Introduction. The present study aims to characterize personal attitudes and knowledge of a sample of Italian Occupational Physicians (OPh) towards influenza vaccine in healthcare workers (HCWs).
Methods. In total, 92 OPh (42.4% males, 57.6% females, mean age of 47.3Â±10.4 years, 50 specialists in Occupational Medicine, 42 specialists in Hygiene and Public Health) were asked about their attitudes towards influenza vaccine, their general knowledge of vaccine practice, their propensity towards vaccines. Eventually, their risk perception about the influenza and influenza vaccine was investigated. A regression analysis was then performed in order to better characterise predictive factors for vaccine propensity.
Results. Â Influenza was recognized as a vaccination recommended for HCWs in 89/92 of the sampled OPh (96.7%). However, prevalence of misconceptions about vaccines was relatively high, with 26/92 (28.3%) and 24/92 (26.1%) referring vaccinations as eliciting allergic and autoimmune diseases, respectively and identifying lethargic encephalitis (18/92, 19.6%), autism (17/92, 18.5%), diabetes mellitus (15/92, 16.3%) and multiple sclerosis (13/92, 14.1%) as causatively vaccine-related. Vaccine propensity was significantly correlated with general knowledge and risk perception (r=0.492, p <0.001 and r=0.280, p=0.007). Regression analysis, controlled for age, sex, professional qualification, confirmed both factors as predictive towards influenza vaccine propensity.
Discussion. Incomplete knowledge of evidence-based recommendations for influenza vaccinations and resulting low vaccination rates in HCWs may found their roots in the attitudes of OPh, the latter significantly influenced by an unsatisfying knowledge of vaccine pros and cons.
Giannattasio A, Mariano M, Romano R, et al. Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients. BMC Infectious Diseases. BMC Infect Dis; 2015;15:329-337
Bonaccorsi G, Santomauro F, Porchia B, et al. Beliefs and Opinions of Health Care Workers and Students Regarding Influenza and Influenza Vaccination in Tuscany, Central Italy. Vaccines. 2015;3:137â47.
Albano L, Matuozzo A, Marinelli P, et al. Knowledge, attitudes and behaviour of hospital health-care workers regarding influenza A/H1N1: a cross sectional survey. BMC Infect Dis 2014;14:208-215.
Bonfiglioli R, Vignoli M, Guglielmi D, et al. Getting vaccinated or not getting vaccinated? Different reasons for getting vaccinated against seasonal or pandemic influenza. BMC Public Health. 2013;13:1221.
Centers for Disease Control and Prevention. General Recommendations on Immunization. MMWR. 2011;60:1â64.
Bonanni P, Ferro A, Guerra R, et al. Vaccine coverage in Italy and assessment of the 2012- 2014 National Immunization Prevention Plan. Epidemiol Prev. 2015;39:145â58.
Barbadoro P, Marigliano A, Di Tondo E, et al. Measles among Healthcare Workers in a Teaching Hospital in Central Italy. J Occup Health. 2012;54:336â9.
Maltezou HC, Gargalianos P, Nikolaidis P, et al. Attitudes towards mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers in tertiary-care hospitals. J Infect. 2012;64:319â24.
Tafuri S, Gallone MS, Cappelli MG, et al. Addressing the anti-vaccination movement and the role of HCWs. Vaccine 2014;32:4860â5.
BarriÃ¨re J, Vanjak D, Kriegel I, et al. Acceptance of the 2009 A(H1N1) influenza vaccine among hospital workers in two French cancer centers. Vaccine 2010;28:7030â4.
To K-W, Lee S, Chan T-O, et al. Exploring determinants of acceptance of the pandemic influenza A (H1N1) 2009 vaccination in nurses. Am J Infect Control 2010;38:623â30.
Hollmeyer HG, Hayden F, Poland G, et al. Influenza vaccination of health care workers in hospitalsâA review of studies on attitudes and predictors. Vaccine. 2009;27:3935â44.
Nowalk PM, Chyongchiou JL, Mahlon R et al. Impact of hospital policies on health care workers' influenza vaccination rates. Am J Infect Control 2013;41:697â701.
Lu PJ, Euler GL. Influenza, hepatitis B, and tetanus vaccination coverage among health care personnel in the United States. Am J Infect Control 2011;39(6):488â94.
Hofmann F, Ferracin C, Marsh G, et al. Influenza Vaccination of Healthcare Workers: a Literature Review of Attitudes and Beliefs. Infection. 2006;34:142â7.
Fortunato F, Tafuri S, Cozza V, et al. Low vaccination coverage among Italian healthcare workers in 2013. Hum Vaccin Immunother. 2015;11:133â9.
Yaqub O, Castle-Clarke S, Sevdalis N, et al. Attitudes to vaccination: a critical review. Soc Sci Med 2014;112:1â11.
Takayanagi IJ, Cardoso MRA, Costa SF, et al. Attitudes of health care workers to influenza vaccination: Why are they not vaccinated? Am J Infect Control 2007;35:56â61.
Betsch C, Wicker S. Personal attitudes and misconceptions, not official recommendations guide occupational physiciansâ vaccination decisions. Vaccine 2014;32:4478â84.
Vasilevska M, Ku J, Fisman DN. Factors Associated with Healthcare Worker Acceptance of Vaccination: A Systematic Review and Meta-analysis. Infect Control Hosp Epidemiol 2014;35:699â708.
Loulergue P, Moulin F, Vidal-Trecan G, et al. Knowledge, attitudes and vaccination coverage of healthcare workers regarding occupational vaccinations. Vaccine. 2009;27:4240â3.
Dinelli Saraiva MI, das Neves Fraga Moreira T, Cruz Paulino ER, et al. Immune status and risk perception of acquisition of vaccine preventable diseases among health care workers. Am J Infect Control 2009;37:858â60.
Zingg A, Siegrist M. Measuring people's knowledge about vaccination: Developing a one-dimensional scale. Vaccine 2012;30:3771â7.
Abbritti G, Apostoli P, Iavicoli S, et al. Needs, education and accreditation in occupational medicine in Italy. Int Arch Occup Environ Health. 2004;78:75â8.
Ramistella E, Maviglia A. [Professional activity of "competent physician" actual troubles and future perspectives] (article in Italian). G Ital Med Lav Erg 2010;32:441â4.
Reyna VF. Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach. Vaccine 2012;30:3790â7.
Awali RA, Samuel PS, Marwaha B, et al. Understanding health care personnelâs attitudes toward mandatory influenza vaccination. Am J Infect Control 2014;42:649â52.
Alicino C, Iudici R, Barberis I, et al. Influenza vaccination among healthcare workers in Italy. Hum Vaccin Immunother 2014;11:95â100.
Black S, Rappuoli R. A Crisis of Public Confidence in Vaccines. Sci Transl Med 2010;2(61):61mr1.
Gilca V, Boulianne N, DubÃ© E, et al. Attitudes of nurses toward current and proposed vaccines for public programs: A questionnaire survey. Int J Nurs Stud 2009;46:1219â35.
Leask J. Target the fence-sitters. Nature. 2011 May 20;473:443â5.
Rachiotis G, Mouchtouri VA, Kremastinou J, et al. Low acceptance of vaccination against the 2009 pandemic influenza A(H1N1) among healthcare workers in Greece. Euro Surveill 2010;15(6):pii=19486.
Cadeddu C, Di Thiene D, Ricciardi W, et al. Knowledge about pandemic flu among Italian health care workers (HCWs) an Italian survey. J Prev Med Hyg. 2011;52(3):127â30.
Falato R, Ricciardi S, Franco G. [Influenza risk perception and vaccination attitude in medical and nursing students during the vaccination campaigns of 2007_2008 (seasonal influenza) and 2009/2010 (H1N1 influenza)] (article in italian) Med Lav. 2011;102(2):208â15.
Spadea A, Unim B, Ursillo P, et al. [Effectiveness of a training course on influenza vaccination in changing medical studentsâ and healthcare workersâ attitudes towards vaccination] (article in italian). Ig Sanita Pubbl. 2013;69(4):387â402.
Boccia A, Di Thiene D, De Giusti M, et al. Seasonal and pandemic influenza: the role of communication and preventive strategies. J Prev Med Hyg. 2011;52(3):124â6.
Verger P, Flicoteaux R, Schwarzinger M, et al. Pandemic Influenza (A/H1N1) Vaccine Uptake among French Private General Practitioners: A Cross Sectional Study in 2010. PLoS ONE 2012;7(8):e41837â8.
Flicoteaux R, Pulcini C, Carrieri P, et al. Correlates of general practitionersâ recommendations to patients regarding vaccination for the 2009â2010 pandemic influenza (A/H1N1) in France: Implications for future vaccination campaigns. Vaccine. 2014;32(20):2281â7.
Betsch C, Korn L, Holtmann C. Donât try to convert the antivaccinators, instead target the fence-sitters. Proc Natl Acac Sci USA. 2015;112:E6725-6.
Quach S, Pereira JA, Heidebrecht CL, et al. Health care worker influenza immunization rates: The missing pieces of the puzzle. Am J Infect Control 2013;41:685â90.
Quach S, Pereira JA, Kwong JC, et al. Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory policies. Am J Infect Control. 2013;41:1017â23.