Abstract
BackgroundHealthcare workers (HCWs) are at an increased risk of exposure to and transmission of infectious diseases. Vaccination lowers morbidity and mortality of HCWs and their patients. To assess vaccination coverage for influenza and hepatitis B virus (HBV) among HCWs in Croatian hospitals, we conducted yearly nationwide surveys.MethodsFrom 2006 to 2011, all 66 Croatian public hospitals, representing 43–60% of all the HCWs in Croatia, were included. Statistical analysis was performed using the Kruskal–Wallis analysis of variance, Dunn’s multiple comparison analysis and the chi-square test, as appropriate.ResultsThe median seasonal influenza vaccination coverage rates in pre-pandemic (2006–2008) seasons were 36%, 25% and 29%, respectively. By occupation, influenza vaccination rates among physicians were 33 ± 21%, 33 ± 22% among graduate nurses, 30±34% among other HCWs, 26 ± 21% among housekeeping and the lowest, 23 ± 17%, among practical nurses (p < 0.01). In 2009–2010 season, seasonal influenza vaccination coverage was 30%, while overall vaccination coverage against pandemic influenza was fewer than 5%. Median vaccination coverage in the post-pandemic seasons of 2010–2011 and 2011–2012 decreased to 15% and 14%, respectively (reduction of 24% and 35%, respectively, p < 0.0001). Meanwhile, the median mandatory HBV vaccination coverage was 98%, albeit with considerable differences according to work setting (range 19–100%) and occupation (range 4–100%).ConclusionsWe found substantial year-on-year variations in seasonal influenza vaccination rates, with reduction in post pandemic influenza seasons. HBV vaccination is satisfactory compared to seasonal influenza vaccination coverage, although substantial variations by occupation and work setting were observed. These findings highlight the need for national strategies that optimize vaccination coverage among HCWs in Croatian hospitals. Further studies are needed to establish the potential role of mandatory vaccination for seasonal influenza.
Highlights
Healthcare workers (HCWs) are at an increased risk of exposure to and transmission of infectious diseases
From 2006 to 2011, the median hepatitis B virus (HBV) vaccination coverage was 98%, albeit with considerable differences according to work setting and occupation (Figures 2, 3, 4, Panel B)
HCWs in university hospitals were more likely to receive HBV vaccine than in general or long-term care hospitals
Summary
Healthcare workers (HCWs) are at an increased risk of exposure to and transmission of infectious diseases. In Croatia, the majority of vaccine-preventable infectious diseases, such as diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella and tuberculosis, are covered by the national mandatory immunization program for children [6,7,8]. Vaccination of HCWs against hepatitis B virus (HBV) began to be introduced in Croatia in the 1990s and for many years has been mandatory and free of charge [9,10]. It is performed using a vaccine obtained from a surface antigen of the hepatitis B virus through genetic engineering that is administered in three doses according to a scheme of 0, 1 and 6 months.
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