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医护人员接种流感疫苗的伦理考量。

Ethical considerations in the uptake of influenza vaccination by healthcare workers.

机构信息

Magill Department of Anaesthesia, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.

出版信息

Public Health. 2018 May;158:61-63. doi: 10.1016/j.puhe.2018.01.020. Epub 2018 Mar 22.

DOI:10.1016/j.puhe.2018.01.020
PMID:29574237
Abstract

OBJECTIVES

The World Health Organization (WHO) recommends annual seasonal influenza vaccination of healthcare workers (HCWs). Under the current voluntary scheme in England, uptake of vaccine in this group remains well below the 75% target. A mandatory scheme may improve rates, but raises the ethical issue of imposed vaccination. However, the existing voluntary scheme could also potentially infringe autonomy if those not wanting to join feel pressured or coerced into vaccination. The aim of this study was to explore HCW views and experiences with the current influenza vaccination programme.

STUDY DESIGN

Questionnaire survey.

METHODS

Between March 2015 and April 2016, a total of 140 questionnaires were completed across seven HCW groups, with the demographic, vaccination and opinion data statistically analysed using the chi-squared test, Kruskal-Wallis test and Mann-Whitney U-test as appropriate.

RESULTS

No staff group met the national influenza vaccination target of 75% and vaccination rates varied between HCW groups. All groups reported some degree of external pressure to be vaccinated and there were mixed views on the concept of mandatory vaccination, with a lack of certainty over the vaccine's efficacy and/or a lack of information the most common reasons for not supporting it.

CONCLUSION

The current voluntary influenza vaccination scheme has a number of flaws. Improvements in the quality and availability of information provided to employees may help Trusts increase vaccination rates, or achieve acceptance of any proposed mandatory programme.

摘要

目的

世界卫生组织(WHO)建议医护人员(HCW)每年接种季节性流感疫苗。在英国目前的自愿计划下,该人群的疫苗接种率仍远低于 75%的目标。强制性计划可能会提高接种率,但这引发了强制接种的伦理问题。然而,如果那些不想接种疫苗的人感到有压力或被迫接种,那么现有的自愿计划也可能会侵犯自主权。本研究旨在探讨 HCW 对当前流感疫苗接种计划的看法和经验。

研究设计

问卷调查。

方法

在 2015 年 3 月至 2016 年 4 月期间,共完成了 140 份问卷,涵盖了 7 个 HCW 群体,使用卡方检验、克鲁斯卡尔-沃利斯检验和曼-惠特尼 U 检验对人口统计学、疫苗接种和意见数据进行了统计分析。

结果

没有一个员工群体达到了全国流感疫苗接种目标的 75%,并且疫苗接种率在 HCW 群体之间存在差异。所有群体都报告说受到了一定程度的外部压力要求接种疫苗,对于强制性接种的概念存在不同看法,最常见的不支持的原因是对疫苗的疗效缺乏信心和/或缺乏信息。

结论

目前的自愿流感疫苗接种计划存在一些缺陷。提高向员工提供的信息的质量和可及性可能有助于信托基金提高疫苗接种率,或接受任何拟议的强制性计划。

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