Volume 18, Number 8—August 2012
CME ACTIVITY - Synopsis
Vaccination of Health Care Workers to Protect Patients at Increased 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.
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