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Volume 18, Number 8—August 2012

CME ACTIVITY - Synopsis

Vaccination of Health Care Workers to Protect Patients at Increased Risk for Acute Respiratory Disease

Gayle P. DolanComments to Author , Rebecca C. Harris, Mandy Clarkson, Rachel Sokal, Gemma Morgan, Mitsuru Mukaigawara, Hiroshi Horiuchi, Rachel Hale, Laura Stormont, Laura Béchard-Evans, Yi-Sheng Chao, Sergey Eremin, Sara Martins, John S. Tam, Javier Peñalver, Arina Zanuzdana, and Jonathan S. Nguyen-Van-Tam

Author affiliations: University of Nottingham, Nottingham, UK (G.P. Dolan, R. Hale, J.S. Nguyen-Van-Tam); World Health Organization, Geneva, Switzerland (R.C. Harris, M. Mukaigawara, L. Stormont, Laura Béchard-Evans, Y.-S. Chao, S. Eremin, S. Martins, J.S. Tam, J. Peñalver); National Health Service Derbyshire County, Chesterfield, UK (M. Clarkson, R. Sokal); Health Protection Agency South West, Gloucester, UK (G. Morgan); Tokyo Medical Dental University, Tokyo, Japan (H. Horiuchi); and University of Bielefeld, Bielefeld, Germany (A. Zanuzdana)

Main Article

Table 5

Measures of death in a review of the vaccination of health care workers to protect patients at risk for acute respiratory disease*

Outcome measure and study Study design Method of assessment Measure of effect in patient population Effect estimate (95% CI), p value
All-cause mortality
Potter et al. (25) Cluster RCT Death certificate OR, vaccinated and nonvaccinated patients 0.56 (0.40–0.80)†
OR, vaccinated patients 0.57 (0.35–0.91)†
OR, nonvaccinated patients 0.56 (0.34–0.94)†
Carman et al. (24) Cluster RCT Not stated OR 0.62 (0.36–1.04), p = 0.092
Hayward et al. (27) Cluster RCT Reporting by lead nurse Rate difference, epidemic period 1 –0.05 (–0.07 to –0.02), p = 0.002
Rate difference, epidemic period 2 –0.01 (–0.04 to 0.02), p = 0.49
Rate difference, nonepidemic period 1 0.00 (–0.03 to 0.03), p = 0.93
Rate difference, nonepidemic period 2 0.01 (–0.03 to 0.04), p = 0.70
Lemaitre et al. (26) Cluster RCT Not stated OR 0.86 (0.72–1.02), p = 0.08
Thomas et al. (19) Pooled data OR, adjusted for clustering 0.68 (0.55–0.84), p<0.001
Respiratory deaths: Lemaitre et al. (26) Cluster RCT Reporting by study nurses OR 1.55 (0.59–4.10), p = 0.38
Pneumonia-associated deaths
Potter et al. (25) Cluster RCT Reporting by lead nurse OR, vaccinated and nonvaccinated patients 0.60 (0.37–0.97)†
OR, vaccinated patients 0.56 (0.28–1.13)†
OR, nonvaccinated patients 0.64 (0.33–1.23)†
Thomas et al. (19) Pooled data Risk ratio, adjusted for clustering 0.87 (0.471.64), p = 0.67
Death with influenza-like illness
Hayward et al. (27) Cluster RCT Reporting by lead nurse Rate difference, epidemic period 1 –0.01 (–0.02 to 0.01), p = 0.24
Rate difference, epidemic period 2 –0.01 (–0.03 to 0.00), p = 0.08
Rate difference, nonepidemic period 1 –0.01 (–0.04 to 0.02), p = 0.59
Rate difference, nonepidemic period 2 0.01 (–0.01 to 0.02), p = 0.35
Thomas et al. (19) Pooled data OR, adjusted for clustering 0.72 (0.31–1.70), p = 0.45
Laboratory-diagnosed influenza at death: Carman et al. (24) Cluster RCT Nasal swab within 12 h before death Difference in proportions, influenza positive at death 20%, p = 0.055

*RCT, randomized controlled trial; OR, odds ratio. Boldface indicates statistical significance. Shaded fields represent pooled data.
†p value not reported.

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