Effectiveness of seasonal influenza vaccination in healthcare workers: A systematic review

Infectious Disease Control Training Centre, Hospital Authority/Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong SAR, China.
The Journal of hospital infection (Impact Factor: 2.54). 12/2011; 79(4):279-86. DOI: 10.1016/j.jhin.2011.08.004
Source: PubMed


Vaccination is considered a key measure to protect vulnerable groups against influenza infection. The objectives of this review are to determine the effect of influenza vaccinations in reducing laboratory-confirmed influenza infections, influenza-like illnesses (ILIs), working days lost among vaccinated HCWs, and associated adverse effects after vaccination. Twenty-two healthcare-related databases and internet resources, as well as reference lists, and the bibliographies of all of the retrieved articles were examined. All randomized controlled trials (RCTs) comparing the effectiveness of any kind of influenza vaccine among all groups of HCWs with a placebo/vaccine other than the influenza vaccine/no intervention were included in the review. Only three RCTs matched the inclusion criteria. There is a limited amount of evidence suggesting that receiving influenza vaccination reduces laboratory-confirmed influenza infections in HCWs. No evidence can be found of influenza vaccinations significantly reducing the incidence of influenza, number of ILI episodes, days with ILI symptoms, or amount of sick leave taken among vaccinated HCWs. There is insufficient data to assess the adverse effects after vaccination. There is no definitive conclusion on the effectiveness of influenza vaccinations in HCWs because of the limited number of related trials. Further research is necessary to evaluate whether annual vaccination is a key measure to protect HCWs against influenza infection and thus increase their confidence in the vaccine. In the mean time, the direction of promoting influenza vaccination to HCWs can be shifted from staff protection to patient protection, with accurate information to address concerns and misconceptions.

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    • "Influenza vaccination is universally recognized as the essential intervention to limit the spread of the virus particularly among elderly and patients with comorbidities [1, 2]. Moreover, during annual influenza epidemics, vaccination of the health care workers can contribute to reduce both the spread of the virus to defenceless patients and the absence from work [3, 4]. Unfortunately, despite influenza vaccine has been demonstrated to be safe and effective in healthy persons under 65 years of age, providing 70 % to 90 % protection against infection, influenza vaccination uptake rates observed in different studies among health care workers appear generally low, far away from the recommended rate of 75 %5678. "
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    ABSTRACT: Background: Although influenza vaccination has been demonstrated to be safe and effective, vaccination coverage rates among health care workers and among medical residents appear generally low. Several investigations have been performed worldwide to analyze the healthcare workers’ educational deficiencies. This multicentre survey aimed to investigate at a nationwide level training quality and work environment associated with seasonal influenza vaccination uptake among Italian medical residents. Methods: A retrospective cohort study was carried out from April 2012 to June 2012 on medical residents regularly attending the post-graduate medical schools of 18 Italian Universities via an anonymous, self administered, web-based questionnaire. Data have been analyzed by using the R statistical software package. Results: A total of 2506 out of 10,854 medical residents (23.1 %) have been recruited. The quality of training on influenza and influenza vaccination was reported as “fair” or “poor” during both pre-graduate (40.7 % of respondents) and post-graduate medical school (59.6 % of respondents). Vaccination uptake was associated with adherence to seasonal 2011/2012 influenza vaccination of medical school tutors (adjusted OR = 4.4; 95 % CI = 1.35–14.26) and other medical residents (adjusted OR = 2.2; 95 % CI = 1.14–4.23). Moreover, influenza vaccination uptake was also associated with correct knowledge about the virus composition of 2011/2012 influenza vaccine (adjusted OR = 2.43; 95 % CI = 1.64–2.58) and consultation of scientific sources or Institutional recommendations on influenza vaccination (adjusted OR = 6.96; 95 % CI = 3.38–214.36). Conclusions: Medical residency represents an opportunity to implement educational and training interventions aiming to promote appropriate professional behaviors and skills. Our study suggest that appropriate training, adequate education and proactive coworkers feelings can improve influenza vaccination attitudes towards young doctor.
    Full-text · Article · Dec 2016 · BMC Medical Education
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    • "Programs intended to increase influenza vaccination uptake among healthcare workers reported 5%–45% increase in uptake with best case cost saving of £12/vaccine [44]. Accurate information dissemination and addressing concerns and misconceptions was identified as the key components to increase the acceptance and uptake of influenza vaccinations [46]. Pharmacist-led interventions aimed to reduce drug-related morbidity, hospitalization or death from medication overuse or misuse in healthcare facility have shown significant impact on reducing hospital admissions (RR: 0.64, 95% CI: 0.43, 0.96) although the evidence is weak and does not report impact on preventable drug related morbidity [49]. "
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    ABSTRACT: Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs for improving maternal and newborn health outcomes. We considered all available systematic reviews published before May 2013 on the pre-defined facility level interventions and included 32 systematic reviews. Findings suggest that additional social support during pregnancy and labour significantly decreased the risk of antenatal hospital admission, intrapartum analgesia, dissatisfaction, labour duration, cesarean delivery and instrumental vaginal birth. However, it did not have any impact on pregnancy outcomes. Continued midwifery care from early pregnancy to postpartum period was associated with reduced medical procedures during labour and shorter length of stay. Facility based stress training and management interventions to maintain well performing and motivated workforce, significantly reduced job stress and improved job satisfaction while the interventions tailored to address identified barriers to change improved the desired practice. We found limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modifications. At the facility level, specialized midwifery teams and social support during pregnancy and labour have demonstrated conclusive benefits in improving maternal newborn health outcomes. However, the generalizability of these findings is limited to high income countries. Future programs in resource limited settings should utilize these findings to implement relevant interventions tailored to their needs.
    Full-text · Article · Sep 2014 · Reproductive Health
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    ABSTRACT: Influenzainfektionen können sich in Krankenhäusern schnell ausbreiten, nosokomiale Influenzaübertragungen sind wiederholt beschrieben worden. Die Influenzaimpfung des medizinischen Personals ist eine wichtige Maßnahme, um sowohl Mitarbeiter als auch Patienten zu schützen. Im Sommer 2011 fand eine anonyme Befragung in hessischen Krankenhäusern über die Influenzaimpfquoten sowie die Art und Durchführung der klinikinternen Impfprogramme statt. Insgesamt 95,8% (68/71) der befragten Krankenhäuser bieten kostenlose Influenzaimpfungen für das medizinische Personal an. Die Influenzaimpfquoten werden jedoch nur von 70,4% (50/71) der Krankenhäuser erfasst. Über 80% (Saison 2009/2010: 41/50; Saison 2010/2011: 44/50) der befragten Krankenhäuser gaben Influenzaimpfquoten der medizinischen Beschäftigten von weniger als 20% an. Die von uns erhobenen Daten zeigen, dass die Influenzaimpfquoten in Krankenhäusern vermutlich noch geringer sind als bisher angenommen und dass hier die üblicherweise in Deutschland kommunizierten Impfquoten von 20–25% nicht erreicht werden. Dreißig Jahre, nachdem die Ständige Impfkommission (STIKO) die Influenzaimpfung für medizinische Beschäftigte empfiehlt, liegen die Impfquoten bei ihnen weiterhin unter 30%. Maßnahmen zur Steigerung der Influenzaimpfquoten sind somit erforderlich. Eine Erfassung der Impfquoten ist Voraussetzung, um die Akzeptanz eines Impfkonzeptes zu bewerten.
    Full-text · Article · Aug 2012 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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