Abstract
Background
Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination.
Objectives
To implement multicenter programs to enhance HCW influenza vaccination.
Design
It was a cluster randomised interventional studies.
Setting
43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France.
Participants
1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group.
Intervention
After the failure of a first educational program giving scientific information and. tested during the 2005–06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of “safety zones”, and to give personal satisfaction. Program 2 was tested during the 2006–07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs).
Measurements
The efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters.
Results
Program 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p>0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p<0.001) regardless their occupational group but only in the non previous vaccinated subgroup.
Conclusions
In geriatric health care centres in France, an active multicenter program giving personal satisfaction and taking into account the profile of non-vaccinated HCWs was more effective in promoting flu vaccination than a scientifically factual information program. HCW involvement is required in program implementation in order to avoid rejection of top-down information.
Similar content being viewed by others
Abbreviations
- Flu:
-
influenza
- HCS:
-
health care setting
- HCW:
-
healthcare worker
- VCR:
-
vaccination coverage rate
References
World Health Organization: Influenza vaccines. Wkly Epidemiol Rec 2005, 80:279–287.
Centers for Diseases Control and Prevention (CDC): Public health and aging: influenza vaccination coverage among adults aged > or =50 years and pneumococcal vaccination coverage among adults aged > or =65 years — United States, 2002. MMWR Morb Mortal Wkly Rep 2003, 52:987–992.
Centers for Disease Control and Prevention (CDC). Fiore AE, Shay DK, Haber P, et al.: Prevention and control of influenza. MMWR Recomm Rep 2007, 56:1–54.
Gross PA, Hermogenes AW, Sacks HS, et al.: The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature. Ann Intern Med 1995, 123:518–527.
Institut de Veille Sanitaire (InVS): [Vaccination schedule for 2008-Recommendations from the “Haut Conseil de la Santé Publique”]. BEH 2008, 16–17:129–148. [article in French]
Lina B, Holm MV, Szucs TD: [Evolution of influenza vaccination coverage in France from 2001 to 2006]. Med Mal Infect 2008, 38:125–132. [article in French]
Gavazzi G, Wazières B, Lejeune B, et al.: Influenza and pneumococcal vaccine coverages in geriatric health care settings in France. Gerontology 2007, 53:382–387.
Strausbaugh LJ, Sukumar SR, Joseph CL: Infectious disease outbreaks in nursing homes: anunappreciated hazard for frail elderly persons. Clin Infect Dis 2003, 36:870–876.
Zadeh MM, Buxton Bridges C, Thompson WW, et al.: Influenza outbreak detection and control measures in nursing homes in the United States. J Am Geriatr Soc 2000, 48:1310–1315.
Pachucki CT, Pappas SA, Fuller GF, et al.: Influenza A among hospital personnel and patients. Implications for recognition, prevention, and control. Arch Intern Med 1989, 149:77–80.
Pearson ML, Bridges CB, Harper SA: Influenza vaccination of health-care personnel. recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006, 55:1–16.
Carman WF, Elder AG, Wallace LA, et al.: Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000, 355:93–97.
Institut de Veille Sanitaire (InVS): [Vaccination schedule for 2000 — Recommendations from the “Conseil Supérieur d’Hygiène Publique de France”]. BEH 2000, 27:115–118 [article in French].
Saxen H, Virtanen M: Randomized, placebo-controlled double blind study on efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J 1999, 18:779–783.
Wilde JA, McMillan JA, Serwint J, et al.: Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999, 281:908–913.
Rothan-Tondeur M., Filali-Zegzouti Y; Belmin J, Lejeune B., Golmard JL, De Wazieres B; Carrat F, Piette F; Mouala C, Gavazzi G., on behalf of « Observatoire pour le Risque Infectieux en Gériatrie → Association. Health Care Worker Influenza Vaccination Program Assessment in French Geriatric Wards: A Cluster-Randomized Controlled Trial Aging Clin Exp Res 2010, (in press)
Kroneman M, Paget WJ, van Essen GA: Influenza vaccination in Europe: an inventory of strategies to reach target populations and optimise vaccination uptake. Euro Surveill 2003, 8:130–138.
Gil H., Bailly P, Meaux-Ruault N, et al.: [Influenza vaccination among health-care workers.Vaccination rates in universitary hospital of Besançon, winter 2003–2004]. Rev Med Interne 2006, 27:5–9.
Valour F, Maulin L, Ader F, et al.: [Vaccination against influenza: results of a study on vaccination coverage among health care workers in the Croix-Rousse Hospital (Hospitals of Lyon)]. Med Mal Infect 2007, 37:51–60.
Chamoux A, Denis-Porret M, Rouffiac K, et al.: [Impact study of an active antiflu vaccination programme on the Clermont-Ferrand Teaching Hospital staff]. Med Mal Infect 2006, 36:144–150.
Hofmann F, Ferracin C, Marsh G, et al.: Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection 2006, 34:142–147.
Gavazzi G Influenza vaccination for healthcare workers: from a simple concept to a resistant issue ? Aging Clin Exp Res 2009, 21:216–221
Nace DA, Hoffman EL, Resnick NM, Handler SM: Achieving and sustaining high rates of influenza immunization among long-term care staff. J Am Med Dir Assoc 2007, 8:128–133.
Bouchet C, Guillemin F, Briançon S: Nonspecific effects in longitudinal studies: impact on quality of life measures. J Clin Epidemiol 1996, 49:15–20.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rothan-Tondeur, M., Filali-Zegzouti, Y., Golmard, J.L. et al. Randomised active programs on healthcareworkers’ flu vaccination in geriatric health care settings in France: The VESTA study. J Nutr Health Aging 15, 126–132 (2011). https://doi.org/10.1007/s12603-011-0025-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-011-0025-5