scholarly journals The scientific basis for offering seasonal influenza immunisation to risk groups in Europe

2008 ◽  
Vol 13 (43) ◽  
Author(s):  
A Nicoll ◽  
B C Ciancio ◽  
S Tsolova ◽  
P R Blank ◽  
C Yilmaz
Keyword(s):  
Older People ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Scientific Evidence ◽  
Care Home ◽  
Risk Groups ◽  
Scientific Basis ◽  
Adverse Outcomes ◽  
Average Risk ◽  
Eu Countries

This paper summarises the scientific evidence supporting selection of risk groups that would benefit from annual seasonal influenza immunisation in European Union (EU) countries. Risk groups are defined restrictively as persons in Europe at higher than average risk of adverse outcomes should they be infected with seasonal influenza and for whom use of vaccine is demonstrated to be effective in reducing the risk of those outcomes. Existing evidence indicate that older people and those with chronic disease are at higher risk of severe adverse outcome and that immunisation reduces this risk. There is thus good scientific evidence for routinely offering annual immunisation to all older people (at least those aged 65 years and older), and people with certain groups of chronic medical conditions. We estimated that these two groups account for between 19% and 28% of the population of EU countries. Thus in 2006, an estimated 84 million older people aged 65 years and over and 41 million people younger than 65 years of age with chronic conditions were living in these countries. There is also strong evidence for immunising staff caring for patients belonging to these two risk groups in residential (care home) settings in order to protect the patients. There are as yet no strong data on whether or not immunising other healthcare workers and carers protect patients though immunisation of healthcare workers can be justified on occupational health grounds. At present the scientific evidence for immunising other suggested risk groups, notably children and pregnant women is not strong for Europe though equally there is no evidence against immunising these groups.

scholarly journals Seasonal influenza immunisation in Europe. Overview of recommendations and vaccination coverage for three seasons: pre-pandemic (2008/09), pandemic (2009/10) and post-pandemic (2010/11)

2014 ◽  
Vol 19 (16) ◽  
Author(s):  
J Mereckiene ◽  
S Cotter ◽  
A Nicoll ◽  
P Lopalco ◽  
T Noori ◽  
...  
Keyword(s):  
Older People ◽  
Influenza Vaccination ◽  
Pregnant Women ◽  
Vaccination Coverage ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Risk Groups ◽  
European Economic Area ◽  
Clinical Risk ◽  
The Impact

Since 2008, annual surveys of influenza vaccination policies, practices and coverage have been undertaken in 29 European Union (EU)/ European Economic Area (EEA) countries. After 2009, this monitored the impact of European Council recommendation to increase vaccination coverage to 75% among risk groups. This paper summarises the results of three seasonal influenza seasons: 2008/09, 2009/10 and 2010/11. In 2008/09, 27/29 countries completed the survey; in 2009/10 and 2010/11, 28/29 completed it. All or almost all countries recommended vaccination of older people (defined as those aged ≥50, ≥55, ≥59, ≥60 or ≥65 years), and people aged ≥6 months with clinical risk and healthcare workers. A total of 23 countries provided vaccination coverage data for older people, but only 7 and 10 had data for the clinical risk groups and healthcare workers, respectively. The number of countries recommending vaccination for some or all pregnant women increased from 10 in 2008/09 to 22 in 2010/11. Only three countries could report coverage among pregnant women. Seasonal influenza vaccination coverage during and after the pandemic season in older people and clinical groups remained unchanged in countries with higher coverage. However, small decreases were seen in most countries during this period. The results of the surveys indicate that most EU/EEA countries recommend influenza vaccination for the main target groups; however, only a few countries have achieved the target of 75% coverage among risk groups. Coverage among healthcare workers remained low.

scholarly journals 332 GEMS: Geriatric Emergency Service - Outputs and Outcomes from the Acute Floor Team

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lorna Cornally ◽  
Megan Hayes Brennan ◽  
Danielle Reddy ◽  
Grainne Gallagher ◽  
Maureen O'Callaghan ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Median Time ◽  
Emergency Service ◽  
Scientific Evidence ◽  
Adverse Outcomes ◽  
Older Person ◽  
Home Team ◽  
Care Approach ◽  
Care Outcomes

Abstract Background Frailty is now a key concept in healthcare planning and delivery and is driving vertical and horizontal integration. The positive narrative of Frailty is further emphasised by the growing scientific evidence in the prevention, reversal and modification of Frailty. Early identification of Frailty and early intervention with Comprehensive Geriatric Assessment (CGA) is fundamental. Older people with Frailty admitted to hospital who receive a CGA early are more likely to return home. Benefits are seen early and are sustained (Ellis et al 2011). Methods The aim of GEMS is to improve care, outcomes and the patient experience for older people living with Frailty. All people aged 75 years and older who attend as an emergency are screened on triage using the Variable Indicative of Placement Tool (VIP). Screening is automatic and mandatory. The GEMS Acute Floor Team respond early to those who screen positive by starting a CGA. The GEMS Home Team case manage those who are admitted. Results Over 2 years 10,037 patients were triaged. The median time from arrival to VIP was 15 minutes. 43% screened positive for Frailty. 66% received a CGA. The median time from VIP to CGA was 1.7 hours. 84% identified at risk of polypharmacy, 27% at risk of malnutrition, 29% with delirium. 74% were admitted from home. 78% returned to pre-admission residence. 4% new admissions to NH care. Median length of stay was 7 days. The readmission rate within 30 days was 16%. 7% in hospital mortality. Conclusion The GEMS Team have developed and delivered a pioneering integrated care approach to the management of older person at high risk of adverse outcomes attending the acute floor.

Forced relocation between nursing homes: residents' health outcomes and potential moderators

2012 ◽  
Vol 22 (4) ◽  
pp. 301-319 ◽  
Author(s):  
Jacquetta M Holder ◽  
David Jolley
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Health Outcomes ◽  
Psychological Health ◽  
Care Home ◽  
Well Being ◽  
Adverse Outcomes ◽  
Legal Challenges ◽  
Forced Relocation ◽  
Poor Outcomes

SummaryThat transfer of older people from one institution to another is detrimental to well-being, health and survival has been reported for 50 years. This has led to fear, anger and legal challenges when closures occur. Previous reviews identified accounts of relocation followed by adverse outcomes and others where problems were avoided or benefits claimed. This paper reviews the last twelve years of literature on health outcomes following involuntary relocation between nursing homes. Reports of post-move mortality, physical or psychological health suggest and confirm that relocation without preparation carries higher risk of poor outcomes than moves that are orderly and include preparation. The literature on the care home closure process, admissions and individual transfers offers insights into practices that might help minimize adverse outcomes. A number of agencies have produced helpful guidelines. How these are implemented needs to be monitored and linked to in-depth studies of sample closures.

scholarly journals Seasonal influenza vaccination: from hesitancy to social norm

2021 ◽  
Vol 9 (3) ◽  
pp. 902
Author(s):  
Asif Parvez Malik ◽  
Sanjeewa Sumathipala
Keyword(s):  
High Risk ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Social Norm ◽  
Disease Risk ◽  
Vaccine Coverage ◽  
Risk Groups ◽  
Vaccine Uptake ◽  
World Health

Seasonal influenza is of the most globally burdening vaccine-preventable diseases, infecting 3-5 billion people annually and according to the World Health Organisation (WHO) resulting in 250,000 to 500,000 deaths worldwide. Vaccination against influenza and all respiratory infections carries greater emphasis in the light of the COVID-19 pandemic. With added pressure on healthcare systems due to the coronavirus, Qatar is one country that is keen to emphasise the importance of influenza vaccination to prevent potential co-infection causing severe disease especially in high-risk groups. Currently seasonal influenza vaccines protect against 3 or 4 strains with revised data from the WHO twice yearly due to the changing natures of strains helping to maximise efficacy of the vaccines. It is recommended for specific high-risk groups to be prioritised for vaccination, including pregnant women, the elderly, children above 6 months of age, patients with chronic conditions as well as front line healthcare workers with risk of exposure. However, uptake of the vaccine remains low and contributes significantly to the burden of the disease. Barriers to vaccine uptake can be physical, such as unhealthy lifestyles, psychological, such as perception of disease as low-risk, contextual, such as lack of access to vaccinations, or sociodemographic, such as living alone. Vaccine coverage can be increased by knowledge of these barriers and how to address them. The physical barriers highlight the need to support behavioural change in lifestyle in order to increase vaccine uptake. Psychological barriers, usually due to misconceptions, can be addressed with education through public health campaigns and interactions between health professionals and patients. This education is not just a need for patients but also healthcare workers. It is up to healthcare providers and contractors to find ways of addressing contextual and sociodemographic barriers by increasing access to vaccination whether through transport, or home–care etc. A key barrier of those mentioned to vaccination is a lack of knowledge which needs to be addressed though positive discussions about the health benefits of immunisation as well as the traditional idea of disease-risk prevention. Addressing the above barriers will help to increase vaccine uptake, and produce health-conscientious societies where vaccination becomes a social norm.

scholarly journals Healthcare Workers’ Perspectives on the Upcoming COVID-19 Vaccine in Terms of Their Exposure to the Influenza Vaccine in Riyadh, Saudi Arabia: A Cross-Sectional Study

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 465
Author(s):  
Leena R. Baghdadi ◽  
Shatha G. Alghaihb ◽  
Alanoud A. Abuhaimed ◽  
Dania M. Alkelabi ◽  
Rawan S. Alqahtani
Keyword(s):  
Saudi Arabia ◽  
Influenza Vaccine ◽  
Work Experience ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Seasonal Influenza Vaccine ◽  
History Of

In 2019, a novel severe acute respiratory syndrome (SARS-CoV-2 (COVID-19)) caused a global pandemic. There was an urgent need to develop a vaccine against COVID-19 to reduce its spread and economic burden. The main objective of this study was to understand the attitudes and concerns of healthcare workers (HCWs) towards the upcoming COVID-19 vaccine, whether their decision was influenced by their history of taking the seasonal influenza vaccine, and factors that influence the acceptance of the upcoming COVID-19 vaccine. This was a cross-sectional study conducted in Riyadh, Saudi Arabia. We selected and surveyed 356 HCWs via an electronic self-administered questionnaire. A total of 61.16% of HCWs were willing to receive the COVID-19 vaccine, and 55.9% of them had received the seasonal influenza vaccine in the preceding year (2019–2020). The strongest predictors for taking the COVID-19 vaccine were the HCWs’ belief that the COVID-19 vaccine would be safe, needed even for healthy people, that all HCWs should be vaccinated against COVID-19, and that HCWs will have time to take the vaccine. Being female, being middle aged, having <5 years of work experience, having no fear of injections, and being a non-smoker were predictive factors for taking the upcoming COVID-19 vaccine. No associations were found between the intention to take the COVID-19 vaccine and a history of taking the seasonal influenza vaccine.

scholarly journals Risk Factors for Pneumonia and Death in Adult Patients With Seasonal Influenza and Establishment of Prediction Scores: A Population-Based Study

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Koichi Miyashita ◽  
Eiji Nakatani ◽  
Hironao Hozumi ◽  
Yoko Sato ◽  
Yoshiki Miyachi ◽  
...  
Keyword(s):  
High Risk ◽  
Seasonal Influenza ◽  
Prediction Models ◽  
Validation Cohort ◽  
Risk Groups ◽  
Population Based ◽  
Limited Data ◽  
Population Based Study ◽  
Relative Risks ◽  
Primary Care Settings

Abstract Background Seasonal influenza remains a global health problem; however, there are limited data on the specific relative risks for pneumonia and death among outpatients considered to be at high risk for influenza complications. This population-based study aimed to develop prediction models for determining the risk of influenza-related pneumonia and death. Methods We included patients diagnosed with laboratory-confirmed influenza between 2016 and 2017 (main cohort, n = 25 659), those diagnosed between 2015 and 2016 (validation cohort 1, n = 16 727), and those diagnosed between 2017 and 2018 (validation cohort 2, n = 34 219). Prediction scores were developed based on the incidence and independent predictors of pneumonia and death identified using multivariate analyses, and patients were categorized into low-, medium-, and high-risk groups based on total scores. Results In the main cohort, age, gender, and certain comorbidities (dementia, congestive heart failure, diabetes, and others) were independent predictors of pneumonia and death. The 28-day pneumonia incidence was 0.5%, 4.1%, and 10.8% in the low-, medium-, and high-risk groups, respectively (c-index, 0.75); the 28-day mortality was 0.05%, 0.7%, and 3.3% in the low-, medium-, and high-risk groups, respectively (c-index, 0.85). In validation cohort 1, c-indices for the models for pneumonia and death were 0.75 and 0.87, respectively. In validation cohort 2, c-indices for the models were 0.74 and 0.87, respectively. Conclusions We successfully developed and validated simple-to-use risk prediction models, which would promptly provide useful information for treatment decisions in primary care settings.

A prospective study to determine the clinical utility of pharmacogenetic testing of veterans with treatment-resistant depression

2021 ◽  
pp. 026988112110152
Author(s):  
Michael J McCarthy ◽  
Yucui Chen ◽  
Anna Demodena ◽  
Susan G Leckband ◽  
Eileen Fischer ◽  
...  
Keyword(s):  
Social Stress ◽  
Risk Groups ◽  
Adverse Outcomes ◽  
Treatment Resistant Depression ◽  
Post Traumatic Stress ◽  
Treatment Resistant ◽  
Treatment As Usual ◽  
Resistant Depression ◽  
The Difference ◽  
A Prospective Study

Background: Pharmacotherapies for depression are often ineffective and treatment-resistant depression (TRD) is common across bipolar disorder (BD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Patient genetic information can be used to predict treatment outcomes. Prospective studies indicate that pharmacogenetic (PGX) tests have utility in the treatment of depression. However, few studies have examined the utility of PGX in other diagnoses typified by depression, or in veterans, a cohort with high rates of medical comorbidity, social stress, and suicide. Aim: To determine the efficacy of genetically guided pharmacological treatment of TRD. Methods: We conducted an 8-week, prospective, multisite, single-blind study in 182 veterans with TRD including patients with BD, MDD, and PTSD. Subjects were randomly assigned to PGX-guided treatment in which the clinician incorporated PGX information into decision-making, or treatment as usual (TAU). Results: Overall, the PGX group improved marginally faster compared to TAU, but the difference was not statistically significant. Secondary analyses revealed that only PTSD patients showed a potential benefit from PGX testing. Patients predicted by PGX testing to have moderate levels of genetic risk showed a significant benefit from the PGX-guided treatment, whereas other risk groups demonstrated no benefit. Clinicians generally found the PGX test was useful, particularly in more depressed patients and/or those with more warnings for significant or serious adverse outcomes. Clinicians more often used the results to select a drug, but only rarely to adjust dosing. Conclusions: The data reveal possible group differences in the utility of PGX testing in veterans with TRD. ClinicalTrials.gov Identifier: NCT04469322.

scholarly journals Characteristics of Healthcare Workers Vaccinated against Influenza in the Era of COVID-19

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 695
Author(s):  
Giorgia Della Polla ◽  
Francesca Licata ◽  
Silvia Angelillo ◽  
Concetta Paola Pelullo ◽  
Aida Bianco ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Perceived Risk ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
High Risk Group ◽  
High Coverage ◽  
Cross Sectional ◽  
Current Season ◽  
Study Results

Understanding the potential impact of COVID-19 on receiving influenza vaccination among healthcare workers (HCWs) is of utmost importance. The purposes of the present cross-sectional study were to describe the characteristics and to explore the predictors of receiving influenza vaccination among a large cohort of Italian HCWs in hospital settings. Information was collected through an anonymous questionnaire from December 2020 through January 2021. General and practice characteristics, perceived risk of seasonal influenza, attitudes towards efficacy and safety of influenza vaccination, and reasons behind the decision to be vaccinated against influenza were explored. Fewer than half (46.2%) of HCWs agreed that influenza is a serious illness and perceived the risk of getting infected with influenza, and concerns about the safety of the vaccination were significant positive predictors. Fewer than half of the respondents were not concerned at all about the efficacy (48.6%) and safety (49.8%) of influenza vaccination, and 51.9% reported that they have not received a seasonal influenza vaccine during the previous season. The most mentioned reason for receiving the influenza vaccine in the current season was that influenza and COVID-19 share some similar symptoms. Study results will aid policymakers in developing vaccination education programs, promotion of trust to address negative misconceptions, and to achieve future high coverage among this high-risk group.

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