Elsevier

Journal of Infection

Volume 61, Issue 3, September 2010, Pages 252-258
Journal of Infection

Determinants of intention to get vaccinated against novel (pandemic) influenza A H1N1 among health-care workers in a nationwide survey

https://doi.org/10.1016/j.jinf.2010.06.004Get rights and content

Summary

A nationwide survey was conducted in October–November 2009 to investigate determinants of intention to get vaccinated against novel (pandemic) influenza A H1N1 among health-care workers (HCWs) in Greece. Out of 12,879 participating HCWs (response rate: 12.1%) working in 152 (40%) of 380 health-care facilities in Greece, 2814 (21.8%) reported that they intend to get vaccinated against novel influenza A N1H1. Intention rates to get vaccinated increased with age, male sex, being a physician, history of vaccination against seasonal influenza, training in use of personal protective equipment and hand hygiene, and training and involvement in the management of novel influenza cases. Main reasons for refusing vaccination were concerns about vaccine safety (43.1%), inadequate information about the vaccine (27.8%), and perception that they were not at risk for contracting novel influenza (10.7%). Given the low rates of acceptance of pandemic vaccination among HCWs, as found in this study, public health bodies should consider the implementation of a mandatory vaccination policy for HCWs for future pandemics, in order to prevent nosocomial transmission and to protect patients at high-risk for influenza-related complications and death, and to assure the continuity of the essential health-care infrastructure. New strategies should be explored to built safety perception towards influenza vaccines and enhance vaccination rates among HCWs.

Introduction

In April 2009, a novel influenza A H1N1 virus (hereafter referred as novel influenza virus) was detected in North America and spread shortly worldwide, necessitating the raise of the alert level to phase 6 (pandemic) in June 11 by World Health Organization (WHO).1, 2 Despite the fact that novel influenza virus is no more virulent than seasonal influenza A viruses, a considerable influx and rapid turnover of patients in health-care facilities were anticipated during autumn and winter months. Given the fact that novel influenza virus may spread rapidly and trigger outbreaks in closed settings, health-care workers (HCWs) may become ill as a result of occupational exposure or serve as carriers for influenza transmission to their patients and families.3, 4, 5, 6 In accordance with WHO, the United States Centers for Disease Control and Prevention (CDC), and the European Union Health Security Committee recommendations, HCWs are a priority group for vaccination against novel influenza.7, 8 We present the results of a nationwide survey that was conducted by the Hellenic Center for Diseases Control and Prevention (HCDCP; Athens, Greece) in order to study determinants of intention to get vaccinated against novel influenza among HCWs.

Section snippets

Recommendations and communication with health-care facilities

In Greece there are 195 hospitals and 185 primary health-care centers grouped in 7 Health Distincts. In May 2009 the HCDCP sent to all hospitals and primary health-care centers recommendations regarding infection control measures against novel influenza, including use of antiviral agents. The recommendations were prepared in accordance with WHO and were updated accordingly in July and December 2009.9, 10, 11 In September and November 2009 the HCDCP sent to all health-care facilities informative

Results

A total of 152 health-care facilities (92 hospitals and 60 primary health-care centers) participated in the study (40% overall response rate for health-care facilities: 47% for hospitals and 32.4% for health-care centers), sending 12,879 questionnaires completed by a respective number of HCWs (17.4% out of 73,988 HCWs working in the participating health-care facilities and 12.1% out of a total of 106,448 HCWs working in hospitals and health-care centers in Greece). Of them, 2814 (21.8%) HCWs

Discussion

In this prospectively conducted nationwide survey it was shown that only 21.8% of 12,879 participating HCWs in Greece intended to get vaccinate against novel (pandemic) influenza A H1N1. HCWs, along with adults and children with chronic underlying diseases and pregnant women, constitute a priority group for vaccination against novel (pandemic) influenza.7, 8 The rational of this is to protect HCWs from occupationally-acquired influenza and to protect the essential health-care infrastructure. A

Authors statement

The opinions in this article are those of the authors, and do not necessarily represent the views of the Hellenic Center for Diseases Control and Prevention.

Acknowledgement

We would like to thank the HCWs who participated in the study, as well as the members of the Infection Control Committees who organized the vaccination campaigns against seasonal and novel A H1N1 influenza within health-care facilities.

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