Dataset Information

Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review.

ABSTRACT: Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity.

SUBMITTER: Bechini A

PROVIDER: S-EPMC7348755 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review.

Bechini Angela A Lorini Chiara C Zanobini Patrizio P Mandò Tacconi Francesco F Boccalini Sara S Grazzini Maddalena M Bonanni Paolo P Bonaccorsi Guglielmo G

Vaccines 20200405 2

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Revi ...[more]

PMID: 32260594

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Project description:BackgroundThe elderly bear the highest burden of South Africa's estimated annual > 10 million influenza cases and > 11,000 influenza-related deaths. Unvaccinated healthcare workers (HCWs) are at high occupational risk of contracting influenza, and may transmit influenza to elderly patients in their care. Thus, the South African National Department of Health recommends that HCWs receive annual influenza vaccination. This study aimed to determine influenza vaccination coverage among HCWs; identify reasons for their vaccination status; and investigate if HCWs recommend vaccination to their elderly patients.MethodsA descriptive study was conducted in 18 community health centres and 44 private sector and non-governmental organisation managed old age homes across South Africa, using a self-administered structured questionnaire, which was distributed to 360 HCWs present on the day of data collection. Data were captured using Microsoft Excel® and imported to Epi Info™ 7 (Centers for Disease Control and Prevention, USA) for descriptive statistical analysis. Ethics approval (SMUREC/P/36/2018: PG) and permission to conduct the study at the facilities were obtained. All participants provided informed consent.ResultsThe response rate was 76.7% (276/360). Most participants were female (90.9% [251/276]), nursing professionals (81.2% [224/276]) with a mean age of 41.1 ± 11.7 years. Although 62.7% of participants indicated having ever received at least one dose of the influenza vaccine, influenza vaccine uptake for 2017 and 2018 was 24.36% (41/276) and 33.3% (92/276) respectively. The main reasons given for never being vaccinated against influenza were related to the unavailability of the vaccine (70.9%) and vaccine hesitancy (27.2%). Most participants (67.8% [187/276]) recommended vaccines to elderly patients in their care.ConclusionThe main reasons behind low influenza vaccine uptake by HCWs in South Africa who care for the elderly were related to unavailability of the vaccine and vaccine hesitancy. Strategies to educate HCWs on the importance of influenza vaccination, while concurrently increasing sustained and easy access to the vaccine by HCWs are needed to preserve public health.

Project description:BackgroundVaccination of healthcare workers (HCW) aims to protect them and to reduce transmission to susceptible patients. Influenza, measles, pertussis, and varicella vaccinations are recommended but not mandatory for HCW in France. Insufficient vaccine coverage for these diseases in HCW has raised the question of introducing mandatory vaccination. We conducted a survey to estimate acceptability of mandatory vaccination for these four vaccines by HCW working in healthcare facilities (HCF) in France, and to identify associated determinants.MethodsIn 2019, we performed a cross-sectional survey of physicians, nurses, midwives and nursing assistants working in HCF in France using a randomised stratified three-stage sampling design (HCF type, ward category, HCW category). Data were collected in face-to-face interviews using a tablet computer. We investigated the possible determinants of acceptability of mandatory vaccination using univariate and multivariate Poisson regressions, and estimated prevalence ratios (PR).ResultsA total of 8594 HCW in 167 HCF were included. For measles, pertussis, and varicella, self-reported acceptability of mandatory vaccination (very or quite favourable) was 73.1% [CI95%: 70.9-75.1], 72.1% [69.8-74.3], and 57.5% [54.5-57.7], respectively. Acceptability varied according to i) HCW and ward category for these three vaccinations, ii) age group for measles and pertussis, and iii) sex for varicella. For mandatory influenza vaccination, acceptability was lower (42.7% [40.6-44.9]), and varied greatly between HCW categories (from 77.2% for physicians to 32.0% for nursing assistants).ConclusionHCW acceptability of mandatory vaccination was high for measles, pertussis and varicella but not as high for influenza. Vaccination for COVID-19 is mandatory for HCW in France. Replication of this study after the end of the COVID-19 crisis would help assess whether the pandemic had an impact on their acceptability of mandatory vaccination, in particular for influenza.

Project description:Influenza imposes a significant burden worldwide from the healthcare and socio-economic standpoints. This is also due to suboptimal vaccination coverage among the target population, even though immunization is recommended since many years and still remains the fundamental tool for its prevention. Healthcare workers (HCWs) are at increased risk of exposure to respiratory pathogens compared with the general population, including flu, with potential threat for their health and for patients' safety. Nevertheless, despite recommendation for immunization of this work-category in most of Western Countries, inadequate flu vaccine uptake is reported during the last decade in the European area. According to recent systematic reviews on this topic, the main determinants of vaccine acceptance among HCWs have been largely investigated and include desire for self-protection and to protect family rather than absolute disease risk or desire to protect patients, among the main drivers. On the other hand, concerns regarding safety of the vaccines resulted in decreased vaccine uptake. Moreover, influenza vaccine hesitancy among HCWs was also associated with several issues such as low risk perception, denial of the social benefit of influenza vaccination, low social pressure, lack of perceived behavioral control, negative attitude toward vaccines, not having been previously vaccinated against influenza, not having previously had influenza, lack of adequate influenza-specific knowledge, lack of access to vaccination facilities, and socio-demographic variables. The topic of influenza vaccination among HCWs is challenging, full of ethical issues. Systematic reviews of randomized controlled trials (RCTs) investigating the effectiveness of interventions for improving vaccine uptake among HCWs found that combined strategies were more effective than isolate approaches. Mandatory policies are currently under debate in several countries. High quality studies would help policy-makers and stake-holders to shape evidence-based initiatives and programs to improve the control of influenza.

Project description:BackgroundSeasonal influenza is a highly contagious vaccine-preventable disease that may cause high morbidity and mortality in susceptible populations. Healthcare workers are a priority group for seasonal influenza vaccination to protect them from contracting influenza and prevent nosocomial transmission to patients. This study aimed to evaluate knowledge, attitudes, and practices (KAP) of seasonal influenza vaccination among healthcare workers in Honduras.MethodFrom August 24 to October 21, 2018, we conducted a cross-sectional KAP survey regarding seasonal influenza vaccination to a random sample of healthcare workers who attended patients in hospitals of the Ministry of Health of Honduras (SESAL) and Honduran Social Security Institute (IHSS). We reported frequency distributions of demographics, vaccination KAP, sources of information, and reasons for non-vaccination. We used principal components factor analysis to create knowledge and attitude scores. We used linear regression to analyze associations between demographics and sources of information about the influenza vaccine, and knowledge and attitude scores. We used logistic regression to analyze associations between demographics, sources of information, knowledge scores, and attitude scores, and influenza vaccination.ResultWe surveyed 947 healthcare workers who attended patients in 13 SESAL hospitals and two IHSS hospitals. Only 4.6% of participants knew the seasonal influenza vaccine was composed of inactivated viruses, 94.7% believed vaccination causes flu-like symptoms, and 52.0% were vaccinated for influenza in 2018. Knowledge scores were lower for nursing assistants and other healthcare professionals compared to doctors, and higher for healthcare workers who attended a healthcare facility training (P-values≤0.030). Attitude scores were higher for healthcare workers who attended ≥11 patients per day having ≤10 patients per day as reference, self-reported influenza vaccination in previous year, and cited trainings and informal information at the healthcare facility as sources of information for influenza vaccination (P-values≤0.030). Factors associated with self-reported vaccination were self-reported influenza vaccination in previous year (aOR: 7.61; 95% CI: 5.24-11.04), attitude score (aOR: 1.14; 95% CI: 1.07-1.21), and worked in a SESAL hospital (aOR: 1.73; 95% CI: 1.12-2.68) having IHSS as reference.ConclusionAlthough influenza vaccination is required by law in Honduras and available for free in public health centers, coverage of healthcare workers in 2018 was half that reported in 2017. Lower coverage may be attributed to misconceptions of vaccination side effects.

Dataset Information

Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review.

Publications

Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review.

Similar Datasets

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