Infectious Diseases and Vaccinations in Healthcare Professionals

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (29 February 2020) | Viewed by 31070

Special Issue Editors

1. Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
2. Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
Interests: occupational medicine; workplace safety and health; occupational epidemiology; vaccines; preventive medicine
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Special Issue Information

Dear Colleagues,

Infectious diseases are pathologies caused by micro-organisms, such as bacteria, fungi, and viruses. Most infectious diseases can be transmitted from person to person, and, in our case, i.e., the healthcare sector, from the patient to the healthcare worker (HCW) or vice versa.

The aim of this Special Issue is to present a broad picture of the epidemiology of infectious diseases among HCWs at the international level, as well as the impact of vaccinations on preventing the spread of these diseases in the healthcare setting among HCWs and communities.

The Special Issue “Infectious Diseases and Vaccinations in Healthcare Professionals” is open to the submission of manuscripts that use different study designs, such as observational studies, systematic reviews, and meta-analyses, as well as other types of articles that can improve our knowledge on this issue.

Prof. Dr. Giuseppe La Torre
Prof. Dr. Paolo Durando
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infectious diseases
  • vaccinations
  • healthcare professionals
  • biological risk
  • prevention

Published Papers (8 papers)

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Editorial

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8 pages, 222 KiB  
Editorial
Tackling Biological Risk in the Workplace: Updates and Prospects Regarding Vaccinations for Subjects at Risk of Occupational Exposure in Italy
Vaccines 2019, 7(4), 141; https://doi.org/10.3390/vaccines7040141 - 08 Oct 2019
Cited by 12 | Viewed by 2668
Abstract
Occupational activities may expose workers to a variety of risks. Exposure to biological agents constitutes a traditional risk in numerous occupational settings. Legislative Decree (D.Lgs.) 81/2008 constitutes the main Italian legislative basis for the management and the prevention of biological risk in occupational [...] Read more.
Occupational activities may expose workers to a variety of risks. Exposure to biological agents constitutes a traditional risk in numerous occupational settings. Legislative Decree (D.Lgs.) 81/2008 constitutes the main Italian legislative basis for the management and the prevention of biological risk in occupational settings and lists the available vaccinations against each single biological agent. The 2017–2019 National Vaccination Prevention Plan (PNPV) identifies some categories of workers for whom specific vaccinations are indicated. In this context, the occupational physician identifies work processes that are at risk—identifying susceptible workers and providing information on health monitoring—and is responsible for ensuring that vaccinations are carried out. Adequate and thorough evaluation of risk are indispensable to appropriate consultation by the occupational physician in order to enable the employer to provide efficacious vaccinations. Close collaboration among the services of occupational medicine, vaccination clinics, and healthcare management together with the implementation of vaccination programs that are agreed upon at the institutional level provides an opportunity to reduce the number of workers who are susceptible to vaccine-preventable diseases, thereby yielding benefits in terms of biological risk management in the workplace and contributing to increasing vaccination coverage rates, which in many cases are currently unsatisfactory. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)

Research

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14 pages, 729 KiB  
Article
Health Literacy, Vaccine Confidence and Influenza Vaccination Uptake among Nursing Home Staff: A Cross-Sectional Study Conducted in Tuscany
Vaccines 2020, 8(2), 154; https://doi.org/10.3390/vaccines8020154 - 30 Mar 2020
Cited by 26 | Viewed by 4390
Abstract
The aim of this cross-sectional study is to address whether health literacy (HL) and vaccine confidence are related with influenza vaccination uptake among staff of nursing homes (NHs). It was conducted in Tuscany (Italy) in autumn 2018, including the staff of 28 NHs. [...] Read more.
The aim of this cross-sectional study is to address whether health literacy (HL) and vaccine confidence are related with influenza vaccination uptake among staff of nursing homes (NHs). It was conducted in Tuscany (Italy) in autumn 2018, including the staff of 28 NHs. A questionnaire was used to collect individual data regarding influenza vaccination in 2016–2017 and 2017–2018 seasons; the intention to be vaccinated in 2018–2019; as well as demographic, educational, and health information. It included also the Italian Medical Term Recognition (IMETER) test to measure HL and eight Likert-type statements to calculate a Vaccine Confidence Index (VCI). The number of employees that fulfilled the questionnaire was 710. The percentage of influenza vaccination uptake was low: only 9.6% got vaccinated in 2016–2017 and 2017–2018 and intended to vaccinate in 2018–2019. The VCI score and the IMETER-adjusted scores were weakly correlated (Rho = 0.156). At the multinomial logistic regression analysis, the VCI was a positive predictor of vaccination uptake. In conclusion, vaccine confidence is the strongest predictor of influenza vaccination uptake among the staff of NHs. The development of an adequate vaccine literacy measurement tool could be useful to understand whether skills could be related to vaccine confidence. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
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9 pages, 754 KiB  
Article
Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback
Vaccines 2020, 8(1), 1; https://doi.org/10.3390/vaccines8010001 - 19 Dec 2019
Cited by 13 | Viewed by 3221
Abstract
Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the [...] Read more.
Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. The students were examined during the first year of their Degree Course and were checked two years later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within one month. The proportion of students that were vaccinated during adolescence showing anti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus 31.7%; p-value < 0.001). Receiving HBV vaccination at adolescence was significantly associated with a fourfold increased possibility of having anti-HBsAg titers ≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers ≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
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15 pages, 276 KiB  
Article
Assessing Vaccine Hesitancy among Healthcare Workers: A Cross-Sectional Study at an Italian Paediatric Hospital and the Development of a Healthcare Worker’s Vaccination Compliance Index
Vaccines 2019, 7(4), 201; https://doi.org/10.3390/vaccines7040201 - 29 Nov 2019
Cited by 28 | Viewed by 4930
Abstract
Healthcare workers (HCWs) in paediatric hospitals are an important source of advice on vaccinations, but vaccine hesitancy can affect even these professionals. The aim of this study is to assess this phenomenon, measuring it by means of a scoring system. A survey was [...] Read more.
Healthcare workers (HCWs) in paediatric hospitals are an important source of advice on vaccinations, but vaccine hesitancy can affect even these professionals. The aim of this study is to assess this phenomenon, measuring it by means of a scoring system. A survey was conducted in five departments of an Italian paediatric university hospital of national interest. Vaccination against influenza was considered a behavioral indicator of vaccination uptake. Using the collected data, the healthcare worker’s vaccination compliance index (HVCI) was computed. The results demonstrate statistically significant differences between departments and professional profiles. Nearly 80% of the sample was not immunized against seasonal influenza. According to the HVCI scores, the most hesitant departments are the intensive care unit, emergency room, and oncohematology department, while the most hesitant professional profiles are nurses and auxiliary staff. The score of the unvaccinated is significantly lower than that of the vaccinated, and the same difference was found between those who self-perceive to be skilled versus unskilled. The HVCI score was statistically verified as a predictive parameter to assess vaccination against seasonal influenza. By means of strategic training policies, both HVCI and perceived skills could be improved, suggesting that hospital management should draw a complex intervention program to fight against hesitancy. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
13 pages, 1424 KiB  
Article
Trends in Socioeconomic Inequalities in Full Vaccination Coverage among Vietnamese Children Aged 12–23 Months, 2000–2014: Evidence for Mitigating Disparities in Vaccination
Vaccines 2019, 7(4), 188; https://doi.org/10.3390/vaccines7040188 - 18 Nov 2019
Cited by 5 | Viewed by 4700
Abstract
There has been no report on the situation of socioeconomic inequalities in the full vaccination coverage among Vietnamese children. This study aims to assess the trends and changes in the socioeconomic inequalities in the full vaccination coverage among Vietnamese children aged 12–23 months [...] Read more.
There has been no report on the situation of socioeconomic inequalities in the full vaccination coverage among Vietnamese children. This study aims to assess the trends and changes in the socioeconomic inequalities in the full vaccination coverage among Vietnamese children aged 12–23 months from 2000 to 2014. Data were drawn from Multiple Indicator Cluster Surveys (2000, 2006, 2011, and 2014). Concentration index (CCI) and concentration curve (CC) were applied to quantify the degree of the socioeconomic inequalities in full immunization coverage. The prevalence of children fully receiving recommended vaccines was significantly improved during 2000–2014, yet, was still not being covered. The total CCI of full vaccination coverage gradually decreased from 2000 to 2014 (CCI: from 0.241 to 0.009). The CC increasingly became close to the equality line through the survey period, indicating the increasingly narrow gap in child full immunization amongst the poor and the rich. Vietnam witnessed a sharp decrease in socioeconomic inequality in the full vaccination coverage for over a decade. The next policies towards children from vulnerable populations (ethnic minority groups, living in rural areas, and having a mother with low education) belonging to lower socioeconomic groups may mitigate socioeconomic inequalities in full vaccination coverage. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
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8 pages, 219 KiB  
Article
Immunization Status against Measles of Health-Care Workers Operating at Three Sicilian University Hospitals: An Observational Study
Vaccines 2019, 7(4), 175; https://doi.org/10.3390/vaccines7040175 - 03 Nov 2019
Cited by 19 | Viewed by 3057
Abstract
Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, [...] Read more.
Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, evaluating the immunization and vaccination status against measles of HCWs working at three Sicilian university hospitals, was conducted. All subjects not completely immune (vaccinated with only one dose in their lifetime), not immune (not vaccinated or not naturally immunized), and with an unknown immunization status were considered not immunized. Among HCWs operating in the three Sicilian university hospitals, 54.6% were not immune against measles. The average age of not immune HCWs was 51.3 (SD ± 9.8), ranging between 25 and 71 years old. In particular, 46.9% of HCWs not immunized worked in “at-risk” hospital units, based on medical conditions of patients which increases the probability of contracting an infection. Vaccination coverage rates observed against measles are considerably lower than other European countries and inadequate. It is therefore crucial to tackle vaccine hesitancy among HCWs, promoting strategies targeted to evaluate immunization status against VPDs and to significantly increase vaccine coverages, such as tailored training and vaccination offer or compulsory vaccination programs. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
12 pages, 256 KiB  
Article
Knowledge of Human Papillomavirus (HPV), Attitudes and Practices Towards Anti-HPV Vaccination Among Israeli Pediatricians, Gynecologists, and Internal Medicine Doctors: Development and Validation of an Ad Hoc Questionnaire
Vaccines 2019, 7(4), 157; https://doi.org/10.3390/vaccines7040157 - 21 Oct 2019
Cited by 12 | Viewed by 3697
Abstract
Human papillomavirus (HPV) is a highly widespread virus which is responsible for one of the most common sexually transmitted infections. Two main preventative strategies exist: anti-HPV vaccination and cervical screening. Health-care workers play a key role in promoting public health campaigns; however, vaccine [...] Read more.
Human papillomavirus (HPV) is a highly widespread virus which is responsible for one of the most common sexually transmitted infections. Two main preventative strategies exist: anti-HPV vaccination and cervical screening. Health-care workers play a key role in promoting public health campaigns; however, vaccine hesitancy is an often under-recognized challenge. To investigate the overall knowledge of HPV and HPV-related issues, as well as the attitudes and practices of health professionals towards recommending the anti-HPV vaccine, an ad hoc knowledge, attitudes, and practices (KAP) questionnaire was developed and validated in a sample of 139 Israeli pediatricians, gynecologists, and internal medicine doctors. The KAP questionnaire was found to be psychometrically valid and sound (with an rKR-20 coefficient of 0.74 for the second part and a Cronbach’s alpha of 0.85 for the third part). Furthermore, the present study confirmed the importance of health-care providers in recommending the immunization practice. Parents that had been strongly advised by health-care providers to vaccinate their children accepted immunization for their girls (odds ratio (OR) 1.09 (95% CI 1.04–1.14)) and boys (OR 1.06 (95% CI 1.02–1.10)), had a lower probability of deciding to postpone the immunization appointment (OR 0.81 (95% CI 0.66–0.98)), had fewer doubts and concerns about the vaccine (OR 0.69 (95% CI 0.54–0.89)), and had a lower probability of refusing the vaccination (OR 0.93 (95% CI 0.86–0.99)). Interestingly, the use of new, emerging tools such as ad hoc websites, applications, and other interactive devices reduced vaccine hesitancy (OR 0.90 (95% CI 0.82–0.99)) and concerns about the side-effects of the vaccine (OR 0.92 (95% CI 0.86–0.99)). However, among Israeli health-care workers, knowledge was generally moderate, with updated information lacking in about 30% of surveyed health-care providers and approximately 20% of them not recommending the anti-HPV vaccine among boys. This study has practical implications for policy- and decision-makers in that they should be aware of the overall level of knowledge among health-care workers and should implement ad hoc educational interventions to address gaps in knowledge and help medical providers routinely recommend the anti-HPV vaccine both to male and female children and adolescents. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)

Review

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14 pages, 702 KiB  
Review
Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review
Vaccines 2020, 8(2), 165; https://doi.org/10.3390/vaccines8020165 - 05 Apr 2020
Cited by 15 | Viewed by 3689
Abstract
Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types [...] Read more.
Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity. Full article
(This article belongs to the Special Issue Infectious Diseases and Vaccinations in Healthcare Professionals)
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