  
Vaccination Rates ◽  
Immunization Rates ◽  
Health Authorities ◽  
Educational Meetings

Abstract Issue Influenza vaccination of Healthcare workers (HCW) has a key role in avoiding flu transmission among patients and HCWs and is annually recommended by health authorities. Despite the 75% target identified by WHO, coverage is still inadequate in many European countries. Description of the problem The Infection Control Team and Public Health Residents of a University Hospital annually cooperate to actively offer flu shots directly in the Units, but in 2017-18 campaign only 12,1% of HCWs took advantage of the service. From July to December 2018 a composite intervention was performed to increase immunization rates. In each Unit a medical doctor and a nurse (midwife for the Obstetrics unit) were identified as Link Professionals (LPs).Two educational meetings with Infectious Diseases and Public Health experts were organized for LPs to deal with their hesitancies and to engage them for the vaccination promotion among colleagues.The calendar (2/week ambulatory + 16 in-ward appointments), tailored to maximise the HCW accessibility, was sent to medical consultants and head of departments, to all physicians, and to head nurses for dissemination. Promotional posters and videos were displayed across the hospital. Results Educational meetings were attended by 130 LPs. A total of 772/3420 HCW took advantage of the 2018-19 active campaign (22,6%), with a significant increase from the previous year (+10,4%; 95%CI 8,7-12,2; p < 0,001). The immunization rates raised in all HCWs categories: 279/660 doctors (it was 167/660 in 2017-18; +17.0%; 95%CI 11,9-21.9; p < 0,001); 303/1615 nurses (150/1615 in 2017-18; +9.5%; 95%CI 7.1-11-9; p < 0,001); 13/43 midwives (2/43 in 2017-18; +25,6%; 95%CI 9.7-40.8; p = 0,002). Lessons Despite the significant increase,further efforts are necessary to reach the WHO target rate. All HCWs categories were positively affected by the multi-modal intervention. LPs seem to play an important role in promoting vaccination among colleagues, in a peer-to-peer trust relationship. Key messages Influenza vaccination rates needs to be increased in healthcare workers for their protection and for patient safety. A well-structured multi-modal intervention programme involving prepared HCW promoters into wards is essential to increase compliance.

A relationship between US healthcare worker smallpox vaccination rates in 2003 and presidential election results in 2004

2007 ◽  
Vol 2 (4) ◽  
pp. 189-194
Author(s):  
David G. Schultz, Jr, MPH ◽  
Melinda R. Mihelic ◽  
F. Matthew Mihelic, MD
Keyword(s):  
Decision Making ◽  
Healthcare Worker ◽  
Presidential Election ◽  
Healthcare Workers ◽  
Political Influence ◽  
Smallpox Vaccination ◽  
Statistical Relationship ◽  
Vaccination Rates ◽  
Per Capita ◽  
Election Results

A statistical relationship exists between state per capita smallpox vaccination rates of healthcare workers in 2003 and state presidential election results in 2004. The potential implications of political influence on national biosecurity decision making are discussed.

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

2011 ◽  
Vol 32 (6) ◽  
pp. 616-618 ◽  
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%.

scholarly journals Spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for front-line healthcare workers

2021 ◽  
pp. medethics-2020-107175
Author(s):  
Owen M Bradfield ◽  
Alberto Giubilini
Keyword(s):  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccination Policy ◽  
Front Line ◽  
Medical Reason ◽  
Vaccination Rates ◽  
Vaccination Uptake ◽  
Patient Morbidity ◽  
The World ◽  
Least Restrictive Alternative

Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This ‘conditional’ policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large.

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

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.

scholarly journals Developing the Resilience Framework for Nursing and Healthcare

2021 ◽  
Vol 8 ◽  
pp. 233339362110054
Author(s):  
Janice M. Morse ◽  
Jacqueline Kent-Marvick ◽  
Lisa A. Barry ◽  
Jennifer Harvey ◽  
Esther Narkie Okang ◽  
...  
Keyword(s):  
Mental Illness ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
The State ◽  
Dyadic Relationship ◽  
Unexpected Events ◽  
Dynamic Framework ◽  
Resilience Framework ◽  
The Individual ◽  
Selection Of

Despite four decades of resilience research, resilience remains a poor fit for practice as a scientific construct. Using the literature, we explored the concepts attributed to the development of resilience, identifying those that mitigate symptoms of distress caused by adversity and facilitate coping in seven classes of illness: transplants, cancer, mental illness, episodic illness, chronic and painful illness, unexpected events, and illness within a dyadic relationship. We identified protective, compensatory, and challenge-related coping-concept strategies that healthcare workers and patients use during the adversity experience. Healthcare-worker assessment and selection of appropriate coping concepts enable the individual to control their distress, resulting in attainment of equanimity and the state of resilience, permitting the resilient individual to work toward recovery, recalibration, and readjustment. We inductively developed and linked these conceptual components into a dynamic framework, The Resilience Framework for Nursing and Healthcare, making it widely applicable for healthcare across a variety of patients.

scholarly journals Prevalence of influenza vaccination among physicians and related enhancing and preventing factors in Italy

2010 ◽  
Vol 1 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Alice Mannocci ◽  
Paolo Ursillo ◽  
Claudio Bontempi ◽  
Antonella Sferrazza ◽  
Giuseppe La Torre
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Close Contact ◽  
Data Extraction ◽  
Vaccination Rates ◽  
Health Authorities ◽  
Pooled Prevalence ◽  
Educational Campaigns ◽  
Self Protection ◽  
Influenza Vaccinations

Introduction: Several studies proved the convenience of vaccinating health care workers (HCWs), especially physicians, and vaccination is recommended by health authorities in many Countries. Nonetheless in Italy only a small part of HCWs get vaccinated. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among physicians in Italy and to investigate the enhancing/preventing factors associated with this kind of preventive tool.Methods: Relevant articles up to 1st May 2010 have been identified through Scopus, PubMed and Google Scholar; data extraction and quality assessment were performed independently by two researchers.The analysis was performed using StatsDirect 2.7.8.Results: Sixteen studies, performed between 1990 and 2008, reported vaccination rates with pooled prevalence among all HCWs. From nine of them data regarding physicians have been extracted and analysed, finding a pooled proportion of 23.18% (95% CI = 17.85-28.98%). One study allowed an analysis of the reasons encouraging and preventing influenza vaccination. The main ones are on one side self protection, and patients’ and family’s protection, and on the other side “not caring about influenza,” followed by “fear of adverse effects” and “belief that vaccine isn’t effective.”Discussion: Italy has a good overall influenza vaccination coverage, and national records are available for population aged over 65 years or with chronic illness. Unfortunately there isn’t any national record about HCWs or physicians vaccination, and from the data gathered from the studies examined in this analysis vaccination prevalence is low. The reasons brought from physicians are worrying because of their position in the society and in the health care system, in close contact with patients.This shows a great need for well-done information and educational campaigns stressing the importance of prevention.

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