Preventive Medicine and Epidemiology Unit, Institut d'investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic of Barcelona, Barcelona, Spain.
Am J Infect Control. 2010 Aug;38(6):476-81. doi: 10.1016/j.ajic.2010.01.013. Epub 2010 Apr 24.
The most effective strategy for avoiding nosocomial influenza outbreaks is through vaccination of health care workers (HCWs). In Spain, HCW vaccination coverage rarely exceeds 25%. The objective of this study was to determine whether an active vaccination campaign promoting communication among HCWs increased influenza vaccination coverage rates and permitted a shorter campaign.
This was a before-after trial, comparing free mobile vaccination teams without and with strategies promoting HCW involvement by means of weekly educational and promotional messages through electronic mail, including 2 prize draws for vaccinated HCWs and a Web page including pictures of vaccinated HCWs and all senior hospital management. Weekly coverages were publicized, the staff of mobile units was increased, and their routes in the hospital were advertised. The study population was >4500 HCWs (permanent and temporary staff) at a Spanish university hospital during the 2007-08 and 2008-09 influenza seasons.
Coverage was 23% (95% confidence interval [CI], 22.5%-24.9%) in the 2007-08 season and 37% (95% CI, 34.7%-37.4%) in 2008-09 season. The vaccination rate was highest in HCWs aged > or =65 years and in physicians. The weekly vaccination rates were significantly higher for the 2008-09 season compared with the 2007-08 season except for the first and third weeks; for example, in week 2, the rate was 1.7 HCWs per 100 persons-week (95% CI, 1.3-2.1) in 2007-08, compared with 3.7 HCWs per 100 persons-week (95% CI, 3.2-4.4) in 2009-09. Rate increases were concentrated in the first weeks of the program, with a peak occurring in week 3 during the 2007-08 season and in week 2 during the 2008-09 season.
This intervention improved influenza vaccination coverage of HCWs and allowed more rapid achievement of higher coverage.
避免医院内流感爆发的最有效策略是对医护人员(HCWs)进行疫苗接种。在西班牙,HCW 疫苗接种覆盖率很少超过 25%。本研究的目的是确定是否通过积极的疫苗接种运动来促进 HCW 之间的沟通,可以提高流感疫苗接种率并缩短疫苗接种运动的周期。
这是一项前后对照试验,比较了没有和有通过电子邮件每周发送教育和宣传信息策略的免费流动疫苗接种团队,这些策略包括对已接种 HCWs 进行两次抽奖,并在网页上展示已接种 HCWs 和所有医院高层管理人员的照片。每周公布接种覆盖率,增加流动单位工作人员数量,并在医院内宣传其路线。研究人群为西班牙某大学医院在 2007-08 和 2008-09 流感季节期间的 4500 多名 HCWs(固定和临时工作人员)。
2007-08 季节的覆盖率为 23%(95%置信区间[CI],22.5%-24.9%),2008-09 季节为 37%(95%CI,34.7%-37.4%)。年龄≥65 岁和医师的 HCWs 疫苗接种率最高。与 2007-08 季节相比,2008-09 季节每周疫苗接种率显著提高,除第一周和第三周外;例如,在 2007-08 季节的第 2 周,每 100 人-周接种 1.7 名 HCWs(95%CI,1.3-2.1),而在 2009-09 季节每 100 人-周接种 3.7 名 HCWs(95%CI,3.2-4.4)。增长率集中在计划的第一周,2007-08 季节的第 3 周和 2008-09 季节的第 2 周达到高峰。
该干预措施提高了 HCWs 的流感疫苗接种率,并允许更快地达到更高的接种率。