Ratti Matteo, Rescinito Riccardo, Gigante Domenico, Lontano Alberto, Panella Massimiliano
Department of Translational Medicine (DiMeT), Università del Piemonte Orientale, 28100 Novara, Italy.
Azienda Ospedaliero Universitaria Maggiore della Carità, 28100 Novara, Italy.
Nurs Rep. 2025 Mar 3;15(3):87. doi: 10.3390/nursrep15030087.
Seasonal influenza currently remains a major public health concern for the community and, in particular, the health care worker (HCW). According to the World Health Organization, HCWs are among the high-risk categories for which vaccination is recommended, due to the derived absenteeism, productivity loss, and high probability of transmitting the disease to vulnerable individuals or patients. Therefore, an HCW vaccination policy should be adopted by every health care provider. There is growing evidence that a time effect of the vaccination event is probable, which may influence vaccine effectiveness. We designed and conducted an observational study to investigate the time to anti-influenza vaccination event of different categories of HCWs belonging to different occupational settings in a tertiary hospital during three seasons in order to retrieve some insight about HCW prioritization when designing vaccination campaigns. We retrospectively analyzed the results of two HCW anti-influenza vaccination campaigns (2022 and 2023) to assess any difference regarding job typology and unit typology (critical care, surgical, medical, service). We first fitted a classic Cox proportional hazard model and then an AI random forest model to assess variable importance. We used R, RStudio, and the survex package. Overall, other HCWs reported a lower vaccination rate compared to nurses (HR 0.77; 95%CI 0.62-0.97), and service unit personnel appeared to more likely be vaccinated (HR 1.42; 95%CI 1.01-1.99) compared to those belonging to the critical care units. As expected, older workers tended to be vaccinated more frequently (HR 1.70 for the (46, 65] category compared to the younger one; 95%CI 1.39-2.09). The variable importance analysis showed consistent superiority of the ward typology and age category variables with respect to time. During the entire timeline, the ward typology appeared to be more important than the HCW typology. Our results suggest a prioritization policy based firstly on the unit typology followed by the job typology for HCW anti-influenza campaigns.
季节性流感目前仍然是社区，尤其是医护人员面临的主要公共卫生问题。根据世界卫生组织的说法，医护人员属于建议接种疫苗的高风险类别，因为这会导致缺勤、生产力损失，以及将疾病传播给弱势群体或患者的可能性很高。因此，每个医疗服务提供者都应采用医护人员疫苗接种政策。越来越多的证据表明，疫苗接种事件可能存在时间效应，这可能会影响疫苗效果。我们设计并开展了一项观察性研究，以调查一家三级医院不同职业环境的不同类别医护人员在三个季节中进行抗流感疫苗接种的时间，以便在设计疫苗接种活动时获得有关医护人员优先级的一些见解。我们回顾性分析了两次医护人员抗流感疫苗接种活动（2022年和2023年）的结果，以评估工作类型和科室类型（重症监护、外科、内科、服务）方面的任何差异。我们首先拟合了一个经典的Cox比例风险模型，然后拟合了一个人工智能随机森林模型来评估变量的重要性。我们使用了R、RStudio和survex软件包。总体而言，与护士相比，其他医护人员的疫苗接种率较低（风险比0.77；95%置信区间0.62 - 0.97），与重症监护病房的人员相比，服务科室人员似乎更有可能接种疫苗（风险比1.42；95%置信区间1.01 - 1.99）。正如预期的那样，年长的工作人员往往接种频率更高（与年轻人员相比，年龄在(46, 65]岁的类别风险比为1.70；95%置信区间1.39 - 2.09）。变量重要性分析表明，病房类型和年龄类别变量在时间方面具有一致的优势。在整个时间范围内，病房类型似乎比医护人员类型更重要。我们的结果表明，医护人员抗流感活动的优先级政策应首先基于科室类型，其次是工作类型。
