Literature required, promoted, or offered on site (45.8%). In

Literature ReviewInfluenza is a significant diseasethat affects the whole population, including both HCW and the patients. This significanceis due to the large morbidity, mortality, and high economic burden the influenzacarries. Owing to the fact that infected HCW can transmit influenza to theirpatients, which may increase the risk of complications, influenza vaccinationof HCW is recommended in many countries around the world and more campaigns arelunched to increase the coverage of vaccination.The aim of this review is to shed lighton the coverage of vaccination among HCW in different countries, the campaignslunched in some countries and their effects on the coverage rate.

 Coverage of Vaccination:In the USA, the CDC conducted anopt-in internet panel survey of 2438 health care personnel during March 28th-April 19th, 2017, to estimate the coverage of influenza vaccinationduring the 2016-2017 season.78.6% of the survey respondents reported receiving thevaccination during the 2016-2017 season. The coverage was highest among thosewho were required by their employers to be vaccinated (96.7%) and lowest amongthose working in the settings were vaccination was not required, promoted, oroffered on site (45.8%).In Qatar, a cross sectional surveywas conducted in 2015 to estimate the percentage of vaccination among 300pediatrics healthcare professionals, the study showed that 67.

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7% of the 230 respondentsreceived the vaccine and 32.2% did not receive it. The study concluded thatthose rates were higher than the previously reported ones.In another cross-sectional surveycarried out at King Abdullah Medical City Makkah, Saudi Arabia during October 1st-16th,2015,500 HCW were approached using questionnaire. Of the 447 valid returned questionnaires,88.

3% reported receiving vaccination during the 2014/2015 season, higher than duringthe 2013/2014 (61.2%) and the 2012/2013 (54.5%) seasons. The study also statedthat the increase in vaccination rates during the 2014/2015 season was followingthe adoption of mandatory vaccination policy. Another study was done in Malaysia, wherea cross sectional survey was conduced in 3 hospitals in Klang Valley. A totalof 690 questionnaires were distributed to HCW, of the 527 returned questionnaires51.

4% reported receiving the vaccine during the year 2013, with a significantproportion of them believed they were vaccinated to protect themselves. The studyalso stated that most of the employers did not have a vaccination policy andthere was a need for the government to enforce such policies and make annualvaccination mandatory for HCW. Vaccination Campaigns:Different campaigns in differentcountries were conducted with the aim to improve the vaccination coverage.In Qatar, following the low rates ofvaccination coverage among HCW in 2014 which approached 35%, the ministry ofpublic health lunched a campaign the following year between the 1stand 15th of November, 2015. The target of the campaign was tovaccinate 60% of 4700 HCW in 22 primary care corporation centers.

Vaccine wasoffered free of charge at all centers and information about the importance ofinfluenza vaccination was provided through direct communication, emails, andsocial media. The campaign exceeded its goal and 77%(n=3629) of the targetpopulation were vaccinated. Only 9%(n=453) refused the vaccine and remaining 14%were either on leave or had already been vaccinated. The uptake of the vaccine significantlyincreased during this campaign.

 In Madrid, Spain, at GregorioMarañon Paediatric Hospital. An 18-question survey regarding influenza vaccinationwas distributed to 705 HCW. The survey showed a vaccination percentage of 30%.An influenza educational program was then implemented in October, 2012 beforethe next flu season. The program was not mandatory and involved interactive sessionsthat provided information about the virus and infection, the risk of nosocomialtransmission, and the effectiveness of influenza vaccination. In January 2013,the same surveys were delivered to 687 HCW. There was a significant increase inthe vaccination rates from 30% to 40%.

In its summary the study found that a simpleand inexpensive educational program significantly increased the uptake ofvaccination among HCW.