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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. 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 A3

Cases and consultation for laboratory-diagnosed influenza in a review of the vaccination of HCWs 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)
Laboratory-diagnosed influenza
Carman et al. (24) Cluster RCT Nasal and oropharyngeal swabs (tissue culture/RT-PCR) Difference in proportions Routine surveillance, p = 0.42; opportunistic sampling, p = 0.54
Thomas et al (19) Pooled data† OR, adjusted for clustering 0.87 (0.38–1.99), p = 0.74
Weinstock et al. (32) Ecologic Clinical definition plus positive shell viral assay, enzyme immunoassay, or tissue culture Difference in proportions (before to after implementation) 72.1% decrease, p<0.01
Engels et al. (31) Ecologic Nasopharyngeal aspirate culture Difference in proportions (before to after implementation) p<0.001, all children); p = 0.05, children with underlying disease; p<0.05, children <24 mos
Laboratory-diagnosed outbreaks of ILI, Monto et al. (36) Cohort with case–control analysis Laboratory confirmation of cases by using rapid antigen detection testing, viral cell culture, or RT-PCR Difference in proportions Median staff vaccination coverage in homes with outbreaks = 42% vs. 24% in homes without outbreaks, p>0.05

*HCW, health care worker; RCT, randomized controlled trial; RT-PCR, reverse transcription PCR; OR, odds ratio. Boldface indicates statistical significance. Shading indicates pooled data.
†Pooled by using data from Potter and Carman but no estimate of effect reported by Potter et al.

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