A successful season for influenza A immunization: 2009

Background: In 2009, the Turkish Ministry of Health, and World Health Organization (WHO) have recommended and H1N1 influenza vaccination of all healthcare personnel (HCP) and seasonal influenza vaccination to protect HCP from influenza illness and prevent nosocomial influenza transmissions. 

Objective: In this report, we describe influenza vaccination rates of different categories of HCP at a University Hospital in Turkey.

Methods: Our hospital is a University hospital with 410 beds. In 2009, 1295 HCPs were working in the hospital, of whom 310 were physicians, 406 were nurses, therapists and the other health-care workers (HCWs) providing care directly to patients, 579 were the other employees, who worked at the offices. Between November 3^rd and December 12^th, all the employees were informed and recommended about the vaccine of influenza A (H1N1) (Focetria®; Novartis) and as well as the employees who worked in the department of infectious diseases, chest diseases, ear, nose and throat department, worked intensive care units, and emergency room informed about the seasonal flu vaccination (Vaxigrip ®; Sanofi Pasteur). The volunteers were vaccinated.

Results: Ninety- three percent of all HCP (1206/1295) was received influenza A (H1N1) vaccine.  Eighty percent of the employees, who recommended seasonal influenza vaccination, (145/181) was vaccinated with seasonal flu vaccine. Vaccination rates by HCPs and setting are described in the Table. 

Table: Vaccination rates of HCPs

HCP	Influenza A (H1N1) vaccine		Seasonal flu vaccine
	Total N	Vaccinated N (%)	Total N	Vaccinated N (%)
Physicians	310	304 (98%)	80	74 (93%)
HCWs providing patient care*	406	178 (44%)	65	41 (63%)
The others**	579	481 (83%)	36	30 (83%)
Total	1295	1206 (93%)	181	145 (80%)
* Nurses, therapists and other HCWs ** Employee works in offices

Conclusions: The rate of influenza vaccination among HCPs is approximately 40% according to different reports. The most important causes of the rejecting are poorly understanding of adverse effect of the vaccine. The first week of our vaccination campaign, for health personnel was lost of lives due to influenza A (H1N1), influenza vaccination rates were very high. Due to the increase of flu cases, a second rise was observed in the third week. Influenza vaccination rates of HCP varied widely among different categories of staff.  The rates for physicians and officers were close to the target, but vaccination rates of HCW’s providing patient care were significantly lower than the other groups.  For vaccination campaign of 2010, we need alternative approaches to raise vaccination rates of HCWs.