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医护人员职业健康监测计划中的疫苗接种情况及工作适宜性:一项意大利回顾性队列研究

Vaccination Offer during the Occupational Health Surveillance Program for Healthcare Workers and Suitability to Work: An Italian Retrospective Cohort Study.

作者信息

Bianchi Francesco Paolo, Stefanizzi Pasquale, De Maria Luigi, Martinelli Andrea, Diella Giusy, Larocca Angela Maria Vittoria, Vimercati Luigi, Tafuri Silvio

机构信息

Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70124 Bari, Italy.

Hygiene Unit, Bari Policlinico General Hospital, 70124 Bari, Italy.

出版信息

Vaccines (Basel). 2022 Sep 28;10(10):1633. doi: 10.3390/vaccines10101633.

Abstract

The active immunization of health care workers (HCWs) is a crucial measure to avoid nosocomial infection; nevertheless, vaccine coverage (VC) among health personnel in Italy is unsatisfactory. To improve VC in the healthcare set, the Hygiene and Occupational Medicine departments of Bari Policlinico General University Hospital applied a specific program. The operative procedure demands that in the context of the occupational medical examination, all workers are evaluated for susceptibility to vaccine-preventable diseases (VDPs), with immunization prophylaxis offered to those determined to be susceptible. This study analyzed data from workers who attended the biological risk assessment protocol from December 2017 to October 2021 ( = 1477), who were evaluated for the immune status for measles, mumps, rubella, and varicella. Among the enrolled subjects, non-protective antibody titers were higher for measles and mumps (13%), followed by rubella (11%) and varicella (8%). Appropriate vaccinations were offered to all susceptible HCWs, and HCWs were re-tested one month after immunization. The seroconversion rate after the administration of one or more booster dose(s) was over 80%. Overall, 2.5% of the subjects refused the offered vaccine(s); the main determinant of immunization compliance was younger age (aOR = 0.86; 95%CI = 0.80-0.92). Especially during the COVID-19 pandemic, VPDs may still present a hazard in nosocomial environment. Our experience suggests that, despite hospital procedures and dedicated human assets, satisfactory VC cannot be reached without the provision of federal regulations. Nevertheless, public health policymakers have to improve the promotion of vaccine prophylaxis and education to reach higher VC.

摘要

医护人员的主动免疫是避免医院感染的关键措施;然而,意大利卫生人员的疫苗接种率(VC)并不理想。为提高医疗机构中的疫苗接种率,巴里综合大学医院的卫生与职业医学部门实施了一项特定计划。操作程序要求在职业医学检查过程中,对所有工作人员进行疫苗可预防疾病(VDPs)易感性评估,为确定易感的人员提供免疫预防措施。本研究分析了2017年12月至2021年10月参加生物风险评估方案的工作人员(n = 1477)的数据,这些人员接受了麻疹、腮腺炎、风疹和水痘免疫状态评估。在登记的受试者中,麻疹和腮腺炎的非保护性抗体滴度较高(13%),其次是风疹(11%)和水痘(8%)。为所有易感医护人员提供了适当的疫苗接种,医护人员在免疫接种后1个月重新进行检测。接种一剂或多剂加强针后的血清转化率超过80%。总体而言,2.5%的受试者拒绝接种提供的疫苗;免疫接种依从性的主要决定因素是年龄较小(调整后比值比 = 0.86;95%置信区间 = 0.80 - 0.92)。特别是在新冠疫情期间,VDPs在医院环境中可能仍然构成危害。我们的经验表明,尽管有医院程序和专门的人力资源,但如果没有联邦法规,就无法达到令人满意的疫苗接种率。然而,公共卫生政策制定者必须加强疫苗预防的推广和教育,以实现更高的疫苗接种率。

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