Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Mar 30;35(12):e76. doi: 10.3346/jkms.2020.35.e76.
Healthcare personnel (HCP) are at risk of being exposed to or transmitting infections in hospitals, and vaccination against vaccine-preventable diseases (VPDs) is a well-known preventive strategy. Vaccination against influenza, hepatitis B virus, measles-mumps-rubella, varicella, and pertussis is recommended for HCP. However, there is no information on the current status of hospitals' vaccination policies for HCP in Korea.
We conducted a nationwide survey on hospital vaccination policies and barriers to implementing recommended vaccination programs in 2018. The online survey questionnaire was distributed to 652 hospitals, and 200 of them responded.
Of the 200 surveyed hospitals, 151 (75.5%) conducted a pre-employment screening program for at least one VPD, and 196 (98%) had vaccination programs that included at least one vaccine. Influenza vaccine was most commonly included in their programs (97.5%, n = 195), followed by hepatitis B vaccines (69%, n = 138). However, < 25% of the hospitals included other vaccines in their policies (measles-mumps-rubella, 24.5%; varicella, 18.5%; pertussis, 11%). Only 13 hospitals (6.5%) included the five recommended vaccines for HCP in their policies. Influenza vaccination coverage had a mean of 89.9% and was significantly higher in hospitals fully funding the vaccination cost (91.8% vs. 80.4%, P < 0.001). Among hospitals funding influenza vaccines, the coverage was lower in hospitals with ≥ 700 beds (-6.5%, P = 0.003). Hospitals' financial burden was the most important barrier to implementing vaccination polices as recommended (78.6%, 121/154), followed by lack of awareness (21%) or campaign (21%) and lack of leadership (17%).
Despite the recommendations on vaccination for HCP, the vaccination policies for HCP differ in hospitals and appear to be insufficient to protect HCP and prevent nosocomial transmission. Strong leadership of each hospital to protect HCP and financial support from the government are required to implement appropriate vaccination policies in hospitals.
医护人员（HCP）在医院中面临感染或传播感染的风险，接种疫苗预防可预防疾病（VPD）是一种众所周知的预防策略。建议医护人员接种流感、乙型肝炎病毒、麻疹-腮腺炎-风疹、水痘和百日咳疫苗。然而，目前尚无关于韩国医院针对医护人员的疫苗接种政策的信息。
我们于 2018 年对医院的疫苗接种政策以及实施推荐疫苗接种计划的障碍进行了全国性调查。在线调查问卷调查分发给 652 家医院，其中 200 家医院做出了回应。
在接受调查的 200 家医院中，有 151 家（75.5%）对至少一种 VPD 进行了入职前筛查计划，有 196 家（98%）实施了至少包含一种疫苗的接种计划。流感疫苗最常包含在其计划中（97.5%，n=195），其次是乙型肝炎疫苗（69%，n=138）。然而，<25%的医院将其他疫苗纳入其政策（麻疹-腮腺炎-风疹，24.5%；水痘，18.5%；百日咳，11%）。仅有 13 家（6.5%）医院将推荐给医护人员的五种疫苗纳入其政策。流感疫苗接种率的平均值为 89.9%，在全额资助疫苗接种费用的医院中显著更高（91.8% vs. 80.4%，P<0.001）。在资助流感疫苗的医院中，床位≥700 张的医院的覆盖率较低（-6.5%，P=0.003）。实施推荐疫苗接种政策的最大障碍是医院的经济负担（78.6%，121/154），其次是缺乏认识（21%）或活动（21%）以及缺乏领导力（17%）。
尽管针对医护人员接种疫苗有建议，但医院针对医护人员的疫苗接种政策存在差异，似乎不足以保护医护人员并防止医院内传播。每个医院都需要强有力的领导来保护医护人员，并需要政府的财政支持，以在医院中实施适当的疫苗接种政策。
