Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients.
Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients.
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DOI：
10.1186/s12879-015-1090-x
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发表时间：
2015-08-12
影响因子：
3.7
通讯作者：
Lo Vecchio A
中科院分区：
文献类型：
--
作者：
Giannattasio A;Mariano M;Romano R;Chiatto F;Liguoro I;Borgia G;Guarino A;Lo Vecchio A
尽管所有公共卫生当局一致建议支持高危人群每年接种流感疫苗，但这些人群（包括卫生保健工作者（HCW））的流感疫苗接种率仍然很低。本研究的目的是评估一所大学医院医务工作者在随后四个流感季节和大流行性H1N1流感的免疫接种率，并调查其分布模式和免疫接种的主要决定因素。第一阶段的数据收集是在2009-2010年H1N1大流行高峰期间进行的。2012-2013年进行了第2阶段数据收集，旨在调查大流行后三个季节的季节性流感疫苗接种覆盖率。总体H1N1疫苗接种率由医院免疫登记处得出。2010年，三个科室（传染病科、儿科和妇产科）的工作人员完成了一项关于流感的调查。2012年进行了第二阶段分析，以调查连续三个季节的流感疫苗接种覆盖率。第一阶段调查显示，所有类别的流感覆盖率都很低（17%），护士的覆盖率最低（8.1%）。共有37%的医护人员接种了甲型H 1 N 1流感疫苗，医生接种率最高，护士接种率最低。甲型H1N1流感疫苗接种与科室密切相关，感染科（53.7%）和儿科（42.4%）高于妇产科（8.3%）。第二阶段调查显示，2012/13流感季的流感疫苗接种率最低。未接种疫苗的主要原因是“不确定疫苗的效力”和“感觉没有感染流感或其并发症的风险”。尽管提出了建议，但流感疫苗的接种率仍然很低。免疫接种在很大程度上被视为一种个人保护，而不是防止疾病传播给高危患者所需的措施。应将强制接种流感疫苗视为一种可能的战略，至少在收治高危患者的卫生机构是这样。本文的在线版本（doi：10.1186/s12879-015-1090-x）包含补充材料，可供授权用户使用。
Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009–2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012–2013. The overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons. The first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were “Unsure of the efficacy of vaccine” and “Feel not at-risk of getting influenza or its complications”. Despite recommendations, influenza vaccine uptake remains poor. Immunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted. The online version of this article (doi:10.1186/s12879-015-1090-x) contains supplementary material, which is available to authorized users.