Incentives and barriers regarding immunization against influenza and hepatitis of health care workers.

A meeting of the Viral Hepatitis Prevention Board in Barcelona in November 2012 brought together health care professionals concerned with viral hepatitis and those concerned with other vaccine-preventable diseases (especially influenza) in order to share experiences and find ways to increase the protection of health care workers through vaccination. Despite the existence of numerous intergovernmental and national resolutions, recommendations or published guidelines, vaccine uptake rates in health care workers are often shockingly low and campaigns to increase those rates have been generally unsuccessful. Participants reviewed the numerous incentives and barriers to vaccine uptake. Reasons for low uptake range from lack of commitment by senior management of health facilities and unclear policies to lack of knowledge, and denial of risk. Positive factors included leadership, involvement of all concerned parties, reminders and peer pressure. Innovative approaches, including the use of social media, are needed. It was concluded that strategies should be modified appropriately to reach specific health care worker populations at risk and that policies for preventing infection of health care workers could include obligatory health checks to determine vaccination status or immunity. Further, mandatory vaccination of health care workers may be the only effective means in order to achieve high vaccination coverage rates. Suggested possible future activities included: refurbishment of the image of the occupation health profession; resolving the logistical problems of administering vaccine; elaborating policy on managing health care workers who have been vaccinated against hepatitis B at birth or in early childhood and who are now starting to work in the health professions; and embedding and applying policies on vaccination against vaccine-preventable diseases in all health care facilities and training institutions. Above all, national action plans need to be written, with the involvement of health care workers in their design and implementation.