Seasonal influenza vaccination coverage and its determinants among nursing homes personnel in western France

Christelle Elias,Rémi Demillac,Anca Vasiliu,Anna Fournier,Hélène Tillaut,Nicolas Beix,Serge Eyebe,Pascal Crépey,Bastien Mollo,Yvonnick Guillois

doi:10.1186/s12889-017-4556-5

Abstract

BackgroundInfluenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide. Vaccination coverage among residents is high but poorly effective due to immunosenescence. Hence, vaccination of personnel is an efficient way to protect residents. Our objective was to quantify the seasonal influenza vaccination (IV) coverage among NH for elderly workers and identify its determinants in France.MethodsWe conducted a cross-sectional study in March 2016 in a randomized sample of NHs of the Ille-et-Vilaine department of Brittany, in western France. A standardized questionnaire was administered to a randomized sample of NH workers for face-to-face interviews. General data about the establishment was also collected.ResultsAmong the 33 NHs surveyed, IV coverage for the 2015–2016 season among permanent workers was estimated at 20% (95% Confidence Interval (CI) 15.3%–26.4%) ranging from 0% to 69% depending on the establishments surveyed. Moreover, IV was associated with having previously experienced a “severe” influenza episode in the past (Prevalence Ratio 1.48, 95% CI 1.01–2.17), and varied by professional categories (p < 0.004) with better coverage among administrative staff. Better knowledge about influenza prevention tools was also correlated (p < 0.001) with a higher IV coverage. Individual perceptions of vaccination benefits had a significant influence on the IV coverage (p < 0.001). Although IV coverage did not reach a high rate, our study showed that personnel considered themselves sufficiently informed about IV.ConclusionsIV coverage remains low in the NH worker population in Ille-et-Vilaine and also possibly in France. Strong variations of IV coverage among NHs suggest that management and working environment play an important role. To overcome vaccine “hesitancy”, specific communication tools may be required to be adapted to the various NH professionals to improve influenza prevention.

Highlights

Influenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide
Characteristics of nursing homes and workers Among NHs, 52.5% were public versus 47.5% with a private status, with a median number of 71 beds (Table 1)
We show that access to vaccination is not likely to be a determinant of low influenza vaccination (IV) coverage, since only 0.4% of the responders declared being vaccinated as time consuming and considering that 80% of the vaccinations occurred inside the facilities

Summary

Introduction

Influenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide. Our objective was to quantify the seasonal influenza vaccination (IV) coverage among NH for elderly workers and identify its determinants in France. Seasonal influenza epidemics are a major public health problem worldwide, increasing annually the morbidity and mortality burden in vulnerable populations, children younger than 2 years old and adults aged 65 years and older. Prevention of influenza cases relies mainly on preventing infection among their direct contacts – an indirect protection strategy. In NHs, preventing influenza cases and deaths depends on preventing the virus from entering the community via the vaccination of healthcare workers (HCW) and other NH workers. Improving NH workers’ IV rate is a major public health target to alleviate the morbidity and mortality burden of influenza in the elderly population. Immunizing NH workers has been shown to decrease influenza transmission which increases the benefits of vaccination [5, 6]

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