Promotion of the influenza vaccination to hospital staff during pre-employment health check: a prospective, randomised, controlled trial

Michael Currat, Catherine Lazor-Blanchet, Giorgio Zanetti, Michael Currat, Catherine Lazor-Blanchet, Giorgio Zanetti

Abstract

Background: Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital.

Methods: All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016's influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups.

Results: Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046).

Conclusions: Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check.

Trial registration: ClinicalTrials, NCT02758145 . Registered 26 April 2016.

Keywords: Healthcare workers; Influenza; Occupational health service; Vaccination coverage; Vaccine.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram

References

    1. FOPH. Grippe saisonnière 2014/2015: Epidémiologie, virologie, approvisionnement en vaccins et composition des vaccins. Bulletin. 28:529–37 In: OFSP Bull. 2015. . Accessed 11 Dec 2018.
    1. Russell K. Update: influenza activity — United States, October 4, 2015–February 6, 2016. MMWR Morb Mortal Wkly Rep. 2016. 10.15585/mmwr.mm6506a3.
    1. Public Health Agency of Canada. FluWatch report: May 1 to May 21, 2016 (weeks 18–20). In: aem. 2016. . Accessed 25 Sept 2017.
    1. Nicoll A, Sprenger M. Low effectiveness undermines promotion of seasonal influenza vaccine. Lancet Infect Dis. 2013;13:7–9. doi: 10.1016/S1473-3099(12)70313-4.
    1. WHO Influenza (Seasonal). In: WHO. . Accessed 11 Dec 2018.
    1. Centers for Disease Control and Prevention. Immunization of Health-Care Personnel, Recommendations of the Advisory Committee on Immunization Practices (ACIP), Morbidity and Mortality Weekly Report Vol.60/No.7. 2011. . Accessed 11 Dec 2018.
    1. FOPH. Recommandations pour la vaccination contre la grippe, Directives et recommandations. 2011. . Accessed 11 Dec 2018.
    1. Potter J, Stott DJ, Roberts MA, Elder AG, O’Donnell B, Knight PV, Carman WF. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis. 1997;175:1–6. doi: 10.1093/infdis/175.1.1.
    1. Carman WF, Elder AG, Wallace LA, McAulay K, Walker A, Murray GD, Stott DJ. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet Lond Engl. 2000;355:93–97. doi: 10.1016/S0140-6736(99)05190-9.
    1. Hayward AC, Harling R, Wetten S, Johnson AM, Munro S, Smedley J, Murad S, Watson JM. Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ. 2006;333:1241. doi: 10.1136/bmj.39010.581354.55.
    1. van den Dool C, Bonten MJM, Hak E, Wallinga J. Modeling the effects of influenza vaccination of health care workers in hospital departments. Vaccine. 2009;27:6261–6267. doi: 10.1016/j.vaccine.2009.07.104.
    1. Elder AG, O’Donnell B, McCruden EA, Symington IS, Carman WF. Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993-4 epidemic: results of serum testing and questionnaire. BMJ. 1996;313:1241–1242. doi: 10.1136/bmj.313.7067.1241.
    1. Maltezou HC. Nosocomial influenza: new concepts and practice. Curr Opin Infect Dis. 2008;21:337–343. doi: 10.1097/QCO.0b013e3283013945.
    1. European Centre for Disease Prevention and Control . Seasonal influenza vaccination and antiviral use in Europe - Overview of vaccination recommandations and coverage rates in the EU Member States for the 2013–14 and 2014–15 influenza seasons. 2016.
    1. Luzurier Q, Nicolay N. Étude de la couverture vaccinale contre la grippe saisonnière des professionnels de santé du CHU-Hôpitaux de Rouen avant et après campagne de promotion de la vaccination, saisons 2013/14 et 2014/15. 2016.
    1. Hollmeyer HG, Hayden F, Poland G, Buchholz U. Influenza vaccination of health care workers in hospitals--a review of studies on attitudes and predictors. Vaccine. 2009;27:3935–3944. doi: 10.1016/j.vaccine.2009.03.056.
    1. Seal H, Leask J, MacIntyre CR. Attitudes amongst Australian hospital healthcare workers towards seasonal influenza and vaccination. Influenza Other Respir Viruses. 2010. 10.1111/j.1750-2659.2009.00112.x.
    1. WHO Regional Office for Europe . Tailoring Immunization Programmes for Seasonal Influenza (TIP FLU). Understanding health care workers’ uptake of seasonal influenza vaccination in Montenegro: a case study for policy-makers and programme managers. 2015.
    1. Seasonal influenza vaccinations using interventions with actively promoted, off-site vaccinations – healthcare workers. In: Guide Community Prev. Serv. Community Guide. 2014. . Accessed 29 Aug 2019.
    1. Brewer NT, Chapman GB, Rothman AJ, Leask J. Increasing vaccination: putting psychological science into action. Psychol Sci Public Interest. 2017. 10.1177/1529100618760521.
    1. Heinrich-Morrison K, McLellan S, McGinnes U, Carroll B, Watson K, Bass P, Worth LJ, Cheng AC. An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy. BMC Infect Dis. 2015;15:42. doi: 10.1186/s12879-015-0765-7.
    1. Kok G, van Essen GA, Wicker S, Llupià A, Mena G, Correia R, Ruiter RAC. Planning for influenza vaccination in health care workers: an intervention mapping approach. Vaccine. 2011;29:8512–8519. doi: 10.1016/j.vaccine.2011.09.008.
    1. Lytras T, Kopsachilis F, Mouratidou E, Papamichail D, Bonovas S. Interventions to increase seasonal influenza vaccine coverage in healthcare workers: a systematic review and meta-regression analysis. Hum Vaccines Immunother. 2016;12:671–681. doi: 10.1080/21645515.2015.1106656.
    1. Hollmeyer H, Hayden F, Mounts A, Buchholz U. Review: interventions to increase influenza vaccination among healthcare workers in hospitals. Influenza Other Respir Viruses. 2013;7:604–621. doi: 10.1111/irv.12002.
    1. 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 Vaccines Immunother. 2017;14:772–789. doi: 10.1080/21645515.2017.1348442.
    1. Seale H, Macintyre CR. Seasonal influenza vaccination in Australian hospital health care workers: a review. Med J Aust. 2011;195:336–338. doi: 10.5694/mja11.10067.
    1. Lam P-P, Chambers LW, MacDougall DMP, McCarthy AE. Seasonal influenza vaccination campaigns for health care personnel: systematic review. CMAJ. 2010;182:E542–E548. doi: 10.1503/cmaj.091304.
    1. Atamna Z, Chazan B, Nitzan O, Colodner R, Kfir H, Strauss M, Schwartz N, Markel A. Seasonal influenza vaccination effectiveness and compliance among hospital health care workers. Isr Med Assoc J. 2016;18:5–9.
    1. Llupià A, Mena G, Olivé V, et al. Evaluating influenza vaccination campaigns beyond coverage: a before-after study among health care workers. Am J Infect Control. 2013;41:674–678. doi: 10.1016/j.ajic.2013.04.006.
    1. Schmid P, Rauber D, Betsch C, Lidolt G, Denker M-L. Barriers of influenza vaccination intention and behavior - a systematic review of influenza vaccine hesitancy, 2005–2016. PLoS One. 2017;12:e0170550. doi: 10.1371/journal.pone.0170550.
    1. Jung Y, Kwon M, Song J. Stepwise intervention including 1-on-1 counseling is highly effective in increasing influenza vaccination among health care workers. Am J Infect Control. 2017;45:635–641.
    1. Hussain H, McGeer A, McNeil S, et al. Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada. Influenza Other Respir Viruses. 2018;12:319–325. doi: 10.1111/irv.12545.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe