Polgreen Philip M, Chen YiYi, Beekmann Susan, Srinivasan Arjun, Neill Marguerite A, Gay Ted, Cavanaugh Joseph E
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City 52242, USA.
Clin Infect Dis. 2008 Jan 1;46(1):14-9. doi: 10.1086/523586.
To address suboptimal influenza vaccination rates among health care workers, the Healthcare Infection Control Practices Advisory Committee and the Advisory Committee on Immunization Practices recently issued recommendations designed to increase the number of health care workers vaccinated against influenza. The purpose of the present study was to determine how widely these recommendations have been implemented and to identify important elements of successful influenza vaccine programs.
The Infectious Diseases Society of America Emerging Infections Network surveyed 991 infectious diseases consultants. Infectious diseases consultants were asked about vaccination programs and vaccination rates at their respective institutions. Multinomial logistic regression models based on proportional odds were used to determine predictors of vaccination-rate categories. All program elements were significant univariable factors in predicting vaccination rates. Because the program elements were highly associated with one another, principal components analysis was used to find combinations of the covariates that would serve as optimal predictors of higher vaccination rates.
Most infectious diseases consultants indicated that the vaccination rate for all health care workers in their institution had a range of 41%-60%. Vaccination rates were significantly higher in institutions that required signed declination statements (P = .004). In the model based on principal components analysis for predicting institutional vaccination rates, only the first principal component warranted retention (P < .001). In this component, the program elements weighted the most heavily were (1) offering the influenza vaccine free of charge, (2) providing adequate staff and resources, and (3) educating targeted groups of health care workers. Requiring signed declinations was not heavily weighted.
Influenza vaccination rates remain suboptimal, and hospitals have not completely implemented the Healthcare Infection Control Practices Advisory Committee-Advisory Committee on Immunization Practices recommendations to maximize vaccination rates.
为解决医护人员流感疫苗接种率不理想的问题，医疗感染控制实践咨询委员会和免疫实践咨询委员会最近发布了旨在提高接种流感疫苗的医护人员数量的建议。本研究的目的是确定这些建议的实施范围，并确定成功的流感疫苗接种计划的重要要素。
美国传染病学会新发感染网络对991名传染病顾问进行了调查。询问传染病顾问有关其各自机构的疫苗接种计划和接种率。使用基于比例优势的多项逻辑回归模型来确定接种率类别的预测因素。所有计划要素在预测接种率方面都是显著的单变量因素。由于这些计划要素彼此高度相关，因此使用主成分分析来找到协变量的组合，这些组合将作为更高接种率的最佳预测指标。
大多数传染病顾问表示，其机构中所有医护人员的接种率在41%至60%之间。在要求签署拒绝声明的机构中，接种率显著更高（P = 0.004）。在基于主成分分析预测机构接种率的模型中，只有第一个主成分值得保留（P < 0.001）。在该成分中，权重最大的计划要素是：（1）免费提供流感疫苗，（2）提供充足的人员和资源，以及（3）对目标医护人员群体进行教育。要求签署拒绝声明的权重不大。
流感疫苗接种率仍然不理想，医院尚未完全实施医疗感染控制实践咨询委员会 - 免疫实践咨询委员会的建议以实现最高接种率。
