Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 78-84).

Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 32-34).

Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 83-96).

published_or_final_version / Community Medicine / Master / Master of Public Health

Introduction: Influenza is one of the commonest infectious diseases among human beings. The annual attack rates were 5-10% and 20-30% in adult and children respectively around the world. Fortunately, this is a vaccine preventable disease. Vaccinating health care workers can reduce risk of infection among themselves so as to maintain the availability of health care services. This can also prevent nosocomial infections and associated morbidity and mortality of their patients. The World Health Organization recommended 60% influenza vaccination coverage by 2006 in high risk groups and targeted 75% by 2010. However, the vaccine uptake rate among health care workers is still low globally. The vaccination coverage is in Western Europe 20-40%, in Hong Kong 30%, in Australia 16-60% and in the United States 63.5%. This systematic review aims at identifying the factors influencing influenza vaccine uptake among health care workers which can help formulation of future vaccination strategies so as to protect health care workers themselves and their patients. Methods: Electronic databases (PubMed, MEDLINE and eKG) of journal articles published after January 2011 using title and keywords related to health care workers and influenza vaccination uptake were searched. Predefined inclusion and exclusion criteria were applied. Data were extracted and quality was assessed from the eligible studies using individualized data extraction form and quality assessment form by two reviewers. The reasons of vaccination acceptance and declination were divided into different categories. A score was given to each category according to the percentage of respondents stating that as an important influencing factor. The factor with higher score indicated the more important it is. The predictive factors positively associated with vaccination acceptance were retrieved from results of multivariate logistic regression models of the studies which had an odd ratio greater than one. The PRISMA statement is used to guide the methodology and reporting of the studies. Results: Nine eligible studies were finally identified. The studies reviewed found that the reasons behind low seasonal influenza vaccination uptake rate among health care workers are complex and made up by both perceptual and organizational factors. For factors of influenza vaccination acceptance, self protection, risk perception, and protection of patients were identified as the most important. For factors of influenza declination, concern of vaccine side effects, lack of concern, and doubts of vaccine safety and efficacy showed the greatest influence. Convenient vaccination location and time was suggested to be the strongest predictive factor which positively associated with future vaccination uptake. Conclusion: As influenza vaccination is an effective measure to prevent infection among health care workers and nosocomial infection of their patients, annual seasonal influenza vaccination program is essential in health care settings. In order to promote annual seasonal influenza vaccination among health care worker, multipronged approach is recommended. Targeted educational intervention can be used to overcome the perceptual barriers on misconception about influenza and influenza vaccines. The organizational barriers can be fixed by introducing mobile vaccination team which provide services in flexible period of time around the workplace. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Community Medicine / Master / Master of Public Health

Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 63-67).

Background The pandemic of influenza A (H1N1-2009) virus was particularly widespread among children. Children and young adults were more likely to be infected than older adults, and infection among infants tended to lead to a higher risk of severe complications than among older children and adults. Vaccination against the virus was thus recommended as an effective countermeasure to protect these susceptible age strata from influenza infection and subsequent complications. Parental perception, attitudes and beliefs would thus play a major role in mitigating the pandemic influenza because these factors underlie the degree of vaccination uptake among children. Objective The primary aim of this study is to understand factors that are associated with parental acceptance of pediatric vaccination against influenza (H1N1-2009). The secondary aim is to consider the effective future vaccination campaign in the event of a pandemic and to increase child vaccination coverage. Methods We conducted a systematic literature search of the electronic databases, PubMed and the Web of Science. We identified and examined published literatures associated with parental acceptance dating back to the beginning of the 2009 pandemic. We extracted key datasets from these literatures, summarized the evidence systematically and determined the relationship amongst the aforementioned parental characteristics and acceptance of pandemic influenza vaccines. Results We included a total of 14 studies in this review. Our systematic review indicates that parents were more willing to accept H1N1 pandemic influenza vaccination if 1) their children had previous experience with seasonal influenza; 2) they have had the pandemic influenza vaccine themselves; or 3) they intended to have their children vaccinated against seasonal influenza vaccine. We also founded that parental perceptions and attitudes towards both the influenza pandemic itself and the pandemic influenza vaccine are significantly associated with acceptance. Our study identified misperceptions and distrust in vaccine safety as the main reason for parents to refuse pandemic influenza vaccination for their children. In addition, we found that parents usually received negative appraisal on pediatric influenza vaccination from the media and tended to regard health care workers as the most reliable source of information on pediatric influenza vaccination. . Conclusions Parental perceptions are influential on pandemic influenza vaccine acceptance of their children. We affirm the importance of the role of health care workers in delivering appropriate information on influenza vaccines to parents in increasing pediatric vaccination uptake. We recommend public health officials to employ effective strategies for risk communication regarding pediatric influenza vaccines in order to increase the coverage and hence effectiveness of vaccination program against a future influenza pandemic. / published_or_final_version / Public Health / Master / Master of Public Health