engleski

Vaccination agains infuluenza in healthcare workers

Respiratory disease is a leading cause of deaths worldwide, and influenza and pneumococcal infections are major contributors. Certain groups, such as persons >65 years of age or with chronic underlying health problems are particularly vulnerable to severe respiratory disease and have poorer outcomes after infection than does the general population. Therefore effective vaccine and non- vaccine interventions are important to reduce the global burden of respiratory diseases. Vaccination against influenza is the best way to prevent the influenza virus infection, as well as development of the disease and its complications. However, severe respiratory infections occur despite high vaccine coverage rates among patients. Evidence from some outbreaks suggests that transmission from healthcare workers (HCWs) to patients is likely since they often continue to work when infected with influenza. Observational studies have demonstrated that high vaccination rates among HCWs indirectly protect those patients who have not been vaccinated and is associated with decreased deaths from all causes including pneumonia among elderly and nursing home patients. However, to prevent the spread of influenza, vaccination rates among HCWs should exceed 80%. Despite recommendations that HCWs should be vaccinated annually, coverage levels in Europe are variable and uptake poor (less than 25%). Available vaccination records from Croatian hospitals in five subsequent seasons (2006 to 2010) revealed changing trends after introducing 2009 pandemic influenza pH1N1 vaccine. Until 2010, median HCWs vaccination rates were stable, 34% (range from 29 do 38%). Physicians were more likely to be vaccinated than nurses and other hospital staff (31% vs 24% vs 21%, p<0.05). While 2009 seasonal influenza vaccination had similar trends as previous one (overall 37%), the estimated vaccination rate against pH1N1 was <5%. In 2010, only 18% of HCWs were vaccinated with a significant decrease in all analyzed institutions. HCWs who decline vaccination frequently express doubts about the risk for influenza and the need for vaccination, and are concerned about vaccine’s effectiveness and efficacy. As satisfactory vaccination rates among HCWs were not achieved through voluntary vaccination, mandatory vaccination is being introduced on the global level. However, solutions to the problem of low uptake must rest on strong justification from pragmatic, epidemiological, and ethical perspectives, underscored by strong evidence.

influenza; vaccination; HBV; health care workers

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