Volume 18, Number 8—August 2012
CME ACTIVITY
Vaccination of Health Care Workers to Protect Patients at Increased Risk for Acute Respiratory Disease
Gayle P. Dolan
, 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
, 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-TamTable A1
Characteristics of primary studies of the vaccination of HCWs to protect patients at risk for acute respiratory disease*
| Study | Study design | Setting | Intervention/exposure | No. HCWs | No. patients | Primary outcome in patient population | Duration of follow-up (no. influenza seasons) |
|---|---|---|---|---|---|---|---|
| Carman et al., 2000 (24) | Cluster RCT | Geriatric hospitals, Scotland | Routine offer of vaccination or no offer | 1,217 in intervention arm (620 vaccinated); not stated for control arm | 749 in intervention arm; 688 in control arm | All-cause mortality | 6 mo (1) |
| Potter et al., 1997 (25) | Cluster RCT | Geriatric hospitals, Scotland | Stratified by policy for patient vaccination; randomized to routine offer of influenza vaccine to HCWs or no vaccination of HCWs | 1,078 in intervention arm (440 HCWs, (of which 67% vaccinated), in vaccinated patient group, and 638 HCWs, (of which 57% vaccinated), in nonvaccinated patient group); not stated for control arm | 490 patients in HCW intervention arm (230 patients in vaccinated patient group and 260 in nonvaccinated patient group); 544 in control arm (283 in vaccinated patient group and 261 in nonvaccinated patient group) | All-cause mortality | 5 mo (1) |
| Lemaitre et al., 2009 (26) | Cluster RCT | Nursing homes, France | Promotional influenza vaccination campaign or provision of routine information | 989 in intervention arm (678 vaccinated); 1,015 in control arm | 1,722 intervention arm; 1,678 control arm | Al-cause mortality | 2.5 mo (1) |
| Hayward et al., 2006 (27) | Cluster RCT | Care homes, England | Staff influenza vaccination policy or policy of not actively promoting vaccination | Year 1: 1,610 in intervention arm (570 vaccinated); 1,674 in control arm. Year 2: 1,726 in intervention arm (517 vaccinated); 1,766 in control arm | Year 1: 1,233 intervention arm; 1,371 control arm. Year 2: 1,270 intervention arm; 1,391 control arm. | All-cause mortality | 8 mo (2) |
| Oshitani et al., 2000 (28) | Prospective cohort | Nursing homes/ geriatric health service facilities, Japan | Staff and patient influenza vaccination | 7,459 (1,532 vaccinated) | 12,784 (3,933 vaccinated) residents in 149 facilities | ILI cases | 3 mo (1) |
| Kanaoka et al., 2010 (29) | Cross-sectional study | Long-term care facility, Japan | Influenza vaccination of staff and patients | 179–188 over 7-y period (vaccination coverage 79%–91%) | 180–185 over 7-y period (vaccination coverage 45%–72%) | Influenza cases | Seven 6-mo periods (7) |
| Ando et al., 2010 (30) | Cross-sectional study | Hemodialysis clinics, Japan | Staff influenza vaccination coverage | 691–1,221 over 6-mo period (vaccination coverage 45%–87%) | 2,881–5,055 over 6-mo period (vaccination coverage not reported) | ILI cases | 6 mo (1) |
| Engels et al., 2005 (31) | Ecologic | Pediatric hospital, unknown | Staff influenza vaccination | Not stated. Vaccination coverage reported as negligible in 1999–2002 (before implementation); 48% in 2002 and 47% in 2003 (after implementation). | Not stated | Laboratory-diagnosed influenza | Exact duration not clear (3) |
| Weinstock et al., 2000 (32) | Ecologic | Adult oncology hospital, United States | Staff influenza vaccination with concurrent promotional campaign | Not clear. 1,457 vaccinated before implementation 1997–98 (12% of bone marrow transplant HCWs) and 1,956 vaccinated after implementation in 1998–99 (58% of bone marrow transplant HCWs) | Not stated | Laboratory-confirmed influenza | 7 mo (1) |
| Saito et al., 2002 (33) | Prospective cohort | Care home, Japan | Staff and patient influenza vaccination | Year 1: 440 (154 vaccinated). Year 2: 517 (360 vaccinated) | Year 1: 699 (331 vaccinated). Year 2: 930 (743 vaccinated) | ILI cases | 8 mo (2) |
| Munford et al., 2008 (34) | Ecologic | Extended-care unit, Canada | Staff influenza vaccination with concurrent promotional campaign | Numbers unknown. Vaccination coverage was 39% in 2005–06 (before implementation) 84% in 2006–07 and 83% in 2007–08 (after implementation) | Not specified. Reported to be ≈150 residents in unit | ILI cases | Exact duration not clear (3) |
| Shugarman et al., 2006 (35) | Cross-sectional study | Not stated; assumed care homes, United States | Staff and patient influenza vaccination coverage | 301 homes with 28,174 staff. Categorized as high uptake where >55% coverage and low where uptake <55%. | 301 homes with 30,371 patients. Categorized as high uptake where >89% coverage, low where <89% coverage. | ILI clusters | 8 mo (1) |
| Monto et al., 2004 (36) | Observational with case–control comparison | Nursing homes, United States | Staff influenza vaccination coverage | Not stated (mean vaccination coverage 32%) | Not stated (31 homes with mean of 136 residents and mean vaccination coverage 76%) | Laboratory-diagnosed influenza outbreaks | 5 mo (1) |
| Stevenson et al., 2001 (37) | Cross-sectional study | Long-term elderly care facilities, Canada | Staff and patient influenza vaccination coverage | Not reported (1,270 facilities responded in 1991, 430 in 1995, and 380 in 1999) | Not reported (1,270 facilities responded in 1991, 430 in 1995, and 380 in 1999) | ILI outbreaks | (1) |
*HCW, health care worker; RCT, randomized controlled trial; ILI, influenza-like illness.
