Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-21T14:20:43.849Z Has data issue: false hasContentIssue false
  • English
  • Français

Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services

Published online by Cambridge University Press:  09 February 2016

Alexandre Moser ,
Cédric Mabire ,
Olivier Hugli ,
Victor Dorribo ,
Giorgio Zanetti ,
Catherine Lazor-Blanchet  and
Pierre-Nicolas Carron
Alexandre Moser*
Affiliation:
Department of Internal Medicine, Hospital of Thun and Simmental (STS AG), Zweisimmen, Switzerland
Cédric Mabire
Affiliation:
University of Health Sciences (HESAV), Lausanne, Switzerland
Olivier Hugli
Affiliation:
Emergency Department, Lausanne University Hospital, Lausanne, Switzerland
Victor Dorribo
Affiliation:
Service of Occupational Medicine, Institute for Work and Health, Lausanne, Switzerland
Giorgio Zanetti
Affiliation:
Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
Catherine Lazor-Blanchet
Affiliation:
Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
Pierre-Nicolas Carron
Affiliation:
Emergency Department, Lausanne University Hospital, Lausanne, Switzerland
*
Correspondence: Alexandre Moser Department of Internal Medicine Hospital of Thun and Simmental (STS AG) Karl Haueter-Strasse 21 CH – 3770 Zweisimmen Switzerland E-mail: alexandre.moser@h-ne.ch
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Influenza is a major concern for Emergency Medical Services (EMS); EMS workers’ (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.

Hypothesis

The influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.

Methods

A survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.

Results

Response rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women’s vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.

Conclusion

Average vaccination rate in this study’s EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a “pandemic effect.” These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.

MoserA, MabireC, HugliO, DorriboV, ZanettiG, Lazor-BlanchetC, CarronPN. Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services. Prehosp Disaster Med. 2016;31(2):155–162.

Keywords

Emergency Medical ServicesEMS-workersinfluenzavaccination
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Supplement 2 , April 2016 , pp. 155 - 162
Copyright
© World Association for Disaster and Emergency Medicine 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Thompson, WW, Shay, DK, Weintraub, E, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292(11):1333-1340.Google Scholar
2. Rueckmann, E, Shah, MN, Humiston, SG. Influenza vaccination among Emergency Medical Services and emergency department personnel. Prehosp Emerg Care. 2009;13(1):1-5.Google Scholar
3. Poland, GA, Tosh, P, Jacobson, RM. Requiring influenza vaccination for health care workers: seven truths we must accept. Vaccine. 2005;23(17-18):2251-2255.CrossRefGoogle ScholarPubMed
4. Hubble, MW, Zontek, TL, Richards, ME. Predictors of influenza vaccination among Emergency Medical Services personnel. Prehosp Emerg Care. 2011;15(2):175-183.Google Scholar
5. Bledsoe, BE, Sweeney, RJ, Berkeley, RP, Cole, KT, Forred, WJ, Johnson, LD. EMS provider compliance with infection control recommendations is suboptimal. Prehosp Emerg Care. 2014;18(2):290-294.Google Scholar
6. Emanuelsson, L, Karlsson, L, Castrèn, M, Lindström, V. Ambulance personnel adherence to hygiene routines: still protecting ourselves but not the patient. Eur J Emerg Med. 2013;20(4):281-285.Google Scholar
7. Goodman, CS, Cone, DC. Emergency Medical Services equipment hygiene practices. Prehosp Emerg Care. 2001;5(2):169-173.Google Scholar
8. Eustis, TC, Wright, SW, Wrenn, KD, Fowlie, EJ, Slovis, CM. Compliance with recommendations for universal precautions among prehospital providers. Ann Emerg Med. 1995;25(4):512-515.CrossRefGoogle ScholarPubMed
9. Carman, WF, Elder, AG, Wallace, LA, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomized controlled trial. Lancet. 2000;355(9198):93-97.CrossRefGoogle Scholar
10. 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(10):908-913.Google Scholar
11. Nichol, KL, Margolis, KL, Wuorenma, J, Von Sternberg, T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med. 1994;331(12):778-784.CrossRefGoogle ScholarPubMed
12. Nichol, KL, Lind, A, Margolis, KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med. 1995;333(14):889-893.Google Scholar
13. Bridges, CB, Thompson, WW, Meltzer, MI, et al. Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA. 2000;284(13):1655-1663.CrossRefGoogle ScholarPubMed
14. Saxén, 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(9):779-783.CrossRefGoogle ScholarPubMed
15. Chan, SS-W. Does vaccinating ED health care workers against influenza reduce sickness absenteeism? Am J Emerg Med. 2007;25(7):808-811.Google Scholar
16. Centers for Disease Control and Prevention (CDC). Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2007;56(RR06):1-54.Google Scholar
17. Caplan, A. Time to mandate influenza vaccination in health-care workers. Lancet. 2011;378(9788):310-311.CrossRefGoogle ScholarPubMed
18. Ottenberg, AL, Wu, JT, Poland, GA, Jacobson, RM, Koenig, BA, Tilburt, JC. Vaccinating health care workers against influenza: the ethical and legal rationale for a mandate. Am J Public Health. 2011;101(2):212-216.Google Scholar
19. King, WD, Woolhandler, SJ, Brown, AF, et al. Brief report: influenza vaccination and health care workers in the United States. J Gen Intern Med. 2006;21(2):181-184.Google Scholar
20. Masserey, E. Communication du 9 Novembre 2009 à l’intention des services d’ambulances et de leur médecin conseil. Service de la Santé Publique Vaudoise; 2009.Google Scholar
21. Boubaker, K, Masserey, E. Vaccination contre la grippe et port du masque. Service de la Santé Publique Vaudoise; 2010.Google Scholar
22. WHO. Influenza A(H1N1) [Internet]. WHO Web site. http://www.who.int/mediacentre/ news/statements/2009/h1n1_20090429/en/index.html. Accessed January 18, 2014.Google Scholar
23. WHO. Pandemic (H1N1) 2009 - update 58 [Internet]. WHO Web site. http://www.who.int/csr/don/2009_07_06/en/index.html. Accessed April 8, 2013.Google Scholar
24. WHO. Clinical features of severe cases of pandemic influenza [Internet]. WHO Web site. http://www.who.int/csr/disease/swineflu/notes/h1n1_clinical_features_20091016/en/index.html. Accessed January 18, 2014.Google Scholar
25. Hugli, O, Dorribo, V, Lazor-Blanchet, C, Zanetti, G. Differential proportion of health care workers immunization against the seasonal and pandemic influenza in 2009 in an emergency department. Acad Emerg Med. 2010;18(suppl 1):S196.Google Scholar
26. Dorribo, V, Hugli, Oliviers, Lazor-Blanchet, C, Zanetti, G. Health care workers’ influenza A(H1N1)2009 vaccination: motivations and mandatory mask policy. Occupational Medicine. 2015; (In Press).Google Scholar
27. Prematunge, C, Corace, K, McCarthy, A, Nair, RC, Pugsley, R, Garber, G. Factors influencing pandemic influenza vaccination of health care workers--a systematic review. Vaccine. 2012;30(32):4733-4743.Google Scholar
28. Bish, A, Yardley, L, Nicoll, A, Michie, S. Factors associated with uptake of vaccination against pandemic influenza: a systematic review. Vaccine. 2011;29(38):6472-6484.Google Scholar
29. Barnett, DJ, Levine, R, Thompson, CB, et al. Gauging US Emergency Medical Services workers’ willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework. PLoS ONE. 2010;5(3):e9856.Google Scholar
30. Goldstein, AO, Kincade, JE, Gamble, G, Bearman, RS. Policies and practices for improving influenza immunization rates among health care workers. Infect Control Hosp Epidemiol. 2004;25(11):908-911.Google Scholar
31. Salgado, CD, Giannetta, ET, Hayden, FG, Farr, BM. Preventing nosocomial influenza by improving the vaccine acceptance rate of clinicians. Infect Control Hosp Epidemiol. 2004;25(11):923-928.Google Scholar
32. Heimberger, T, Chang, HG, Shaikh, M, Crotty, L, Morse, D, Birkhead, G. Knowledge and attitudes of health care workers about influenza: why are they not getting vaccinated? Infect Control Hosp Epidemiol. 1995;16(7):412-415.CrossRefGoogle Scholar
33. Smith, EC, Burkle, FM Jr, Holman, PF, Dunlop, JM, Archer, FL. Lessons from the front lines: the prehospital experience of the 2009 novel H1N1 outbreak in Victoria, Australia. Disaster Med Public Health Prep. 2009;3(Suppl 2):S154-S159.Google Scholar
34. Smith, E. Paramedic Perception of Risk and Willingness to Work during Disasters: A Quantitative and Qualitative Analysis. Unpublished PhD thesis. 2009.Google Scholar
Supplementary material: File

Moser supplementary material

Appendix 1

Download Moser supplementary material(File)
File 186.8 KB