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1.
Background
Many health care personnel (HCP) choose not to get vaccinated against influenza despite recommendations to do so. The pH1N1 epidemic gave a unique opportunity to evaluate the attitudes to influenza vaccination of a group of HCP who routinely choose not to get vaccinated, but accepted the pH1N1 vaccine.Methods
HCP employed at a tertiary care hospital in Winnipeg, Canada who received the pH1N1 vaccine were invited to participate in an online survey asking about attitudes and experiences regarding seasonal and pH1N1 influenza and vaccination. Those eligible included primarily nurses, other clinical staff, and support staff, as few physicians work as employees.Results
Of the 684 respondents (29% return rate), 504 reported routinely getting vaccinated (RV) for seasonal influenza and 180 reported routinely not getting vaccinated (NRV). These two groups had different attitude towards the two strains of influenza, with markedly lower level of concern about seasonal influenza than pH1N1 for the NRV group. The contrast was especially notable regarding the NRV's view of the seriousness of the illness, their sense of exposure risk, and their confidence in the vaccine effectiveness (for all, seasonal < pH1N1, p < 0.001). The most common motivators for getting vaccinated for both NRV and RV groups related to concerns about personal or family safety, while the choice to decline seasonal vaccination related primarily to lack concern about the illness and concerns about vaccine effectiveness and safety. Coworkers were influential in the decision to get the pH1N1 vaccine for the NRV group.Conclusion
For HCP who do not routinely get the seasonal vaccination, perception of risk outweighing side effect concerns appeared to be a major influence in going ahead with the pH1N1 vaccine. Educational campaigns that focus on personal benefit, engage peer champions, and address concerns about the vaccine may improve influenza vaccine uptake among health care personnel. 相似文献2.
Objective
was to improve understanding of mechanisms contributing to healthcare personnel's (HCP) reluctance to get vaccinated against seasonal influenza. We assessed the role of several drivers: vaccination knowledge, vaccination recommendations and the role of the Internet (so-called e-health) in creating vaccination knowledge. The key mechanism under consideration was the perceived own risk (regarding disease and the vaccine).Method
310 medical students at the Frankfurt University Hospital answered an anonymous questionnaire assessing risk perceptions, intentions to get vaccinated, knowledge, preferences regarding information sources for personal health decisions and search-terms that they would use in a Google-search directed at seasonal influenza vaccination.Results
The key driver of vaccination intentions was the perceived own risk (of contracting influenza and of suffering from vaccine adverse events). The recommendation to get vaccinated was a significant, yet weaker predictor. As an indirect driver we identified one's knowledge concerning vaccination. 32% of the knowledge questions were answered incorrectly or as don’t know. 64% of the students were e-health users; therefore, additional information search via the Internet was likely. An analysis of the websites obtained by googling the search-terms provided by the students revealed 30% commercial e-health websites, 11% anti-vaccination websites and 10% public health websites. Explicit searches for vaccination risks led to fewer public health websites than searches without risk as a search term. Content analysis of the first three websites obtained revealed correct information regarding the questions of whether the doses of vaccine additives were dangerous, whether chronic diseases are triggered by vaccines and whether vaccines promote allergies in 58%, 53% and 34% of the websites, respectively. These questions were especially related to own risk, which strongly predicted intentions. Correct information on vaccination recommendations were provided on 85% of the websites.Conclusion
Concentrating on the key drivers in early medical education (own risk of contracting influenza, vaccine safety, vaccination recommendation) promises to be a successful combination to increase vaccination uptake in HCP. 相似文献3.
Background
In June 2009 a global influenza pandemic was declared by the World Health Organisation. A vaccination programme against H1N1 influenza was introduced in many countries from September 2009, but there was low uptake in both the general population and health professionals in many, though not all, countries.Purpose
To examine the psychological and demographic factors associated with uptake of vaccination during the 2009 pandemic.Method
A systematic literature review searching Web of Science and PubMed databases up to 24 January 2011.Results
37 articles met the study inclusion criteria. Using the framework of Protection Motivation Theory the review found that both the degree of threat experienced in the 2009 pandemic influenza outbreak and perceptions of vaccination as an effective coping strategy were associated with stronger intentions and higher uptake of vaccination. Appraisal of threat resulted from both believing oneself to be at risk from developing H1N1 influenza and concern and worry about the disease. Appraisal of coping resulted from concerns about the safety of the vaccine and its side effects. There was evidence of an influence of social pressure in that people who thought that others wanted them to be vaccinated were more likely to do so and people getting their information about vaccination from official health sources being more likely to be vaccinated than those relying on unofficial sources. There was also a strong influence of past behaviour, with those having been vaccinated in the past against seasonal influenza being more likely to be vaccinated against pandemic influenza. Demographic factors associated with higher intentions and uptake of vaccination were: older age, male gender, being from an ethnic minority and, for health professionals, being a doctor.Discussion
Interventions designed to increase vaccination rates could be developed and implemented in advance of a pandemic. Strategies to improve uptake of vaccination include interventions which highlight the risk posed by pandemic influenza while simultaneously offering tactics to ameliorate this risk (e.g. vaccination). Perceived concerns about vaccination can be tackled by reducing the omission bias (a perception that harm caused by action is worse than harm caused by inaction). In addition, interventions to increase seasonal influenza vaccination in advance of a future pandemic may be an effective strategy. 相似文献4.
Objective
Cervical cancer is a leading cause of cancer-related mortality among women in Ghana. As of this writing no data are available concerning knowledge, attitudes and acceptability of human papillomavirus (HPV) vaccination by women in Ghana.Methods
Between November and December 2009, a self-administered survey was used to elicit information from 264 Ghanaian women, ages 18-65.Results
Overall, 40% had heard about HPV vaccine and 94% were willing to vaccinate themselves or their daughters. Ideal age for vaccination was 12.7 years. Most women (75%) thought the vaccine should be received regardless of one's number of sex partners. The most prevalent concerns were whether the vaccine would be administered safely using clean needles (82%), and possible future side effects (77%). Concerns about cost and vaccine encouraging earlier sex were reported by nearly half. Significant barriers to vaccine acceptance were women's lack of knowledge about the gravity of cervical cancer in Ghana and utility of Pap test in detecting it, low perceived risk for cervical cancer, low social support to vaccine use, and low self-efficacy to find a doctor or clinic to get vaccinated (p < 05). About 55% of the women did not know the vaccine only works among those who are not yet infected with HPV. Schools and television were the most preferred methods of educating the public and cervical cancer prevention ranked as the ideal message (80%). Most respondents believed the decision to vaccinate their daughter should be made by both parents (34%) or in conjunction with the daughter (37%), as opposed to the government (17%).Conclusions
Educational programs addressing specific barriers identified in the current study have the potential to significantly improve HPV vaccine uptake in Ghana. 相似文献5.
Objective
Existing data suggest that influenza vaccination rates among adults in the United States fall far short of the Healthy People 2010 goals and the updated Healthy People 2020 targets. We identified characteristics associated with influenza vaccination that might inform strategies for increasing coverage.Methods
We used data from the 2009 Behavioral Risk Factor Surveillance System to estimate adjusted prevalence ratios for receiving the influenza vaccine in the past 12 months.Results
Among 134,101 adults aged ≥ 65 years, the influenza vaccination coverage level was 68.9%. Among 286,867 younger adults aged 18-64 years, coverage was markedly lower: 31.8%. Having health care coverage was the strongest predictor of vaccination in both age groups, after accounting for other sociodemographic characteristics, health behaviors, and health status. Those reporting older age, white race, higher education, non-smoking status, being physically active, or having poor physical health or a personal history of various chronic conditions were also more likely to report having received the influenza vaccine.Conclusion
Our results show clearly that vaccine uptake in the United States is related to social position as well as other health behaviors. These findings call for renewed attention to vaccination strategies to meet the updated Healthy People 2020 goals. 相似文献6.
Objective
The existence of two vaccines—seasonal and pandemic—created the potential for confusion and misinformation among consumers during the 2009-2010 vaccination season. We measured the frequency and nature of influenza vaccination communication between healthcare providers and adults for both seasonal and 2009 influenza A(H1N1) vaccination and quantified its association with uptake of the two vaccines.Methods
We analyzed data from 4040 U.S. adult members of a nationally representative online panel surveyed between March 4th and March 24th, 2010. We estimated prevalence rates and adjusted associations between vaccine uptake and vaccination-related communication between patients and healthcare providers using bivariate probit models.Results
64.1% (95%-CI: 61.5%-66.6%) of adults did not receive any provider-issued influenza vaccination recommendation. Adults who received a provider-issued vaccination recommendation were 14.1 (95%-CI: − 2.4 to 30.6) to 32.1 (95%-CI: 24.3-39.8) percentage points more likely to be vaccinated for influenza than adults without a provider recommendation, after adjusting for other characteristics associated with vaccination.Conclusions
Influenza vaccination communication between healthcare providers and adults was relatively uncommon during the 2009-2010 pandemic. Increased communication could significantly enhance influenza vaccination rates. 相似文献7.
Objectives
To measure the seasonal influenza vaccination coverage rate (VCR) in France in 2009, year of the A(H1N1) influenza pandemic, by age and target disease and compare it with the VCR for the 2007 and 2008 influenza seasons.Method
At the beginning of each annual seasonal vaccination campaign, the National Health Insurance, covering 86% of the French population, sends free influenza vaccination vouchers to at-risk beneficiaries aged under 65 suffering from diverse chronic diseases and to all individuals aged 65 and over (around 11 million). Vaccination is estimated from refund claims registered in the National Health Insurance Information System.Results
The global VCR for the target population was 51% in 2007, 55.8% in 2008 and 56.9% in 2009. In 2009, the VCR for children under 10 years old was 24.3%, 28.1% in the 10-19 age range, 39.2% in the 20-64 age range and 63.3% for individuals aged 65 and over, of which 72.3% with a targeted chronic disease and 56.9% without. The inclusion of asthma as a target disease, lowered the global VCR for children under 10 years old (30.6% without asthma) but VCR increased proportionally with the number of annual refunds for drugs against asthma and chronic obstructive pulmonary disease. The 2009 vaccine uptake rates in target group children, adolescents, young adults and to a lesser extent the population aged 65 and over suffering from a chronic disease (particularly chronic respiratory disease), could have been positively impacted by the A(H1N1) influenza context.Conclusion
The influenza VCR varies considerably according to age and target disease but globally remains inferior to the recommended 75% coverage rate. These results permit the detailed analysis of VCR distribution by disease and target group and highlights areas for reflection and action. Specific studies should be conducted in order to understand why the VCR is lower in certain target groups. 相似文献8.
Martínez-Baz I Aguilar I Morán J Albéniz E Aldaz P Castilla J 《Preventive medicine》2012,55(3):246-250
Objective
We aimed to analyze the factors influencing continued adherence to influenza vaccination in elderly persons vaccinated in the preceding season.Methods
Using a population-based vaccination registry, we evaluated the proportion of persons vaccinated against influenza in Navarre, Spain, in the 2010-11 season among non-institutionalized persons aged 65 years or over who had been vaccinated in the 2009-10 season. Logistic regression was used to analyze the influence of sociodemographic, clinical and health care factors.Results
Of the 64,245 persons vaccinated against influenza in the 2009-10 season, 87% were vaccinated in the 2010-11 season. Continued adherence to vaccination increased with the number of physician visits per year. It was lower in women, in the 65-69 and ≥ 95 year age-groups, in those hospitalized or diagnosed with any major chronic condition in the previous year, and in persons with hematological cancer or dementia. Health districts and physicians with higher coverage in the previous season continued to have higher adherence in the following season.Conclusions
People vaccinated against influenza in one season tend to be vaccinated in the following one. Sociodemographic, clinical and health care factors have a moderate effect on the continuity of vaccination, with the most important factor being the treating physician. 相似文献9.
Background
Recent guidance from related regulatory agencies and medical societies supports mandatory vaccination of healthcare workers (HCW) against influenza. At St. Jude Children's Research Hospital, a pediatric oncology referral center, more than 90% of HCWs receive vaccine each year without a policy mandating immunization. Factors associated with HCW uptake of influenza vaccines have not previously been evaluated in a high compliance rate setting.Methods
A structured, anonymous, electronic questionnaire was distributed in August 2010 to employees (HCW and non-HCW). Demographics, prior receipt of influenza vaccines, reasons for acceptance or refusal of seasonal and 2009 H1N1 pandemic vaccine, and attitudes on mandatory vaccination were assessed.Results
95.0% of 925 HCWs and 63.1% of all 3227 qualifying employees responded to the survey. 93.8% and 75.2% of HCW reported receiving seasonal and 2009 H1N1 influenza vaccines, respectively, in the 2009-2010 season. Benefits to self and/or patients were cited as the most frequent reasons for accepting seasonal (83.5% and 78.3%, respectively) and 2009 H1N1 (85.9% and 81.1%, respectively) vaccination. 36.6% of HCWs opposed mandating influenza vaccination; 88.2% and 59.9% of whom reported receiving the seasonal and 2009 H1N1 influenza vaccines, respectively. Violation of freedom of choice and personal autonomy were the most frequently reported reasons for opposition.Conclusion
In this cohort of HCWs with a high influenza vaccination rate, realistic assessments of the potential benefits of vaccination appear to have driven the choice to accept immunization. Despite this, mandating vaccination was viewed unfavorably by a significant minority of vaccinated individuals. Employee concerns over autonomy should be addressed as institutions transition to mandatory vaccination policies. 相似文献10.
Introduction
Approximately 5% of cases of acute disseminated encephalomyelitis are preceded by vaccination within 1 month prior to symptom onset. This occurs rarely following influenza immunization.Methods
Case presentation and literature review.Results
A 75-year-old woman developed acute disseminated encephalomyelitis within 3 weeks of receiving the seasonal influenza vaccine. The patient subsequently passed away, despite treatment with methylprednisolone and plasma exchange therapy.Conclusions
The literature on post-influenza vaccination encephalomyelitis is limited. The majority of published cases had favourable outcomes following treatment with intravenous methylprednisolone. Given the limited number of cases, no incidence estimates have been published. 相似文献11.
Objective
Previous studies suggest a possible association between using chiropractic care and lower influenza vaccination rates. We examined adult influenza vaccination rates for chiropractic patients to determine if they are different than those for users of other complementary and alternative medicine (CAM).Method
We used the 2007 National Health Interview Survey to examine influenza vaccination rates among adult respondents who were considered high priority for the influenza vaccine (n = 12,164). We separated respondents into clinically meaningful categories according to age and whether or not they had recently used chiropractic care, some other type of CAM, or neither. We used adjusted logistic regression to determine whether user status predicted influenza vaccination.Results
Only 33% of younger and 64% of older high priority Chiropractic Users were vaccinated in 2007; these rates approximated those of Non-CAM Users. However, younger Non-Chiropractic CAM Users were more likely than Non-CAM Users to have been vaccinated (p-value = 0.05). In adjusted logistic regressions, we found statistically insignificant differences when comparing Chiropractic Users to Non-CAM Users for younger adults (OR = 0.93(95% CI:0.76-1.13), or for older adults OR = 0.90 (95% CI:0.64-1.20).Conclusion
Chiropractic Users appear no less likely to be vaccinated for influenza; whereas, younger Non-chiropractic CAM Users are more likely than Non-CAM Users to be vaccinated. 相似文献12.
Omon E Damase-Michel C Hurault-Delarue C Lacroix I Montastruc JL Oustric S Escourrou B 《Vaccine》2011,29(52):9649-9654
In 2009, during the influenza A (H1N1)v pandemic, the French Health authorities recommended influenza immunisation for pregnant women because of the higher risk of serious influenza outcomes in that population. Thus, the non-adjuvanted inactivated influenza vaccine Panenza® was administered to French women from the second trimester of pregnancy. Several studies suggest that inactivated seasonal influenza vaccines are safe during pregnancy but there are few data about the effects of new A (H1N1)vaccines (new antigen) on pregnant women.
Objective
The aim of the present prospective study was to describe pregnancy outcomes among women vaccinated with non-adjuvanted influenza vaccines in South Western France.Methods
the study ran from November 2009 to February 2010 and included, on a voluntary basis, pregnant women who were vaccinated against A (H1N1) influenza in vaccination clinics or maternity wards.Results
569 pregnant women were monitored until delivery. Compared with the general population, the risks of maternal conditions, malformations and neonatal conditions were not statistically different.Conclusion
This study does not reveal any sign of safety concerns regarding the effects of the vaccine on pregnancy outcomes. 相似文献13.
Thompson MG Gaglani MJ Naleway A Ball S Henkle EM Sokolow LZ Brennan B Zhou H Foster L Black C Kennedy ED Bozeman S Grohskopf LA Shay DK 《Vaccine》2012,30(24):3557-3565
Background
The relative importance of different attitudes in predicting vaccination among healthcare personnel (HCP) is unclear. We hypothesized that HCP who feel at risk without vaccination or say they would regret not getting vaccinated would be more likely to get vaccinated than HCP who do not expect these emotional benefits.Methods
A prospective cohort of 1544 HCP with direct patient care was enrolled from September 18 to December 18, 2010 at Scott &; White Healthcare in Texas and Kaiser Permanente Northwest in Oregon and Washington. An Internet-based questionnaire assessed pre-season intention to be vaccinated and included 12 questions on attitudes about vaccination: single-item measures of perceived susceptibility and vaccine effectiveness, 5 items that were summed to form a concerns about vaccine scale, and 5 items summed to form an emotional benefits of vaccination scale. Influenza vaccination status for the 2010–2011 season and for 5 prior seasons was confirmed by medical record extraction.Results
There were significant differences between vaccinated and unvaccinated HCP on all attitude items; 72% of vaccinated HCP agreed that they “worry less about getting the flu” if vaccinated, compared to only 26% of the unvaccinated (odds ratio = 7.4, 95% confidence interval = 5.8–9.5). In a multivariate model, the emotional benefits scale was the strongest predictor of 2010–2011 seasonal influenza vaccination, after adjusting for other attitude measures, prior vaccination history, and pre-season intention to be vaccinated. The predictive value of the emotional benefits scale was strongest for HCP with low pre-season intention to be vaccinated, where HCP vaccine receipt was 15% versus 83% for those with low versus high scores on the emotional benefits scale.Conclusions
The expected emotional benefits of vaccination strongly affect seasonal influenza vaccination among HCP, even after taking into account other attitudes, pre-season intentions, and prior vaccination history. These attitudes are promising targets for future vaccination campaigns. 相似文献14.
Background
Institutional requirements for influenza vaccination, ranging from policies that mandate declinations to those terminating unvaccinated healthcare personnel (HCP), are increasingly common in the US. Our objective was to determine HCP vaccine uptake following requirements for influenza vaccination at US hospitals.Methods
Survey mailed in 2011 to a nationally representative sample of 998 acute care hospitals. An institutional requirement was defined as an institutional policy that requires receipt or declination of influenza vaccination, with or without consequences for vaccine refusal. Respondents reported institutional-level, seasonal influenza vaccination coverage, if known, during two consecutive influenza seasons: the season prior to (i.e., pre-requirement), and the first season of requirement (i.e., post-requirement). Weighted univariate and multivariate analyses accounted for sampling design and non-response.Results
808 (81.0%) hospitals responded. Of hospitals with institutional requirements for influenza vaccination (n = 440), 228 hospitals met analytic inclusion criteria. Overall, mean reported institutional-level influenza vaccination coverage among HCP rose from 62.0% in the pre-requirement season to 76.6% in the post-requirement season, representing a single-season increase of 14.7 (95% CI: 12.6-16.7) percentage points. After adjusting for potential confounders, single-season increases in influenza vaccination uptake remained greater among hospitals that imposed consequences for vaccine refusal, and among hospitals with lower pre-requirement vaccination coverage. Institutional characteristics were not associated with vaccination increases of differential magnitude.Conclusion
Hospitals that are unable to improve suboptimal influenza vaccination coverage through multi-faceted, voluntary vaccination campaigns may consider institutional requirements for influenza vaccination. Rapid and measurable increases in vaccination coverage followed institutional requirements at hospitals of varying demographic characteristics. 相似文献15.
Christopher C. Blyth Peter C. Richmond Peter Jacoby Patrick Thornton Annette Regan Christine Robins Heath Kelly David W. Smith Paul V. Effler 《Vaccine》2014
Introduction
Parental attitudes towards vaccination significantly influence vaccine uptake. The A(H1N1)pdm09 influenza pandemic was followed in 2010 by an unprecedented increase in febrile reactions in children receiving trivalent inactivated influenza vaccine manufactured by bioCSL. Uptake of TIV in children <5 years in Western Australia (WA) decreased in 2010 and has remained low. The impact of pandemic A(H1N1)pdm09 and adverse-events on parental attitudes towards vaccination is uncertain.Materials and Methods
A parental attitudes survey towards influenza illness and vaccination was conducted as part of the West Australian Influenza Vaccine Effectiveness study. Vaccination status was assessed by parental interview and confirmed by the national register and/or vaccine providers. Parental attitudes from vaccinated and unvaccinated children and attitudes in 2008–2009 and 2010–2012 were compared. Principal Component Analysis was conducted to determine core attitudes that influenced vaccine uptake.Results
Vaccination history and parental attitude surveys were available from 2576 children. Parents of fully vaccinated children less frequently stated that influenza was a mild disease, more frequently stated that influenza vaccine was safe and were less frequently worried about vaccine side effects.Uptake of influenza vaccine decreased significantly from 2010 onwards. From 2010, parents were less concerned about severe influenza, but more concerned about vaccine side effects and safety. Despite this significant shift in attitudes towards influenza vaccine, parental acceptance of vaccines on the national immunisation program did not change. Principal Component Analysis revealed that attitudes around vaccine safety and efficacy were the most important attitudes impacting on vaccine uptake.Conclusions
Parental attitudes to influenza vaccine changed from 2010. Confidence in the WA preschool influenza vaccination program remains low yet appeared unchanged for other vaccines. Restoring public confidence in childhood influenza vaccination is needed before uptake can be improved. 相似文献16.
Background
Influenza A (H1N1) vaccination has been recommended for all frontline healthcare workers (HCWs) in the UK since October 2009, to protect individuals and their patients from infection. Understanding the factors influencing vaccine uptake by HCW may improve future vaccination programmes in current and subsequent years.Aims
To assess the uptake of influenza A (H1N1) vaccine, and factors affecting vaccine uptake, in frontline healthcare workers in a large pediatric hospital.Method
A cross-sectional questionnaire survey conducted in a regional Pediatric Hospital in Scotland incorporating intensive care and ECMO services. One page, anonymised questionnaires were distributed to all frontline HCW in high risk departments of the hospital.Results
260 questionnaires were completed, capturing an estimated 52% of all staff. Vaccination rate was 49.6%, and was significantly higher amongst doctors (OR 2.4, 95% CI 1.3-4.5, P = 0.005). Commonest reasons for vaccine uptake were high risk of contact with H1N1 (88%) and responsibility to protect patients (71%). Uncertainty about vaccine side-effects (47%), concern about vaccine safety (33%) and being too busy to attend the vaccine clinic (22%) were the commonest reasons for non-vaccination. Reasons for vaccination varied between staff grouping and department. 36% of non-vaccinated staff would accept the vaccine if offered.Conclusions
Vaccine uptake may be increased by addressing HCW knowledge and attitudes and access to vaccine. Future vaccination programmes should include targeted education and vaccine delivery, at the convenience of staff, and in their own department. 相似文献17.
José Sánchez-Payá Ignacio Hernández-GarcíaJulio Barrenengoa Sañudo Hector Rolando MartínezRobert Camargo Ángeles Lidia Cartagena LlopisCésar Villanueva Ruiz María González Hernández 《Gaceta sanitaria / S.E.S.P.A.S》2011,25(1):29
Objectives
To determine vaccination coverage against seasonal influenza and the new A (H1N1) influenza virus among healthcare personnel during the 2009-2010 season and to identify its determining factors.Methods
We performed a cross-sectional study among healthcare staff at the General University Hospital in Alicante (Spain) during the 2008-2009 and 2009-2010 influenza vaccination campaigns. The 2009-2010 vaccination campaign was subdivided into two phases. In the first phase, from 1st October to 19th November, 2009, the seasonal influenza vaccine was administered; in the second phase, from 16th November to 30th December, 2009, vaccination against the new A (H1N1) influenza virus was performed. Each of the vaccine programs was preceded by a specific vaccination promotion campaign. Healthcare staff were asked to complete a brief self-administered questionnaire containing a list of reasons for being vaccinated. Coverage during both vaccination campaigns was calculated, and the results, both overall and for each profession, were then compared using a Chi-square test.Results
Coverage against seasonal influenza was 31% and that against the new A (H1N1) influenza virus was 22.2% (p < 0.05); these percentages were 36% and 34% respectively in medical personnel (NS), 33% and 24% respectively in nursing personnel (p < 0.001), and 21% and 12% respectively in nursing assistants (p < 0.001). The main reason given for being vaccinated was self-protection.Conclusions
The low coverage achieved is a public health problem. Specific intervention programs should be implemented. 相似文献18.
Manhart LE Burgess-Hull AJ Fleming CB Bailey JA Haggerty KP Catalano RF 《Vaccine》2011,29(32):5238-5244
Objectives
Despite the high efficacy of the human papillomavirus (HPV) vaccine, uptake has been slow and little data on psychosocial barriers to vaccination exist.Methods
A community sample of 428 women enrolled in a longitudinal study of social development in the Seattle WA metropolitan area were interviewed about HPV vaccine status, attitudes, and barriers to HPV vaccination in spring 2008 or 2009 at ∼age 22.Results
Nineteen percent of women had initiated vaccination, 10% had completed the series, and ∼40% of unvaccinated women intended to get vaccinated. Peer approval was associated with vaccine initiation (adjusted prevalence ratio (APR) 2.1; 95% confidence interval 1.4-3.2) and intention to vaccinate (APR 1.4; 1.1-1.9). Belief the vaccine is <75% effective was associated with less initiation (APR 0.6; 0.4-0.9) or intention to vaccinate (APR 0.5; 0.4-0.7). Vaccine initiation was also less likely among cigarette smokers and illegal drug users, whereas intention to vaccinate was more common among women currently attending school or with >5 lifetime sex partners, but less common among women perceiving low susceptibility to HPV (APR 0.6; 0.5-0.9).Conclusions
HPV vaccination uptake was low in this community sample of young adult women. Increasing awareness of susceptibility to HPV and the high efficacy of the vaccine, along with peer interventions to increase acceptability, may be most effective. 相似文献19.
Glaser MS Chui S Webber MP Gustave J Lee R McLaughlin MT Ortiz V Prezant D Kelly K 《Vaccine》2011,29(34):5675-5680
Background
There is a widely recognized need for vaccination of health care workers (HCWs). We undertook this study to assess the 2009-2010 H1N1 vaccination rates in ∼14,000 firefighters and emergency medical service (EMS) workers at the Fire Department of New York (FDNY) and to determine predictors of H1N1 vaccine acceptance.Methods
After 9/11/01, FDNY developed a bio-preparedness drill where units are dispatched to FDNY-BIOPOD (biologic points of distributions) for rapid distribution of medications/vaccines in the event of a biological disaster. Since 2005, FDNY offers free, voluntary seasonal influenza vaccination during routine medical monitoring/treatment examinations and at FDNY-BIOPOD. In 2009, FDNY-BIOPOD instead offered the H1N1 vaccine. We report on FDNY H1N1 vaccination rates and on predictors of acceptance using bivariate and multivariable techniques.Results
Overall, 10,612 (77%) FDNY workers were offered H1N1 vaccination, of whom 5831 (55%) accepted. Acceptance was 57.2% during FDNY-BIOPOD compared with 34.4% during medical monitoring/treatment exams (p = 0.0001). Workers who accepted prior seasonal influenza vaccinations were 4 times more likely to accept H1N1 vaccination (AOR = 4.4, CI95 = 4.0-4.8).Conclusion
FDNY offered H1N1 vaccination to 77% of its workforce during the 2009-2010 season. Prior seasonal vaccine acceptance and vaccination in a group setting such as FDNY-BIOPOD dramatically increased acceptance of the H1N1 vaccine. However, within a voluntary program, additional strategies are needed to further increase vaccine acceptance in first responders and other HCWs. 相似文献20.