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Availability of Trivalent Inactivated Influenza Vaccine to Parents of Neonatal Intensive Care Unit Patients and Its Effect on the Healthcare Worker Vaccination Rate

Published online by Cambridge University Press:  02 January 2015

Shetal I. Shah  and
Martha Caprio
Shetal I. Shah*
Affiliation:
Department of Pediatrics, Divison of Neonatology, School of Medicine, State University of New York, Stony Brook, New York
Martha Caprio
Affiliation:
Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, New York
*
130 Post Avenue, Suite 418, Westbury, NY 11590 (shetal.shah@stonybrook.edu)
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Abstract

Background.

Trivalent inactivated influenza vaccine (TIV) is indicated for healthcare workers (HCWs); however, the vaccination rate in this population is estimated at 35%. We implemented a program for the administration of TIV, targeted at parents of neonatal intensive care unit (NICU) patients.

Objective.

To determine the effect of availability of TIV to parents in the NICU on HCW vaccination rates.

Design.

Questionnaire survey after an intervention-based study.

Setting.

Tertiary-care neonatal intensive care unit.

Participants.

Physicians, nurses, and other NICU-based staff.

Methods.

For the 2005-2006 influenza season, parents of NICU patients were screened and administered TIV, if informed consent was obtained. As a consequence, TIV was available 20 hours/day to all staff. Previous vaccination history and comorbidities in HCWs were also assessed.

Results.

Of 120 neonatal HCWs, 112 (93%) were screened during the 2005-2006 season; 80 (67%) were vaccinated, compared with 49 (41%) prior to the implementation of this program (P < .03, by Student's t test); 54 (45% of the study population, which includes senior neonatologists, fellow and resident physicians, nurses, respiratory therapists, X-ray technicians and clerical staff) received TIV in the NICU, compared with the 17 (14%) of 120 HCWs the previous year; and 20 (46%) of 43 HCWs of the nursing staff were vaccinated in the NICU, whereas only 3 (7%) of 43 HWCs were vaccinated outside the unit. Attending physicians had the lowest vaccination rate, and most cited efficacy and/or side effects in their deferral. Nurses most often refused influenza vaccination because they had a fear of injection.

Conclusions.

Administration of TIV in the NICU is an effective means of increasing the vaccination rate among neonatal HCWs. To increase compliance with vaccination, educational efforts for nurses should emphasize the possibility of viral transmission to neonates as motivation for vaccination. Physician-directed efforts should include tolerability of vaccine side effects. Live attenuated influenza vaccine, administered intranasally, should be considered to increase vaccination rates among NICU nurses.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 4 , April 2008 , pp. 309 - 313
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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References

1.Glezen, WP, Couch, RB. Interpandemic influenza in the Houston Area, 1974-1976. N Engl J Med 1978;298:587–592.Google Scholar
2.Neuzil, KM, Zhu, Y, Griffin, MR, et al.Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 2002;185:147–152.CrossRefGoogle Scholar
3.Glezen, WP. Serious morbidity and mortality associated with influenza epidemics. Epidemiol Rev 1982;4:25–44.CrossRefGoogle ScholarPubMed
4.Bhat, N, Wright, G, Broder, R, et al.Influenza-associated deaths among children in the United States. N Engl J Med 2005;353:2559–2569.Google Scholar
5.Glezen, WP, Decker, M, Joseph, SW, et al.Acute respiratory disease associated with influenza epidemics in Houston, 1981-1983. J Infect Dis 1987;155:1119–1126.CrossRefGoogle ScholarPubMed
6.Poehling, K, Edwards, K, Weinberg, G, et al.The underrecognized burden of influenza in young children. N Engl J Med 2006;355:31–40.CrossRefGoogle ScholarPubMed
7.Glezen, WP, Greenberg, S, Atmar, R, et al.Impact of respiratory virus infections on persons with chronic underlying conditions. JAMA 2000;283:499–505.CrossRefGoogle ScholarPubMed
8.Izurieta, H, Thompson, W, Kramarz, P, et al.Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med 2000;342:232–239.CrossRefGoogle ScholarPubMed
9.Ferson, MJ, Morton, JR, Robertson, PW. Impact of influenza on morbidity in children with cystic fibrosis. J Paediatr Child Health 1991;27:308–311.CrossRefGoogle ScholarPubMed
10.Neuzil, KM, Wright, PF, Mitchel, EF Jr, et al.The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr 2000;137:856–864.Google Scholar
11.Rennels, M, Mesissner, C; Committee on Infectious Diseases. Technical report: reduction of the influenza burden in children. Pediatrics 2002; U0(6):e80.CrossRefGoogle Scholar
12.Bernstein, DI, Zahradnik, JM, De Angelis, CJ, et al.Clinical reactions and serologic responses after vaccination with while-virus or split-virus influenza vaccines in children aged 6 to 36 months. Pediatrics 1982;69:404–408.CrossRefGoogle ScholarPubMed
13.Cohen, G, Nettleman, M. Economic impact of influenza vaccination in preschool children. Pediatrics 2000;106:973–976.Google Scholar
14.Committee on Infectious Disease Policy Statement. Reduction of the influenza burden in children. Pediatrics 2002;110:1246–1252.Google Scholar
15.Pearson, ML, Bridges, CB, Harper, SA; Health Care Infection Control Practices Advisory Committee; Advisory Committee on Immunization Practices (ACIP). Influenza vaccination of health-care personnel: recommendations of the Health Care Infection Control Practices Advisory Committee and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;5(RR-2):1–16.Google Scholar
16.Berg, H, Van Gendt, J, Rimmelzwaan, G, et al.Nosocomial influenza infection among post-influenza vaccinated patients with severe pulmonary disease. J Infect 2003;46:129–132.Google Scholar
17.Maltezou, H, Drancourt, M. Nosocomial infection in children. J Hosp Infect 2003;55:83–91.Google Scholar
18.Cunney, RJ, Bialachowski, A, Thornley, D, et al.An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449–454.CrossRefGoogle Scholar
19.Saldago, CD, Giannetta, ET, Hayden, FG, et al.Preventing nosocomial influenza by improving the vaccine acceptance rates for clinicians. Infect Control Hosp Epidemiol 2004;25:923–928.Google Scholar
20.Bauer, CR, Elie, K, Spence, L, et al.Hong Kong influenza in a neonatal intensive care unit. JAMA 1973;223:1233–1235.Google Scholar
21.Meibalane, R, Sedmark, GV, Sasidharan, P, et al.Outbreak of influenza in a neonatal intensive care unit. J Pediatr 1977;91:974–976.CrossRefGoogle Scholar
22.Joshi, W, Escobar, MR, Stewart, L, et al.Fatal influenza A2 viral pneumonia in a newborn infant. Am J Dis Child 1973;126:839–840.Google Scholar
23.Puck, JM, Glezen, WP, Frank, AL, et al.Protection of infants from infection with influenza A virus by transplacentally acquired antibody. J Infect Dis 1980;142:844–849.Google Scholar
24.Smith, NM, Bresee, JS, Shay, DK, Uyeki, TM, Cox, NJ, Strikas, RA; Advisory Committee on Immunization Practices. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55(RR-10):1–42.Google ScholarPubMed
25.Carman, WF, Elder, AG, Wallace, LA, et al.Effects of influenza vaccination on health care workers on mortality of elderly people in long-term care: a randomized controlled trial. Lancet 2000;355:93–97.CrossRefGoogle Scholar
26.Centers for Disease Control and Prevention (CDC). Estimated influenza vaccination coverage among adults and children—United States, September 1, 2004-January 31, 2005. MMWR Morb Mortal Wkly Rep 2005;54;304–307.Google Scholar
27.Wodi, A, Samy, S, Ezeanolue, E, et al.Influenza vaccine: immunization rates, knowledge, and attitudes of resident physicians in an urban teaching hospital. Infect Control Hosp Epidemiol 2005;26:867–873.Google Scholar
28.Tapiainen, T, Bar, G, Schaad, U, et al.Influenza vaccination among health care workers in a university children's hospital. Infect Control Hosp Epidemiol 2005;26:855–858.Google Scholar
29.Doebbeling, B, Edmond, M, Davis, C, et al.Influenza vaccination of health care workers: evaluation of factors that are important in acceptance. Prev Med 1997;26:68–77.Google Scholar
30.Shah, S, Caprio, M. Optimizing long-term care by administration of influenza vaccine to parents of NICU patients. J Perinatal 2004;24:273–274.Google Scholar
31.Shah, SI, Caprio, M, Hendricks-Munoz, K. Administration of inactivated trivalent influenza vaccine to parents of high-risk infants in the neonatal intensive care unit. Pediatrics 2007;120:e617–e621.Google Scholar
32.Rennels, M, Meissner, H. Reduction of the Influenza burden in children: policy statement of the Committee on Infectious Diseases: American Academy of Pediatrics. Pediatrics 2002;110:1246–1252.Google Scholar
33.Nichol, KL, Mendelman, PM, Malion, KP, et al.Effectiveness of live, at-tendated intranasal influenza virus vaccine in healthy, working adults, a randomized controlled trial. JAMA 1999;282:137–144.Google Scholar
34.Bridges, CB, Thompson, WW, Meitzer, MI, et al.Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA 2000;284:1655–1663.Google Scholar
35.Christini, AB, Shutt, KA, Byers, KE. Influenza vaccination rates and motivators among healthcare worker groups. Infect Control Hosp Epidemiol 2007;28:171–177.CrossRefGoogle ScholarPubMed
36.Belshe, R, Edwards, K, Vesikari, T, et al.Live attenuated versus inactivated influenza vaccinein infants and young children. N Engl J Med 2007;356:685–696.CrossRefGoogle Scholar