title: Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services.
abstract: BACKGROUND
  Influenza is a major concern for Emergency Medical Services (EMS); EMS workers' (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.
  
  
  OBJECTIVE
  The influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.
  
  
  METHODS
  A survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.
  
  
  RESULTS
  Response rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women's vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.
  
  
  CONCLUSIONS
  Average vaccination rate in this study's EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a "pandemic effect." These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.
authors: 1Department of Internal Medicine,Hospital of Thun and Simmental (STS AG),Zweisimmen,Switzerland.
authors: Alexandre
authors: A
authors: Moser
authors: 2University of Health Sciences (HESAV),Lausanne,Switzerland.
authors: Cédric
authors: C
authors: Mabire
authors: 3Emergency Department,Lausanne University Hospital,Lausanne,Switzerland.
authors: Olivier
authors: O
authors: Hugli
authors: 4Service of Occupational Medicine,Institute for Work and Health,Lausanne,Switzerland.
authors: Victor
authors: V
authors: Dorribo
authors: 5Service of Infectious Diseases,Lausanne University Hospital,Lausanne,Switzerland.
authors: Giorgio
authors: G
authors: Zanetti
authors: 6Service of Hospital Preventive Medicine,Lausanne University Hospital,Lausanne,Switzerland.
authors: Catherine
authors: C
authors: Lazor-Blanchet
authors: 3Emergency Department,Lausanne University Hospital,Lausanne,Switzerland.
authors: Pierre-Nicolas
authors: PN
authors: Carron
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D058873:Pandemics / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: EMS Emergency Medical Service; EMS-W Emergency Medical Service workers; EMS-workers; Emergency Medical Services; HCW health care workers; PI pandemic influenza; PPE personal protective equipment; SI seasonal influenza; influenza; vaccination