Health-Care Worker Vaccination for Influenza: Strategies and Controversies

Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 545, Norfolk, VA, 23507, USA, .
Current Infectious Disease Reports (Impact Factor: 1.68). 09/2012; 14(6). DOI: 10.1007/s11908-012-0291-3
Source: PubMed


Influenza infections cause significant morbidity and mortality throughout the world, and vaccination rates of health-care workers remain well below target goals. Strategies for increasing vaccination rates include mandatory vaccination of health-care workers, mandatory declination, employee incentives, intensive education, increased access to vaccines, and the use of social media to inform employees of the safety and efficacy of vaccination. While these strategies in combination have been shown to be effective in increasing vaccination rates, personal and religious objections, as well as the potential for infringing on individual autonomy, remain challenges in our efforts to bring health-care worker vaccination rates up to target goals.

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    • "In the case of adults, the Advisory Committee on Immunization Practices (ACIP) and a variety of healthcare organizations support mandatory seasonal influenza vaccination for healthcare workers (HCW), particularly given three decades of low compliance with voluntary vaccination (Derber and Shankaran 2012; Ottenberg et al. 2011). Although mandatory vaccination policies have been shown to be the strongest predictor of compliance with seasonal influenza vaccine uptake among both hospital-based and nonhospital-based HCW's (n=3,188; Rebmann et al. 2012), institutional and HCW resistance to such policies persist, with few published studies of HCW's perspectives on such mandates (Derber and Shankaran 2012; Ottenberg et al. 2011). Assessment of attitudes toward compulsory HIV vaccination among populations at elevated risk of HIV exposure, and in settings that might serve as venues for vaccine delivery, may support effective interventions to facilitate future HIV vaccine dissemination. "
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    ABSTRACT: Compulsory vaccination is a frequently implemented policy option for ensuring comprehensive vaccine coverage. Ongoing controversies around human papillomavirus vaccine dissemination, and suboptimal coverage, suggest the value of assessing acceptability of compulsory vaccinations-particularly among likely target populations-in advance of their public availability to support evidence-informed interventions. With the first HIV vaccine to demonstrate partial efficacy in a large-scale clinical trial, we examined individual characteristics and attitudes associated with support for compulsory HIV vaccination policy among a diverse, representative sample of adults attending probable HIV vaccine dissemination venues in a large urban county. Participants were recruited using three-stage probability sampling from likely venues for future HIV vaccine dissemination. We used Audio-CASI to administer a 60-min structured questionnaire. Items included endorsement of compulsory HIV vaccination policy, sociodemographic characteristics, injecting drug use, vaccine attitudes and perceived HIV risk. Among 1,225 participants (mean age = 36.8 years; 55.6 % males, 37.6 % non-English speaking Hispanic, 78.8 % heterosexual, 25.7 % injection drug users), almost half (48.2 %) endorsed a compulsory HIV vaccination policy. Non-English speaking Hispanics compared to whites, participants with less than high school education, higher positive vaccine attitude scores and higher perceived HIV risk were significantly more likely, and people who inject drugs significantly less likely to endorse compulsory HIV vaccination. Public health interventions to promote positive vaccine attitudes and accurate perceptions of HIV risk among vulnerable populations, and strategies tailored for people who inject drugs, may build support for compulsory HIV vaccination policy and promote broad HIV vaccine coverage.
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    ABSTRACT: Objective To explore the impact of community healthcare workers' (CHWs) knowledge, attitude and practice (KAP) on the influenza vaccination among elderly people. Methods By means of simple random sampling, 1 residential quarter of each communities, 2 communities of each districts, 5 districts of Chengdu city were randomly selected, and the elderly equal to or more than 60-year-old were on-site investigated. Meanwhile, the questionnaire survey was conducted among healthcare workers in the selected communities. Results There were 4 KAP factors played a positive role in influenza vaccination among elderly people: CHWs' afrmation of the effectiveness of influenza vaccine, explicitly knowing the focus groups for influenza vaccination, recommendation of vaccination in fu season when the elderly visits, and participation in fu-related education activities. When the accuracy rate of each factor got improved by 1%, the influenza vaccination rate would improve by 2.747%, 1.299%, 0.864%, 0.602%, respectively. Conclusion Te knowledge, attitude and practice of HCWs have impacts on the influenza vaccination rates of elderly people. They are significant to improve the influenza vaccination rates of the elderly.
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