NHS staff who refuse flu vaccine this winter will have to give reasons

NHS staff who refuse to have the flu vaccine this winter will have to give reasons to their employer, as leaders make efforts to improve take-up rates|  BMJ 2017359 

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Image source: Daniel Dionne – Flickr // CC BY-SA 2.0

 NHS leaders are to write to all NHS staff urging them to be vaccinated against flu as soon as possible. The letter will make it clear that staff who refuse the vaccine will have to give reasons to their employing NHS trust, which will then be recorded.

The heads of NHS England, Public Health England, the Department of Health for England, and NHS Improvement said that they were writing to remind staff of their “professional duty to protect their patients.” Trusts are also being urged to make the flu vaccine “readily available” to staff.

Although last year saw record take-up of the vaccine among staff, more than a third of NHS staff members did not take up the offer, with just a fifth being vaccinated in some trusts.

Hospitals and GP surgeries are being warned by NHS England to be prepared for a big increase in cases of flu this winter after a heavy season in the southern hemisphere.

Full story via BMJ 2017359 doi: https://doi.org/10.1136/bmj.j4766

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Screening programmes | Childhood flu vaccination

Public Health England has updated the following documents:

 

Exposure to information and seasonal influenza vaccination uptake in nurses

Coverage of annual influenza vaccination of healthcare workers (HCWs) varies and remains at a sub-optimal level in many countries | Journal of Hospital Infection

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As HCWs are often exposed to a variety of information on vaccination, their pattern of exposure may impact their decision, which deserves further investigation.

Practising nurses in Hong Kong were invited to participate in an anonymous online survey in February 2015, after the winter seasonal peak. The questionnaire covered demographics, work nature and experiences, vaccination uptake history and reasons for vaccination decisions. Two categories of behaviors with regards to information access were defined – (A) passive exposure to information, and (B) active information-seeking, as differentiated by the source, type and nature of information accessed. Chi-square test, Mann-Whitney U test, logistic regression were performed to compare between vaccinated and unvaccinated nurses.

A total of 1177 valid returns were received from nurses who had a median age of 32, of whom 86% were female. The overall vaccination rate was 33%. Passive exposure to information from workplace, professional body and social network did not predict vaccination decision, while mass media did (OR:1.78). Active information-seeking involving consulting seniors (OR:2.46), having organized promotion activities (OR:2.85) and performing information search (OR:2.43) were significantly associated with increased vaccination uptake. Cumulative effect could be demonstrated for active information seeking (OR:1.86) but not passive exposure to information.

Current strategy of promotions and campaigns for seasonal influenza vaccination in HCWs may not be effective in increasing vaccination coverage. Measures targeting information-seeking behaviors may serve as an alternative approach.

Full reference: Cheung, E.K.H. et al. (2017) Pattern of exposure to information and its impacts on seasonal influenza vaccination uptake in nurses. Journal of Hospital Infection. Published online: 11 August 2017

Record numbers of NHS frontline staff have had flu jab this winter

Record numbers of NHS staff have had their flu jab this winter, official figures from Public Health England (PHE) show | OnMedica

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Some 594,700 (61.8%) frontline NHS staff across England were vaccinated against flu between 1 September and 31 December last year. That figure is expected to increase in January and February.

The highest level achieved by the end of February in previous winters was 541,757 (just under 55%) in 2014-15.

PHE does not have recorded numbers of deaths from flu. But it is estimated that, in 2015-16, there were about 2,300 excess deaths over the winter linked to the time of year. Flu and extreme cold weather are the two most likely causes.

Read the news story here

Meningitis and septicaemia prevention

Public Health England has published Guidance on the prevention and management of meningococcal meningitis and septicaemia in higher education institutions: raising awareness, promoting immunisation and planning ahead.

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Image source: http://www.gov.uk

This guidance includes information on understanding invasive meningococcal disease and why freshers are at increased risk; raising awareness of the signs and symptoms of meningitis; encouraging all first time university entrants up to 25 years old to have the MenACWY vaccination; planning ahead for possible case or cluster of cases of meningitis; and sourcing resources to support awareness of immunisation.

Practice Transformation Program Increases Adult Influenza Vaccination

Infection Control Today | Published online: 3 November 2016

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An evidence-based, step-by-step guide, the 4 Pillars™ Practice Transformation Program, was the foundation of an intervention to increase adult immunizations in primary care and was tested in a randomized controlled cluster trial. The purpose of this study by Lin, et al. (2016) was to report changes in influenza immunization rates and on factors related to receipt of influenza vaccine.

Twenty-five primary care practices were recruited in 2013, stratified by city (Houston, Pittsburgh), location (rural, urban, suburban) and type (family medicine, internal medicine), and randomized to the intervention (n = 13) or control (n = 12) in Year 1 (2013-14). A follow-up intervention occurred in Year 2 (2014-15). Demographic and vaccination data were derived from de-identified electronic medical record extractions.

A cohort of 70,549 adults seen in their respective practices (n = 24 with 1 drop out) at least once each year was followed. Baseline mean age was 55.1 years, 35 % were men, 21 % were non-white and 35 % were Hispanic. After one year, both intervention and control arms significantly (P < 0.001) increased influenza vaccination, with average increases of 2.7 to 6.5 percentage points. In regression analyses, likelihood of influenza vaccination was significantly higher in sites with lower percentages of patients with missed opportunities (P < 0.001) and, after adjusting for missed opportunities, the intervention further improved vaccination rates in Houston (lower baseline rates) but not Pittsburgh (higher baseline rates). In the follow-up intervention, the likelihood of vaccination increased for both intervention sites and those that reduced missed opportunities (P < 0.005).

The researchers say that reducing missed opportunities across the practice increases likelihood of influenza vaccination of adults. The 4 Pillars™ Practice Transformation Program provides strategies for reducing missed opportunities to vaccinate adults.

Read the full overview here

Read the original article here