Ormen Bahar, Türker Nesrin, Vardar Ilknur, Kaptan Figen, El Sibel, Ural Serap, Kaya Fatih, Coşkun Nejat Ali
İzmir Atatürk Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İzmir, Turkey.
Mikrobiyol Bul. 2012 Jan;46(1):57-64.
The aims of this study were to evaluate the attitudes towards H1N1 vaccination and to determine the safety and side effects following 2009 pandemic influenza A (H1N1) vaccination. Pandemic influenza vaccine had been administered to the healthcare personnel in our research and training hospital in December 2009. The rate being vaccinated was established as 40% (800/2000). Four months following vaccination, the opinions about vaccination were asked to the healthcare workers, and also side effects were questioned to the vaccinated group. Two different questionnaires (for vaccinated and unvaccinated subjects) were delivered to the volunteers who agreed to participate in the study. Demographic features, reasons related to being vaccinated or not, were questioned. The vaccinated group was also questioned for the presence of chronic diseases, previous vaccinations (pandemic/seasonal influenza), local or systemic reactions that develop after vaccination. A total of 332 volunteers participated in the questionnaire. Of them 247 (74.4%) were vaccinated and 85 (25.6%) were unvaccinated. Male/female ratio of the participants was 1.2, and 55.7% of them were older than 30-year-old. Most of the participants (82.8%) were highly educated (high school and faculty-graduated). Vaccination rates were found statistically significant in advanced age group compared to young adults (p= 0.042); in male gender compared to females (p= 0.001) and in parents compared to subjects who didn't have children (p= 0.021). Vaccination rates were observed to be higher (57.5%) in non-medical staff (cleaning employers, administrative personnel, etc.) than the physicians (29.1%) and nurses (13.4%), and the rate was also high (54.7%) in personnel who worked in intensive care units, emergency department and administrative units than the personnel who worked in the clinics of internal medicine (22.3%) and surgery (23.1%) (p= 0.001). The most important causes of rejecting vaccination were being afraid of the side effects (69.4%) and not believing the effectiveness of the vaccine (56.4%). The leading causes of accepting vaccination were worries about infecting their family (60.3%) and being in a risk group (54.3%). After vaccination, local reactions (pain, swelling and redness at the vaccination site) were described in 43.3% and systemic reactions (weakness, fatigue, muscle aches, influenza-like symptoms, etc.) were described in 43.7% of the subjects. Severe side effects such as vasculitis, neuritis, encephalomyelitis, Guillian-Barre syndrome and anaphylactic reaction were not observed in any of the vaccinated cases. It was detected that worries about the safety of vaccine had negative impact for vaccination. Since no serious side effects were detected related to vaccination, it was concluded that the vaccine was safe. In spite of the scientific proofs, negative concerns about the safety of the vaccines can unfavorably affect the vaccination campaigns and can jeopardize efforts of influenza control. As a result, data collection systems about the safety and side effects of the vaccine all over the country and regular reports about these data may more efficiently guide vaccination programs in the future.
本研究的目的是评估对甲型H1N1流感疫苗接种的态度，并确定2009年甲型H1N1大流行性流感疫苗接种后的安全性和副作用。2009年12月，在我们的研究与培训医院，已对医护人员接种了大流行性流感疫苗。接种率确定为40%（800/2000）。接种疫苗四个月后，向医护人员询问了有关疫苗接种的意见，并向接种组询问了副作用情况。向同意参与研究的志愿者发放了两份不同的问卷（一份针对接种者，一份针对未接种者）。询问了人口统计学特征、与接种或未接种相关的原因。还向接种组询问了慢性病的存在情况、既往接种情况（大流行性/季节性流感疫苗）、接种后出现的局部或全身反应。共有332名志愿者参与了问卷调查。其中247人（74.4%）接种了疫苗，85人（25.6%）未接种。参与者的男女比例为1.2，其中55.7%年龄超过30岁。大多数参与者（82.8%）受过高等教育（高中及大学毕业）。与年轻人相比，老年组的接种率具有统计学显著性（p = 0.042）；男性的接种率高于女性（p = 0.001），有孩子的父母的接种率高于没有孩子的人（p = 0.021）。非医务人员（清洁员工、行政人员等）的接种率（57.5%）高于医生（29.1%）和护士（13.4%），在重症监护病房、急诊科和行政单位工作的人员的接种率（54.7%）也高于在内科（22.3%）和外科诊所工作的人员（23.1%）（p = 0.001）。拒绝接种的最重要原因是害怕副作用（69.4%）和不相信疫苗的有效性（56.4%）。接受接种的主要原因是担心感染家人（60.3%）和属于高危人群（54.3%）。接种后，43.3%的受试者出现了局部反应（接种部位疼痛、肿胀和发红），43.7%的受试者出现了全身反应（虚弱、疲劳、肌肉疼痛、流感样症状等）。在任何接种病例中均未观察到诸如血管炎、神经炎、脑脊髓炎、格林-巴利综合征和过敏反应等严重副作用。结果发现，对疫苗安全性的担忧对疫苗接种有负面影响。由于未检测到与疫苗接种相关的严重副作用，得出结论认为该疫苗是安全的。尽管有科学证据，但对疫苗安全性的负面担忧可能会对疫苗接种运动产生不利影响，并可能危及流感防控工作。因此，全国各地关于疫苗安全性和副作用的数据收集系统以及关于这些数据的定期报告可能会在未来更有效地指导疫苗接种计划。
