Rebmann Terri, Wilson Kristin D, Loux Travis, Iqbal Ayesha Z, Peters Eleanor B, Peavler Olivia
Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, St. Louis, MO, USA.
Department of Health Management and Policy, Saint Louis University, College for Public Health & Social Justice, USA.
AIMS Public Health. 2016 Mar 15;3(1):116-130. doi: 10.3934/publichealth.2016.1.116. eCollection 2016.
In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today's environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.
20世纪90年代初，圣路易斯县发生了多起与食品服务工作人员相关的甲型肝炎疫情，标准的疫情干预措施无法控制这些疫情。餐饮利益集团和公众向当地公共卫生官员施加政治压力，要求采取更严格的干预措施，包括强制接种疫苗政策。地方卫生部门可以制定强制接种疫苗政策，但这种情况很少发生。研究目的是描述在地方管辖层面通过强制接种疫苗政策所采用的方法，并说明该条例15年后的结果。采用了案例研究设计。2015年春季，使用引导性问题对6名直接了解强制接种疫苗政策过程的关键信息提供者进行了深入的半结构化访谈。还分析了会议记录和/或报告。使用泊松分布分析来计算强制接种疫苗政策实施前后的疫情发生率。该政策似乎减少了甲型肝炎疫情的数量，降低了圣路易斯县的发病率和经济负担。地方公共卫生官员在通过甲型肝炎强制接种疫苗政策过程中吸取的经验教训在当今环境中很重要且具有相关性。所获得的经验和教训可能会在其他地方卫生部门面临对任何疫苗可预防疾病实施强制政策的潜在需求时提供帮助。
