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Use of, Effectiveness of, and Attitudes Regarding Influenza Vaccine Among House Staff

Published online by Cambridge University Press:  02 January 2015

Richard T. Lester
Affiliation:
Departments of Medicine and Health Policy, Management, and Evaluation, University of Toronto Department of Medicine, University Health Network, Toronto, Ontario, Canada Shared Department of Microbiology, Toronto Medical Laboratories and the Mount Sinai Hospital, Toronto, Ontario, Canada
Allison McGeer*
Affiliation:
Departments of Medicine and Health Policy, Management, and Evaluation, University of Toronto Department of Medicine, University Health Network, Toronto, Ontario, Canada Shared Department of Microbiology, Toronto Medical Laboratories and the Mount Sinai Hospital, Toronto, Ontario, Canada
George Tomlinson
Affiliation:
Departments of Medicine and Health Policy, Management, and Evaluation, University of Toronto Department of Medicine, University Health Network, Toronto, Ontario, Canada Shared Department of Microbiology, Toronto Medical Laboratories and the Mount Sinai Hospital, Toronto, Ontario, Canada
Allan S. Detsky
Affiliation:
Departments of Medicine and Health Policy, Management, and Evaluation, University of Toronto Department of Medicine, University Health Network, Toronto, Ontario, Canada Shared Department of Microbiology, Toronto Medical Laboratories and the Mount Sinai Hospital, Toronto, Ontario, Canada
*
Mount Sinai Hospital, Room 1460, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5

Abstract

Objective:

To determine influenza vaccination rates, vaccine effectiveness, and factors influencing vaccination decisions among house staff.

Design:

Cross-sectional survey.

Setting and Participants:

All residents registered at the University of Toronto were surveyed after the 1999-2000 influenza season. Of the 1,159 questionnaires mailed, 670 (58%) could be evaluated.

Results:

Influenza-like illnesses were reported by 36% of house staff. The vaccination rate was 51% among respondents, being highest for community and occupational medicine and pediatric staff (77% and 75%) and lowest for psychiatry, surgery, and radiology staff (32%, 36%, and 36%). Vaccinees reported significantly fewer episodes of illness (42 vs 54 per 100 subjects; P = .03) and fewer days of illness (272 vs 374 per 100 subjects; P = .02); absenteeism was not different (63 vs 69 per 100 subjects; P = .69). Self-protection was the most common reason for vaccination. Vaccinees believed the vaccine was more effective than did non-vaccinees (P < .01). Non-vaccinees considered influenza-like symptoms the most important side effect of the vaccine. Busy schedules and inconvenience were the most common reasons for not getting vaccinated. Overall, 44% of house staff believed the influenza vaccine should be mandatory.

Conclusions:

Influenza-like illness was common among house staff. They tended to work through their illnesses, potentially putting patients at risk. They were motivated mostly by self-protection and did report a benefit. Despite busy schedules and an unfounded fear of getting influenza symptoms from the vaccine, many thought the vaccine should be mandatory.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1. Recommendations of the Advisory Committee on Immunization Practices (ACIP): prevention and control of influenza. MMWR 2000;49(RR3):138.Google Scholar
2. Evans, ME, Hall, KL, Berry, SE. Influenza control in acute care hospitals. Am J Infect Control 1997;25:357362.Google Scholar
3. Potter, J, Stott, DJ, Roberts, MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:16.CrossRefGoogle ScholarPubMed
4. Carman, WE, Elder, AG, Wallace, LA, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000;358:9397.CrossRefGoogle Scholar
5. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(RR4):128.Google Scholar
6. Health Canada. Canadian Immunization Guide, 6th ed. Ottawa: Health Canada; 2002:120127. Available at www.hc-sc.gc.ca/pphb-dgspsp/publicat/cig-gci/index.html.Google Scholar
7. Heimberger, T, Chang, HO, Shaikh, M, Crotty, L, Morse, D, Birkhead, G. Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated? Infect Control Hosp Epidemiol 1995;16:412415.Google Scholar
8. Nichol, KL, Olson, R. Medical students' exposure and immunity to vaccine-preventable diseases. Arch Intern Med 1993;153:19131916.Google Scholar
9. Ammon, CE. A survey of institutional influenza vaccination in Switzerland. Soz Praventivmed 2000;45:182187.CrossRefGoogle ScholarPubMed
10. Eisenfeld, L, Perl, L, Burke, G, et al. Lack of compliance with influenza immunization for caretakers of neonatal intensive care unit patients. Am J Infect Control 1994;22:307311.CrossRefGoogle ScholarPubMed
11. Weingarten, S, Riedinger, M, Bolton, LB, Miles, P, Ault, M. Barriers to influenza vaccine acceptance: a survey of physicians and nurses. Am J Infect Control 1989;17:202207.Google Scholar
12. Monto, AS, Gravenstein, S, Elliot, M, Colopy, M, Schweinle, J. Clinical signs and symptoms predicting influenza infection. Arch Intern Med 2000;160:32433247.Google Scholar
13. Boivin, G, Hardy, I, Tellier, G, Maziade, J. Predicting influenza infections during epidemics with use of a clinical case definition. Clin Infect Dis 2000;31:11661169.Google Scholar
14. Ontario Ministry of Health and Long Term Care. Influenza Bulletin, vol. 1. Ontario: Ontario Ministry of Health and Long Term Care; 2000. Available at www.gov.on.ca/health/english/program/pubhealth/flu_bul99/flubul_nin.html.Google Scholar
15. Demicheli, V, Rivetti, D, Deeks, JJ, Jefferson, TO. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev 2000;2:CD001269.Google Scholar
16. Weingarten, S, Staniloff, H, Ault, M, Miles, P, Bamberger, M, Meyer, RD. Do hospital employees benefit from the influenza vaccine? A placebo-controlled clinical trial. J Gen Intern Med 1988;3:3237.Google Scholar
17. Nichol, KL, Lind, A, Margolis, KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995;333:889893.Google Scholar
18. Bridges, CB, Thompson, WW, Meltzer, MI, et al. Effectiveness and cost-benefit of influenza vaccination of healthy adults: a randomized controlled trial. JAMA 2000;284:16551663.Google Scholar
19. Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281:908913.Google Scholar
20. Saxen, H, Virtanen, M. Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J 1999;18:779783.Google Scholar
21. Ohrt, CK, McKinney, WP. Achieving compliance with influenza immunization of medical housestaff and students: a randomized controlled trial. JAMA 1992;267:13771380.Google Scholar
22. Dyer, DL, Shinder, A, Shinder, F. Alcohol-free instant hand sanitizer reduces elementary school absenteeism. Fam Med 2000;32:633638.Google Scholar
23. Ryan, MA, Christian, RS, Wohlrabe, J. Handwashing and respiratory illness among young adults in military training. Am J Prev Med 2001;2:7983.CrossRefGoogle Scholar
24. Niffenegger, JR Proper handwashing promotes wellness in child care. Journal of Pediatric Health Care 1997;11:2631.Google Scholar
25. Salgado, DC, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.Google Scholar
26. Raad, I, Abbas, J, Whimbey, E. Infection control of nosocomial respiratory viral disease in the immunocompromised host. Am J Med 1997;102(3A):4852.CrossRefGoogle ScholarPubMed
27. Nichol, KL, Margolis, KL, Lind, A, et al. Side effects associated with influenza vaccination in healthy working adults: a randomized, placebo-controlled trial. Arch Intern Med 1996;156:15461550.Google Scholar
28. Nafziger, DA, Herwaldt, LA. Attitudes of internal medicine residents regarding influenza vaccination. Infect Control Hosp Epidemiol 1994;15:3235.Google Scholar
29. Fedson, DS. Influenza vaccination of medical residents at the University of Virginia: 1986-1994. Infect Control Hosp Epidemiol 1996;17:431433.Google Scholar
30. Levanthal, H, Singer, R, Jones, S. Effects on fear and specificity of recommendations upon attitudes and behavior. J Pers Soc Psychol 1965;1:2029.CrossRefGoogle Scholar
31. Duclos, P, Hatcher, J. Epidemiology of influenza vaccination in Canada. Can J Public Health 1993;84:311315.Google Scholar
32. Langmnir, AD, Bregman, DJ, Kurland, LT, Nathanson, N, Victor, M. An epidemiologic and clinical evaluation of Guillain-Barre syndrome reported in association with the administration of swine influenza vaccines. Am J Epidemiol 1984;119:841879.CrossRefGoogle Scholar
33. Lasky, T, Terracciano, GJ, Magder, L, et al. The Guillain-Barre syndrome and the 1992-1993 and 1993-1994 influenza vaccines. N Engl J Med 1998;339:17971802.CrossRefGoogle ScholarPubMed