Factors associated with uptake of pandemic influenza vaccine among general practitioners and practice nurses in Shropshire, UK

Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK.
Primary care respiratory journal: journal of the General Practice Airways Group (Impact Factor: 2.5). 07/2012; 21(3):302-7. DOI: 10.4104/pcrj.2012.00056
Source: PubMed


At the time of the 2009-10 influenza pandemic there was considerable unease about vaccination. Early surveys suggested that the intention to be vaccinated amongst healthcare workers was low.
To determine what influenced vaccination uptake among general practice healthcare workers in Shropshire County Primary Care Trust in the UK.
A cross-sectional survey was distributed to all frontline healthcare workers in Shropshire County's general practices in June 2010. All 45 practices participated. Questionnaires were distributed by practice managers to frontline staff and returned by post. Practices with the lowest return rates were reminded by telephone after 3 months.
205 valid replies were received, giving a response rate of 48.0%. 10.0% reported being infected with the pandemic H1N1 strain by the time they received the questionnaire. 172 (83.9%) respondents reported that they had been vaccinated against H1N1. Influenza infection prior to vaccination had a negative impact on uptake (adjusted OR 0.17, 95% CI 0.05 to 0.56) and previous vaccination against seasonal influenza was associated with increased uptake (adjusted OR 4.07, 95% CI 1.62 to 10.24). Those who received the pandemic vaccine were seven times more likely to accept future vaccines (adjusted OR 7.04, 95% CI 2.70 to 18.37).
Vaccination uptake was significantly higher than the national (40.3%), regional (40.9%), and county averages (49.3%). Motivation for and against vaccination was very similar to that for seasonal vaccination, with previous vaccination having the greatest influence. Ensuring healthcare workers receive vaccination early in their career is likely to set a precedent for future vaccination. This is the first detailed study purely in general practice in England.

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    • "However, there are few studies on seasonal influenza vaccination in primary healthcare workers (PHCWs) (Ward et al., 2011), although they are the gateway to the health system, serving the vast majority of patients with influenza and playing an important role in vaccinating patients (Tuells et al., 2012). The factors influencing influenza vaccination coverage in healthcare workers have been analysed in other studies (Brandt et al., 2011; Hothersall et al., 2012; Maltezou et al., 2008; Sánchez-Payá et al., 2012), but the factors that mark the advances and setbacks in coverage during successive vaccination campaigns have hardly been evaluated. A decreased uptake of seasonal influenza vaccines has been recently reported in Spain in the first post-pandemic season (Sánchez-Payá et al., 2012). "
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    ABSTRACT: To evaluate trends in seasonal influenza vaccination coverage in primary healthcare workers (PHCWs) in Spain between 2008 and 2011. METHODS: We made an anonymous web survey of PHCWs in 2012. Information on attitudes towards and knowledge of influenza vaccine, and immunization in previous seasons was collected. Self-reported vaccination coverage and factors related to vaccination continuity were analysed. RESULTS: Of 5433 workers contacted, 2625 (48.3%) responded to the survey: 47.0% were general practitioners, 10.3% paediatricians and 42.7% nurses. Their reported vaccination rates from seasons 2008-2009 to 2011-2012 decreased over time: 58.4%, 57.4%, 53.2% and 49.3% (linear trend, p<0.001). Among workers vaccinated in any previous season, 70.2% were vaccinated again in 2011-2012, compared with 5.2% among those not previously vaccinated (p<0.001). Continuity of vaccination increased with age and with the worker or cohabitant having a major chronic condition. Vaccination was higher in workers who recognized vaccination as effective and those worried about being infected or infecting patients. CONCLUSION: Influenza vaccination coverage in PHCWs has declined, especially after the pandemic. Intensive interventions are needed to change this trend. Knowledge of vaccination should be reinforced by stressing the effectiveness of the vaccine and the risks of influenza for workers and patients.
    Preventive Medicine 09/2013; 57(3):206-11. DOI:10.1016/j.ypmed.2013.05.021 · 3.09 Impact Factor
  • Primary care respiratory journal: journal of the General Practice Airways Group 08/2012; 21(3):246-7. DOI:10.4104/pcrj.2012.00081 · 2.50 Impact Factor
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    ABSTRACT: Background Influenza vaccination rates among Japanese people of working age (20–69 years) is currently suboptimal, and the reasons for this have not been clearly elucidated. This study examined factors associated with vaccination intention among the working age population in Japan during September 2011, one-month prior to influenza vaccination becoming available. Methodology/Principal Findings A web-based survey of intention to be vaccinated against influenza in the coming season was undertaken among 3,129 Japanese aged 20 to 69 years. Multinomial logistic regression analysis was used to explore the associations between vaccination intent and other variables. Influenza vaccination intent was associated with having been vaccinated in the previous year (Odds Ratio (OR): 3.81; 95% Confidence Interval (CI): 3.75–3.86), the number of children per household (one compared with zero; OR: 1.37; 95%CI: 1.11–1.65), and household income ($50,000 to <$100,000 compared with $0 to <$50,000; OR: 1.30; 95%CI: 1.07–1.54). Smoking was inversely associated with influenza vaccine uptake (current smokers compared with non-smokers; OR: 0.79; 95%CI: 0.61–0.98). A history of either the survey respondent or a household member having being medically diagnosed with influenza in the previous year was not statistically associated with future influenza vaccination intent. Conclusions/Significance Overall, this suggests that intention to be vaccinated among working age Japanese is associated with a past history of influenza vaccination, having children, and the household's income. As such, consideration of these factors should now form the cornerstone of strategies to encourage increased uptake of vaccination against influenza in future years.
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