Elsevier

Vaccine

Volume 27, Issue 8, 18 February 2009, Pages 1242-1247
Vaccine

Willingness of healthcare workers to accept voluntary stockpiled H5N1 vaccine in advance of pandemic activity

https://doi.org/10.1016/j.vaccine.2008.12.006Get rights and content

Abstract

Healthcare workers may be at risk during the next influenza pandemic. Priming with stockpiled vaccine may protect staff and reduce nosocomial transmission. Despite campaigns to increase seasonal influenza vaccine coverage, uptake among healthcare workers is generally low; creating uncertainty whether they would participate in pre-pandemic vaccine programmes. We conducted a cross-sectional questionnaire survey of healthcare workers in a UK hospital during, and 6 months after, a period of media reporting of an H5N1 outbreak at a commercial UK poultry farm. A total of 520 questionnaires were returned, representing 20% of frontline workforce. More respondents indicated willingness to accept stockpiled H5N1 vaccine during the period of media attention than after (166/262, 63.4% vs. 134/258, 51.9%; p = 0.009). Following multivariate analysis, factors associated with willingness to accept H5N1 vaccine included: previous seasonal vaccine (OR 6.2, 95% CI 3.0–12.8, p < 0.0001), awareness of occupational seasonal vaccine campaigns (OR 2.2, 95% CI 1.4–3.5, p = 0.001), belief that seasonal vaccine benefits themselves (OR 2.5, 95% CI 1.6–4.0, p < 0.0001) or the hospital (OR 3.6, 95% CI 2.3–5.8, p < 0.0001), belief that pandemic risk is high/moderate (OR 14.1, 95% CI 7.6–26.1, p < 0.0001) and would threaten healthcare workers (OR 2.9, 95% CI 1.8–4.5, p < 0.0001). Those who would not accept vaccine (220 respondents, 42.7%) if offered before the pandemic do not perceive pandemic influenza as a serious threat, and have concerns regarding vaccine safety. A majority of healthcare workers are amenable to accept stockpiled H5N1 vaccine if offered 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)

  • I. Stephenson et al.

    Healthcare workers and their attitudes to influenza vaccination

    Commun Dis Public Health

    (2002)
  • R.T. Lester et al.

    Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff

    Infect Control Hosp Epidemiol

    (2003)
  • Cited by (0)

    View full text