Taddei Cristina, Ceccherini Vega, Niccolai Giuditta, Porchia Barbara Rita, Boccalini Sara, Levi Miriam, Tiscione Emilia, Santini Maria Grazia, Baretti Simonetta, Bonanni Paolo, Bechini Angela
a Department of Health Sciences; Section of Hygiene; Preventive Medicine and Public Health ; University of Florence ; Florence , Italy.
Hum Vaccin Immunother. 2014;10(9):2612-22. doi: 10.4161/21645515.2014.970879. Epub 2014 Oct 30.
Health care workers (HCWs) are at risk of infection and transmission of vaccine-preventable infectious diseases. In recent years cases of measles or varicella in health care workers were observed with increasing frequency. The aim of our study was to investigate attitude toward immunization and risk perception of measles, rubella, mumps, varicella, and pertussis in HCWs working in 6 hospitals of Florence (Italy).
A cross-sectional survey among the physicians, nurses, midwives, and nursing assistants working in selected departments was performed trough a self-administered, anonymous questionnaire. Overall, 600 questionnaires were sent and 436 HCWs' completed forms were included into the study (Participation rate: 72.7%). Data were analyzed with STATA 11.0® and odds ratio (OR) were calculated in a multivariate analysis.
Among all respondents 74.9% were females. The average age was nearly 43-years-old (42.9-SD 8.95). The majority of participants (58.6%) were nurses, 21.3% physicians, 12.9% nursing assistants, and 7.2% were midwives. Among those HCWs reporting no history of disease, 52.8% (95% CI: 42.0-63.3%) declared to have been immunized for measles, 46.9% for rubella (95% CI: 39.0-54.9%), 21.6% for mumps (95% CI: 15.1-29.4%), 14.9% for varicella (95% CI: 7.4-25.7%), and 14.5% for pertussis (95% CI: 10.0-20.0%). When considering potentially susceptible HCWs (without history of disease or vaccination and without serological confirmation), less than a half of them feel at risk for the concerned diseases and only less than 30% would undergo immunization. One of the main reasons of the relatively low coverage was indeed lack of active offer of vaccines.
Attitudes toward immunization observed in this study are generally positive for preventing some infectious diseases (i.e., measles and rubella), but relatively poor for others (i.e., varicella). More information should be made available to HCWs on the benefits of vaccination and efforts to encourage vaccination uptake should be performed. Educational program on the risk of being infected working in a hospital should be implemented in order to increase the risk perception toward infectious diseases among HCWs.
医护人员面临疫苗可预防传染病的感染和传播风险。近年来，医护人员中麻疹或水痘病例的出现频率不断增加。我们研究的目的是调查在意大利佛罗伦萨6家医院工作的医护人员对免疫接种的态度以及对麻疹、风疹、腮腺炎、水痘和百日咳的风险认知。
通过自行填写的匿名问卷，对选定科室工作的医生、护士、助产士和护理助理进行横断面调查。总共发放了600份问卷，436份医护人员填写完整的表格纳入研究（参与率：72.7%）。数据用STATA 11.0®进行分析，并在多变量分析中计算比值比（OR）。
在所有受访者中，74.9%为女性。平均年龄近43岁（42.9 - 标准差8.95）。大多数参与者（58.6%）是护士，21.3%是医生，12.9%是护理助理，7.2%是助产士。在那些报告无疾病史的医护人员中，52.8%（95%置信区间：42.0 - 63.3%）宣称已接种麻疹疫苗，46.9%接种风疹疫苗（95%置信区间：39.0 - 54.9%），21.6%接种腮腺炎疫苗（95%置信区间：15.1 - 29.4%），14.9%接种水痘疫苗（95%置信区间：7.4 - 25.7%），14.5%接种百日咳疫苗（95%置信区间：10.0 - 20.0%）。当考虑潜在易感的医护人员（无疾病史或疫苗接种史且无血清学确认）时，不到一半的人认为自己有感染相关疾病的风险，只有不到30%的人愿意接种疫苗。疫苗接种覆盖率相对较低的一个主要原因确实是缺乏主动提供疫苗。
本研究中观察到的医护人员对免疫接种的态度总体上对预防某些传染病（如麻疹和风疹）较为积极，但对其他一些传染病（如水痘）则相对较差。应向医护人员提供更多关于疫苗接种益处的信息，并应努力鼓励他们接种疫苗。应实施关于在医院工作时感染风险的教育计划，以提高医护人员对传染病的风险认知。
