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  • 1
    Language: English
    In: Vaccine, 27 August 2014, Vol.32(38), pp.4844-4848
    Description: Nosocomial influenza outbreaks and the transmission of influenza to health care workers (HCWs) have been well described. However, vaccine coverage among HCWs still remains low. After three decades of official recommendations that all HCWs be vaccinated against influenza, vaccination rates generally remain below 30% in Europe. Experiences in the USA have shown that mandatory policies achieve a compliance rate of nearly 100%. However, the discussion about mandatory vaccination policies for HCWs has not advanced very far in Europe. This article therefore discusses the question whether it is time to consider mandatory vaccination policies for HCWs in Europe. We further elaborate under which conditions mandatory vaccination polices would be ethically justified and how far these conditions are met in the case of influenza vaccination of HCWs. From a methodological perspective, it would be desirable to have further high-quality RCTs with a lower risk of bias that investigate the effectiveness of HCWs influenza vaccination. From a policy perspective, however, we have to decide whether we have already sufficient (albeit not perfect) evidence to justify mandatory influenza vaccination programs for HCWs. We conclude: Given the available evidence concerning the benefits, burdens and risks of HCWs influenza vaccination and the limited effectiveness of voluntary policies, it is time to consider mandatory vaccination policies for HCWs in Europe.
    Keywords: Health Care Worker ; Infection Control ; Influenza ; Mandatory Vaccination ; Policy ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0264-410X
    E-ISSN: 1873-2518
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  • 2
    Language: English
    In: Vaccine, 17 October 2013, Vol.31(44), pp.5111-5117
    Description: Healthcare personnel (HCP) are at risk from occupational exposure to airborne and bloodborne pathogens, and the risk of infection among HCP is greater than among the general population. The aim of the study was to characterize attitudes toward occupational recommended vaccines as well as the perception of risks of occupationally acquired infections. We surveyed 650 medical students to assess their perception of influenza and hepatitis B and their opinions and beliefs about influenza and hepatitis B vaccines. We found differences between pre-clinical and clinical students regarding the uptake of influenza and hepatitis B vaccines, about the chances of being occupationally infected with influenza or hepatitis B, and about the likelihood of suffering from severe side-effects following immunization. Interestingly, the risk perception varied drastically between the two vaccine-preventable diseases hepatitis B and influenza. Medical students rated the probability of contracting hepatitis B due to a work-related exposure and the severity of disease significantly higher than for influenza, and this may be an explanation for the greater acceptance of the hepatitis B vaccine. Furthermore, our findings suggest that medical students are frequently inaccurate in assessing their own risk level, and their specific knowledge about both diseases and the severity of these diseases proved to be unsatisfactory.
    Keywords: Infection Control ; Influenza ; Healthcare Personnel ; Hepatitis ; Medical Students ; Vaccination ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0264-410X
    E-ISSN: 1873-2518
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  • 3
    Language: English
    In: Vaccine, 01 February 2012, Vol.30(6), pp.1143-1148
    Description: ► Perceived own risk key driver of medical students’ vaccination intention. ► Own risk predicted intentions more strongly than knowledge of recommendation. ► Vaccination knowledge relates to greater perceived influenza risk and lower perceived AEFI risk. ► 63.5% of med students consider Internet to be an important or very important source of health information. ► 34–58% of websites provided correct information concerning vaccine safety questions. was to improve understanding of mechanisms contributing to healthcare personnel's (HCP) reluctance to get vaccinated against seasonal influenza. We assessed the role of several drivers: vaccination knowledge, vaccination recommendations and the role of the Internet (so-called e-health) in creating vaccination knowledge. The key mechanism under consideration was the perceived own risk (regarding disease and the vaccine). 310 medical students at the Frankfurt University Hospital answered an anonymous questionnaire assessing risk perceptions, intentions to get vaccinated, knowledge, preferences regarding information sources for personal health decisions and search-terms that they would use in a -search directed at seasonal influenza vaccination. The key driver of vaccination intentions was the perceived own risk (of contracting influenza and of suffering from vaccine adverse events). The recommendation to get vaccinated was a significant, yet weaker predictor. As an indirect driver we identified one's knowledge concerning vaccination. 32% of the knowledge questions were answered incorrectly or as don’t know. 64% of the students were e-health users; therefore, additional information search via the Internet was likely. An analysis of the websites obtained by the search-terms provided by the students revealed 30% commercial e-health websites, 11% anti-vaccination websites and 10% public health websites. Explicit searches for vaccination risks led to fewer public health websites than searches without risk as a search term. Content analysis of the first three websites obtained revealed correct information regarding the questions of whether the doses of vaccine additives were dangerous, whether chronic diseases are triggered by vaccines and whether vaccines promote allergies in 58%, 53% and 34% of the websites, respectively. These questions were especially related to own risk, which strongly predicted intentions. Correct information on vaccination recommendations were provided on 85% of the websites. Concentrating on the key drivers in early medical education (own risk of contracting influenza, vaccine safety, vaccination recommendation) promises to be a successful combination to increase vaccination uptake in HCP.
    Keywords: Vaccine Risk Perception ; Internet ; E-Health ; Hcp/Hcw Vaccine Refusal ; Drivers of Vaccination Decision ; Medical Students ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0264-410X
    E-ISSN: 1873-2518
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  • 4
    Language: English
    In: Vaccine, 07 July 2014, Vol.32(32), pp.4025-4031
    Description: Healthcare personnel (HCP) are at increased risk of acquiring vaccine-preventable diseases (VPDs). Vaccination protects HCP and their patients from nosocomial transmission of VPDs. HCP who have underlying diseases (e.g., immunocompromised, HIV-infected, or those with chronic diseases) and HCP in particular phases of life (e.g., pregnant, elderly) require special consideration in regards the provision of vaccines. On the one hand, live virus vaccines may be contraindicated (e.g., pregnant HCP, immunocompromised HCP), while on the other hand, vaccines not routinely recommended (e.g., pneumococcal) may be indicated (e.g., elderly or immunocompromised HCP). It is not known how many HCP with underlying conditions require special consideration in the healthcare setting. This is an important issue, because the risk for serious morbidity, complications and mortality for HCP with underlying conditions will only increase. The prevention of nosocomial infections requires comprehensive occupational safety programs. The healthcare system must engage HCP and occupational physicians to ensure sufficient vaccination rates as part of an effective nosocomial infection prevention and HCP safety strategy.
    Keywords: Healthcare Personnel ; Healthcare Worker ; Immunocompromised ; Immunization ; Occupational Infections ; Vaccination ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0264-410X
    E-ISSN: 1873-2518
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  • 5
    Language: English
    In: Vaccine, 31 July 2014, Vol.32(35), pp.4478-4484
    Description: Healthcare personnel (HCP) are often under-vaccinated. The aim of this study was to evaluate occupational physicians’ potential role by assessing relations between their knowledge and attitudes regarding HCP vaccination and the extent to which official vaccination recommendations are communicated. Cross-sectional survey, = 135 occupational physicians. Occupational physicians who treat HCP recommend vaccinations more often to HCP when they have better knowledge of official vaccination recommendations and a more positive attitude towards vaccination compared to physicians with less such knowledge or a more negative attitude. The attitude towards vaccination most strongly affects whether occupational physicians recommend the measles, mumps, and rubella (MMR) vaccination: physicians with less positive attitudes recommend MMR to HCP in a more restricted way. A more positive attitude towards vaccination also relates to fewer misconceptions. Occupational physicians’ knowledge and attitude further influence the extent to which pregnant HCP receive vaccinations against influenza. Knowledge about official recommendations does not influence the recommendation of influenza vaccination for pregnant women. Reasons for vaccination gaps in HCP might have their roots in occupational physicians’ incomplete knowledge of vaccination recommendations. Attitudes, which are related to misperceptions, also influence which vaccinations are recommended to HCP. Official recommendations, and not personal attitudes and misconceptions, should guide occupational vaccination behavior.
    Keywords: Healthcare Personnel ; Immunization ; Nosocomial Infection ; Occupational Infection ; Occupational Physician ; Vaccination Recommendation ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0264-410X
    E-ISSN: 1873-2518
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  • 6
    Language: English
    In: Journal of Clinical Virology, 2015, Vol.69, p.200(3)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jcv.2015.06.099 Byline: Sabine Wicker, Holger F. Rabenau Abstract: * Long-term Influenza A virus H3N2 shedding occurred in an otherwise healthy individual. * Long-term virus shedding might have implications for infection control. * Predictive value of influenza PCR regarding infection control must be evaluated. Author Affiliation: (a) Occupational Health Service, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany (b) Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596 Frankfurt am Main, Germany Article History: Received 21 April 2015; Revised 9 June 2015; Accepted 23 June 2015
    Keywords: Influenza – Health Aspects
    ISSN: 1386-6532
    Source: Cengage Learning, Inc.
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  • 7
    Language: English
    In: AJIC: American Journal of Infection Control, July 2013, Vol.41(7), pp.661-663
    Description: Despite the availability of an effective and safe vaccine for almost half a century, measles is re-emerging in several developed countries because of the insufficient vaccination coverage among specific subpopulations, the emerging anti-vaccination movement, and the increasing movement of humans across borders. In this context, health-care settings play a critical role in the transmission of infection and generation of numerous cases. Health-care-associated outbreaks may be associated with severe morbidity and mortality among specific groups of patients, disruption of health-care services, and considerable costs. Misdiagnosis or delayed diagnosis of a measles case and inadequate implementation of infection control measures are common in almost all events of nosocomial spread. Measles vaccination of health-care workers is an effective means of prevention of nosocomial measles outbreaks. Eliminating measles by 2010 has not been accomplished. Stronger recommendations and higher vaccination coverage against measles in health-care workers could contribute to eliminate measles in the general population. [PUBLICATION ]
    Keywords: Outbreak ; Nosocomial ; Hospital ; Transmission ; Health-Care Workers ; Vaccine-Preventable Disease ; Public Health
    ISSN: 0196-6553
    E-ISSN: 1527-3296
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  • 8
    Language: English
    In: Medizinische Klinik, 2010, Vol.105(12), pp.882-886
    Description: Byline: Sabine Wicker (1,3), Markus A. Rose (2) Keywords: Health care worker; Nosocomial transmission; Occupational infections; Pertussis; Vaccination schedule; Mitarbeiter im Gesundheitswesen; Nosokomiale Infektionen; Arbeitsbedingte Infektionen; Pertussis; Impfkalender Abstract: Abstract Purpose: Communicable and vaccine-preventable airway infections are a major public and occupational health issue. The epidemiology of pertussis has changed, with unprotected adults being the main source of infections. Thus, the prevention of a transmission from health care workers (HCWs) to patients is an important strategy to control this communicable infection. The Standing Committee on Vaccination (STIKO) at the Robert Koch-Institute in Germany has explicitly recommended that HCWs ought to be vaccinated against pertussis. However, vaccination rates among HCWs remain low. This study was meant to evaluate the attitudes of HCWs towards the pertussis vaccination and to determine the correlation between the influenza and pertussis vaccination status of HCWs. Methods: An anonymous questionnaire was distributed to HCWs at a German university hospital. Results: Overall, we found a disturbingly low level of awareness concerning official recommendations as to immunizations (35.6%) and the personal risk assessment of acquiring a work-related pertussis infection (23.2%). In general, both aspects were frequently associated with a refusal to get immunized. A strong correlation between the immunization status of pertussis and influenza was found among physicians: overall, 93.1% of physicians who were vaccinated against pertussis were also vaccinated against influenza. Nurses showed significantly weaker correlation rates as well as lower vaccination rates (p〈0.05). Conclusions: Misconceptions about pertussis and low vaccination rates were prevalent among HCWs, particularly nurses. Hospital-based pertussis vaccination campaigns should focus on the risk of nosocomial pertussis transmission and on the new recommendations for pertussis immunization among adults and HCWs. Abstract (German): Zusammenfassung Zielsetzung: Impfpraventable respiratorische Erkrankungen sind sowohl fur die offentliche Gesundheit als auch die Arbeitsmedizin von besonderer Bedeutung. Die Epidemiologie von Pertussis hat sich verandert, mittlerweile sind nicht-immune Erwachsene am haufigsten betroffen. Aus diesem Grund ist die Vermeidung von Infektionsubertragungen durch Mitarbeiter des Gesundheitswesens auf Patienten eine wichtige Strategie, um diese ansteckende Erkrankung einzudammen. Die Standige Impfkommission (STIKO) am Robert Koch-Institut (RKI) nennt medizinisches Personal explizit als eine Risikogruppe, die gegen Pertussis geimpft werden sollte. Ungeachtet dessen ist die Akzeptanz der Pertussisimpfung bei medizinischem Personal gering. Unsere Studie beschreibt die Einstellungen der Mitarbeiter des Gesundheitswesens bezuglich der Pertussisimpfung und korreliert den Influenzaimpfstatus des medizinischen Personals mit dem Pertussisimpfstatus. Methode: Anonyme Fragebogenerhebung bei medizinischem Personal einer deutschen Universitatsklinik. Ergebnisse: Offizielle Impfempfehlungen werden nur unzureichend wahrgenommen. Lediglich 35,6% der Befragten kannten die Impfempfehlung fur Pertussis, nur 23,2% sahen ein arbeitsbedingtes Infektionsrisiko. Oftmals waren diese beiden Aspekte mit einer Impfablehnung verknupft. Bei Arzten fand sich eine starke Korrelation zwischen dem Impfstatus von Pertussis und Influenza: Insgesamt 93,1% der Arzte, die gegen Pertussis geimpft waren, waren ebenso gegen Influenza geimpft. Pflegepersonal zeigte sowohl geringere Korrelationsraten als auch niedrigere Impfraten (p 〈 0,05). Schlussfolgerungen: Das Wissen uber Pertussis und der Impfstatus des medizinischen Personals (insbesondere beim Pflegepersonal) sind unzureichend und erfordern krankenhausinterne Impfkampagnen. Das Risiko von nosokomialen Pertussisinfektionen sowie die neuen Impfempfehlungen fur Pertussis sollten hierbei im Mittelpunkt stehen. Author Affiliation: (1) Occupational Health Service, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany (2) Children's Hospital, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany (3) Occupational Health Service, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany Article History: Registration Date: 01/01/2010 Received Date: 10/08/2010 Accepted Date: 12/09/2010 Online Date: 16/01/2011
    Keywords: Health care worker ; Nosocomial transmission ; Occupational infections ; Pertussis ; Vaccination schedule
    ISSN: 0723-5003
    E-ISSN: 1615-6722
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  • 9
    Language: English
    In: International Archives of Occupational and Environmental Health, 2010, Vol.83(1), pp.77-83
    Description: Byline: Sabine Wicker (1,2), Holger F. Rabenau (2) Keywords: Bloodborne viruses; Dental infection control; Needlestick injury; Occupational infections Abstract: Purpose Exposures to bloodborne pathogens pose a serious risk to dental healthcare workers (DHCW). Despite improved methods of preventing exposures like needlestick injuries (NSI), occupational exposures still continue to occur. The purpose of this study was to evaluate the incidence of occupational exposures to patient body fluids among German DHCW, to assess the rate of reporting of such incidents, and to evaluate the association of various factors with these exposures. Methods Data was obtained through an anonymous questionnaire. Results Our study confirms that occupational skills are an important factor concerning NSI. It turned out that dental students (0.74 NSI p. a.) had nearly twice the number of NSI compared with dentists with more or less than 10 years working experience (0.42, 0.49 NSI p. a., respectively, P 〈 0.0001). Overall, 54.3% (n = 144/265) of respondents had sustained at least one NSI in their professional life. Only 28.5% of injured dental students and DHCW reported all of their NSI, the main reason (19.1%) for not reporting NSI was little or no perception of risk on behalf of the respondent. One-fourth of respondents were not wearing a mask and 55.6% were not wearing protective goggles during their last occupational exposures. Conclusions Occupational exposure to blood or body fluids is a common problem among DHCW and dental students. Measures must be adopted by official institutions, public health service, occupational health association and universities in order to reverse this situation. Author Affiliation: (1) Occupational Health Service, Hospital of the Johann Wolfgang Goethe-University of Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany (2) Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe-University of Frankfurt, Paul-Ehrlich-Str. 40, 60596, Frankfurt am Main, Germany Article History: Registration Date: 08/07/2009 Received Date: 21/11/2008 Accepted Date: 08/07/2009 Online Date: 22/07/2009
    Keywords: Bloodborne viruses ; Dental infection control ; Needlestick injury ; Occupational infections
    ISSN: 0340-0131
    E-ISSN: 1432-1246
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  • 10
    Language: English
    In: International Journal of Hygiene and Environmental Health, July 2012, Vol.215(4), pp.482-486
    Description: Influenza viruses are highly contagious. Medical personnel are at risk of occupational exposure to influenza. Data on dental healthcare workers (DHCWs) immunization status has not been published. We conducted a cross-sectional survey of DHCWs and dental students at a German dental university hospital. Surveys, completed between October 2010 and March 2011, focused on reasons of DHCWs for accepting or declining the influenza vaccination. Furthermore, we characterized attitudes towards influenza infection due to the emergence of the H1N1/2009. Compliance rates with the influenza vaccination among DHCWs were low (31.6%). The main reason for not getting vaccinated against the pandemic influenza A/H1N1 virus in the 2009/2010 season was the objection to the AS03-adjuvants (48.5%). Of the DHCWs surveyed, 30.6% (74/242) cited that the H1N1/2009 pandemic influenced their attitudes towards vaccination in general. Our findings confirm the importance of a comprehensive approach to the influenza vaccination, ensuring that DHCWs are correctly informed about the vaccine and that it is convenient to receive it. It could be shown that an immunization campaign at the workplace seems to be capable of improving vaccination rates, one-third of the vaccinees have been vaccinated for the first time.
    Keywords: Dental Health Care Workers ; Influenza ; Influenza A/H1n1 ; Occupational Infections ; Vaccination ; Biology ; Public Health
    ISSN: 1438-4639
    E-ISSN: 1618-131X
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