Influenza Vaccine among Health Workers
Influenza Vaccine among Health Workers
Evidently, the human body possesses a remarkable capability, which can however be jeopardized by disease. Influenza occurs as one of the widely discussed diseases whose influence on humans has and continues to raise immense concern across various contexts all over the globe. This can be accredited to the fact that this disease occurs as one of the leading causes of respiratory infections. In fact, influenza remains a significant cause of mortality amongst the elderly populations aged above 65 years. Worth noting is the fact that the pathogenicity of influenza is dependent on environmental factors; hence grouping the elderly in the long term care centres create an environment where the disease can spread rapidly. Many at times, health care workers are predisposed to influenza because they often come in contact with patients suffering from this disease. As such, notions have been proposed on the need to vaccinate health care workers against this disease. This has created a contentious debate pitting those opposed to and those in support of such vaccination (Thomas et al., 1993).
Accessed through the Emerald database, Carman et al., (2000) article “Effects of Influenza Vaccination of Healthcare Workers on the Mortality of Elderly People in Long Term Care: a Randomized Control Trial” offers a critical analysis on various issues regarding influenza vaccination. In fact, the article is based on an empirical study carried out with the sole aim of examining whether immunization of health care workers could reduce the mortality and prevalence of influenza amongst the elderly. Carman at al. study, the participants comprised of close to 1,217 health care workers. Of this proportion, close to 50.9%: 620 health care workers had been immunized against influenza. This study included 1,437 patients.
On another note, the article “Vaccination of Healthcare Workers: a Literature Review of Attitudes and Beliefs” by Hoffmann et al. (2006) offers critical insights regarding the possible reasons that contribute to the success or failure of influenza vaccination programs. This article is based on a study that was carried out with the sole intent of establishing the beliefs and attitudes of health care workers towards influenza vaccination. Published in the Journal of Clinical and Epidemiological Study Hoffmann et al. (2006) reviews close to thirty two primary publications that dwelled on influenza vaccination amongst health care workers form the year 1985 to the year 2002. Of the thirty two publications, twenty five of them examined the attitudes that health care workers had with regards to influenza vaccination. As such this article offers succinct insights on matters aligned with heath care workers attitudes towards influenza vaccination. This article notes that the approximate vaccination rates amongst health care workers as indicated in the reviewed publications ranged from 2.1% to 82%.
Appearing in JSTOR database, Steiner et al. 2002 article “Factors Influencing Decisions Regarding Influenza Vaccination and Treatment: A Survey of Healthcare Workers” is another article that offers critical insights regarding the topic on influenza vaccination amongst health care workers. This article is based on a survey that was carried out at the university of Wisconsin hospitals and clinics. Precisely, the survey aimed at assessing the factors that increase acceptance of influenza vaccination by the health care workers. Similarly, the survey sought to find the opinion that heath care workers have towards incentives towards prevention and treatment of influenza. In the current study, data collection on the subject demographics, medical history, influenza exposure potential and reasons for receiving or rejecting the vaccination were done accordingly. In addition, information on their willingness to pay for vaccine as well as how to consider the availability of new influenza medications for prophylaxis treatment might affect their decision making.
Poland et al. (2008) article is yet another crucial source that explores in different issues pertaining the need to immunize health care workers against influenza. This article also appears in JSTOR database and is a peer reviewed article whose content is of immense significance on matters regarding influenza vaccination. In this article, the perceptions held by registered nurses on strategies for preventing influenza were examined. Data from Poland et al., 2008 were drawn from a representative population of close to on thousand registered nurses working under Mayo Clinic. This research was closely aligned with the need to assess the perceptions of health care workers towards mandatory vaccination policies. Notably, this survey utilized close to the 93-item questionnaire, which evaluated the participant’s receptivity to mandatory policies on influenza vaccination and immunization.
In yet another study on matters regarding influenza vaccination, Delden et al., 2008 notes that vaccination of health care workers against influenza have a reciprocal effect of reducing the incidences of influenza amongst patients who are more predisposed to a wider array of diseases. Despite this, the current article notes that voluntary uptake of influenza vaccine by health care workers is low. For this purpose, mandatory influenza vaccination of health care workers is justified. This is because such vaccination will reduce the incidences of influenza amongst the elderly, who are more vulnerable to this disease. In a nutshell, this article identifies the fact that it is the duty of every health care worker to advocate for good health of the patients. As such, acceptance of influenza vaccination by health care workers is a substantive indicator of their commitment to patient care.
Finally, Nichol et al., 1995 article named “The Effectiveness of Vaccination against Influenza in Healthy, Working Adults” notes that annual vaccination against influenza should be mandatory amongst populations who are at high risk of the disease. Nichol et al., 2008 study utilized a randomized control study design whereby adults aged 18 to 64 years were randomly selected and partitioned into two groups. One group received influenza vaccine, whereas the other group was given a placebo. Conclusively, Nichol et al. (1995) sought to clarify the beneficial outcomes on immunization among the subjects. Specifically, they sought to examine the effects of vaccination on rate of upper respiratory illness, use of health care services and sick leave from work among health care workers.
A close analysis of the current articles shows that the factors that determine vaccine acceptance and reception are relatively similar to those identified by previous studies. 75% of individuals who had received influenza vaccine were willing to make personal payments for the same. Despite the obvious benefits of vaccination against influenza, only 62% of health care workers supported the need for vaccination. On a similar note, there was a 33% drop out in the uptake of influenza vaccine in the subsequent programs. This shows that there exist a wider array of issues that jeopardize uptake of influenza vaccine. Despite the existence of alternative options, vaccine recipients would still opt for vaccination because they perceived that prevention is essential. Of all the health care workers, nurses exhibited an increased preference for vaccination when compare to other health care workers.
Of the 513 respondents interviewed on the matter in influenza vaccination, close to 426 confessed that the vaccine was significant in preventing the occurrence of influenza. On matters aligned with mandatory influenza vaccination, 55.2% vaccination was reported. This indicates that of all the registered nurses, only 283 were in support of the framework. Notably, 59.3% of the respondents were in support of a policy that called for the vaccination of all health care workers who are often in direct contact with patients. Those opposed to such calls were not certain on these policies. On another note, past vaccination against influenza influenced the respondent’s opinions on mandatory influenza vaccination. Precisely, those who had received influenza vaccine in the past supported the need to mandatory influenza vaccination. Similarly, nurses with adequate information regarding influenza confided that mandatory influenza vaccination was pertinent (Galanakis et al., 2003).
Deductively, there is no doubt that the placebo-controlled trial has benefits that vaccination against influenza offers for healthy working health care workers. Vaccination reduced the rate of upper respiratory infection by 25%, work absenteeism and the number of visits to physicians. It was also estimated that vaccination was cost-effective considering the cost savings of 46.85 dollars per individual who received the vaccination. Immunization of the elderly against influenza clearly is economical. Analyses of the influenza vaccine in healthy young adults also indicate that it is cost effective and possibly cost saving (Nichol et al., 1995).
Undeniably, acceptance of mandatory influenza vaccine amongst health care workers remains a matter of immense concern across various health care context. From the above results, 50% uptake of influenza vaccine results in a 4% reduction in mortality rate of elderly patients receiving long term care and treatment. According to the Canadian National Advisory Committee on Immunization (NACI) the minimum influenza immunization rate should be 90% of all the eligible recipients. The WHO and ACIP state coverage rates of 50%-90% for the elderly population and 60% for high risk adults, but none for health care workers. The current influenza vaccination coverage is far below the figures: 26-61% in Canada, 38% in the USA and 12-25% in Europe. For this reason, there is the need to strategies aimed at increasing uptake of the influenza vaccine (Hofmann et al., 2006).
Those in support of influenza vaccination reported that the vaccine was convenient as it was offered at no cost, and it also minimizes the chances of missing work. In addition, 50% of the previously immunized populations desired the vaccine because it offers prevention. On the other hand, those opposed to influenza vaccination noted that such vaccination would led to disease. Those opposed to the vaccine had a dislike for needs and injections. Besides, others perceived that they had a lower risk of contracting influenza (Delden et al., 2008). Worth noting is the fact that there was a proportion of employees who were concerned with the contraindication of the vaccine. Such notions are false because there are no contraindications; hence, there is the need to educate such populations on the same. Arguably, cold-adapted, intranasal administered influenza vaccine can be utilized as an alternative for populations who are aversive to injection or needles.
Other issues that raise a number of concern regarding the mandatory vaccination of health care workers include issues on effectiveness and efficacy of such vaccination. This can be attributed to the fact that immunization against influenza reduces the mortality rates amongst patients, but does not result in a reduction of influenza incidences. There also exists concerns on the barriers to uptake, which cannot be addressed adequately by strategies aligned with creating awareness amongst the population on the same. Such barriers include lack of education and information regarding vaccination. These barriers are exemplified by misperception on influenza, its risks, and the role of health care workers in its transmission. Besides, the barrier of lack of vaccination forms a critical backlog for vaccine uptake (Thomas et al., 1993).
Notably, various arguments have been developed in support and opposition of influenza vaccination. Arguments in favour of mandatory vaccination include the duty of not causing harm to others and special obligations for the health care workers. The other argument for vaccine uptake among health care workers is consistency as depicted by the eligibility of health care workers who are aware of the need to be consistent with institutions. The arguments against mandatory vaccination include freedom of choice by the health care workers and options to mandatory vaccination programmes. Other arguments are exemplified by mandatory programmes that may lead to opportunity costs, and that vaccination is only in the interest of the employer (Poland et al., 2008).
Carman, W., Elder, A., Wallace, L., McAulay, K., Walker, A., Murray, G., & Stott, D. (2000). Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet, 93-97.
Delden, J., Ashcroft, R., Dawson, A., Marckmann, G., Upshur, R., & Verweij, M. (2008). The ethics of mandatory vaccination against influenza for health care workers. Vaccine, 5562–5566.
Galanakis, E., Jansen, A., Lopalco, P., & Giesecke, J. (2013). Ethics of mandatory vaccination for healthcare workers. Euro Surveillance, 1-8.
Hofmann, F., Ferracin, C., Marsh, G., & Dumas, R. (2006). Influenza Vaccination of Healthcare Workers: a Literature Review of Attitudes and Beliefs. Infection, 142-147.
Nichol, K., Lind, A., Margolis, K., Murdoch, M., McFadden, R., Hauge, M., Drake, M. (1995).The effectiveness of vaccination against influenza in healthy, working adults. The New England Journal of Medicine, 889-893.
Poland, G., Ofstead, C., Tucker, S., & Beebe, T. (2008). Receptivity to Mandatory Influenza Vaccination Policies for Healthcare Workers Among Registered Nurses Working on Inpatient Units. Infection Control and Hospital Epidemiology, 170-173.
Steiner, M., Vermeulen, L., Mullahy, J., & Hayney, M. (2002). Factors Influencing Decisions Regarding Influenza Vaccination and Treatment: A Survey of Healthcare Workers. Infection Control and Hospital Epidemiology, 625-627.
Thomas, D., Winsted, B., & Koontz, C. (1993). Improving neglected influenza vaccination among healthcare workers in long-term care. Journal of American Geriatric Society, 928-930.