Undergraduate Medicine Program, Faculty of Medicine, University of New South Wales, NSW, Australia.
School of Public Health and Community Medicine, University of New South Wales, NSW, Australia.
Vaccine. 2019 Jan 29;37(5):705-710. doi: 10.1016/j.vaccine.2018.12.029. Epub 2019 Jan 6.
Healthcare worker (HCW) vaccination against seasonal influenza is considered a key preventative measure within hospitals and aged-care facilities (ACFs) to reduce the risk of transmission and related disease. Despite this, many facilities experience persistently low vaccination coverage rates and mandatory vaccination has been explored as a potential strategy to improve coverage. This study explored the current climate around staff vaccination in Australia from the perspective of opinion leaders and key stakeholders.
Qualitative semi-structured interviews were conducted between April and July 2018 with 22 individuals involved in vaccination policy and program development and implementation from a range of organisations including state health departments, hospitals and ACFs across Australia. In addition, interviews were undertaken with individuals from aged care and nursing peak bodies/colleges. Interviews were transcribed, and thematic analysis was undertaken using NVivo 12 software.
Major themes emerging from the interviews included a sense that attitudes around staff vaccination are changing; the persistence of administrative and resource barriers; the importance of positive workplace culture towards influenza vaccination; and the need for individualised and personal communication strategies. Perspectives were diverse on the necessity of introducing stronger policies, with participants divided in their support mandatory influenza vaccinations. Some advocated that key performance indicators should be used as an alternative to vaccine mandates.
This study provides policy makers with useful insights into the current Australian context around occupational vaccination policies, to inform acceptable and effective strategies to improve influenza vaccination uptake among Australian hospital and aged care staff.
医护人员（HCW）接种季节性流感疫苗被认为是医院和老年护理机构（ACF）内降低传播风险和相关疾病的关键预防措施。尽管如此，许多机构的疫苗接种覆盖率仍然持续较低，并且已经探索了强制性疫苗接种作为提高覆盖率的潜在策略。本研究从意见领袖和主要利益相关者的角度探讨了澳大利亚目前员工疫苗接种的情况。
2018 年 4 月至 7 月期间，对 22 名来自澳大利亚不同组织（包括州卫生部门、医院和 ACF）的参与疫苗接种政策和计划制定与实施的个人进行了定性半结构式访谈。此外，还对来自老年护理和护理专业团体/学院的个人进行了访谈。访谈记录被转录，并使用 NVivo 12 软件进行主题分析。
访谈中出现的主要主题包括：人们对员工疫苗接种态度正在发生变化的感觉；行政和资源障碍的持续存在；对流感疫苗接种的积极工作场所文化的重要性；以及对个性化和个人沟通策略的需求。对于是否需要引入更严格的政策，参与者的观点存在分歧，他们对强制接种流感疫苗的支持程度不一。一些人主张应该使用关键绩效指标作为疫苗接种要求的替代方法。
本研究为政策制定者提供了有关澳大利亚当前职业疫苗接种政策背景的有用见解，为改善澳大利亚医院和老年护理人员的流感疫苗接种率提供了可接受和有效的策略。
