Physician attitudes towards influenza immunization and vaccine mandates
ABSTRACT We surveyed physicians' opinions and acceptance of influenza immunization.
A web-based survey was sent to all physicians in two academic departments during spring 2009.
227 (40.5%) physicians responded. Physicians who frequently cared for high-risk patients self-reported higher immunization rates than physicians with infrequent contact (P=0.0002). There were no significant differences in immunization rates between emergency medicine (EM) and internal medicine (IM), between those with and without children at home, nor by age group. A majority (84.6%) supported mandatory vaccination. IM physicians were more supportive of mandates than EM physicians (P<0.0001).
Self-reported immunization rates were high among study physicians. Acceptance of mandatory vaccination was substantial, but varied by specialty.
- SourceAvailable from: Alexander Borisovich Kurzhanski[Show abstract] [Hide abstract]
ABSTRACT: It is well known that among the first motivations for modern control theory were dynamic optimization problems in rocket launching and navigation in aerospace. These problems had become especially important in the 1940s and 1950s due to requirement to minimize various costly resources and design parameters, such as flight time, amount (mass) of fuel, weight of the spacecraft, the drag forces and other items. This had to be done under various restrictions on control capacities and other complicating factors, such for example, as incomplete information on the system. Among the precious techniques of applied mathematics there had long been developed an adequate tool for such problems which is the Calculus of Variations. Problems in flight dynamics had become the earliest serious technical object for its application. A large number of new basic ideas for adapting Calculus of Variations to modern control problems and synthesizing them into modern control theory were elaborated in the course of investigations in flight dynamics. This presentation traces some seminal investigations, which were crucial for related theoretical developments in former Soviet Union and present Russia and had also influenced related research beyond national borders. Such investigations had good historical precursors in the earlier mathematical works of P.L. Chebyshev, A.M. Lyapunov, A.A. Markov, the works in mechanics by N.E. Zhukovski and S.A. Chaplygin and the activities in dynamic systems theory of the 1930s (A.A. Andronov, L.S. Pontryagin, et al.).The present paper is confined only to deterministic problems in trajectory analysis, control and optimization within the framework of mathematical theory of controlled processes. The national community of researchers involved in these topics was enormous, including those in the Academy of Sciences, the Universities and the numerous institutions and plants supervised by related industrial ministries. While giving tribute to all those involved, this paper does not claim to give a full review of available publications, concentrating on what the authors believe to be the seminal issues in the field. This publication will therefore inevitably have a subjective flavor. We sincerely apologize to all those whose contributions may have been missed.Annual Reviews in Control 01/2005; 29(1-29):13-31. DOI:10.1016/j.arcontrol.2005.01.002 · 2.52 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The emergence of 2009 pandemic H1N1 influenza A (pH1N1) has provided a unique challenge to influenza control in healthcare settings. We provide an overview of the early lessons from the 2009 pandemic. The modes of influenza transmission and their contributions to the development of infections remain unclear. Recent studies in the guinea pig model have demonstrated airborne transmission, but data from human studies and outbreaks are inconclusive. Data on physical interventions to prevent transmission support the use of hand hygiene, gowns, gloves, face shields and respiratory protection. The effectiveness of surgical masks compared to N95 respirators has been investigated, and there is evidence from one trial that surgical masks are noninferior to N95 respirators in preventing infection. Experiences with mandatory vaccination suggest that this is a highly successful approach to increase healthcare personnel vaccination rates. Lessons from pH1N1 have multiple implications for future pandemic preparedness planning. Further research is needed on appropriate respiratory protection for influenza. Mandatory vaccination programs should be considered in all healthcare settings. Pandemic preparedness plans should be revised, focusing on flexibility, communication, stockpiling of essential supplies, and staffing support for infection control.Current Opinion in Infectious Diseases 08/2010; 23(4):293-9. DOI:10.1097/QCO.0b013e32833bb804 · 5.01 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: This document serves as an update and companion piece to the 2005 Society for Healthcare Epidemiology of America (SHEA) Position Paper entitled "Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages."1 In large part, the discussion about the rationale for influenza vaccination of healthcare personnel (HCP), the strategies designed to improve influenza vaccination rates in this population, and the recommendations made in the 2005 paper still stand. This position paper notes new evidence released since publication of the 2005 paper and strengthens SHEA's position on the importance of influenza vaccination of HCP. This document does not discuss vaccine allocation during times of vaccine shortage, because the 2005 SHEA Position Paper1 still serves as the Society's official statement on that issue. SHEA views influenza vaccination of HCP as a core patient and HCP safety practice with which noncompliance should not be tolerated. It is the professional and ethical responsibility of HCP and the institutions within which they work to prevent the spread of infectious pathogens to their patients through evidence-based infection prevention practices, including influenza vaccination. Therefore, for the safety of both patients and HCP, SHEA endorses a policy in which annual influenza vaccination is a condition of both initial and continued HCP employment and/or professional privileges. The implementation of this policy should be part of a multifaceted, comprehensive influenza infection control program; it must have full, visible leadership support with the expectation for influenza vaccination fully and clearly communicated to all existing and applicant HCP; and it must have ample resources and support to implement and to sustain the HCP vaccination program. This recommendation applies to all HCP working in all healthcare settings, regardless of whether the HCP have direct patient contact or whether the HCP are directly employed by the facility. It also applies to all students, volunteers, and contract workers. SHEA recommends that only exemptions due to recognized medical contraindications to influenza vaccination be considered. © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved.Infection Control and Hospital Epidemiology 10/2010; 31(10):987-95. DOI:10.1086/656558 · 4.18 Impact Factor