Less than one third of healthcare workers have themselves vaccinated against classic influenza. This reluctance is astounding, firstly because vaccination against influenza viruses is considered safe and effective and secondly because it has been proved to prevent nosocomial transmission of disease to patients—provided at least 50% of employees have been vaccinated. In the new issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106(36): 567-72), Sabine Wicker of Johann Wolfgang Goethe University Hospital, Frankfurt and her co-authors reveal why vaccination rates have stayed so low and how they can be improved.
The attitudes of healthcare personnel to influenza vaccination were investigated by means of several anonymous questionnaires. Those who opted for vaccination did so principally to protect themselves and their family, friends, and colleagues. Concern for patients was relegated to third place. The most frequent reasons given for refusing vaccination were low estimation of the risk of infection, fear of adverse effects, and scepticism whether the vaccine offered adequate protection.
In the influenza season 2008/2009, the vaccination rate at Frankfurt University Hospital was greatly improved by making it mandatory for all unvaccinated employees to wear a protective mask in order to break chains of infection in the hospital. Within 10 days the vaccination coverage rose from 33% to 57.7%.
The authors conclude that satisfactory vaccination rates obviously cannot be achieved by means of voluntary, free-of-charge vaccination programs and information campaigns. They recommend, therefore, that hospital authorities consider compulsory vaccination for employees who care for immune-compromised patients.