Elsevier

Vaccine

Volume 27, Issue 31, 24 June 2009, Pages 4240-4243
Vaccine

Knowledge, attitudes and vaccination coverage of healthcare workers regarding occupational vaccinations

https://doi.org/10.1016/j.vaccine.2009.03.039Get rights and content

Abstract

Objectives

Immunization of healthcare workers (HCWs) is a major issue for infection control in healthcare facilities. The aim of this study was to evaluate knowledge regarding occupational vaccinations, HBV, varicella and influenza vaccination rates and attitudes towards influenza vaccine among HCWs.

Design and setting

A cross-sectional survey was conducted in two wards (Medicine and Paediatrics) of a 1182-bed teaching hospital in Paris, France.

Methods

A standardized, anonymous, self-administered questionnaire was used.

Results

Of 580 HCWs, 395 (68%) completed the questionnaire. Knowledge about the occupational vaccinations of HCWs was low. HBV (69%), tuberculosis (54%) and influenza (52%) were the most cited vaccinations. Paediatric staff was more aware of influenza and pertussis immunizations (p < .05). HBV vaccination rate was 93%, among whom 65% were aware of their immune status. Influenza vaccination rate for 2006–2007 was 30% overall, ranging from 50% among physicians to 20% among paramedical staff (p < .05). Physicians based their refusal on doubts about vaccine efficacy, although paramedics feared side effects. Influenza vaccination was associated with knowledge of vaccine recommendations [OR = 1.75, 95% CI: 1.13–2.57] and contact with patients [OR = 3.05, 95% CI: 1.50–5.91].

Conclusions

Knowledge of recommended occupational vaccinations is insufficient in HCWs, except for HBV and influenza. Although the HBV vaccine coverage of HCWs is satisfactory, a large proportion of them is unaware of immune status. Influenza vaccine coverage remains low, especially among paramedical staff because of fear of side effects. As vaccine coverage is associated with knowledge, educational campaigns should be strengthened to increase the adhesion of HCWs to vaccinations.

Introduction

Immunization of healthcare workers (HCWs) is a major issue for infection control in healthcare facilities. Many institutions recommend vaccination for HCWs to protect them from transmissible agents, but also to prevent nosocomial transmission of pathogens and its consequences [1], [2]. In France, the health authorities require that HCWs have five vaccines, to protect them against diphtheria, tetanus, poliomyelitis (dTP), hepatitis B virus (HBV), and tuberculosis (BCG), and recommend that they have four vaccines to protect both them and patients against influenza, pertussis, varicella and measles. The last two vaccines are recommended only for non-immune HCWs (www.invs.sante.fr/BEh/2008/16_17/beh_16_17_2008.pdf). The few studies on vaccination coverage among HCWs have found low coverage rates [3]. Influenza vaccination is offered free each autumn to every HCW by Occupational Medicine Departments in French hospitals, but vaccine coverage remains low.

The aims of this study were to evaluate the global knowledge of HCWs regarding mandatory and recommended occupational vaccinations, the rates of vaccination against HBV, varicella, and influenza, and the HCWs’ attitudes towards influenza vaccination.

Section snippets

Study design and setting

Between 30 January and 28 February 2007, we conducted a cross-sectional study in the HCWs of two medical departments (Internal Medicine and Paediatrics) of the Cochin-Saint Vincent de Paul Hospital, a 1152-bed hospital belonging to the Assistance Publique – Hôpitaux de Paris, located in the centre of Paris. The Department of Internal Medicine is an 82-bed unit with 350 HCWs, caring mostly for immunocompromised patients (systemic inflammatory diseases receiving immunosuppressant, patients with

Study population characteristics

Response rate was 68%: 80% and 46% in the Departments of Internal Medicine and Paediatrics, respectively. A total of 395 HCWs were surveyed: 82 (21%) were physicians, 124 (31%) nurses, 63 (16%) nurses’ assistants, 75 (19%) students and 51 (13%) HCWs without close and repeated contact with patients. Their median age was 33 years (range: 18–67), and 80% were female.

Knowledge regarding occupational vaccinations (Table 1)

Twenty-five percent of the HCWs involved were able to list correctly the three mandatory vaccines, 37% only two, 35% only one and 3%

Discussion

Our study found in an HCW population a poor knowledge of occupational vaccinations and a low influenza vaccination uptake. Moreover, our results highlighted several factors associated with influenza vaccination and vaccination refusal in the different categories.

Despite national recommendations published each year in France, little is known by HCWs about occupational vaccinations. However, mandatory vaccinations were more cited than recommended vaccinations because French HCWs have to provide a

Acknowledgments

We thank all the medical and paramedical staff who agreed to participate.

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