High vaccination rates for seasonal and pandemic (A/H1N1) influenza among healthcare workers in Dutch general practice

doi:10.1016/j.vaccine.2010.07.031

Vaccine

Volume 28, Issue 38, 31 August 2010, Pages 6164-6168

https://doi.org/10.1016/j.vaccine.2010.07.031 Get rights and content

Abstract

In previous years, the influenza vaccination rate among Dutch general practitioners (GPs) was low (36% during the 2007/2008 season). Since 2008, yearly influenza vaccination has been actively recommended for GPs in The Netherlands. Moreover, in 2009 the Dutch government urged healthcare workers to receive additional vaccination against the pandemic influenza (A/H1N1). The effects of these recommendations are unknown. In February 2010, a questionnaire was mailed to random samples of GPs (n = 810) and GP-trainees (n = 300). Vaccination rates were determined and motives and barriers for vaccination were assessed. The response rates for GPs and GP-trainees were 83% and 90%, respectively. In total, 63% of the GPs were vaccinated against seasonal influenza and 85% against pandemic (A/H1N1) influenza. For GP-trainees, these percentages were 47% and 77%, respectively. With regard to the medical staff working in the respondents’ practices, 60% received the seasonal and 76% the pandemic (A/H1N1) influenza vaccine. Reducing the risk of transmitting the virus to vulnerable patients and the individual's personal protection were the most frequently reported motives for vaccination. Having no medical indication for influenza vaccination and the conviction of being protected against influenza because of frequent professional exposure to the virus were the most frequently mentioned reasons for not being vaccinated. In conclusion, the seasonal influenza vaccination rate among Dutch GPs has risen considerably since the previous survey and the vaccination rate against pandemic (A/H1N1) influenza was very high. Moreover, Dutch GPs were convinced that influenza vaccination will reduce the risk of transmitting the virus to their patients.

Introduction

Influenza is a major respiratory tract infection that can cause substantial morbidity and mortality [1]. High-risk individuals are young children who will easily catch and transmit the influenza, and elderly individuals, especially those with comorbidities, who are at risk of flu-related complications. The recent pandemic outbreak of influenza-A (H1N1) demonstrated that, besides these traditional high-risk groups, individuals from other age groups can also be seriously affected [2]. Vaccination against the influenza virus is considered the best preventive measure. However, the immune response of elderly (especially those with comorbidities) and immunocompromised patients to the influenza vaccine is reduced, resulting in decreased clinical protection [3], [4], and the influenza vaccine has not been registered for children younger than 6 months of age.

Another protective measure is to reduce exposure to the influenza virus. Since healthcare workers are often in contact with influenza patients, they are considered a potential source of transmission. Therefore, vaccinating healthcare workers has been advocated in order to prevent transmission of the virus to vulnerable patients [5]. Vaccination also gives healthcare workers personal protection against the disease, thus reducing absenteeism from work, especially during influenza epidemics.

A study conducted during the 2007/2008 season showed a low (36%) influenza vaccination rate among Dutch general practitioners (GPs) [6]. Since then, yearly influenza vaccination has been actively recommended for GPs in The Netherlands [7]. Moreover, in 2009 the Dutch government urged healthcare workers to receive additional vaccination against the pandemic influenza (A/H1N1) and financed the costs of the vaccine.

This paper describes a questionnaire study conducted among GPs and GP-trainees to obtain insight into their present vaccination status and their motives for (not) complying with national GP guidelines. It also compares these findings with the results of a previous study [6].

Section snippets

Setting and study subjects

In February 2010, a questionnaire was mailed to a random sample of about 10% of all practising members of the Dutch College of General Practitioners (DCGP). A reminder was sent 3 weeks later, regardless of the response to the first mailing. The DCGP is the scientific association of Dutch GPs that is engaged in the development and implementation of professional guidelines for GPs. Approximately 85% of all practising Dutch GPs are members of this association.

Concomitantly, a questionnaire was

Response rate to the questionnaire

Of the 810 questionnaires sent out to GPs, 670 (83%) were completed and returned. Compared with national figures (Table 1) [8], this study sample contained slightly more females (47% vs. 38%) and younger GPs (mean age 46 years vs. 48 years). The response rate among GP-trainees was 269/300 (90%). Mean age and gender distribution were comparable in the entire group of GP-trainees [9].

Rates of vaccination against seasonal influenza

In total, 425 (63%) GPs were vaccinated against seasonal influenza during the 2009/2010 season, 84 of whom because

Discussion

Our study showed that during the 2009/2010 season, 63% of the Dutch GPs had received the seasonal influenza vaccine and 85% the A/H1N1 influenza vaccine. For GP-trainees, these percentages were 47% and 77%, respectively. There were no independent determinants for being vaccinated. The motive for vaccination that was reported most frequently by GPs and GP-trainees was the lower risk of viral transmission to patients. Having no medical indication for influenza vaccination and the conviction of

Acknowledgements

We thank Rutger van Petersen, MSc, for his statistical advice.

Conflict of interests: GAvE is a member of the European Scientific Working group on Influenza (ESWI), an independent scientific organization that is equally financed by all manufacturers of influenza vaccines and antiviral medicines. Funding: This study was financed by the National Institute for Public Health and the Environment (RIVM) and the Foundation Vocational Training General Practitioners (SBOH).

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High vaccination rates for seasonal and pandemic (A/H1N1) influenza among healthcare workers in Dutch general practice

Abstract

Introduction

Section snippets

Setting and study subjects

Response rate to the questionnaire

Rates of vaccination against seasonal influenza

Discussion

Acknowledgements

Lancet

Vaccine

Vaccine

Vaccine

Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study

BMJ

Serological response to influenza vaccination and nutritional and functional status of patients in geriatric medical long-term care

Age Ageing

Prevention and control of influenza: recommendations of the advisory committee on immunization practices (ACIP)

MMWR Recomm Rep

Cijfers uit de registratie van huisartsen. Peiling 2009

NIVEL

Interim results: influenza A (H1N1) 2009 monovalent and seasonal influenza vaccination coverage among health-care personnel – United States, August 2009–January 2010

MMWR Morb Mortal Wkly Rep