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Potential Ceiling Effect of Healthcare Worker Influenza Vaccination on the Incidence of Nosocomial Influenza Infection

Published online by Cambridge University Press:  21 April 2016

Brandon Dionne*
Affiliation:
Department of Pharmacy Practice, College of Pharmacy–Glendale, Midwestern University, Glendale, Arizona
Meghan Brett
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Karissa Culbreath
Affiliation:
Department of Pathology, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Tricore Reference Laboratory, Albuquerque, New Mexico
Renee-Claude Mercier
Affiliation:
Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
*
Address correspondence to Brandon Dionne, PharmD, BCPS, AAHIVP, 19555 N 59th Ave, Glendale, AZ 85308 ([email protected]).

Abstract

OBJECTIVE

To evaluate the effect of healthcare worker (HCW) influenza vaccination on the incidence of nosocomial influenza

DESIGN

Retrospective cross-sectional study

SETTING

A 550-bed tertiary-care academic medical center

METHODS

All admitted patients with a direct fluorescent antibody (DFA) or polymerase chain reaction (PCR) assay positive for influenza ordered between October 1 and May 31 from 2010 to 2015 were eligible for inclusion. Nosocomial influenza was defined as a positive influenza test collected ≥48 hours after admission in patients without influenza-like illness present within 24 hours of admission. Relative nosocomial influenza frequency was calculated by dividing the number of nosocomial cases by the total number of admitted patients with influenza for each season. A univariate logistic regression was used to determine the association between HCW influenza vaccination coverage and nosocomial influenza.

RESULTS

Over 5 seasons, 533 patients had positive influenza tests during their hospitalization; 29 of these patients (5.4%) acquired influenza during their hospitalization. HCW vaccination coverage increased over the 5 seasons from 47% to 90% (P<.001). Despite an initial decrease in relative nosocomial influenza frequency during the first year (9% to 4.9%), subsequent seasons failed to show an additional decrease in nosocomial infections (4.3%, 5.2%, and 4.8%, respectively); the overall decrease in nosocomial influenza from the first season to the final season was not significant (P=.282). No association was detected between HCW vaccination coverage and nosocomial influenza (odds ratio [OR], 0.990; 95% confidence interval [CI], 0.970–1.011).

CONCLUSION

HCW vaccination >50% may not have a significant effect on nosocomial influenza.

Infect Control Hosp Epidemiol 2016;37:840–844

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Thompson, WW, Weintraub, E, Dhankhar, P, et al. Estimates of US influenza-associated deaths made using four different methods. Influenza Other Respi Viruses 2009;3:3749.Google Scholar
2. CDC. Estimates of deaths associated with seasonal influenza—United States, 1976–2007. MMWR Morb Mortal Wkly Rep 2010;59:10571062.Google Scholar
3. Thompson, WW, Shay, DK, Weintraub, E, et al. Influenza-associated hospitalizations in the United States. J Am Med Assoc 2004;292:13331340.Google Scholar
4. Malavaud, S, Malavaud, B, Sandres, K, et al. Nosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation 2001;72:535537.Google Scholar
5. Maltezou, HC, Drancourt, M. Nosocomial influenza in children. J Hosp Infect 2003;55:8391.Google Scholar
6. Weinstock, DM, Eagan, J, Malak, SA, et al. Control of influenza A on a bone marrow transplant unit. Infect Control Hosp Epidemiol 2000;21:730732.CrossRefGoogle ScholarPubMed
7. Cunney, RJ, Bialachowski, A, Thornley, D, Smaill, FM, Pennie, RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449454.Google Scholar
8. Hall, CB, Douglas, RG Jr. Nosocomial influenza infection as a cause of intercurrent fevers in infants. Pediatrics 1975;55:673677.CrossRefGoogle ScholarPubMed
9. Salgado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.Google Scholar
10. Kapila, R, Lintz, DI, Tecson, FT, Ziskin, L, Louria, DB. A nosocomial outbreak of influenza A. Chest 1977;71:576579.Google Scholar
11. Sartor, C, Zandotti, C, Romain, F, et al. Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak. Infect Control Hosp Epidemiol 2002;23:615619.CrossRefGoogle Scholar
12. Serwint, JR, Miller, RM. Why diagnose influenza infections in hospitalized pediatric patients? Pediatr Infect Dis J 1993;12:200204.Google Scholar
13. Saxen, H, Virtanen, M. Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J 1999;18:779783.Google Scholar
14. Carman, WF, Elder, AG, Wallace, LA, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000;355:9397.CrossRefGoogle ScholarPubMed
15. Potter, J, Stott, DJ, Roberts, MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:16.Google Scholar
16. Lemaitre, M, Meret, T, Rothan-Tondeur, M, et al. Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc 2009;57:15801586.Google Scholar
17. Pearson, ML, Bridges, CB, Harper, SA, HICPAC, ACIP. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55:116.Google Scholar
18. Amodio, E, Restivo, V, Firenze, A, Mammina, C, Tramuto, F, Vitale, F. Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients? J Hosp Infect 2014;86:182187.Google Scholar
19. Salgado, CD, Giannetta, ET, Hayden, FG, Farr, BM. Preventing nosocomial influenza by improving the vaccine acceptance rate of clinicians. Infect Control Hosp Epidemiol 2004;25:923928.Google Scholar
20. CDC. Influenza vaccination coverage among health-care personnel—United States, 2012–2013 influenza season. MMWR Morb Mortal Wkly Rep 2013;62:781786.Google Scholar
21. Immunization and Infectious Diseases. Healthy People 2020 website. http://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Published 2015. Accessed August 20, 2015.Google Scholar
22. van den Dool, C, Bonten, MJM, Hak, E, Heijne, JCM, Wallinga, J. The effects of influenza vaccination of health care workers in nursing homes: Insights from a mathematical model. PLoS Medicine 2008;5:e200.CrossRefGoogle ScholarPubMed
23. Wendelboe, AM, Grafe, C, McCumber, M, Anderson, MP. Inducing herd immunity against seasonal influenza in long-term care facilities through employee vaccination coverage: A transmission dynamics model. Comput Math Methods Med 2015;2015:178247.Google Scholar
24. van den Dool, C, Bonten, MJ, Hak, E, Wallinga, J. Modeling the effects of influenza vaccination of health care workers in hospital departments. Vaccine 2009;27:62616267.Google Scholar
25. Weekly U.S. influenza surveillance report. Center for Disease Control and Prevention website. http://www.cdc.gov/flu/weekly/. Published 2015. Accessed June 12, 2015.Google Scholar
26. Seasonal influenza vaccine effectiveness, 2005–2015. Center for Disease Control and Prevention website. Published 2015. Accessed August 19, 2015.Google Scholar
27. CDC. Influenza vaccination coverage among health-care personnel—United States, 2012–2013 influenza season. MMWR Morb Mortal Wkly Rep 2013;62:781786.Google Scholar
28. Reyes, K, Kilgore, P, Karwowski, K, Johnson, L, Weinmann, A, Zervos, M. Flu vaccine uptake among HCW: What gives? What intervention? In: Abstracts of the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC); September 5–9, 2014; Washington, DC. Abstract I-564.Google Scholar
29. Wendelboe, AM, Avery, C, Andrade, B, Baumbach, J, Landen, MG. Importance of employee vaccination against influenza in preventing cases in long-term care facilities. Infect Control Hosp Epidemiol 2011;32:990997.Google Scholar
30. Leclair, JM, Freeman, J, Sullivan, BF, Crowley, CM, Goldmann, DA. Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions. N Engl J Med 1987;317:329334.Google Scholar
31. Patrozou, E, Mermel, LA. Does influenza transmission occur from asymptomatic infection or prior to symptom onset? Public Health Rep 2009;124:193196.Google Scholar
32. Mermel, LA. Influenza fever restrictions for healthcare workers and pandemic planning: Time for reappraisal. Infect Control Hosp Epidemiol 2015;36:1248.Google Scholar
33. New Mexico influenza surveillance update: 2011–2012 influenza season. New Mexico Department of Health website. http://nmhealth.org/data/view/infectious/1410/. Published May 19, 2012. Accessed January 8, 2016.Google Scholar