Section of Hygiene; Department of Biomedical Sciences and Public Health; Università Politecnica delle Marche; Ancona, Italy.
Hum Vaccin Immunother. 2013 Apr;9(4):911-6. doi: 10.4161/hv.22997.
We analyzed seasonal influenza vaccination coverage among the Italian healthcare workers (HCW) in order to identify socio-demographic and clinical determinants of vaccination. We used data from the survey "Health and health care use in Italy," which comprised interviews of 5,336 HCWs For each respondent, information on socioeconomic, health conditions, self-perceived health and smoking status were obtained. After bivariate analysis, we used multilevel regression models to assess determinants of immunization. Overall 20.8% of HCWs (95%CI 19.7-21.9) reported being vaccinated against seasonal influenza. After controlling for potential confounders, multilevel regression revealed that older workers have a higher likelihood of vaccine uptake (OR = 6.07; 95% CI 4.72-7.79). Conversely, higher education was associated with lower vaccine uptake (OR = 0.65; 95% IC 0.50-0.83). Those suffering from diabetes (OR = 2.07; 95% CI 1.19-1.69), COPD (OR = 1.95; 95% CI 1.31-2.89) and cardiovascular diseases (OR = 1.48 95% CI 1.11-1.96) were more likely to be vaccinated. Likewise, smokers, or former smokers receive more frequently the vaccination (OR = 1.40; 95% CI 1.15-1.70; OR = 1.54; 95% CI 1.24-1.91, respectively) compared with never-smokers as well as those HCWs reporting fair or poor perceived health status (ORs of 1.68, 95% CI 1.30-2.18). Vaccine coverage among HCWs in Italy remains low, especially among those with no comorbidities and being younger than 44 y old. This behavior not only raises questions regarding healthcare organization, infection control in healthcare settings and clinical costs, but also brings up ethical issues concerning physicians who seem not to be very concerned about the impact of the flu on themselves, as well as on their patients. Influenza vaccination campaigns will only be effective if HCWs understand their role in influenza transmission and prevention, and realize the importance of vaccination as a preventive measure.
我们分析了意大利医护人员（HCW）季节性流感疫苗接种率，以确定疫苗接种的社会人口学和临床决定因素。我们使用了“意大利健康和医疗保健使用”调查的数据，该调查包括对 5336 名 HCW 的访谈。对于每个受访者，都获得了关于社会经济、健康状况、自我感知健康和吸烟状况的信息。在进行单变量分析后，我们使用多水平回归模型评估免疫接种的决定因素。总体而言，20.8%的 HCW（95%CI 19.7-21.9）报告接种了季节性流感疫苗。在控制潜在混杂因素后，多水平回归显示，年龄较大的工人更有可能接种疫苗（OR=6.07；95%CI 4.72-7.79）。相反，较高的教育程度与较低的疫苗接种率相关（OR=0.65；95%IC 0.50-0.83）。患有糖尿病（OR=2.07；95%CI 1.19-1.69）、COPD（OR=1.95；95%CI 1.31-2.89）和心血管疾病（OR=1.48 95%CI 1.11-1.96）的人更有可能接种疫苗。同样，吸烟者或曾经吸烟者比从不吸烟者更频繁地接种疫苗（OR=1.40；95%CI 1.15-1.70；OR=1.54；95%CI 1.24-1.91），以及那些报告健康状况一般或较差的 HCW（ORs 为 1.68，95%CI 1.30-2.18）。意大利 HCW 的疫苗接种率仍然较低，尤其是那些没有合并症且年龄小于 44 岁的 HCW。这种行为不仅对医疗机构的组织、医疗机构中的感染控制和临床成本提出了质疑，还引发了关于医生的伦理问题，因为医生似乎并不太关心流感对自己和患者的影响。只有当 HCW 了解他们在流感传播和预防中的作用，并认识到疫苗接种作为预防措施的重要性时，流感疫苗接种活动才会有效。
