中国流感疫苗优先推荐接种人群疫苗犹豫现状及影响因素

流行性感冒(简称流感)是一种传播速度快、范围广、传播途径易实现的呼吸道传染病,危害人群健康,对社会经济发展造成负担.世界卫生组织将其列为全球监测的首要传染病.由于疫苗犹豫问题,我国目标人群接种率处于较低水平.本研究就我国老年人、学龄前儿童、孕产妇、慢性病患者、医务工作者这五类人群的疫苗犹豫现状及影响因素进行综述,为我国...     

医务人员计划接种季节性和甲型H1N1流感疫苗情况调查

2009年甲型H1N1流感在世界范围内的流行,医务人员作为特殊人群[1],流感疫苗是预防和控制流感的最有效途径.多年来我国将医务人员指定为流感疫苗接种的重点人群[2],为此,2009年8月我们对北京市东城区医务人员对计划接种季节性和甲型H1N1流感疫苗等情况进行了调查.     

青岛市医务人员对流感及接种流感疫苗的态度与接种意愿研究

  目的  了解山东省青岛市医务人员流行性感冒（流感）疫苗接种心理的影响因素,为改善医务人员流感疫苗的接种情况提供参考依据。  方法  于2019年1月采用立意抽样和分层抽样相结合的方法在青岛市抽取3507名医务人员进行问卷调查,分析医务人员流感疫苗接种心理的影响因素。  结果  青岛市3507名医务人员中,接种流感疫苗者413人,医务人员流感疫苗接种率为11.8 %;医务人员流感疫苗接种心理得分最低分为12分,最高为60分,平均得分为（37.31 ± 4.25）分;多元线性逐步回归分析结果显示,健康状况越好、每周与患者直接接触时间越长、医院级别越高和有领导/同事等对疫苗推荐的青岛市医务人员流感疫苗接种心理得分越高,了解疫苗事件越多的青岛市医务人员流感疫苗接种心理得分越低。  结论  青岛市医务人员流感疫苗接种心理得分相对较低,心理得分越高者流感疫苗接种率越高;健康状况、每周与患者直接接触时间、了解疫苗事件次数、医院级别和有无领导/同事对疫苗推荐是该地区医务人员流感疫苗接种心理的主要影响因素。     

上海市社区老年人流感疫苗犹豫现状及其心理学前因分析

目的 了解上海市社区老年人流感疫苗犹豫现状,并基于5C心理学前因分析其影响因素。方法 采用方便抽样方法,于2022年2—3月选取上海市12个城区的多家社区卫生服务中心的老年人作为研究对象,采用一般资料调查问卷和中文版疫苗犹豫5C量表进行线上、线下调查。结果 本研究共回收402份有效问卷。调查对象平均年龄为71.5岁,其中69.7%存在流感疫苗犹豫,接种率仅为14.9%。多因素分析结果提示,女性（OR=1.697,P=0.027）、患有慢性疾病（OR=2.105,P=0.012）的社区老年人更容易产生流感疫苗犹豫。而心理学前因中的自信（OR=0.755,P=0.046）、集体责任（OR=0.770,P=0.013）是流感疫苗犹豫的保护因素,自满（OR=1.280,P=0.004）、约束（OR=1.362,P=0.004）则是危险因素。结论 上海市社区老年人流感疫苗犹豫率较高,疫苗接种率不足。而注重提高社区老年人的疫苗信心和集体责任感,降低其自满情绪以及消除约束因素,对于提高该群体的流感疫苗认知和接种率有重要的现实意义与实践价值。     

上海市静安区社区医务人员流感疫苗接种率及其影响因素

目的 了解上海市静安区社区医务人员流感疫苗接种率及其影响因素.方法 2019年4月,对上海市静安区共15家社区卫生服务中心的所有医务人员进行问卷调查,采用x2检验和多因素Logistic回归分析模型对流感疫苗接种率的影响因素进行单因素和多因素分析.结果 上海市静安区社区医务人员流感疫苗接种率为14.57％,多因素Log...     

传染病医院医务人员接种流感疫苗不良反应分析

目的分析流感疫苗接种后不良反应（ADR）的发生情况。方法对我院2006年11月-2007年1月接种流感疫苗的241例医务人员进行调查，包括接种人员一般情况，ADR发生率、ADR出现时间、持续时间、转归等进行统计分析。结果241例接种者中ADR发生率33．61％（81／241），其中局部反应占64，20％（52／81），全身反应占35．80％（29／81），男女性接种者ADR发生率分别为23．08％（15／65）和37．50％（66／176）（χ2=4．425，P〈0．05），所有发生ADR者均能自愈或治愈（自愈75例，治愈6例），治愈的6例均为全身反应者，且接种半月前患感冒或急性感染。结论流感疫苗接种后ADR发生率虽较高，且女性不良反应发生率高于男性，但ADR持续时间短，症状较轻，对于全身反应者，应引起高度重视，预防并发症的发生；接种半月前惠有感冒或急性感染等自身免疫处于紊乱状态应慎用。     

传染病医院医务人员接种流感疫苗不良反应分析

目的分析流感疫苗接种后不良反应(ADR)的发生情况。方法对我院2006年11月~2007年1月接种流感疫苗的241例医务人员进行调查,包括接种人员一般情况,ADR发生率、ADR出现时间、持续时间、转归等进行统计分析。结果241例接种者中ADR发生率33.61%(81/241),其中局部反应占64.20%(52/81),全身反应占35.80%(29/81),男女性接种者ADR发生率分别为23.08%(15/65)和37.50%(66/176)(2χ=4.425,P(0.05),所有发生ADR者均能自愈或治愈(自愈75例,治愈6例),治愈的6例均为全身反应者,且接种半月前患感冒或急性感染。结论流感疫苗接种后ADR发生率虽较高,且女性不良反应发生率高于男性,但ADR持续时间短,症状较轻,对于全身反应者,应引起高度重视,预防并发症的发生;接种半月前患有感冒或急性感染等自身免疫处于紊乱状态应慎用。     

母亲HPV疫苗犹豫的现状及影响因素探究

目的 调查母亲对于女儿接种HPV疫苗犹豫的现状以及影响因素,据此提出降低母亲HPV疫苗的犹豫程度、提高适龄女性HPV疫苗接种率的对策建议。方法 采用随机抽样方法选取502名家里至少有一个9~26岁女儿的女性进行调查,运用描述性分析、〖XC小五号.EPS;P〗检验、Kruskal-Wallis H秩和检验、二分类非条件logistic回归对数据进行统计分析。结果:母亲HPV疫苗犹豫的比例为37.20%。logistic回归显示是否对女儿进行过生理健康教育、HPV疫苗认知程度、宫颈癌认知程度、免疫体系信任程度是母亲对于女儿接种HPV疫苗犹豫的影响因素(OR值分别1.787,0.482,0.643,0.527,P<0.05)。结论 母亲对于女儿接种HPV疫苗犹豫的程度较高,需要通过加强HPV疫苗的宣传等途径,提高母亲对HPV疫苗的认知以及信任程度,消除母亲为女儿接种HPV疫苗的犹豫。     

季节性流感疫苗接种效果观察

目的评价不同人群接种流感疫苗的效果。方法采取面访与自填式相结合的问卷调查方法,了解接种组和未接种组在2002-2003年度内流感样症状的发病情况,用Epi2002软件进行统计分析。结果共调查2238人,接种组1202人,未接种组1036人;接种组流感样症状发病率为2.91%,未接种组发病率为11.00%;全人群流感疫苗保护率为72.21%,其中18岁以下儿童组、18～60岁工龄组、60以上老年组的保护率分别为79.22%、55.89%、91.28%。结论应将老人和儿童作为流感疫苗重点推广的目标人群。     

新型冠状病毒疫苗接种意愿影响因素及犹豫原因分析

目的 了解乌鲁木齐市人群对新型冠状病毒疫苗的接种意愿,分析影响因素及犹豫原因。方法 于2021年2-3月在乌鲁木齐市常住居民中通过便利抽样的方法抽取不同年龄段、不同文化程度的人群,通过微信等自媒体平台以二维码或链接的形式发布问卷,调查居民的新冠疫苗接种意愿影响因素和接种犹豫原因。结果 共回收问卷335份,有效问卷327份（97.60%）。愿意接种新冠疫苗人群占63.30%(207/327),单因素分析显示性别、文化程度、月收入、是否患病、是否认为疫苗是预防新冠的重要手段、是否听从家人朋友建议影响新冠疫苗接种意愿（P<0.05）。多因素Logistic回归分析结果显示,性别为男性（OR=2.160）、认为疫苗是预防新冠肺炎的重要手段（OR=2.935）、听从家人朋友建议（OR=4.426）的人群更愿意接种新冠疫苗。犹豫接种新冠疫苗的主要原因为担心疫苗不安全或担心接种疫苗后的副作用（31.80%）。结论 乌鲁木齐市人群对新冠疫苗的接种意愿程度中等,可加强对女性、患病人群开展疫苗相关知识科普。     

Factors influencing uptake of influenza vaccination among hospital-based health care workers

BACKGROUND: Vaccination of health care workers against influenza has been shown to lower mortality among elderly patients, but uptake of voluntary vaccination among health care workers remains low. AIMS: Factors influencing uptake of vaccination were examined among a cross-section of health care workers based in an NHS Trust. METHODS: A structured, self-administered questionnaire was mailed to a random sample of health care workers based in the acute services sector of a UK National Health Service Trust, 6 months following a voluntary immunization programme implemented as part of the Scottish Executive Health Department winter planning arrangements for 2000-2001. The programme was promoted using posters in clinical areas and a single leaflet given to all staff through a paycheck advice note. RESULTS: Five hundred and fifty-one health care workers (53%) responded to the questionnaire and influenza vaccination was accepted by 150 (28%). The occupational health poster strongly influenced the decision to accept vaccination [odds ratio (OR) = 11.01; 95% confidence interval (CI) = 2.13-56.80; P < 0.0001]. Other significant influences included female sex (OR = 9.11; 95% CI = 1.26-65.72) and perceived risk of contracting flu without the vaccine (OR = 7.70; 95% CI = 1.44-41.05). Misconceptions regarding the purpose of the vaccination campaign were common and concern regarding possible side-effects was a deterring factor for vaccination uptake. CONCLUSION: Our study showed that visual material displayed throughout the workplace strongly influenced the acceptance of influenza vaccination. Future campaigns should also emphasize the positive benefits to patients of health care worker immunization, with readily accessible information regarding side-effects available from all sources.     

Nudging influenza vaccination among health care workers

Our online randomized controlled trial on 6230 healthcare workers (HCWs) tests the impact that three nudges – social norms, reminding the impact on beneficiaries, and defaults – have on the intention to vaccinate against seasonal influenza across job families. Willingness to get a flu shot was higher among subjects invited to imagine themselves working at the local health authority (LHA) with the greatest immunization coverage within their region relative to their counterparts prompted to imagine working at the LHA with the lowest coverage. Reminding the impact of flu vaccination on beneficiaries had different effects across job families, with physicians caring more benefits for themselves, nurses about patients’ benefits, and technicians about family and friends. Default responses anchoring toward a high rather than a low vaccination intention increased the willingness to immunize among all HCW except physicians. Targeted nudges can be considered in developing interventions to promote influenza vaccination among HCWs.     

Factors affecting influenza vaccine uptake among health care workers

BACKGROUND: In 2000, the UK Departments of Health recommended influenza immunization to employees directly involved in patient care. Uptake of this immunization had tended to be variable and usually low. AIMS: To assess personal and organizational factors associated with influenza immunization uptake among Health Care Workers (HCWs). METHODS: A cross-sectional survey of all HCWs within the Health and Social Care Trusts in Northern Ireland and a parallel-group study of nursing staff within Elderly Care using self-administered questionnaires. RESULTS: Of 203 nurses working in elderly care units 76(37%) were immunized and 127(63%) declined. Almost 70% of those not immunized perceived themselves to be 'healthy' and gave this reason for declining immunization. Nurses were more likely to be immunized by a factor of four if they believed there was benefit for healthy HCWs, three if they felt at-risk of contracting influenza and nine on a recommendation from the occupational health (OH) unit. Fifteen OH units participated in a survey of HCWs at the time of immunization. Five thousand two hundred and thirty (9.7%) HCWs were immunized. Increased uptake was correlated with immunization in area of work (r=0.74, P=0.02) and when provided out of hours (r=0.83; P<0.001) and by a factor of two with individual targeting of availability (P<0.001) and when individuals had been previously immunized (P<0.001). CONCLUSION: Uptake of influenza immunization is low. Attitudes to one's health and to the value of influenza immunization affect the uptake as does the delivery of the immunization programme.     

Motivating factors for high rates of influenza vaccination among healthcare workers

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.     

Modeling the effects of influenza vaccination of health care workers in hospital departments

Nowadays health care worker (HCW) vaccination is widely recommended. Although the benefits of this strategy have been demonstrated in long-term care settings, no studies have been performed in regular hospital departments. We adapt a previously developed model of influenza transmission in a long-term care nursing home department to study the effects of HCW vaccination in hospital wards. We study both the effectiveness and efficiency in reducing the hazard rates of influenza virus infection for patients. Most scenarios under study show a similar or higher impact of hospital HCW vaccination than has been predicted for the long-term care nursing home department. Therefore, it seems justified to extend the recommendations for HCW vaccination, based on results in the long-term care setting, to short-term care settings as well.     

宁波市医务人员流感疫苗接种情况及影响因素分析

目的了解浙江省宁波市医务人员流感疫苗接种情况,探讨影响医务人员流感疫苗接种的主要因素。方法采用二阶段抽样法对浙江省宁波市30家各级医疗机构1 217名医务人员进行问卷调查,了解其一般情况、流行性感冒(流感)和流感疫苗知识、2010—2012流感疫苗接种率、2012—2013流感疫苗接种意愿及不考虑接种的原因等信息。结果2010—2012年2个流行季节医务人员流感疫苗接种率为12.37%;38.39%的医务人员表示会在2012年流感高峰到来前接种流感疫苗,如果疫苗免费接种则有62.13%的医务人员考虑接种;不考虑接种的因素包括"疫苗效果有限"(66.76%)、"担心疫苗副作用"(55.52%)、"身体好没必要接种"(54.15%)、"每年接种太麻烦"(43.20%)和"疫苗不免费"(35.30%)等;多因素分析结果显示,2年内接种过流感疫苗、认为接种流感疫苗是预防流感最有效的手段、知晓医务人员是推荐接种流感疫苗人群、知晓流感疫苗可以用医保支付、流感疫苗知识掌握好、二级医疗机构、在医技/护士/医生岗位可提高宁波市医务人员流感疫苗的接种意愿;而知晓流感疫苗每年接种1次、三级医疗机构、在感染/传染和其他科室可降低医务人员流感疫苗的接种意愿。结论宁波市医务人员流感疫苗接种率较低,不考虑接种的主要原因是对流感疫苗有效性和安全性缺乏信心、对流感危害认识不足以及疫苗不免费。     

Behavioral change with influenza vaccination: factors influencing increased uptake of the pandemic H1N1 versus seasonal influenza vaccine in health care personnel

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.     

青岛市医务人员流感疫苗接种及影响因素分析

目的 了解山东省青岛市医务人员流感疫苗接种情况, 探索影响医务人员接种流感疫苗的主要因素。方法 采用整群分层抽样方法对青岛市6家不同级别医疗机构的1 301名医务人员进行调查。对流感及流感疫苗认知现状进行描述性分析, 用logistic回归模型对疫苗接种率的影响因素进行单因素和多因素分析。结果 2013—2014年流感季流感疫苗接种率为4.8%(63/1 301), 未接种的主要原因是担心出现疫苗不良反应, 占43.4%(412/950)。多因素分析结果显示, 社区乡镇卫生院(OR=8.23, 95%CI=3.78~17.93)、二级医院(OR=2.27, 95%CI=1.02~5.06)、之前3年不连续接种(OR=2.01, 95%CI=1.08~3.77)或每年均接种流感疫苗(OR=3.49, 95%CI=1.23~9.92)、担心流感季节患流感(OR=2.72, 95%CI=1.46~5.05)、认同不接种流感疫苗, 容易得流感(OR=2.49, 95%CI=1.26~4.91)和得流感会后悔(OR=3.03, 95%CI=1.29~7.08)、季前接种意愿为有可能(OR=2.73, 95%CI=1.42~5.26)、可能性大(OR=6.44, 95%CI=2.55~16.26)的医务人员更容易接种流感疫苗。结论 医务人员流感疫苗接种率很低, 担心疫苗安全性是阻碍接种的首要原因;医院层级、流感疫苗接种史、季前接种意愿和态度心理等因素是医务人员季节性流感疫苗接种影响因素。     

Changing the default to promote influenza vaccination among health care workers

BackgroundThe prevention of health care acquired infections is an important objective for patient safety and infection control in all health care settings. Influenza vaccination uptake among health care workers (HCWs) is the most effective method to prevent transmission to patients, but vaccination coverage rates are low among HCWs. Several educational campaigns have been developed to increase the influenza vaccination coverage rates of HCWs, but showed only small effects. The aim of this study was to test an opt-out strategy in promoting uptake among HCWs in a tertiary care center for patients with complex chronic organ failure.MethodsHCWs were randomly assigned to one of two conditions. In the opt-out condition (N = 61), participants received an e-mail with a pre-scheduled appointment for influenza vaccination, which could be changed or canceled. In the opt-in condition (N = 61), participants received an e-mail explaining that they had to schedule an appointment if they wanted to get vaccinated.ResultsThe findings show no statistically detectable effect of condition on being vaccinated against influenza. However, HCWs in the opt-out condition were more likely to have an appointment for influenza vaccination, which in turn increased the probability of getting vaccinated.ConclusionTo change the default to promote influenza vaccination among HCWs might be an easy and cost-effective alternative to the complex vaccination campaigns that have been proposed in recent years.