Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance.

Emily Sellens,Lynne Hayes,Harold Willaby,Jacqueline M Norris,Heather F Gidding,Katrina L Bosward,Navneet K Dhand,Nicholas Wood,Jane Heller,Glenn F Browning

doi:10.1371/journal.pone.0198421

Abstract

Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31–38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge (OR 2.27), (4) working within small animal practice (OR 1.67), (5) disagreeing the vaccine is expensive (OR 1.55), and (6) age, with veterinarians under 39 years most likely to recommend vaccination. Of the veterinary nursing cohort who reported a known Q fever vaccination status (n = 688), 29% (95% CI 26–33%) had sought vaccination. This was significantly (p<0.05) associated with (1) agreeing the vaccine is important (OR 8.34), (2) moderate/high Q fever knowledge (OR 5.51), (3) working in Queensland (OR 4.00), (4) working within livestock/mixed animal practice (OR 3.24), (5) disagreeing the vaccine is expensive (OR 1.86), (6) strong reliance on work culture for biosecurity information (OR 2.5), (7) perceiving personal exposure to Coxiella burnetii to be at least low/moderate (OR 2.14), and (8) both agreeing the vaccine is safe and working within a corporate practice structure (OR 4.28). The study identified the need for veterinarians to take greater responsibility for workplace health and safety promotion, and calls for better education of veterinary personnel to raise awareness of the potential for occupational exposure to C. burnetii and improve the perception of the Q fever vaccine as being important, safe and cost-effective.

Highlights

Q fever is a vaccine-preventable zoonotic disease caused by the bacterium Coxiella burnetii, which is distributed worldwide, with the exception of New Zealand and French Polynesia [1]
Personal invitation emails sent to 882 veterinary nurses and 1200 veterinarians registered with the Western Australia state veterinary board, 245 veterinarians registered with the veterinary board of Tasmania, and 917 veterinary nurse member of the Veterinary Nursing Council of Australia (VNCA)
This study identified that the majority of veterinarians in Australia were not willing to at least slightly recommend the Q fever vaccine to veterinary personnel across all practice types, despite vaccination being the most effective preventative measure

Summary

Introduction

Q fever is a vaccine-preventable zoonotic disease caused by the bacterium Coxiella burnetii, which is distributed worldwide, with the exception of New Zealand and French Polynesia [1]. Infection during pregnancy may lead to adverse pregnancy outcomes including miscarriage [1, 7]. Sheep and goats are most commonly implicated in human Q fever [5], human outbreaks associated with dogs and cats are well described [3, 10,11,12] and C. burnetii has been found within a wide range of host species [5, 13]. Bacteria are shed in greatest numbers from the placenta of infected animals at parturition, while chronic shedding may occur in the urine, faeces and milk [5]. Coxiellosis may manifest as abortion, still birth and low birth weight in cattle, sheep and goats, while clinical manifestations in other species is poorly understood and not well documented [14]. The majority of infected animals remain asymptomatic during both acute and persistent infection, and coxiellosis is rarely diagnosed in animals in the absence of routine surveillance [5]

Objectives

Methods

Results

Discussion

Conclusion