Effect of intervention on influenza vaccination during 2021 – 2022 influenza season among hospital professionals in a district of Shenzhen city
-
摘要:
目的 评价以非强制性的具体接种率要求对提高医务人员流感流行季流感疫苗的干预效果。 方法 采用非随机分组的社区干预试验设计，对深圳市南山区7家医院进行分组，干预组4家医院共4 599人，对照组3家医院共2 139人。于2021年10月 — 2022年4月，对干预组实施“免费接种 + 现场接种 + 宣传提醒 + 接种率目标要求”的干预模式，对照组实施“免费接种 + 现场接种 + 宣传提醒”的干预模式；干预组高风险科室以80%的接种率作为目标，低风险科室以60%作为接种目标，采用调整比估计量的Pearson χ2检验对干预组和对照组的基线接种率以及干预后的接种率进行检验。 结果 2021 — 2022年流感流行季，干预后干预组高风险科室医务人员当季流感疫苗接种率为62.67%，对照组接种率为23.71%，2组绝对率差（absolute rate difference，ARD）为38.96%（P < 0.05，95%CI = 14.17%～63.75%）；干预组低风险科室医务人员当季流感疫苗接种率为34.57%，对照组接种率为22.96%，干预组所有医务人员流感疫苗接种率为43.90%，对照组接种率为23.19%，2组接种率接种率差异均无统计学意义（均P > 0.05）。以高接种率要求的干预效果具有显著差异，低接种率要求的干预效果无显著差异。 结论 在未设置奖惩制度的前提下，以非强制性的具体接种率要求提高医务人员的流感疫苗接种率时，需设置较高的接种率目标以达到预期效果。 Abstract:Objective To evaluate the effect of an intervention with a required non-mandatory vaccination rate on improving influenza vaccination among healthcare workers in 2021 – 2022 influenza season. Methods We conducted a non-randomized community intervention trial on influenza vaccination among healthcare workers in 7 hospitals in Nanshan district of Shenzhen city during an influenza season from October 2021 to April 2022. Free on-site influenza vaccination and prompt publicity for the vaccination were carried out among all the participants; compared to the 2 139 control participants in 3 hospitals, an additional dissemination about the expected non-mandatory vaccination rate of 80% and 60% for the staff working in departments assessed as at high- and low-risk of influenza infection was implemented among 4 599 participants in 4 hospitals of the intervention group. Pearson′s chi-square test for adjusted ratio estimators was used to test the baseline and post-intervention vaccination rates for the intervention and control group. Results Over the influenza season for the participants working in high-risk departments, the influenza vaccination rate was 62.67% and 23.71% in the intervention and the control group, with a significant absolute rate difference (ARD) of 38.96% (95% confidence interval: 14.17% – 63.75%) between the two groups (P < 0.05); for the participants of low-risk departments, the influenza vaccination rate was 34.57% and 22.96% in the intervention and the control group (P > 0.05); for all the participants, the influenza vaccination rate was 43.90% and 23.19% in the intervention and in the control group (P > 0.05). The intervention of dissemination about the expected vaccination rate showed a significant impact upon the influenza vaccination rate for the participants working in high-risk departments but not for those in low-risk departments. Conclusion Under the premise of without both reward and punishment for having influenza vaccination, the dissemination of a high expected non-mandatory vaccination rate may increase the influenza vaccination rate among healthcare workers intervened. -
表 1 2021年南山区不同特征医务人员组别分布
Table 1. Demographic characteristics of 4 599 intervened and 2 139 unintervened medical workers from 7 hospitals in a district of Shenzhen city
变量 干预组 对照组 χR2 P 值 人数 % 人数 % 性别 男性 1683 36.59 839 39.22 0.2224 0.6372 女性 2916 63.41 1300 60.78 文化程度 大专及以下 1304 28.35 714 33.38 3.0555 0.0805 本科 2054 44.66 1040 48.62 研究生及以上 1241 26.98 385 18.00 职务 医生 2257 49.08 1196 55.91 2.4876 0.1147 护士 2342 50.92 943 44.09 职称 初级 1 826 39.70 697 32.59 2.0630 0.1509 中级 1176 25.57 668 31.23 高级 839 16.48 415 16.78 无 758 18.24 359 19.40 科室 高风险 1527 33.20 641 29.97 0.1736 0.6770 低风险 3072 66.80 1498 70.03 
下载: 导出CSV
表 2 不同组别医务人员流感疫苗接种率干预前后比较
Table 2. Influenza vaccination rate before and after a relevant intervention among 4 599 intervened and 2 139 unintervened medical workers from 7 hospitals in a district of Shenzhen city
科室 对照组 干预组 P1 P2 P3 P4 基线 干预后 基线 干预后 接种人数 % 接种人数 % 接种人数 % 接种人数 % 高风险科室 242 35.69 152 23.71 529 36.92 957 62.67 0.9018 0.0962 0.0381 0.0001 低风险科室 402 33.22 344 22.96 850 25.53 1062 34.57 0.5445 0.2355 0.5938 0.3996 所有医务人员 644 34.11 496 23.19 1379 28.95 2019 43.90 0.6150 0.0588 0.3133 0.0634 注：P1为干预组与对照组基线接种率比较；P2为对照组干预前后比较；P3为干预组干预前后比较；P4为干预组与对照组干预后比较。
下载: 导出CSV
-
[1] 国家免疫规划技术工作组流感疫苗工作组. 中国流感疫苗预防接种技术指南 (2021 — 2022)[J]. 中华流行病学杂志, 2021, 42(10): 1722 – 1749. [2] Kuster SP, Shah PS, Coleman BL, et al. Incidence of influenza in healthy adults and healthcare workers: a systematic review and meta - analysis[J]. PLoS One, 2011, 6(10): e26239. doi: 10.1371/journal.pone.0026239 [3] Pereira M, Williams S, Restrick L, et al. Healthcare worker influenza vaccination and sickness absence – an ecological study[J]. Clinical Medicine, 2017, 17(6): 484 – 489. doi: 10.7861/clinmedicine.17-6-484 [4] Mossad SB, Deshpande A, Schramm S, et al. Working despite having influenza - like illness: results of an anonymous survey of healthcare providers who care for transplant recipients[J]. Infection Control and Hospital Epidemiology, 2017, 38(8): 966 – 969. doi: 10.1017/ice.2017.91 [5] World Health Organization. Vaccines against influenza: WHO position paper – May 2022[J]. Weekly Epidemiological Record, 2022, 97(19): 185 – 208. [6] Haviari S, Bénet T, Saadatian-Elahi M, et al. Vaccination of healthcare workers: a review[J]. Human Vaccines and Immun-otherapeutics, 2015, 11(11): 2522 – 2537. doi: 10.1080/21645515.2015.1082014 [7] Liu HT, Tan YY, Zhang ML, et al. An internet - based survey of influenza vaccination coverage in healthcare workers in China, 2018/2019 season[J]. Vaccines, 2019, 8(1): 6. doi: 10.3390/vaccines8010006 [8] 李巧巧, 杨义, 马厚芝, 等. 医务人员流感疫苗免费接种措施实施效果评价及改进建议[J]. 实用预防医学, 2021, 28(9): 1111 – 1113. [9] Drees M, Wroten K, Smedley M, et al. Carrots and sticks: achiev-ing high healthcare personnel influenza vaccination rates without a mandate[J]. Infection Control and Hospital Epidemiology, 2015, 36(6): 717 – 724. doi: 10.1017/ice.2015.47 [10] Quan K, Tehrani DM, Dickey L, et al. Voluntary to mandatory: evolution of strategies and attitudes toward influenza vaccination of healthcare personnel[J]. Infection Control and Hospital Epidemi-ology, 2012, 33(1): 63 – 70. doi: 10.1086/663210 [11] Barbara A, Mariani M, De Waure C, et al. A campaign aimed at increasing seasonal influenza vaccination coverage among post graduate medical residents in an Italian teaching hospital[J]. Human Vaccines and Immunotherapeutics, 2019, 15(4): 967 – 972. doi: 10.1080/21645515.2018.1556076 [12] Vimercati L, Bianchi FP, Mansi F, et al. Influenza vaccination in health - care workers: an evaluation of an on - site vaccination strategy to increase vaccination uptake in HCWs of a south Italy hospital[J]. Human Vaccines and Immunotherapeutics, 2019, 15(12): 2927 – 2932. doi: 10.1080/21645515.2019.1625645 [13] Borgey F, Henry L, Lebeltel J, et al. Effectiveness of an intervention campaign on influenza vaccination of professionals in nursing homes: a cluster - randomized controlled trial[J]. Vaccine, 2019, 37(10): 1260 – 1265. doi: 10.1016/j.vaccine.2019.01.066 [14] Costantino C, Restivo V, Gaglio V, et al. Effectiveness of an educa-tional intervention on seasonal influenza vaccination campaign adherence among healthcare workers of the Palermo University Hospital, Italy[J]. Annali di Igiene:MedicinaPreventiva e di Comunità, 2019, 31(1): 35 – 44. [15] 范晓, 彭质斌, 宋英, 等. 2019 — 2020年西宁市医务人员流感疫苗接种现状及影响因素分析[J]. 预防医学情报杂志, 2022, 38(6): 782 – 788. [16] 吴忠丽, 郝晓宁, 滕文杰, 等. 青岛市医务人员流感疫苗接种心理影响因素分析[J]. 中国公共卫生, 2022, 38(6): 716 – 718. [17] CDC. Influenza vaccination coverage among health care personnel – United States, 2019 – 20 influenza season[EB/OL]. (2020 – 10 – 01)[2022 – 11 – 09]. https://www.cdc.gov/flu/fluvaxview/hcp-coverage_1920estimates.htm. [18] Pitts SI, Maruthur NM, Millar KR, et al. A systematic review of mandatory influenza vaccination in healthcare personnel[J]. American Journal of Preventive Medicine, 2014, 47(3): 330 – 340. doi: 10.1016/j.amepre.2014.05.035 -
点击查看大图
表(2)
计量
- 文章访问数: 382
- HTML全文浏览量: 118
- PDF下载量: 114
- 被引次数: 0