Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Promotion of influenza vaccination among health care workers: findings from a tertiary care children’s hospital in Italy

Authors: Vanessa Cozza, Valeria Alfonsi, Maria Cristina Rota, Valerio Paolini, Marta Luisa Ciofi degli Atti

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

The aims of this study were: a) to evaluate attitudes and practices of health care workers (HCWs) towards influenza vaccination and their opinion regarding a vaccination promotion toolkit; b) to estimate hospital HCWs’ influenza vaccination coverage rates (VC).

Methods

The Bambino Gesù Children’s Hospital (OPBG) is an academic hospital in Italy. Since 2009, free influenza vaccination is offered to HCWs during working hours. In October-December 2013, a communication campaign based on a standardized toolkit was conducted. In December 2013, we performed a cross-sectional survey in a sample of hospital wards, based on a self-administered questionnaire including participants’ characteristics; self-reported influenza vaccination history; reasons for vaccination or missed vaccination; opinion regarding the toolkit. Multivariable logistic analysis was used to assess independent predictors of influenza vaccination status. Annual VC for years 2009–2013 was estimated by using the number of seasonal influenza vaccine doses administered to HCWs as numerator, and the number of hospital HCWs as denominator.

Results

Out of 191 HCWs who participated in the survey, 35.6 % reported at least one influenza vaccination during their life; 6.8 % adhered to annual revaccination. Years of service and professional category were significantly and independently associated with vaccination (adjusted-OR: 2.4 for > 10 years of service, compared to < 5 years of service; adjusted-OR: 2.6 for physicians compared to nurses). Patient protection was the main reported reason for vaccination (34.3 %); considering influenza a mild disease was the main reason for non-vaccination (36.9 %); poor vaccine effectiveness was the main reason for missed annual revaccination (28.8 %). Overall, 75 % of respondents saw at least one promotion tool; 65.6 % of them found the information useful. Hospital VC decreased from 30 % in 2009, to 5 % in 2012. In 2013, VC was 14 %.

Conclusions

Satisfactory influenza VC in HCWs is hard to achieve. In 2013, along with the toolkit implementation, we observed an increase in HCWs’ vaccination coverage, nevertheless, it remained unsatisfactory. Tailored information strategies targeting nurses and recently employed HCWs should be implemented. Institution of declination statements, adding influenza vaccination to financial incentive systems, or vaccination requirements should also be considered to increase influenza VC among HCWs.
Literature
3.
go back to reference Advisory Committee on Immunization Practices (ACIP). Recommended adult immunization schedule: United States, 2013. Ann Intern Med. 2013;158(3):191–9.CrossRef Advisory Committee on Immunization Practices (ACIP). Recommended adult immunization schedule: United States, 2013. Ann Intern Med. 2013;158(3):191–9.CrossRef
5.
go back to reference Vanhems P, Voirin N, Roche S, Escuret V, Regis C, Gorain C, et al. Risk of influenza-like illness in an acute health care setting during community influenza epidemics in 2004–2005, 2005–2006, and 2006–2007: a prospective study. Arch Intern Med. 2011;171(2):151–7.CrossRefPubMed Vanhems P, Voirin N, Roche S, Escuret V, Regis C, Gorain C, et al. Risk of influenza-like illness in an acute health care setting during community influenza epidemics in 2004–2005, 2005–2006, and 2006–2007: a prospective study. Arch Intern Med. 2011;171(2):151–7.CrossRefPubMed
6.
go back to reference Chironna M, Tafuri S, Santoro N, Prato R, Quarto M, Germinario CA. A nosocomial outbreak of 2009 pandemic influenza A(H1N1) in a paediatric oncology ward in Italy, October-November 2009. Euro Surveill. 2010;7:15(1). Chironna M, Tafuri S, Santoro N, Prato R, Quarto M, Germinario CA. A nosocomial outbreak of 2009 pandemic influenza A(H1N1) in a paediatric oncology ward in Italy, October-November 2009. Euro Surveill. 2010;7:15(1).
7.
go back to reference Mejia C, Silvestre M, Cazali I, Garcia J, Sanchez R, Garcia L, et al. Large epidemiological influenza a outbreak in a teaching hospital from Guatemala city. ISRN AIDS. 2012;2012:638042.CrossRefPubMedPubMedCentral Mejia C, Silvestre M, Cazali I, Garcia J, Sanchez R, Garcia L, et al. Large epidemiological influenza a outbreak in a teaching hospital from Guatemala city. ISRN AIDS. 2012;2012:638042.CrossRefPubMedPubMedCentral
8.
go back to reference Regis C, Voirin N, Escuret V, Kim BA, Robert O, Lina B, et al. Five years of hospital based surveillance of influenza-like illness and influenza in a short-stay geriatric unit. BMC Res Notes. 2014;7(1):99.CrossRefPubMedPubMedCentral Regis C, Voirin N, Escuret V, Kim BA, Robert O, Lina B, et al. Five years of hospital based surveillance of influenza-like illness and influenza in a short-stay geriatric unit. BMC Res Notes. 2014;7(1):99.CrossRefPubMedPubMedCentral
9.
go back to reference Yassi A1, McGill M, Holton D, Nicolle L. Morbidity, cost and role of health care worker transmission in an influenza outbreak in a tertiary care hospital. Can J Infect Dis. 1993;4(1):52–6.CrossRefPubMedPubMedCentral Yassi A1, McGill M, Holton D, Nicolle L. Morbidity, cost and role of health care worker transmission in an influenza outbreak in a tertiary care hospital. Can J Infect Dis. 1993;4(1):52–6.CrossRefPubMedPubMedCentral
10.
go back to reference Mota NV, Lobo RD, Toscano CM, Pedroso De Lima AC, Souza Dias MB, Komagata H, et al. Cost-effectiveness of sick leave policies for health care workers with influenza-like illness, Brazil, 2009. Emerg Infect Dis. 2011;17(8):1421–9. doi:10.3201/eid1708.101546.PubMedPubMedCentral Mota NV, Lobo RD, Toscano CM, Pedroso De Lima AC, Souza Dias MB, Komagata H, et al. Cost-effectiveness of sick leave policies for health care workers with influenza-like illness, Brazil, 2009. Emerg Infect Dis. 2011;17(8):1421–9. doi:10.​3201/​eid1708.​101546.PubMedPubMedCentral
11.
go back to reference Ahmed F, Lindley MC, Allred N, Weinbaum CM, Grohskopf L. Effect of influenza vaccination of healthcare personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clin Infect Dis. 2014;58(1):50–7.CrossRefPubMed Ahmed F, Lindley MC, Allred N, Weinbaum CM, Grohskopf L. Effect of influenza vaccination of healthcare personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clin Infect Dis. 2014;58(1):50–7.CrossRefPubMed
12.
go back to reference Ajenjo MC, Woeltje KF, Babcock HM, Gemeinhart N, Jones M, Fraser VJ. Influenza vaccination among healthcare workers: ten-year experience of a large healthcare organization. Infect Control Hosp Epidemiol. 2010;31(3):233–40.CrossRefPubMedPubMedCentral Ajenjo MC, Woeltje KF, Babcock HM, Gemeinhart N, Jones M, Fraser VJ. Influenza vaccination among healthcare workers: ten-year experience of a large healthcare organization. Infect Control Hosp Epidemiol. 2010;31(3):233–40.CrossRefPubMedPubMedCentral
13.
go back to reference Influenza vaccination coverage among health-care personnel - United States. 2010–11 influenza season. MMWR Morb Mortal Wkly Rep. 2011;60(32):1073–7. Influenza vaccination coverage among health-care personnel - United States. 2010–11 influenza season. MMWR Morb Mortal Wkly Rep. 2011;60(32):1073–7.
14.
go back to reference Mereckiene J, Cotter S, Nicoll A, Lopalco P, Noori T, Weber JT, D’Ancona F, Lévy-Bruhl D, Dematte L, Giambi C, Valentiner-Branth P, Stankiewicz I, Appelgren E, O’Flanagan D, the VENICE project gatekeepers group. 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). Euro Surveill. 2014;19(16):pii = 20780. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20780 Mereckiene J, Cotter S, Nicoll A, Lopalco P, Noori T, Weber JT, D’Ancona F, Lévy-Bruhl D, Dematte L, Giambi C, Valentiner-Branth P, Stankiewicz I, Appelgren E, O’Flanagan D, the VENICE project gatekeepers group. 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). Euro Surveill. 2014;19(16):pii = 20780. Available online: http://​www.​eurosurveillance​.​org/​ViewArticle.​aspx?​ArticleId=​20780
15.
go back to reference Esposito S, Bosis S, Pelucchi C, Tremolati E, Sabatini C, Semino M, et al. Influenza vaccination among healthcare workers in a multidisciplinary University hospital in Italy. BMC Public Health. 2008;8:422.CrossRefPubMedPubMedCentral Esposito S, Bosis S, Pelucchi C, Tremolati E, Sabatini C, Semino M, et al. Influenza vaccination among healthcare workers in a multidisciplinary University hospital in Italy. BMC Public Health. 2008;8:422.CrossRefPubMedPubMedCentral
16.
go back to reference Blank PR, Schwenkglenks M, Szucs TD. Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009;58(6):446–58.CrossRefPubMed Blank PR, Schwenkglenks M, Szucs TD. Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009;58(6):446–58.CrossRefPubMed
17.
go back to reference Rizzo C, Bella A, Declich S, Rota MC, e il gruppo di lavoro influenza pandemica. Sorveglianza epidemiologica integrata della pandemia influenzale da virus A/H1N1v nella stagione 2009–2010. Roma: Istituto Superiore di Sanità; 2010. Rapporti ISTISAN 10/46. Rizzo C, Bella A, Declich S, Rota MC, e il gruppo di lavoro influenza pandemica. Sorveglianza epidemiologica integrata della pandemia influenzale da virus A/H1N1v nella stagione 2009–2010. Roma: Istituto Superiore di Sanità; 2010. Rapporti ISTISAN 10/46.
18.
go back to reference Alicino C, Iudici R, Barberis I, Paganino C, Cacciani R, Zacconi M, et al. Influenza vaccination among healthcare workers in Italy. Hum Vaccin Immunother. 2015;11(1):95–100.CrossRefPubMed Alicino C, Iudici R, Barberis I, Paganino C, Cacciani R, Zacconi M, et al. Influenza vaccination among healthcare workers in Italy. Hum Vaccin Immunother. 2015;11(1):95–100.CrossRefPubMed
20.
go back to reference Van den Dool C, Van Strien AM, den Akker IL, Bonten MJ, Sanders EA, Hak E. Attitude of Dutch hospital personnel towards influenza vaccination. Vaccine. 2008;26(10):1297–302.CrossRefPubMed Van den Dool C, Van Strien AM, den Akker IL, Bonten MJ, Sanders EA, Hak E. Attitude of Dutch hospital personnel towards influenza vaccination. Vaccine. 2008;26(10):1297–302.CrossRefPubMed
21.
go back to reference Mytton OT, O’Moore EM, Sparkes T, Baxi R, Abid M. Knowledge, attitudes and beliefs of health care workers towards influenza vaccination. Occup Med (Lond). 2013;63(3):189–95.CrossRef Mytton OT, O’Moore EM, Sparkes T, Baxi R, Abid M. Knowledge, attitudes and beliefs of health care workers towards influenza vaccination. Occup Med (Lond). 2013;63(3):189–95.CrossRef
22.
go back to reference Hollmeyer HG, Hayden F, Poland G, Buchholz U. Influenza vaccination of health care workers in hospitals-a review of studies on attitudes and predictors. Vaccine. 2009;27(30):3935–44.CrossRefPubMed Hollmeyer HG, Hayden F, Poland G, Buchholz U. Influenza vaccination of health care workers in hospitals-a review of studies on attitudes and predictors. Vaccine. 2009;27(30):3935–44.CrossRefPubMed
23.
go back to reference Barbadoro P, Marigliano A, Di Tondo E, Chiatti C, Di Stanislao F, D’Errico MM, et al. Determinants of influenza vaccination uptake among Italian healthcare workers. Hum Vaccin Immunother. 2013;9(4):911–6.CrossRefPubMedPubMedCentral Barbadoro P, Marigliano A, Di Tondo E, Chiatti C, Di Stanislao F, D’Errico MM, et al. Determinants of influenza vaccination uptake among Italian healthcare workers. Hum Vaccin Immunother. 2013;9(4):911–6.CrossRefPubMedPubMedCentral
24.
go back to reference Hofmann F, Ferracin C, Marsh G, Dumas R. Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection. 2006;34(3):142.CrossRefPubMed Hofmann F, Ferracin C, Marsh G, Dumas R. Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection. 2006;34(3):142.CrossRefPubMed
25.
go back to reference Riphagen-Dalhuisen J, Gefenaite G, Hak E. Predictors of seasonal influenza vaccination among healthcare workers in hospitals: a descriptive meta-analysis. Occup Environ Med. 2012;69(4):230–5.CrossRefPubMed Riphagen-Dalhuisen J, Gefenaite G, Hak E. Predictors of seasonal influenza vaccination among healthcare workers in hospitals: a descriptive meta-analysis. Occup Environ Med. 2012;69(4):230–5.CrossRefPubMed
26.
go back to reference Brandt C, Rabenau HF, Bornmann S, Gottschalk R, Wicker S. The impact of the 2009 influenza A(H1N1) pandemic on attitudes of healthcare workers toward seasonal influenza vaccination 2010/11. Euro Surveill. 2011;28:16(17). Brandt C, Rabenau HF, Bornmann S, Gottschalk R, Wicker S. The impact of the 2009 influenza A(H1N1) pandemic on attitudes of healthcare workers toward seasonal influenza vaccination 2010/11. Euro Surveill. 2011;28:16(17).
27.
go back to reference Potter J, Stott DJ, Roberts MA, Elder AG, O’Donnell B, Knight PV, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis. 1997;175(1):1–6.CrossRefPubMed Potter J, Stott DJ, Roberts MA, Elder AG, O’Donnell B, Knight PV, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis. 1997;175(1):1–6.CrossRefPubMed
28.
go back to reference WHO. Resolution WHA 56.19. Prevention and control of influenza pandemics and annual epidemics. Geneva: Fifty-sixth World Health Assembly; 2003. p. 19–5. WHO. Resolution WHA 56.19. Prevention and control of influenza pandemics and annual epidemics. Geneva: Fifty-sixth World Health Assembly; 2003. p. 19–5.
29.
go back to reference CDC. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(RR-7):1–45. CDC. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(RR-7):1–45.
Metadata
Title
Promotion of influenza vaccination among health care workers: findings from a tertiary care children’s hospital in Italy
Authors
Vanessa Cozza
Valeria Alfonsi
Maria Cristina Rota
Valerio Paolini
Marta Luisa Ciofi degli Atti
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2067-9

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue