Influenza vaccination policies for health workers in low-income and middle-income countries: A cross-sectional survey,January-March 2020 |
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| Affiliation: | 1. Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, Greece;2. Department of Microbiology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Αthens, Greece;3. Department of HIV Surveillance, National Public Health Organization, Athens, Greece;4. The Task Force for Global Health, Decatur, United States;5. Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, United States;6. Centers for Disease Control and Prevention, Atlanta, United States;7. Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland;1. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa;2. Division of Immunology, Institute of Infectious Disease and Molecular Medicine and Clinical Laboratory Sciences, University of Cape Town, South Africa;3. Department of Bioengineering, University of Washington, Seattle, WA, USA;4. Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St. George''s, University of London, Cranmer Terrace, London SW17 0RE, UK;5. Department of Academic Paediatrics, Imperial College London, Norfolk Place, London W2 1NY, UK;6. Immunology Unit, Division of Medical Microbiology, Department of Pathology, National Health Laboratory Service, University of Stellenbosch, Cape Town, South Africa;7. Division of Medical Virology, Department of Pathology, National Health Laboratory Service, Stellenbosch University, South Africa;8. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, New York, NY, USA;9. Children''s Infectious Diseases Clinical Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa;10. Seattle Children''s Research Institute and Departments of Pediatrics and Global Health, University of Washington, Seattle, WA, USA;1. Department of Infectious Diseases, and Infection Control Unit, University Hospital of Saint-Etienne, France;2. Infection Control Unit, Hospital of Roanne, France;3. Department of occupational medicine, University Hospital of Saint-Etienne, France;4. Groupe Immunité des Muqueuses et Agents Pathogènes, Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France;5. Institut de Recherche PRESAGE, Chaire vaccination, Prévention et Contrôle de l’Infection, Université de Lyon Saint-Etienne, France;1. Center for Vaccine Equity, Task Force for Global Health, GA, USA;2. Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;1. Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland;2. Health Research Institute and Mathematics Applications Consortium for Science and Industry (MACSI), University of Limerick, Limerick, Ireland |
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| Abstract: | IntroductionThe World Health Organization (WHO) recommends vaccination of health workers against influenza, but uptake in low-resource settings remains low. To complement routine global data collection efforts we conducted a detailed survey on influenza vaccination policies for health workers in low-income and middle-income countries (LMICs) in early 2020.MethodsHealth worker vaccination policy data were collected via a web-based survey tool sent to Expanded Programme on Immunization managers or equivalent managers of all eligible countries. High-income countries and countries with active civil war were excluded from the participation. The survey was sent by email to 109 LMICs in all WHO Regions to invite participation. Data were analyzed by World Bank income category and WHO Region. Statistical methods were applied to assess mean vaccination rates across countries.ResultsSixty-eight (62%) out of 109 invited LMICs were studied. Thirty-five (51.5%) reported to have a policy for influenza vaccination of health workers. Vaccinations were voluntary in 23 countries (66%), mandatory in 4 (11%), while in 8 countries (23%) mixed vaccination policies existed. A mechanism to estimate vaccine uptake existed in 26 countries (74%). Low-income and African Region countries were less likely to have influenza vaccination policies for health workers (p-values < 0.001 and 0.009, respectively). The most common reason for not having a vaccination policy for health workers was influenza not being a priority (48.5%).ConclusionsDespite policies being in place in more than half LMICs studied, gaps remain in translating vaccination policies to action, particularly in low-income and African Region countries. To optimize the operationalization of policies, further research is needed within countries, to enable evidence-based introduction decisions, categorization of health workers for vaccination, identification of factors impacting effective service delivery, strengthening monitoring and estimation of vaccination uptake rates and ensure sustainability of funding. |
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| Keywords: | Influenza Vaccination Health workers Healthcare personnel Occupational Policies |
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