Immunization of Health-Care Providers: Necessity and Public Health Policies.

Helena Maltezou,Gregory Poland

doi:10.3390/healthcare4030047

Abstract

Health-care providers (HCPs) are at increased risk for exposure to vaccine-preventable diseases (VPDs) in the workplace. The rationale for immunization of HCPs relies on the need to protect them and, indirectly, their patients from health-care-associated VPDs. Published evidence indicates significant immunity gaps for VPDs of HCPs globally. Deficits in knowledge and false perceptions about VPDs and vaccines are the most common barriers for vaccine uptake and may also influence communication about vaccines between HCPs and their patients. Most countries have immunization recommendations for HCPs; however, there are no universal policies and significant heterogeneity exists between countries in terms of vaccines, schedules, frame of implementation (recommendation or mandatory), and target categories of HCPs. Mandatory influenza immunization policies for HCPs have been implemented with high vaccine uptake rates. Stronger recommendations for HCP immunization and commitment at the level of the health-care facility are critical in order to achieve high vaccine coverage rates. Given the importance to health, mandatory immunization policies for VPDs that can cause serious morbidity and mortality to vulnerable patients should be considered.

Highlights

The time is always right to do what is right.Martin Luther King, Jr. (1929–1968)The widespread implementation of vaccinations during the second half of the past century has had an exceptional impact on childhood morbidity and mortality globally [1]
health-care providers (HCPs) immunization is recommended for protection of older persons, and is especially important for HCPs who have underlying diseases or specific conditions; this issue is usually not addressed [19]
Immunization against hepatitis B and influenza are almost uniformly recommended in most countries

Summary

Introduction

The time is always right to do what is right. The widespread implementation of vaccinations during the second half of the past century has had an exceptional impact on childhood morbidity and mortality globally [1]. Outbreaks of vaccine-preventable diseases (VPDs) still challenge health-care facilities, even in countries with well-established immunization programs, resulting in considerable morbidity and fatal events among patients and health-care providers (HCPs) [2,3,4,5,6,7,8,9,10]. The 1982 recommendations of the United States Advisory Committee on Immunization Practices (ACIP) for HCP immunization against hepatitis B, followed by the 1984 ACIP recommendations for influenza immunization, paved the way for occupational immunization programs for this high-risk occupational group [11]. Immunization programs for HCPs constitute a key role in occupational medicine and infection control within health-care facilities, and several countries and health-care facilities have established comprehensive immunization programs for HCPs [12,13,14,15].

Rationale for Immunization of HCPs

Immunity Status of HCPs

Attitudes and Practices of HCPs toward Vaccines

Immunization Policies for HCPs

Authors’ Recommendations

Conclusions