Prematunge Chatura, Corace Kimberly, McCarthy Anne, Nair Rama C, Roth Virginia, Suh Kathryn N, Garber Gary
Ontario Agency for Health Promotion and Protection, Infection Prevention and Control, Toronto, ON, Canada; University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.
University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Canada.
Vaccine. 2014 Dec 12;32(52):7128-34. doi: 10.1016/j.vaccine.2014.10.023. Epub 2014 Oct 28.
Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCW) remains a key mode of influenza prevention in healthcare settings. Yet influenza vaccine coverage among HCWs continues to be below recommended targets, in pandemic and non-pandemic settings. Thus, the primary objective of this analysis is to identify motivators and barriers to pandemic (panINFLU) and seasonal influenza vaccination (sINFLU) through the qualitative analysis of HCW provided reasons driving HCW's personal vaccination decisions.
Data were collected from a multi-professional sample of HCWs via a cross-sectional survey study, conducted at a tertiary-care hospital in Ontario, Canada. HCW provided and ranked qualitative reasons for personal (1) panINFLU (pH1N1) and (2) sINFLU (2008/2009 season) vaccine uptake and avoidance were used to identify key vaccination motivators and barriers through content analysis methodology.
Most HCW vaccination motivators and barriers were found to be similar for panINFLU and sINFLU vaccines. Personal motivators had the greatest impact on vaccination (panINFLU 29.9% and sINFLU 33.9%). Other motivators included preventing influenza in loved ones, patients, and community, and awareness of HCW role in influenza transmission. In contrast, concerns of vaccine safety and limited HCW knowledge of influenza vaccines (panINFLU 46.2% and sINFLU 37.3%). HCW vaccination during the pandemic was motivated by panINFLU related fear, epidemiology, and workplace pro-vaccination policies. HCW perceptions of accelerated panINFLU vaccine development and vaccine safety compromises, negative views of external sources (i.e. media, pharmaceutical companies, and regulatory agencies) and pandemic management strategies were barriers specific to panINFLU vaccine.
HCW panINFLU and sINFLU vaccine coverage can increase if future vaccination programs (1) highlight personal vaccination benefits (2) emphasize the impact HCW non-vaccination on family members, patients and community, (3) address HCW vaccine related knowledge gaps, and (4) implement pro-vaccination workplace policies consistent with those in place at the study site during pH1N1.
流感是整个医疗环境中的一个主要关注点。医护人员（HCW）每年接种疫苗仍然是医疗机构预防流感的关键方式。然而，在大流行和非大流行环境中，医护人员的流感疫苗接种率仍低于推荐目标。因此，本分析的主要目的是通过对医护人员提供的推动其个人接种决策的原因进行定性分析，确定大流行流感（panINFLU）和季节性流感疫苗接种（sINFLU）的动机和障碍。
通过在加拿大安大略省一家三级护理医院进行的横断面调查研究，从多专业的医护人员样本中收集数据。医护人员提供并对个人（1）大流行流感（pH1N1）和（2）季节性流感（2008/2009季节）疫苗接种和不接种的定性原因进行排序，通过内容分析方法确定关键的疫苗接种动机和障碍。
发现大多数医护人员接种大流行流感和季节性流感疫苗的动机和障碍相似。个人动机对疫苗接种的影响最大（大流行流感为29.9%，季节性流感为33.9%）。其他动机包括预防亲人、患者和社区感染流感，以及认识到医护人员在流感传播中的作用。相比之下，对疫苗安全性的担忧以及医护人员对流感疫苗的了解有限（大流行流感为46.2%，季节性流感为37.3%）。大流行期间医护人员接种疫苗的动机是与大流行流感相关的恐惧、流行病学以及工作场所的疫苗接种支持政策。医护人员对大流行流感疫苗加速研发和疫苗安全性妥协的看法、对外部来源（即媒体、制药公司和监管机构）的负面看法以及大流行管理策略是大流行流感疫苗特有的障碍。
如果未来的疫苗接种计划（1）突出个人接种疫苗的益处，（2）强调医护人员不接种疫苗对家庭成员、患者和社区的影响，（3）解决医护人员与疫苗相关的知识差距，以及（4）实施与pH1N1期间研究地点一致的支持疫苗接种的工作场所政策，那么医护人员的大流行流感和季节性流感疫苗接种率可以提高。
