FitzSimons David, Hendrickx Greet, Lernout Tinne, Badur Selim, Vorsters Alex, Van Damme Pierre
Documentation and Communication, Office of Governing Bodies, WHO, World Health Organization, Via Appia 20, CH-1211 Geneva, Switzerland.
Viral Hepatitis Prevention Board (VHPB), Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, B-2610 Antwerpen, Belgium.
Vaccine. 2014 Aug 27;32(38):4849-54. doi: 10.1016/j.vaccine.2014.06.072. Epub 2014 Jun 23.
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.
2012年11月，病毒性肝炎预防委员会在巴塞罗那召开会议，汇聚了关注病毒性肝炎的医护人员以及关注其他疫苗可预防疾病（尤其是流感）的人员，以便分享经验并找到通过接种疫苗加强医护人员防护的方法。尽管存在众多政府间和国家层面的决议、建议或已发布的指南，但医护人员的疫苗接种率往往低得惊人，提高接种率的活动总体上也未取得成功。与会者审视了疫苗接种的诸多激励因素和障碍。接种率低的原因包括医疗机构高层管理人员缺乏支持、政策不明确、知识欠缺以及对风险的否认。积极因素包括领导力、所有相关方的参与、提醒和同伴压力。需要采用创新方法，包括利用社交媒体。会议得出结论，应适当调整策略以覆盖特定的高危医护人员群体，预防医护人员感染的政策可包括进行强制性健康检查以确定疫苗接种状况或免疫情况。此外，强制医护人员接种疫苗可能是实现高接种覆盖率的唯一有效手段。建议未来可能开展的活动包括：重塑职业健康专业的形象；解决疫苗接种的后勤问题；制定针对出生时或幼儿期接种过乙肝疫苗、现开始从事医疗行业的医护人员的管理政策；在所有医疗机构和培训机构中落实并应用针对疫苗可预防疾病的疫苗接种政策。最重要的是，需要制定国家行动计划，让医护人员参与其设计和实施。
