Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients.

Antonietta Giannattasio,Roberto Romano,Guglielmo Borgia,Alfredo Guarino,Fabrizia Chiatto,Miriam Mariano,Andrea Lo Vecchio,Ilaria Liguoro

doi:10.1186/s12879-015-1090-x

Antonietta Giannattasio, Roberto Romano + Show 6 more

Open Access

https://doi.org/10.1186/s12879-015-1090-x

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Abstract

BackgroundDespite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs). Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Phase 1 data collection was performed in 2009–2010, during the peak of H1N1 pandemic. Phase 2 data collection, aimed to investigate seasonal influenza vaccination coverage in the three seasons after pandemic, was performed in 2012–2013.MethodsThe overall H1N1 vaccination rate was derived by the Hospital immunization registry. In 2010, the personnel of three Departments (Infectious Diseases, Pediatrics and Gynecology/Obstetrics) completed a survey on influenza. A second-phase analysis was performed in 2012 to investigate influenza vaccination coverage in three consecutive seasons.ResultsThe first-phase survey showed a low coverage for influenza in all categories (17 %), with the lowest rate in nurses (8.1 %). A total of 37 % of health care workers received H1N1 vaccine, with the highest rate among physicians and the lowest in nurses. H1N1 vaccination was closely related to the Department, being higher in the Department of Infectious Diseases (53.7 %) and Pediatrics (42.4 %) than in Gynecology/Obstetrics (8.3 %). The second-phase survey showed the lowest rate of influenza vaccination in 2012/13 season. The main reasons for not being vaccinated were “Unsure of the efficacy of vaccine” and “Feel not at-risk of getting influenza or its complications”. Despite recommendations, influenza vaccine uptake remains poor.ConclusionImmunization is largely perceived as a personal protection rather than a measure needed to prevent disease spreading to at-risk patients. Compulsory vaccination against influenza should be considered as a possible strategy, at least in health institutions where at-risk patients are admitted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1090-x) contains supplementary material, which is available to authorized users.

Highlights

Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs)
University Hospital H1N1 vaccination rate: computerized immunization records According to data provided by the Department of Human Resources, in 2009 the overall number of HCWs of the University Hospital was 2557
When total data on H1N1 vaccination obtained by the computerized records were analysed in the three selected Departments, we found that H1N1 vaccine uptake was closely to the category of HCWs, and to the belonging Department (Table 1)

Summary

Introduction

Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs) Aim of this observational two-phase study was to estimate the immunization rates for influenza in four subsequent seasons and for pandemic H1N1 influenza in HCWs of a University Hospital, and to investigate its distribution pattern and the main determinants of immunization. Despite consistent recommendations by all Public Health Authorities in support of annual influenza vaccination for at-risk categories, there is still a low uptake of influenza vaccine in these groups including health care workers (HCWs) [4,5,6]. In Spain, where the seasonal vaccination coverage was 31 %, the rate recorded during the 2009 H1N1 pandemic season was father lower (22 %) [15]

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