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      Determinantes de la vacunación antigripal en personal sanitario: temporada 2009-2010 Translated title: Determinants of influenza vaccination in health staff: 2009-2010 season

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          Abstract

          Objetivos: Determinar las coberturas vacunales frente a la gripe estacional y frente a la nueva gripe A (H1N1) en la temporada 2009-2010 en trabajadores sanitarios y conocer sus factores determinantes. Métodos: Estudio transversal realizado en el Hospital General Universitario de Alicante en trabajadores sanitarios durante las campañas de vacunación antigripal 2008-2009 y 2009-2010. La campaña 2009-2010 se subdividió en dos fases: entre el 1-10-09 y el 13-11-09 se administró la vacuna de la gripe estacional 2009-2010; desde el 16-11-09 hasta el 30-12-09 se administró la vacuna frente al nuevo virus de la gripe A (H1N1). Cada fase estuvo precedida por una campaña promocional específica. En el momento de la vacunación, el trabajador sanitario cumplimentó un cuestionario que incluía un listado de motivos para vacunarse. Se calculó la frecuencia de vacunación y se compararon las coberturas vacunales de cada campaña, de manera global y por estamentos, utilizando la prueba de ji cuadrado. Resultados: La cobertura frente a la gripe estacional 2009-2010 fue del 31%, y frente a la nueva gripe A (H1N1) fue del 22,2% (p<0,05). En personal facultativo la cobertura fue del 36% y del 34%, respectivamente (NS); en personal de enfermería fue del 33% y del 24% (p<0,001); en auxiliares de enfermería fue del 21% y del 12% (p<0,001). El principal motivo para vacunarse en ambas campañas fue «proteger mi salud». Conclusiones: Las bajas coberturas alcanzadas constituyen un problema de salud pública que hace necesario el desarrollo de programas de intervención específicos para mejorarlas.

          Translated abstract

          Objectives: To determine vaccination coverage against seasonal influenza and the new A (H1N1) influenza virus among healthcare personnel during the 2009-2010 season and to identify its determining factors. Methods: We performed a cross-sectional study among healthcare staff at the General University Hospital in Alicante (Spain) during the 2008-2009 and 2009-2010 influenza vaccination campaigns. The 2009-2010 vaccination campaign was subdivided into two phases. In the first phase, from 1st October to 19th November, 2009, the seasonal influenza vaccine was administered; in the second phase, from 16th November to 30th December, 2009, vaccination against the new A (H1N1) influenza virus was performed. Each of the vaccine programs was preceded by a specific vaccination promotion campaign. Healthcare staff were asked to complete a brief self-administered questionnaire containing a list of reasons for being vaccinated. Coverage during both vaccination campaigns was calculated, and the results, both overall and for each profession, were then compared using a Chi-square test. Results: Coverage against seasonal influenza was 31% and that against the new A (H1N1) influenza virus was 22.2% (p<0.05); these percentages were 36% and 34% respectively in medical personnel (NS), 33% and 24% respectively in nursing personnel (p<0.001), and 21% and 12% respectively in nursing assistants (p<0.001). The main reason given for being vaccinated was self-protection. Conclusions: The low coverage achieved is a public health problem. Specific intervention programs should be implemented.

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          Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial.

          Vaccination of health-care workers has been claimed to prevent nosocomial influenza infection of elderly patients in long-term care. Data are, however, limited on this strategy. We aimed to find out whether vaccination of health-care workers lowers mortality and the frequency of virologically proven influenza in such patients. In a parallel-group study, health-care workers in 20 long-term elderly-care hospitals (range 44-105 patients) were randomly offered or not offered influenza vaccine (cluster randomisation, stratified for policy for vaccination of patients and hospital size). All deaths among patients were recorded over 6 months in the winter of 1996-97. We selected a random sample of 50% of patients for virological surveillance for influenza, with combined nasal and throat swabs taken every 2 weeks during the epidemic period. Swabs were tested by tissue culture and PCR for influenza viruses A and B. Influenza vaccine uptake in health-care workers was 50.9% in hospitals in which they were routinely offered vaccine, compared with 4.9% in those in which they were not. The uncorrected rate of mortality in patients was 102 (13.6%) of 749 in vaccine hospitals compared with 154 (22.4%) of 688 in no-vaccine hospitals (odds ratio 0.58 [95% CI 0.40-0.84], p=0.014). The two groups did not differ for proportions of patients positive for influenza infection (5.4% and 6.7%, respectively); at necropsy, PCR was positive in none of 17 patients from vaccine hospitals and six (20%) of 30 from no-vaccine hospitals (p=0.055). Vaccination of health-care workers was associated with a substantial decrease in mortality among patients. However, virological surveillance showed no associated decrease in non-fatal influenza infection in patients.
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            Influenza Vaccination of Health Care Workers in Long-Term-Care Hospitals Reduces the Mortality of Elderly Patients

            Abstract Vaccination of health care workers (HCWs) is recommended as a strategy for preventing influenza in elderly patients in long-term care. However, there have been no controlled studies to show whether this approach is effective. During the winter of 1994–1995, 1059 patients in 12 geriatric medical long-term-care sites, randomized for vac.cination of HCWs, were studied. In hospitals where HCWs were offered vaccination, 653 (61%) of 1078 were vaccinated. Vaccination of HCWs was associated with reductions in total patient mortality from 17% to 10% (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.40–0.80) and in influenza-like illness (OR, 0.57; 95% CI, 0.34–0.94). Vaccination of patients was not associated with significant effects on mortality (OR, 1.15; 95% CI, 0.81–1.64). Results of this study support recommendations for vaccination against influenza of HCWs in long-term geriatric care. Vaccination of frail elderly long-term-care patients may not give clinically worthwhile benefits.
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              Knowledge, attitudes and vaccination coverage of healthcare workers regarding occupational vaccinations.

              Immunization of healthcare workers (HCWs) is a major issue for infection control in healthcare facilities. The aim of this study was to evaluate knowledge regarding occupational vaccinations, HBV, varicella and influenza vaccination rates and attitudes towards influenza vaccine among HCWs. A cross-sectional survey was conducted in two wards (Medicine and Paediatrics) of a 1182-bed teaching hospital in Paris, France. A standardized, anonymous, self-administered questionnaire was used. Of 580 HCWs, 395 (68%) completed the questionnaire. Knowledge about the occupational vaccinations of HCWs was low. HBV (69%), tuberculosis (54%) and influenza (52%) were the most cited vaccinations. Paediatric staff was more aware of influenza and pertussis immunizations (p<.05). HBV vaccination rate was 93%, among whom 65% were aware of their immune status. Influenza vaccination rate for 2006-2007 was 30% overall, ranging from 50% among physicians to 20% among paramedical staff (p<.05). Physicians based their refusal on doubts about vaccine efficacy, although paramedics feared side effects. Influenza vaccination was associated with knowledge of vaccine recommendations [OR=1.75, 95% CI: 1.13-2.57] and contact with patients [OR=3.05, 95% CI: 1.50-5.91]. Knowledge of recommended occupational vaccinations is insufficient in HCWs, except for HBV and influenza. Although the HBV vaccine coverage of HCWs is satisfactory, a large proportion of them is unaware of immune status. Influenza vaccine coverage remains low, especially among paramedical staff because of fear of side effects. As vaccine coverage is associated with knowledge, educational campaigns should be strengthened to increase the adhesion of HCWs to vaccinations.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )
                0213-9111
                February 2011
                : 25
                : 1
                : 29-34
                Affiliations
                Alicante orgnameHospital General Universitario de Alicante orgdiv1Servicio de Medicina Preventiva España
                Article
                S0213-91112011000100006 S0213-9111(11)02500100006
                10.1016/j.gaceta.2010.09.018

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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