Increasing vaccination among healthcare workers – Review of strategies and a study of selected Victorian hospitals

K. L. N. S. K. De Alwis; David Dunt; Noleen Bennett; Ann Bull

doi:10.1071/HI10014

REVIEW

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Increasing vaccination among healthcare workers – Review of strategies and a study of selected Victorian hospitals

K. L. N. S. K. De Alwis ^A ^C , David Dunt ^A , Noleen Bennett ^B and Ann Bull ^B

+ Author Affiliations

- Author Affiliations

^A Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Victoria 3010, Australia.

^B Hospital Acquired Infection Surveillance Coordinating Centre (Vic.NISS), No. 10, Wreckyn Street, North Melbourne, Victoria 3051, Australia.

^C Corresponding author. Email: sandealwis@yahoo.com

Healthcare Infection 15(3) 63-69 https://doi.org/10.1071/HI10014
Submitted: 15 April 2010 Accepted: 20 July 2010 Published: 22 September 2010

Abstract

Aim: To describe strategies used in annual influenza vaccination programs for hospital staff in Victorian hospitals and to what extent these programs conform to evidence-based best practice.

Methods: A rapid evidence-based literature review on strategies to increase hospital staff influenza vaccination rates was conducted in conjunction with an interview survey of infection control practitioners in 17 of 27 Victorian hospitals using a structured proforma.

Results: The rapid review identified educational programs, mobile cart vaccination, combining vaccination with other mandatory activities within the institution, declination forms, mandatory vaccination and multiple interventions as being evidence-based. The interview survey made clear that many hospitals had not used some important evidence-based strategies (40% only used both clinics and mobile carts and only 30% had formal planned meetings before initiation of the program). Evidence-based strategies were used more often in larger hospitals. However, vaccination rates in Victorian hospitals were lower in larger hospitals. Resources were frequently considered inadequate, mainly in these larger hospitals (human resources in almost half, financial resources in two-thirds, administrative support around 40%, CEO support in 30%).

Discussion and conclusion: Failure to implement evidence-based strategies and inadequate resources are both important in limiting vaccination take-up rates. Inadequate support and resources may be the more important factor.

Acknowledgements

The authors would like to thank all of the infection control professionals involved in this project, the staff at the Vic.NISS Centre and the Department of Health Victoria.

References

[1] Poland GA, Tosh P, Jacobson RM. Requiring Influenza Vaccination for Health Care Workers: seven truths we must accept. Vaccine 2005; 23 2251–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[2] Harrison J, Abbott P. Vaccination against influenza: UK health care workers not on-message. Occup Med 2002; 52(5): 277–9.
| Crossref | GoogleScholarGoogle Scholar | CAS |

[3] Horcajada J, Pumarola J, Martinez J. A nosocomial outbreak of influenza during a period without influenza epidemic activity. Eur Respir J 2003; 21(2): 303–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[4] Salgado C, Farr BM, Hall KK, Hayden FG. Influenza in the acute hospital setting. Lancet 2002; 2(3): 145–55.
| Crossref | GoogleScholarGoogle Scholar |

[6] Cunney R, Bialachowski A, Thornley D, Smaill FM, Pennie RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000; 21 449–54.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[7] Malavaud S, Malavaud B, Sandres K, Durand D, Marty N, Icart J, et al. Nosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation 2001; 72 535–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[8] Munoz FM, Campbell JR, Atmar RL, Garcia-Prats J, Baxter B, Johsnon LE, et al. Influenza A virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 1999; 18 811–5.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[9] Schaffne W , Pugliese G . Immunizing Healthcare Workers. A Practical Approach . Thorofare: Slack Inc. 2000; pp. 293–7.

[10] Wilde JA, McMillan JA, Serwint J, Butta J, O’Riordan MA, Steinhoff MC. Effectiveness of Influenza Vaccine in Health Care Workers. JAMA 1999; 281 908–13.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[11] Centers for Disease Control and Prevention. Influenza vaccination of health-care personnel. Morbidity and Mortality Weekly Report, 2006 [cited 15 Dec 2009]; 55. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr55e209a1.htm

[12] Influenza Specialist Group. A guide for occupational health professionals. Influenza vaccination among healthcare workers 2006, 2009 [cited 15 Dec 2009]; Available from: http://www.influenzaspecialistgroup.org.au/content/view/46/78/

[13] Potter J, Stott DJ, Roberts MA, Elder AG, O’Donnell B, Knight PV, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997; 175(1): 1–6.
| CAS | PubMed |

[14] O’Reilly F, Stevens A. Sickness absence due to influenza. In depth review. Occup Med 2002; 52(5): 265–9.
| Crossref | GoogleScholarGoogle Scholar | CAS |

[15] Pachucki C, Lentino J, Jackson G. Attitudes and behaviour of health care personnel regarding the use and efficacy of influenza vaccine. J Infect Dis 1985; 151 1170–1.
| CAS | PubMed |

[17] Walker FJ, Singleton JA, Lu P, Wooten KG, Strikas RA. Influenza Vaccination of Healthcare Workers in the United States, 1989–2002. Infect Control Hosp Epidemiol 2006; 27(3): 257–65.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Bull A, Bennett N, Pitcher HC, Russo PL, Richards MJ. Influenza vaccine coverage among health care workers in Victorian public hospitals. Med J Aust 2007; 186(4): 185–6.
| PubMed |

[19] National Health and Medical Reasearch Council. The Australian Immmunisation Handbook 8th Edition. Canberra: NHMRC; 2003.

[20] O’Reilly F, Cran G, Stevens A. Factors affecting influenza vaccine uptake among health care workers. Occup Med 2005; 55(6): 474–9.
| Crossref | GoogleScholarGoogle Scholar | CAS |

[21] Begue R, Gee S. Improving influenza immunization among health care workers. Infect Cont Hosp Epi 1998; 19(7): 518–20.
| Crossref | GoogleScholarGoogle Scholar | CAS |

[22] de Juanes J, Garcia de Codes A, Arrazola MP, Jaén F, Sanz MI, González A. Influenza vaccination coverage among hospital personnel over three consecutive vaccination campaigns (2001–2002 to 2003–2004). Vaccine 2007; 25(1): 201–4.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[23] Rothan-tondeur M, de Wazieres B, Lejeune B, Gavazzi G. Observatoire pour le Risque Infectieux en Gériatrie Association. Influenza vaccine coverage for healthcare workers in geriatric settings in France. Aging Clin Exp Res 2006; 18(6): 512–6.
| PubMed |

[24] Sartor C, Tissot-Dupont H, Zandotti C, Martin F, Roques P, Drancourt M. Use of a mobile cart influenza program for vaccination of hospital employees. Infect Cont Hosp Epi 2004; 25(11): 918–22.
| Crossref | GoogleScholarGoogle Scholar |

[25] Bryant KA, Stover B, Cain L, Levine GL, Siegel J, Jarvis WR. Improving influenza immunization rates among health care workers caring for high risk pediatric patients. Infect Cont Hosp Epi 2004; 25(11): 912–7.
| Crossref | GoogleScholarGoogle Scholar |

[26] Leitmeyer K, Buchholz U, Kramer M, Schenkel K, Stahlhut H, Kollstadt M, et al. Influenza Vaccination in German Health Care Workers: Effects and Findings after Two Rounds of a Nationwide Awareness Campaign. Vaccine 2005; 24 7003–8.
| Crossref | GoogleScholarGoogle Scholar |

[27] Salgado C, Giannetta ET, Hayden FG, Farr BM. Preventing nosocomial influenza by improving the vaccine acceptance rate of clinicians. Infect Cont Hosp Epi 2004; 25(11): 923–8.
| Crossref | GoogleScholarGoogle Scholar |

[28] Steiner M, Vermeulen LC, Mullahy J, Hayney MSS. Factors Influencing Decisions Regarding Influenza Vaccination and Treatment: a Survey of Healthcare Workers. Infect Control Hosp Epidemiol 2002; 23(10): 625–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[29] Lee H, Fong Y. Onsite influenza vaccination arrangements improved influenza vaccination rate of employees of a tertiary hospital in Singapore. Am J Infect Control 2007; 35(7): 481–3.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[30] Ohrt C, McKiney P. Achieving complicance with influenza immunization of medical house staff and students, a randomized controlled trial. JAMA 1992; 267(10): 1377–80.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[31] Polgreen P, Chen YY, Beekman S, Srinivasan A, Neill MA, Gay T, et al. Elements of influenza vaccination programs that predict higher vaccination rates: results of an emerging infections network survey. Clin Infect Dis 2008; 46(1): 14–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[32] Bertin M, Scarpelli M, Proctor AW, Sharp J, Robitson E, Donnelly T, et al. Novel use of the intranet to document health care personnel participation in a mandatory influenza vaccination reporting program. Am J Infect Control 2007; 35(1): 33–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[33] Palmore TN, Vandersluis JP, Morris J, Michelin A, Ruprecht LM, Schmitt JM, et al. A successful mandatory influenza vaccination campaign using an innovative electronic tracking system. Infect Control Hosp Epidemiol 2009; 30(12): 1137–42.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[34] Babcock HM, Gemeinhart N, Jones M, Dunagan WC, Woeltje KF. Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 2010; 50(4): 459–64.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[35] Bellaard-Smith E, Stuart R, Gillespie E. Improving influenza vaccination rates in a large health service. Healthc Infect 2008; 13 63–7.
| Crossref | GoogleScholarGoogle Scholar |

[36] Kimura AC, Nguyen CN, Higa JI, Hurwitz EL, Vugia DJ. The effectiveness of vaccine day and educational interventions on influenza vaccine coverage among health care workers at long term care facilities. Am J Public Health 2007; 97(4): 684–90.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[37] Kimura A , Higa JI , Nguyen C , Vugia DJ , Dysart M , Ellingsen L et al Vaccination clinics, peer vaccination and incentives at Mayo Clinic. Morbidity and Mortality Weekly Report. 2005; March 4: p. 198. Atlanta, GA: Epidemiology Program Office, Centers for Disease Control and Prevention.

[38] Harbarth S, Siegrist C-A, Schira J-C, Wunderli W, Pittet D. Influenza immunization: Improving complicance of healthcare workers. Infect Cont Hosp Epi 1998; 19(5): 337–42.
| Crossref | GoogleScholarGoogle Scholar | CAS |

[39] Tapiainen T, Bär G, Schaad UB, Heininger U. Influenza Vaccination among Healthcare Workers in a University Children’s Hospital. Infect Control Hosp Epidemiol 2005; 26(11): 855–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[41] Ajenjo MC, Woeltje KF, Babcock HM, Gemeinhart N, Jones M, Fraser VJ. Influenza vaccination among healthcare workers: ten-year experience of a large healthcare organization. Infect Control Hosp Epidemiol 2010; 31(3): 233–40.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[42] Stata Corporation, Stata version 11. 2009, College Station, TX: Stata Corporation.

[43] VICNISS Coordinating Centre. VICNISS Hospital Acquired Infection Surveillance. 2010, Melbourne: VICNISS Coordinating Centre.