Assessment of the Efficacy of Vaccination Programs in Healthcare Workers for Infection Control

Abstract

1. Introduction
There is ample evidence that vaccination programs aimed at maintaining the health of workers provide positive returns, in particular, that vaccination of health care workers reduces infection risk for their patients. There is also evidence that vaccination uptake in Australia is suboptimal. However, there is a lack of recent empirical data for Australian health care workers on key influences in the uptake of these vaccinations. This project collected data using the method of a questionnaire from a sample of health care workers in a consortium of two large inner-city hospital districts in Sydney. Responses to the questionnaire were analyzed to ascertain the uptake level of vaccination and to identify the influences affecting barriers to vaccine uptake and facilitators that would increase uptake, including perceived benefits and risks, network influences, and convenient vaccination locations. A Likert scale with four possible responses was used, but the analysis consists of tabulations and statistical analysis.
The survey results demonstrated three key influences on the non-uptake of vaccination by health care workers: fear of injection, perceived health status, and previous incidents. At both hospitals, access and time to attend appointments were significant determinants of the non-uptake. Our results suggest that the take-up of vaccination for the three vaccines is no longer an issue of communication or lack of knowledge for our two hospital settings. The use of combination vaccines and better promotion in hospitals might reduce access and lower the psychological barrier, particularly fear of injection.
Methods
In this study, we analyzed the data on PCVs, both for the 7-9 and 13-valent PCV, performed during 3 consecutive years in all workers employed by an Italian regional healthcare system. We considered the median number of wipes taken from the nasal vestibule and hypopharynx of all workers for each year and for each type of PCV. We compared the median number of accepted wipes and failed PCVs, defined as the median value of the accepted wipes being greater than or equal to 3. Data concerning gender, age, type of healthcare position, and type of PCV performed were also collected and evaluated in relation to the type of PCV and to the year of the performed swabs. All data were collected anonymously. Personal PCV reports and their results were entered completely in dedicated software, in accordance with the Validation Standard.
Conclusion
In conclusion, all the vaccination programs should include specific biomonitoring strategies for antibody response. The evaluation of the biological and psychosocial determinants involved in the interindividual heterogeneity in the immune response should also be considered for an efficient control of the personnel at risk of exposure. These issues warrant a thorough assessment under controlled settings with follow-up data from adverse events in concert with vaccine worth, efficacy, and the immunopathogenicity of the viral infections. It is important to identify molecular and cellular markers of vulnerability predictive of active immunological deficiencies after vaccination in order to develop new personalized vaccination modules for successful health policies. Throughout the entire text, we have considered how the general use of these methods could be extended to other categories at risk of exposure. With a view to the shared responsibility of the operator, careful health education of high-risk groups and accurate clinical and instrumental assessments of the usefulness of immunization are required. The initial hypothesis opens up perspectives to improve the efficacy of health policies that support vaccination strategies, and the health care community has the conviction that more studies on the vaccination of highest-risk subjects can drive the decisions. With this paper, we hope to increase public confidence in vaccines; making their monitoring more effective would certainly improve the health and productivity of our society.