Willingness of healthcare workers to accept voluntary stockpiled H5N1 vaccine in advance of pandemic activity
Introduction
Seasonal influenza poses a hazard in hospitals where outbreaks can increase duration of stay and mortality among patients [1], [2]. As healthcare workers are recognised to be both introducers and reservoirs of influenza virus in the hospital setting, their vaccination is an important strategy to reduce the frequency and mortality of nosocomial outbreaks [2], [3], [4]. Although vaccination of healthcare workers also reduces rates of influenza-related illness and absenteeism among recipients [5], [6], seasonal vaccine uptake among healthcare workers in the UK [3], [7], [8] and elsewhere [7], [9], [10], [11], [12], [13] is often low. Barriers to increasing coverage of seasonal influenza vaccination include inconvenience to obtain vaccine, belief that influenza is a mild illness, and concerns over vaccine efficacy or adverse reactions [1], [8], [9], [12], [13], [14].
The spread of highly pathogenic avian influenza H5N1 has generated media interest in pandemic preparedness. In the UK, an H5N1 outbreak at a commercial poultry farm attracted heightened media attention during February 2007 [15]. During the next pandemic, immunological susceptible healthcare workers are likely to be at increased risk of infection and illness from patients, and may contribute to nosocomial transmission. As shortfalls in the availability of well-matched specific vaccine are predicted at the onset of the pandemic, some authorities have already purchased H5N1 vaccine stockpiles for proactive advance use. Pre-pandemic priming of first responders, including healthcare workers has been suggested [16], [17], [18]. However, it is uncertain how willing healthcare workers would be to receive voluntary ‘pre-pandemic’ H5N1 vaccine from stockpiles. As seasonal vaccine coverage is influenced by their perceptions of influenza, we surveyed healthcare workers in a large UK teaching hospital, during and after a period of heightened H5N1 media attention, to identify their willingness to accept stockpiled H5N1 vaccine if offered to them.
Section snippets
Study timing, subjects and setting
In February 2007, during a well-publicised H5N1 outbreak at a Suffolk poultry farm [15], a cross-sectional questionnaire survey was conducted amongst staff at University Hospitals Leicester NHS Trust which comprises 1500 beds and 7000 employees. The study was repeated 6 months later, in August 2007, among those who had not been previously surveyed. We aimed to sample 10% of 2500 ‘frontline’ employees estimated to have regular patient contact on each occasion, to total 20% of the workforce.
Results
In total, 525 questionnaires were distributed; 520 (262 and 258 in February and August 2007, respectively) were returned representing a 99% response rate and estimated frontline workforce sample of 20.8%.
Discussion
This study examines the willingness of a frontline healthcare workforce in a UK secondary care setting towards the acceptance of a pre-pandemic stockpiled H5N1 vaccination strategy, during and after a period of heightened media reporting of H5N1. As expected, significantly more respondents would have accepted vaccine at the time of heightened media attention. However, a majority of frontline workers still indicated willingness to accept stockpiled H5N1 vaccine even after this period.
The
References (24)
- et al.
Influenza in the acute hospital setting
Lancet Infect Dis
(2002) - et al.
Influenza vaccination among primary healthcare workers
Vaccine
(2008) - et al.
Influenza vaccination acceptance among health-care workers: a nationwide survey
Vaccine
(2008) - et al.
Vaccinating healthcare workers against influenza to protect the vulnerable—is it a good use of healthcare resources?: a systematic review of the evidence and an economic evaluation
Vaccine
(2006) - CDC. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices...
- et al.
Vaccination against influenza: UK health care workers not on message
Occup Med
(2002) - et al.
Influenza vaccination levels and influenza-like illness in long-term-care facilities for elderly people in Niigata, Japan, during an influenza A (H3N2) epidemic
Infect Control Hosp Epidemiol
(2000) - et al.
Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers
Pediatr Infect Dis J
(1999) - et al.
Effectiveness of influenza vaccine in health care professionals: a randomized trial
J Am Med Assoc
(1999) - et al.
Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons
BMC Public Health
(2008)