title: Hospital-based cluster randomised controlled trial to assess effects of a multi-faceted programme on influenza vaccine coverage among hospital healthcare workers and nosocomial influenza in the Netherlands, 2009 to 2011.
abstract: Nosocomial influenza is a large burden in hospitals. Despite recommendations from the World Health Organization to vaccinate healthcare workers against influenza, vaccine uptake remains low in most European countries. We performed a pragmatic cluster randomised controlled trial in order to assess the effects of implementing a multi-faceted influenza immunisation programme on vaccine coverage in hospital healthcare workers (HCWs) and on in-patient morbidity. We included hospital HCWs of three intervention and three control University Medical Centers (UMCs), and 3,367 patients. An implementation programme was offered to the intervention UMCs to assess the effects on both vaccine uptake among hospital staff and patient morbidity. In 2009/10, the coverage of seasonal, the first and second dose of pandemic influenza vaccine as well as seasonal vaccine in 2010/11 was higher in intervention UMCs than control UMCs (all p<0.05). At the internal medicine departments of the intervention group with higher vaccine coverage compared to the control group, nosocomial influenza and/or pneumonia was recorded in 3.9% and 9.7% of patients of intervention and control UMCs, respectively (p=0.015). Though potential bias could not be completely ruled out, an increase in vaccine coverage was associated with decreased patient in-hospital morbidity from influenza and/or pneumonia.
authors.affiliation: Department of PharmacoEpidemiology & PharmacoEconomics, University Center of Pharmacy, University of Groningen, Groningen, the Netherlands. j.riphagen@umcg.nl
authors.forename: J
authors.initials: J
authors.lastname: Riphagen-Dalhuisen
authors.forename: J G
authors.initials: JG
authors.lastname: Burgerhof
authors.forename: G
authors.initials: G
authors.lastname: Frijstein
authors.forename: A D
authors.initials: AD
authors.lastname: van der Geest-Blankert
authors.forename: M B
authors.initials: MB
authors.lastname: Danhof-Pont
authors.forename: H J
authors.initials: HJ
authors.lastname: de Jager
authors.forename: A A
authors.initials: AA
authors.lastname: Bos
authors.forename: E E
authors.initials: EE
authors.lastname: Smeets
authors.forename: M J
authors.initials: MJ
authors.lastname: de Vries
authors.forename: P M
authors.initials: PM
authors.lastname: Gallee
authors.forename: E
authors.initials: E
authors.lastname: Hak
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization; D006801:Humans; D017589:Immunization Programs; D017758:Infectious Disease Transmission, Patient-to-Professional; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010564:Personnel, Hospital / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines