Atamna Zaher, Chazan Bibiana, Nitzan Orna, Colodner Raul, Kfir Hila, Strauss Merav, Schwartz Naama, Markel Arie
Isr Med Assoc J. 2016 Jan;18(1):5-9.
Recent studies show that vaccination of health care workers (HCW) might reduce influenza transmission and mortality among hospitalized patients. No studies have compared the incidence of laboratory-proven influenza in vaccinated versus unvaccinated hospital HCW.
To evaluate the effectiveness of influenza vaccination among hospital HCW and to examine the attitudes of this population towards influenza vaccination.
We performed a prospective cohort study between 1 January and 30 April 2014 of 1641 HCW at our medical center; 733 were vaccinated and 908 were not. A random sample of 199 subjects was obtained: 97 vaccinated and 102 non-vaccinated. Participating individuals were contacted on a weekly basis during the flu season and were asked to report any respiratory or flu symptoms and, if positive, to undergo a polymerase chain reaction (PCR) test for influenza. Results: In the general HCW population vaccination was more frequent among physicians (298/498, 58%) than among nurses (324/862, 38%) and among males than females. Flu symptoms were reported by 20 of 199 participants, 13 in the non-vaccinated group (12.7%) and 7 in the vaccinated group (7.2%). A positive PCR test for influenza A virus was present in 4 of 20 people tested (20%). All positive cases were from the non-vaccinated group (P = 0.0953).
Non-vaccinated HCW showed a higher, although not statistically significant, tendency for contracting laboratory-proven influenza than the vaccinated population. The main reasons for vaccination and non-vaccination were personal beliefs and habits. Education efforts are needed to improve compliance. Larger studies could further clarify this issue.
近期研究表明，医护人员接种疫苗可能会减少住院患者中的流感传播及死亡率。尚无研究比较过接种疫苗与未接种疫苗的医院医护人员中经实验室确诊的流感发病率。
评估医院医护人员中流感疫苗接种的效果，并调查该人群对流感疫苗接种的态度。
2014年1月1日至4月30日，我们在本医疗中心对1641名医护人员进行了一项前瞻性队列研究；733人接种了疫苗，908人未接种。抽取了199名受试者的随机样本：97名接种了疫苗，102名未接种。在流感季节期间，每周与参与研究的个体进行联系，要求他们报告任何呼吸道或流感症状，若呈阳性，则接受流感聚合酶链反应（PCR）检测。结果：在全体医护人员中，医生（298/498，58%）的疫苗接种率高于护士（324/862，38%），男性的疫苗接种率高于女性。199名参与者中有20人报告了流感症状，未接种疫苗组有13人（12.7%）报告了症状，接种疫苗组有7人（7.2%）报告了症状。20名接受检测的人中，有4人（20%）的甲型流感病毒PCR检测呈阳性。所有阳性病例均来自未接种疫苗组（P = 0.0953）。
未接种疫苗的医护人员感染经实验室确诊流感的倾向虽无统计学意义，但高于接种疫苗人群。接种疫苗和未接种疫苗的主要原因是个人信念和习惯。需要开展教育工作以提高依从性。更大规模的研究可以进一步阐明这个问题。
