Keywords
influenza vaccination, healthcare workers, vaccination coverage, Covid-19 pandemic, vaccination strategies
Abstract
Introduction. Healthcare workers (HCWs) are one of the highest priority group recommended for seasonal influenza vaccination (SIV). A greater awareness of influenza vaccination importance among HCWs was observed after the arrival of Covid-19 pandemic. The aim of this study was to analyze SIV coverage rate in the 2019-2020, 2020-2021 and 2021-2022 seasons among HCWs employed within the IRCCS Ospedale Policlinico San Martino in Genoa, in order to observe how acceptance has changed before and during Covid-19 pandemic.
Methods. The vaccinated population was stratified by gender, age, job and area and the characteristics of vaccinated HCWs was analyzed.
Results. The observed SIV coverage was below the recommended target for all seasons, but a sharp increase was observed in the 2020/2021 (12.8%; 40.9%; 23% for 2019/2020, 2020/2021 and 2021/2022 season, respectively). There was an increase in the mean and median age in the 2020/2021 vaccination campaign (46.7 and 49, respectively), comparing to the 2019/2020 season (43.5 and 45 respectively). A higher proportion of vaccinated physician in the 2019/2020 and 2021/2022 season was found. The proportions of vaccinated females were constantly higher than vaccinated males. A higher representation of vaccinated subjects working in medical areas was observed, but over the three-years the most evident increase in proportion of vaccinees was found for subjects from the services area.
Conclusions. This survey highlights the importance of studying the determinants that influenced vaccination adherence and how the Covid-19 pandemic has affected SIV coverage.
References
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34. Panatto D, Lai PL, Mosca S, Lecini E, Orsi A, Signori A, Castaldi S, Pariani E, Pellegrinelli L, Galli C, Anselmi G, Icardi G, Ciri-It Team. Influenza Vaccination in Italian Healthcare Workers (2018-2019 Season): Strengths and Weaknesses. Results of a Cohort Study in Two Large Italian Hospitals. Vaccines (Basel). 2020 Mar 5;8(1):119. doi: 10.3390/vaccines8010119.
2. Grech V, Borg M. Influenza vaccination in the COVID-19 era. Early Hum Dev. 2020 Sep;148:105116. doi: 10.1016/j.earlhumdev.2020.105116.
3. Chittano Congedo E, Paladino ME, Riva MA, Belingheri M. Adherence, Perception of, and Attitude toward Influenza and Flu Vaccination: A Cross-Sectional Study among a Population of Future Healthcare Workers. Int J Environ Res Public Health. 2021 Dec 11;18(24):13086. doi: 10.3390/ijerph182413086.
4. European Centre for Disease Prevention and Control. Seasonal influenza vaccination and antiviral use in EU/EEA Member States – Overview of vaccine recommendations for 2017–2018 and vaccination coverage rates for 2015–2016 and 2016–2017 influenza seasons. Stockholm: ECDC; 2018. [Online]
5. Vimercati L, Bianchi FP, Mansi F, Ranieri B, Stefanizzi P, De Nitto S, Tafuri S. Influenza vaccination in health-care workers: an evaluation of an on-site vaccination strategy to increase vaccination uptake in HCWs of a South Italy Hospital. Hum Vaccin Immunother. 2019;15(12):2927-2932. doi: 10.1080/21645515.2019.1625645.
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8. Campagna M, Argiolas F, Soggiu B, Mereu NM, Lai A, Galletta M, Coppola RC. Current preventive policies and practices against Vaccine-Preventable Diseases and tuberculosis targeted for workers from hospitals of the Sardinia Region, Italy. J Prev Med Hyg. 2016;57(2):E69-74.
9. Alicino C, Iudici R, Barberis I, Paganino C, Cacciani R, Zacconi M, Battistini A, Bellina D, Di Bella AM, Talamini A, Sticchi L, Morando A, Ansaldi F, Durando P. Influenza vaccination among healthcare workers in Italy. Hum Vaccin Immunother. 2015;11(1):95-100. doi: 10.4161/hv.34362.
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11. Dini G, Toletone A, Sticchi L, Orsi A, Bragazzi NL, Durando P. Influenza vaccination in healthcare workers: A comprehensive critical appraisal of the literature. Hum Vaccin Immunother. 2018 Mar 4;14(3):772-789. doi: 10.1080/21645515.2017.1348442.
12. Koh Y, Hegney DG, Drury V. Comprehensive systematic review of healthcare workers' perceptions of risk and use of coping strategies towards emerging respiratory infectious diseases. Int J Evid Based Healthc. 2011 Dec;9(4):403-19. doi: 10.1111/j.1744-1609.2011.00242.x.
13. Boey L, Bral C, Roelants M, De Schryver A, Godderis L, Hoppenbrouwers K, Vandermeulen C. Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers - A cross-sectional survey. Vaccine. 2018 May 31;36(23):3351-3358. doi: 10.1016/j.vaccine.2018.04.044.
14. Ministero della Salute. Prevenzione e controllo dell’influenza: raccomandazioni per la stagione 2020-2021. Available at https://www.trovanorme.salute.gov.it/norme/renderNormsanPdf?anno=2021&codLeg=79647&parte=1%20&serie=null [Online]
15. Robbins T, Berry L, Wells F, Randeva H, Laird S. Healthcare staff perceptions towards influenza and potential COVID-19 vaccination in the 2020 pandemic context. J Hosp Infect. 2021 Jun;112:45-48. doi: 10.1016/j.jhin.2021.02.024.
16. Bertoni L, Roncadori A, Gentili N, Danesi V, Massa I, Nanni O, Altini M, Gabutti G, Montella MT. How has COVID-19 pandemic changed flu vaccination attitudes among an Italian cancer center healthcare workers? Hum Vaccin Immunother. 2022 Dec 31;18(1):1978795. doi: 10.1080/21645515.2021.1978795.
17. Wang K, Wong ELY, Ho KF, Cheung AWL, Chan EYY, Yeoh EK, Wong SYS. Intention of nurses to accept coronavirus disease 2019 vaccination and change of intention to accept seasonal influenza vaccination during the coronavirus disease 2019 pandemic: A cross-sectional survey. Vaccine. 2020 Oct 21;38(45):7049-7056. doi: 10.1016/j.vaccine.2020.09.021.
18. Di Pumpo M, Vetrugno G, Pascucci D, Carini E, Beccia V, Sguera A, Zega M, Pani M, Cambieri A, Nurchis MC, D'Ambrosio F, Damiani G, Laurenti P. Is COVID-19 a Real Incentive for Flu Vaccination? Let the Numbers Speak for Themselves. Vaccines (Basel). 2021 Mar 18;9(3):276. doi: 10.3390/vaccines9030276. PMID: 33803755; PMCID: PMC8003130.
19. Black CL, Yue X; MPS, Ball SW, Fink R, de Perio MA, Laney AS, Williams WW, Lindley MC, Graitcer SB, Lu PJ, Devlin R, Greby SM. Influenza Vaccination Coverage Among Health Care Personnel - United States, 2016-17 Influenza Season. MMWR Morb Mortal Wkly Rep. 2017 Sep 29;66(38):1009-1015. doi: 10.15585/mmwr.mm6638a1.
20. http://www.dovesalute.gov.it/DoveSalute/search/dettaglio?codPtf=H070901&cacheDisableDett=1&lan=EN [Online]
21. Rashid H, Yin JK, Ward K, King C, Seale H, Booy R. Assessing Interventions To Improve Influenza Vaccine Uptake Among Health Care Workers. Health Aff (Millwood). 2016 Feb;35(2):284-92. doi: 10.1377/hlthaff.2015.1087.
22. https://www.alisa.liguria.it/index.php?option=com_content&view=article&id=1784:campagna-vaccinazione-antinfluenzale-2021-2022&catid=7:notizie&Itemid=109 [Online]
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24. Prato R, Tafuri S, Fortunato F, Martinelli D. Vaccination in healthcare workers: an Italian perspective. Expert Rev Vaccines. 2010 Mar;9(3):277-83. doi: 10.1586/erv.10.11.
25. Scardina G, Ceccarelli L, Casigliani V, Mazzilli S, Napoletano M, Padovan M, Petillo A, Sironi D, Brilli C, Gattini V, Tavoschi L, Foddis R, Guglielmi G, Privitera GP, Baggiani A. Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years' Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic. Vaccines (Basel). 2021 Jul 9;9(7):769. doi: 10.3390/vaccines9070769.
26. Harrison EA, Wu JW. Vaccine confidence in the time of COVID-19. Eur J Epidemiol. 2020 Apr;35(4):325-330. doi: 10.1007/s10654-020-00634-3.
27. Lecce M, Biganzoli G, Agnello L, Belisario I, Cicconi G, D'Amico M, De Giorgi F, Ferilli A, Ferraguzzi G, Guzzardi F, Lanzillotti D, Lattanzio R, Marrocu C, Noto ME, Piccinelli S, Sabatelli N, Santisteban S, Sharma S, Tognaccini L, Castaldi S. COVID-19 and Influenza Vaccination Campaign in a Research and University Hospital in Milan, Italy. Int J Environ Res Public Health. 2022 May 26;19(11):6500. doi: 10.3390/ijerph19116500.
28. Antinolfi F, Battistella C, Brunelli L, Malacarne F, Bucci FG, Celotto D, Cocconi R, Brusaferro S. Absences from work among healthcare workers: are they related to influenza shot adherence? BMC Health Serv Res. 2020 Aug 18;20(1):763. doi: 10.1186/s12913-020-05585-9.
29. Durovic A, Widmer AF, Dangel M, Ulrich A, Battegay M, Tschudin-Sutter S. Low rates of influenza vaccination uptake among healthcare workers: Distinguishing barriers between occupational groups. Am J Infect Control. 2020 Oct;48(10):1139-1143. doi: 10.1016/j.ajic.2020.02.004.
30. Ferrante G, Baldissera S, Moghadam PF, Carrozzi G, Trinito MO, Salmaso S. Surveillance of perceptions, knowledge, attitudes and behaviors of the Italian adult population (18-69 years) during the 2009-2010 A/H1N1 influenza pandemic. Eur J Epidemiol. 2011 Mar;26(3):211-9. doi: 10.1007/s10654-011-9576-3.
31. Bienvenu LA, Noonan J, Wang X, Peter K. Higher mortality of COVID-19 in males: sex differences in immune response and cardiovascular comorbidities. Cardiovasc Res. 2020 Dec 1;116(14):2197-2206. doi: 10.1093/cvr/cvaa284.
32. Keske Ş, Mutters NT, Tsioutis C, Ergönül Ö; EUCIC influenza vaccination survey team. Influenza vaccination among infection control teams: A EUCIC survey prior to COVID-19 pandemic. Vaccine. 2020 Dec 14;38(52):8357-8361. doi: 10.1016/j.vaccine.2020.11.003.
33. Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Editor's Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud. 2021 Feb;114:103854. doi: 10.1016/j.ijnurstu.2020.103854.
34. Panatto D, Lai PL, Mosca S, Lecini E, Orsi A, Signori A, Castaldi S, Pariani E, Pellegrinelli L, Galli C, Anselmi G, Icardi G, Ciri-It Team. Influenza Vaccination in Italian Healthcare Workers (2018-2019 Season): Strengths and Weaknesses. Results of a Cohort Study in Two Large Italian Hospitals. Vaccines (Basel). 2020 Mar 5;8(1):119. doi: 10.3390/vaccines8010119.