Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Molestias Infecciosas e Parasitarias, São Paulo, SP, Brazil.
Hospital das Clinicas Divisão de Clinica de Molestias, Infecciosas e Parasitarias, Centro de Referencia para Imunobiologicos Especiais, São Paulo, SP, Brazil.
Braz J Infect Dis. 2019 Jul-Aug;23(4):231-236. doi: 10.1016/j.bjid.2019.06.007. Epub 2019 Jul 26.
Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014.
To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School.
A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap.
The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations.
Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.
自 2014 年 11 月以来，巴西卫生部已建议医护人员（HCWs）接种破伤风、白喉和无细胞百日咳（Tdap）疫苗。
描述为提高 Tdap 接种率而实施的策略，每次干预后疫苗接种的累积覆盖率，与 HCWs 接种 Tdap 相关的变量，以及隶属于圣保罗大学医学院的一家四级医院主楼内 HCWs 未接种疫苗的原因。
生成一份有资格接种百日咳疫苗的 HCWs 名单。2015 年 4 月至 12 月，实施了以下干预措施：在实习医生日志上注明提醒百日咳疫苗接种重要性的说明；向护士长发送电子邮件，强化疫苗接种建议；为妇产科和新生儿科医生举办百日咳和 Tdap 讲座；在妇产科、新生儿科和麻醉科现场为 HCWs 接种疫苗。每月末评估疫苗接种覆盖率。使用具有稳健误差方差的多变量泊松回归模型评估与 Tdap 接种相关的变量。2017 年 1 月至 5 月，通过电话评估未接种 Tdap 的 HCWs 未接种疫苗的原因。
本研究共纳入 456 名 HCWs。干预后，Tdap 覆盖率从 2.8%上升至 41.2%。在多变量分析中，职业（医生）、工作地点（妇产科或麻醉科）和 2015 年接种流感疫苗与 Tdap 接种独立相关。未接种疫苗的主要原因是不知道 Tdap 建议。
我们医院 HCWs 的 Tdap 接种率较低。为 HCWs 提供方便的接种地点/时间似乎是提高疫苗接种率的最有效策略。
