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Volume 18, Number 8—August 2012

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

Gayle P. DolanComments to Author , Rebecca M. 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 1

Risk for bias assessed by using the Cochrane Collaboration tool in a review of the vaccination of health care workers to protect patients at risk for acute respiratory disease

Study Sequence generation Allocation concealment Blinding of participants, personnel and outcome assessors
Incomplete outcome data
Selective outcome reporting Other sources of bias
Primary outcome Secondary outcomes Primary outcome Secondary outcomes
Lemaitre et al. (26)
Hayward et al. (27)
Carman et al. (24)
Potter et al. (25)
Saito et al. (33)
Oshitani et al. (28)

*Black shading, low risk of bias; light gray shading, uncertain risk of bias; dark gray shading, high risk of bias; blank cells, no secondary outcome measure reported.

Main Article

  1. World Health Organization. WHO guidelines for pharmacological management of influenza. Revised February 2010. Part 1: recommendations [cited 2010 Dec 10].
  2. Weingarten  S, Friedlander  M, Rascon  D, Ault  M, Morgan  M, Meyer  RD. Influenza surveillance in an acute-care hospital. Arch Intern Med. 1988;148:1136. DOIPubMedGoogle Scholar
  3. Jacomo  V, Sartor  C, Zandotti  C, Atlan-Gepner  C, Drancourt  M. Nosocomial influenza outbreak in an intensive-care unit. Med Mal Infect. 2001;31:5638. DOIGoogle Scholar
  4. Rivera  M, Gonzalez  N. An influenza outbreak in a hospital. Am J Nurs. 1982;82:18368.PubMedGoogle Scholar
  5. Horcajada  JP, Pumarola  T, Martinez  JA, Tapias  G, Bayas  JM, de la Prada  M, A nosocomial outbreak of influenza during a period without influenza epidemic activity. Eur Respir J. 2003;21:3037. DOIPubMedGoogle Scholar
  6. Malavaud  S. Nosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation. 2001;72:5357. DOIPubMedGoogle Scholar
  7. Hall  CB, Douglas  RG. Nosocomial influenza infection as a cause of intercurrent fevers in infants. Pediatrics. 1975;55:6737.PubMedGoogle Scholar
  8. Lester-Smith  D, Zurynski  YA, Booy  R, Festa  MS, Kesson  AM, Elliott  EJ. The burden of childhood influenza in a tertiary paediatric setting. Commun Dis Intell. 2009;33:20915.PubMedGoogle Scholar
  9. Meibalane  R. Outbreak of influenza in a neonatal intensive care unit. J Pediatr. 1977;91:9746. DOIPubMedGoogle Scholar
  10. Strausbaugh  LJ, Sukumar  SR, Joseph  CL. Infectious disease outbreaks in nursing homes: an unappreciated hazard for frail elderly persons. Clin Infect Dis. 2003;36:8706. DOIPubMedGoogle Scholar
  11. Nuorti  JP, Butler  JC, Crutcher  JM, Guevara  R, Welch  D, Holder  P, An outbreak of multi-drug resistant pneumococcal pneumonia and bacteremia among unvaccinated nursing home residents. N Engl J Med. 1998;338:18618. DOIPubMedGoogle Scholar
  12. Yassi  A, McGill  M, Holton  D, Nicolle  L. Morbidity, cost and role of healthcare worker transmission in an influenza outbreak in a tertiary care hospital. Can J Infect Dis Med Microbiol. 1993;4:526.
  13. Pachucki  CT. Influenza A among hospital personnel and patients: implications for recognition, prevention and control. Arch Intern Med. 1989;149:7780. DOIPubMedGoogle Scholar
  14. Catalyud  L. Six C, Duponchel J, Sillam F, Charlet F, Leussier J, et al. Épisodes de grippe dans deux établissements d’hébergement pour personnes âgées dans les Bouches-du-Rhône, France, mars-avril 2008. Bulletin épidémiologique hebdomadaire. 2009;18–19:189–192.
  15. Elder  AG, O’Donnell  B, McCruden  EAB, Symington  IS, Carman  WF. Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993–4 epidemic: results of serum testing and questionnaire. BMJ. 1996;313:12412. DOIPubMedGoogle Scholar
  16. Wilde  JA, McMillan  JA, Serwint  J, Butta  J, O’Riordan  MA, Steinhoff  MC. Effectiveness of influenza vaccine in healthcare professionals. JAMA. 1999;281:90813. DOIPubMedGoogle Scholar
  17. Centers for Disease Control and Prevention. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59:15.PubMedGoogle Scholar
  18. Burls  A, Jordan  R, Barton  P, Olowokure  B, Wake  B, Albon  E, 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;24:421221. DOIPubMedGoogle Scholar
  19. Thomas  RE, Jefferson  T, Lasserson  TJ. Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database Syst Rev. 2010;(2):CD005187.PubMedGoogle Scholar
  20. Higgins  JPT, Sally Green  S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [cited 2010 Dec 10].
  21. Downs  SH, Black  N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of healthcare interventions. J Epidemiol Community Health. 1998;52:37784. DOIPubMedGoogle Scholar
  22. West  S, King  V, Carey  T, Lohr  K, McKoy  N, Sutton  S, Systems to rate the strength of scientific evidence. Evidence report/technology appraisal number 47. Rockville (MD): Agency for Healthcare Research and Quality; 2002 [cited 2012 May 30].
  23. Centre for Reviews and Dissemination. Systematic reviews. CRD’s guidance for undertaking reviews in healthcare. York (UK): The Centre, University of York; 2008.
  24. Carman  WF, Elder  AG, Wallace  LA, McAulay  K, Walker  A, Murray  GD, Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet. 2000;355:937. DOIPubMedGoogle Scholar
  25. Potter  J, Stott  DJ, Roberts  MA, Elder  AG, O’Donnell  B, Knight  PV, Influenza vaccination of healthcare workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis. 1997;175:16. DOIPubMedGoogle Scholar
  26. Lemaitre  M, Meret  T, Rothan-Tondeur  M, Belmin  J, Lejonc  J, Luquel  L, Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc. 2009;57:15806. DOIPubMedGoogle Scholar
  27. Hayward  AC, Harling  R, Wetten  S, Johnson  AM, Munro  S, Smedley  J, Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ. 2006;333:12412. DOIPubMedGoogle Scholar
  28. Oshitani  H, Saito  R, Seki  N, Tanabe  N, Yamazaki  O, Hayashi  S, Influenza vaccination levels and influenza like illness in long term care facilities for elderly people during an Influenza A (H3N2) epidemic. Infect Control Hosp Epidemiol. 2000;21:72830. DOIPubMedGoogle Scholar
  29. Kanaoka  S. Inpatient and personnel vaccination influence on influenza outbreaks in long-term medical and care hospital [in Japanese]. Kansenshogaku Zasshi. 2010;84:148.PubMedGoogle Scholar
  30. Ando  R, Kaname  S, Yoshida  M, Murakami  A, Kurimoto  Y, Higaki  M, Survey of novel influenza A (H1N1) infection and vaccination in dialysis facilities in the Tokyo Tama area [in Japanese]. Nihon Toseki Igakki Zasshi. 2010;43:8917.
  31. Engels  O, Goldman  N, Doyen  M, Duyse  M, Van Beers  D, Vergison  A. Reduction of the nosocomial influenza A burden in a paediatric hospital by immunisation of the healthcare workers. Abstract no. 1133_242. Presentation at the 15th European Congress of Clinical Microbiology and Infectious Diseases; 2005 April 2–5; Copenhagen, Denmark.
  32. Weinstock  DM, Eagan  J, Malak  SA, Rogers  M, Wallace  H, Kiehn  TE, Control of influenza A on a bone marrow transplant unit. Infect Control Hosp Epidemiol. 2000;21:7302. DOIPubMedGoogle Scholar
  33. Saito  R, Suzuki  H, Oshitani  H, Sakai  T, Seki  N, Tanabe  N. The effectiveness of influenza vaccine against influenza a (H3N2) virus infections in nursing homes in Niigata, Japan, during the 1998–1999 and 1999–2000 seasons. Infect Control Hosp Epidemiol. 2002;23:826. DOIPubMedGoogle Scholar
  34. Munford  C, Finnigan  S. Influenza campaign 2006 and 2007: a residential care success story. Can J Infect Control. 2008;23:2225, 227.PubMedGoogle Scholar
  35. Shugarman  LR, Hales  C, Setodji  CM, Bardenheier  B, Lynn  J. The influence of staff and resident immunization rates on influenza-like illness outbreaks in nursing homes. J Am Med Dir Assoc. 2006;7:5627. DOIPubMedGoogle Scholar
  36. Monto  AS, Rotthoff  J, Teich  E, Herlocher  ML, Truscon  R, Yen  H, Detection and control of influenza outbreaks in well-vaccinated nursing home populations. Clin Infect Dis. 2004;39:45964. DOIPubMedGoogle Scholar
  37. Stevenson  CG, McArthur  MA, Naus  M, Abraham  E, McGeer  AJ. Prevention of influenza and pneumococcal pneumonia in Canadian long-term care facilities: how are we doing? CMAJ. 2001;164:14139.PubMedGoogle Scholar
  38. Talbot  TR, Babcock  H, Caplan  AL, Cotton  D, Maragakis  LL, Poland  GA, Revised SHEA position paper: influenza vaccination of healthcare personnel. Infect Control Hosp Epidemiol. 2010;31:98795. DOIPubMedGoogle Scholar
  39. van den Dool  C, Bonten  MJ, Hak  E, Wallinga  J. Modeling the effects of influenza vaccination of healthcare workers in hospital departments. Vaccine. 2009;27:62617. DOIPubMedGoogle Scholar
  40. Anikeeva  O, Braunack-Mayer  A, Rogers  W. Requiring influenza vaccination for healthcare workers. Am J Public Health. 2009;99:249. DOIPubMedGoogle Scholar

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