CHU de Caen, CPias Normandie, Caen F-14000, France.
CHU de Caen, CPias Normandie, Caen F-14000, France.
Vaccine. 2019 Feb 28;37(10):1260-1265. doi: 10.1016/j.vaccine.2019.01.066. Epub 2019 Feb 7.
Seasonal influenza has a major individual and collective impact, especially among the elderly living in nursing homes. To prevent infection by influenza viruses, vaccination of residents and professionals is an essential measure. However, while the vaccination rates of residents are generally high (>85%), rates among professionals are generally approximately 20%. To evaluate the effectiveness of an intervention campaign on the improvement of the influenza vaccination rate of professionals, a regional intervention study was proposed for nursing homes during the 2014-15 season.
Cluster-randomized controlled trial (with a nursing home representing a cluster). In the intervention group, a campaign on influenza vaccination was offered to staff, combining different teaching aids in a multimodal approach. In the control group, no intervention was proposed. The primary endpoint was the rate of influenza vaccination among staff. Before and after the study, professionals were asked to complete short questionnaires on their perceptions of influenza vaccination. A multilevel analysis was carried out to compare the vaccination rates between the 2 groups and their evolution before/after the winter period.
A total of 32 nursing homes were randomized, and 6 were excluded. Initial vaccination rates were 27.6% in the intervention group and 24.2% in the control group (p = 0.16). After the study, these rates increased to 33.7% and 22.9%, respectively, which was a relative difference of +22.1% in the intervention group compared to -5.4% in the control group, p = 0.0025.
Despite professionals' reluctance to be vaccinate, participation in a promotional campaign with a pragmatic approach has increased the rate of influenza vaccination. The approach will be offered to all nursing homes in the region after revision of the tools to enhance their ease of use and pedagogical messages focused on the direct benefits to professionals.
季节性流感对个人和集体都有重大影响，尤其是在养老院居住的老年人中。为了预防流感病毒感染，为居民和专业人员接种疫苗是一项重要措施。然而，尽管居民的接种率普遍较高（>85%），但专业人员的接种率一般约为 20%。为了评估一项干预活动对提高专业人员流感疫苗接种率的效果，在 2014-15 年流感季节期间，针对养老院提出了一项区域性干预研究。
采用整群随机对照试验（以养老院为一个群组）。在干预组中，为工作人员提供了一项流感疫苗接种运动，采用多种教学方法进行综合干预。在对照组中，不提出干预措施。主要终点是工作人员的流感疫苗接种率。在研究前后，专业人员被要求填写关于他们对流感疫苗接种看法的简短问卷。采用多水平分析比较两组之间的接种率及其在冬季前后的变化。
共随机分配了 32 家养老院，其中 6 家被排除在外。干预组的初始接种率为 27.6%，对照组为 24.2%（p=0.16）。研究后，这两个组的接种率分别增加到 33.7%和 22.9%，干预组相对增加了+22.1%，而对照组相对减少了-5.4%，p=0.0025。
尽管专业人员不愿意接种疫苗，但参与具有实用方法的宣传活动提高了流感疫苗的接种率。该方法将在该地区所有养老院推出，届时将对工具进行修订，以提高其易用性，并加强针对专业人员直接受益的教学信息。
