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CORD-19:f2355e9fac7955ef426142793a3a3597189ba2d1 JSONTXT 8 Projects

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Id Subject Object Predicate Lexical cue
T1 0-77 Sentence denotes Healthcare worker compliance with seasonal and pandemic influenza vaccination
T2 79-464 Sentence denotes Healthcare workers (HCWs) are at increased risk of exposure to influenza and may transmit the disease to patients in their care. [1] [2] [3] Recognising the role that HCWs may play in the transmission of influenza, both the World Health Organization (WHO) and the Strategic Advisory Group of Experts on Immunization recommend seasonal and pandemic influenza vaccination (PIV) for HCWs.
T3 465-619 Sentence denotes 4, 5 In the United States, seasonal vaccination of HCWs has been recommended for more than two decades and is currently endorsed by 29 European countries.
T4 620-810 Sentence denotes 6, 7 Despite these recommendations, vaccination coverage of HCWs has remained disappointingly low and showed little improvement as pandemic influenza A (H1N1) swept across the globe in 2009.
T5 811-938 Sentence denotes The 2010/2011 influenza season was the first time the percentage of HCWs receiving the seasonal vaccine exceeded 60% in the US.
T6 939-1371 Sentence denotes 6 Unfortunately, vaccination rates in this group have been consistently lower in most of Europe, and as will be discussed, recent provision of pandemic vaccine may have actually served to magnify the challenges with influenza vaccination among HCWs. [8] [9] [10] [11] [12] [13] [14] [15] This article reviews and summarises the social sciences literature on factors associated with HCWs' decision to be vaccinated against influenza.
T7 1372-1621 Sentence denotes The articles used for this review are a subset of a larger group of publications identified during the formulation of a report on the quantitative and qualitative trends in the social sciences literature on Influenza published between 1990 and 2010.
T8 1622-1724 Sentence denotes The literature search was performed using Web of Science, and articles in all languages were included.
T9 1725-1924 Sentence denotes Two different search criteria and time-lines were used, one for a search of literature on decision-making and another on literature exploring risk perceptions and behaviours in relation to influenza.
T10 1925-2218 Sentence denotes For the latter, the key words included 'risk perception', 'health behaviours', 'misconceptions', 'knowledge', 'attitudes', 'practices', 'acceptability', 'nonpharmaceutical measures', 'social-distancing', 'quarantine', 'influenza', 'seasonal influenza', 'pandemic', 'avian influenza' and 'flu'.
T11 2219-2360 Sentence denotes The list of articles were compiled using this timeline, and these keywords were evaluated for relevance through an analysis of the abstracts.
T12 2361-2597 Sentence denotes Articles that concerned topics outside the social sciences domain (e.g. virology, pathophysiology, immunology), meeting abstracts and publications that solely addressed non-influenza respiratory illnesses (including SARS) were excluded.
T13 2598-2723 Sentence denotes When there was doubt about the relevance of the content of the abstract, the full texts of the publications were referred to.
T14 2724-2881 Sentence denotes The next step was to conduct an in-depth analysis of the main topics covered in the retained collection of articles and create categories of the main themes.
T15 2882-3108 Sentence denotes Using this method, the main topics covered in the literature on risk perception and behaviours related to influenza included articles that dealt with compliance with influenza vaccination and perceptions of the illness itself.
T16 3109-3436 Sentence denotes In the light of the fact that the perception of influenza vaccination, particularly among the HCW population, was one of the main themes addressed in the literature, a decision was made to focus on some key articles in this extensive collection of over 250 publications to highlight the main findings for this particular group.
T17 3437-3830 Sentence denotes Recognising the impact of introducing pandemic vaccine during the 2009-2010 H1N1 pandemic and the challenges with ensuring HCW compliance in this particular context, we decided to add to our collection a systematic review on the topic published in 2011 found through a simple search using google scholar and using the terms 'healthcare workers', 'pandemic vaccination' and 'systematic review'.
T18 3831-3966 Sentence denotes A further four articles, also published in 2011, were identified through a forward search of citations listed in the systematic review.
T19 3967-4485 Sentence denotes There are two broad reasons why HCWs have been an important target for influenza vaccination: (i) to protect HCWs from illness and prevent absenteeism particularly during outbreaks or pandemics and (ii) to protect others, particularly those in their care, as HCWs can be an important source of nosocomial spread of this disease. [1] [2] [3] 16, 17 When a health professional is vaccinated, this also sets an example for patients to follow and increases the likelihood that the HCW will recommend the vaccine to others.
T20 4486-4717 Sentence denotes 1, [17] [18] [19] [20] [21] [22] The latter is especially important being that members of the community and HCWs themselves often depend on the recommendation of a physician or a nurse when deciding to accept influenza vaccination.
T21 4718-4944 Sentence denotes 8, 12, [23] [24] [25] [26] [27] [28] Demographics of HCW vaccination compliance Although HCWs as a group have low vaccine coverage rates, there is considerable variability within the cohort along various demographic variables.
T22 4945-5070 Sentence denotes In many studies, older age was found to be associated with higher intentions to be vaccinated and vaccine receipt among HCWs.
T23 5071-5254 Sentence denotes 9, 12, 22, [28] [29] [30] Fewer studies have associated younger age with vaccine acceptability, and others have found no significant association between age and influenza vaccination.
T24 5255-5363 Sentence denotes 19, [31] [32] [33] [34] Gender In many studies, male HCWs are found to be more likely to accept vaccination.
T25 5364-5528 Sentence denotes 11, 22, 30, 33, 35 However, following the implementation of a vaccination programme in the UK, female sex was found to be positively associated with vaccine uptake.
T26 5529-5531 Sentence denotes 36
T27 5533-5673 Sentence denotes Among HCWs, physicians are often found to have the highest intentions to receive influenza vaccination and the best rates of vaccine uptake.
T28 5674-5813 Sentence denotes 9, 11, 12, 15, 19, 33, 37, 38 Few studies have shown higher acceptance among non-physician HCWs (nurses, paramedics) compared with doctors.
T29 5814-5899 Sentence denotes 32, 39, 40 In fact, being a nurse is often negatively associated with vaccine uptake.
T30 5900-5910 Sentence denotes 10, 41, 42
T31 5912-6071 Sentence denotes Achieving compliance with Influenza vaccination among HCWs is a complex process and is affected by a wide variety of factors that are difficult to disentangle.
T32 6072-6146 Sentence denotes Country-and culture-specific variables may further complicate the picture.
T33 6147-6308 Sentence denotes Although an individual decision to vaccinate or not may involve unique considerations, some general trends appear to cut across many contexts as discussed below.
T34 6309-6572 Sentence denotes A finding common to most studies is that previous receipt of the seasonal influenza vaccine is positively associated with intentions and receipt of seasonal and pandemic influenza vaccines. [9] [10] [11] [12] 14, 15, 19, 29, 30, 38, 41 In a study by Amodio et al.
T35 6573-6703 Sentence denotes 42 not having been vaccinated against seasonal influenza was also found to be associated with a lower likelihood of accepting PIV.
T36 6704-6854 Sentence denotes Many HCWs base their decision to receive vaccine (or not) on perceptions of risk, which are often calculated with incorrect or incomplete information.
T37 6855-7008 Sentence denotes In some studies, perceptions of seasonal and pandemic influenza as mild diseases were associated with reduced intentions and lower uptake of the vaccine.
T38 7009-7129 Sentence denotes 10, 35 Conversely, the perception of influenza as a severe disease was associated with higher acceptance of vaccination.
T39 7130-7385 Sentence denotes 19, 20, 43 Regardless of severity, HCWs often stated that they declined influenza vaccination because they believed that their immune systems were 'strong', and they did not identify themselves as a risk group needing added protection against the disease.
T40 7386-7534 Sentence denotes 8, 21, 44 Those who intended to get vaccinated or who got vaccinated, on the other hand, had a higher sense of personal susceptibility to influenza.
T41 7535-7687 Sentence denotes 19, 36, 41 In an article not related to influenza, sickness absence among general practitioners, hospital doctors and company fee earners were compared.
T42 7688-7829 Sentence denotes The study revealed that doctors were less likely to take sick leave for minor illnesses and were more likely to 'work through' their ailment.
T43 7830-7996 Sentence denotes 45 This reflects doctor's reluctance to adopt the patient role as well as potential organisational and cultural barriers that make it difficult for them to miss work.
T44 7997-8139 Sentence denotes In another study conducted in Sweden, workers in the care and welfare sectors also showed some of the highest levels of sickness presenteeism.
T45 8140-8347 Sentence denotes 46 While these findings support the argument that HCWs often find themselves at work even when sick, this is not to say that they do indeed benefit from a better health status than other professional groups.
T46 8348-8600 Sentence denotes In fact, their selfperceived 'strength' and the fact that they do not generally miss work due to illness may actually represent other organisational and defensive mechanisms that act to dissuade them from taking sick leave when this would be necessary.
T47 8601-8816 Sentence denotes Despite their training, HCWs appear to lack a proper understanding of their potential role in transmitting influenza while at work, which may be related to the unmet need for scientific information among this group.
T48 8817-9048 Sentence denotes 44, 47, 48 As such, although patient protection was cited as a reason to get vaccinated, it was often secondary to self-protection, the main motivating factor behind intention and actual receipt of seasonal and PIV in many studies.
T49 9049-9187 Sentence denotes 11, 22, 31, 34, 49, 50 Similarly, protection of family members was also found to be an important motivator for vaccine acceptance in HCWs.
T50 9188-9217 Sentence denotes 14, 35, 41 Fears and concerns
T51 9218-9424 Sentence denotes Concerns that the vaccine itself may cause influenza and fears about potential side effects were often cited as reasons for declining vaccination or were found to be negatively associated with immunization.
T52 9425-9539 Sentence denotes 10, 11, 14, 21, 22, 29, 35, 51 Acceptance of vaccination was higher in those who perceived the vaccine to be safe.
T53 9540-9657 Sentence denotes 19, 38 Higher confidence in the efficacy of the vaccine was also associated with acceptance of the influenza vaccine.
T54 9658-9917 Sentence denotes 15, 19, 22, 30, 41 A fear or dislike of needles has been cited in a few studies exploring low uptake of SIV and PIV among some HCWs 16, 30, 34, 52 , while others have shown that an opposition to vaccines in principle can be a strong barrier to receipt of SIV.
T55 9918-10180 Sentence denotes 37 Personal experience with illness Some authors have found that HCWs were more likely to receive influenza vaccination if they had a colleague who had acquired infection with Influenza A (H1N1) or if they had experienced becoming ill with influenza in the past.
T56 10181-10315 Sentence denotes 19, 41 The evidence on the effect of working with patients infected with influenza on motivating compliance with vaccination is mixed.
T57 10316-10444 Sentence denotes A study in Sao Paolo, Brazil, showed that having cared for patients with severe influenza was significantly associated with SIV.
T58 10445-10568 Sentence denotes 53 However, the experience of caring for patients with Influenza A (H1N1) did not have the same effect for nurses in China.
T59 10569-10687 Sentence denotes 54 Similarly, prior experience with SARS was not found to enhance the uptake of influenza vaccine by Hong Kong nurses.
T60 10688-10921 Sentence denotes 31, 55 It seems that despite the high case fatality ratio of this disease and the fact that many cases had been HCWs, there was little impact on the attitudes of this vulnerable group towards other related health protective measures.
T61 10922-10924 Sentence denotes 55
T62 10926-11102 Sentence denotes Many HCWs have cited inconvenience of receiving the vaccine as a barrier to uptake, and others highlighted the importance of having sufficient free time to accomplish the task.
T63 11103-11334 Sentence denotes 22, 41, 49, 50 A literature review covering material published until 2008 showed that inconvenient delivery of the vaccine has remained the third most common reason for vaccine non-receipt among HCWs in countries outside of the US.
T64 11335-11520 Sentence denotes 49 The US Centres for Disease Control and Prevention (CDC) has recommended the use of strategies that enhance accessibility of influenza vaccination, including mobile vaccination carts.
T65 11521-11788 Sentence denotes 56 Despite the consensus about the importance of bringing the vaccine to HCWs, a study conducted during the Influenza A (H1N1) pandemic in China showed that the lack of access to SIV in their hospital continued to be a potential barrier to vaccine receipt among HCWs.
T66 11789-12258 Sentence denotes 15 Related to accessibility, the provision of free vaccine or reimbursement of costs were cited as facilitators of vaccination in many studies and have been recommended by American advisory committees. [56] [57] [58] [59] Other studies have shown that increased governmental and managerial support such as declarations made by ministries of health and health authorities, as well as nonpunitive approaches to promote vaccination, can improve immunization rates in HCWs.
T67 12259-12458 Sentence denotes 48, 51 Conversely, inconsistencies between actions taken by authority figures and conflicting messages provided by health authorities can negatively impact the effectiveness of vaccination campaigns.
T68 12459-12726 Sentence denotes 10,51,60 Peer influence and pressure from family members may also have a positive impact on vaccine uptake 19, 38, 61 , particularly when recommendations come from well-respected colleagues such as infectious disease specialists, physicians and other opinion leaders.
T69 12727-12807 Sentence denotes 12, 19 The media also plays an important role in HCW influenza vaccine coverage.
T70 12808-13140 Sentence denotes While the media may negatively affect HCWs' attitudes towards vaccination when it is used as the main source of information and is focused on the potential negative impact of vaccination 9, 38, 44, 51 , news about deaths from influenza A (H1N1) in the media positively influenced vaccination behaviour in HCWs in at least one study.
T71 13141-13380 Sentence denotes 51 Furthermore, a study on pre-pandemic vaccine acceptance in HCWs in the UK showed that willingness to accept stockpiled H5N1 vaccine was higher during a period of increased media attention to an outbreak of the disease in a poultry farm.
T72 13381-13834 Sentence denotes 62 HCW compliance with seasonal and pandemic influenza vaccination ª 2013 Blackwell Publishing Ltd Relationship between seasonal and pandemic influenza vaccination and the effect of a threatened pandemic Current or past receipt of SIV is a consistent predictor of pandemic vaccine acceptance among HCWs 9, 11, 12, 14, 15, 21, 29, 42 ; however, several studies provide a less clear picture of the link between seasonal and pandemic vaccination behaviour.
T73 13835-14040 Sentence denotes The relationship is further complicated by the emergence of a threat by a pandemic influenza strain, and recent experience has shown that such a threat can have a variable impact on vaccine coverage rates.
T74 14041-14263 Sentence denotes The studies conducted in some settings have shown that transmission of a pandemic strain can serve to improve coverage with the seasonal influenza vaccine, even if the same success may not be seen for pandemic vaccination.
T75 14264-14372 Sentence denotes In the US, the 2009/2010 vaccination season saw SIV coverage rates exceed 60% for the first time among HCWs.
T76 14373-14427 Sentence denotes Despite this improvement, PIV remained just below 40%.
T77 14428-14625 Sentence denotes 6 Similarly, coverage rates with the seasonal vaccine among HCWs in Spain during the 2009/2010 season was higher than that seen in previous seasons although uptake of pandemic vaccine remained low.
T78 14626-14817 Sentence denotes 11 The findings for SIV in the US and Spain are encouraging; however, in other countries, SIV coverage did not improve significantly despite the emergence of the 2009 H1N1 influenza pandemic.
T79 14818-15062 Sentence denotes Two studies conducted in France demonstrated almost equivalent coverage with seasonal and pandemic vaccines of approximately 30% during the 2009/ 2010 vaccine season, which differed very little from coverage rates achieved in the previous year.
T80 15063-15331 Sentence denotes 12,13 A study conducted among National Health System (NHS) and non-NHS workers in the United Kingdom showed that the former were no more likely than the latter to receive the pandemic vaccine, but they did express an increased willingness to take the seasonal vaccine.
T81 15332-15493 Sentence denotes 14 In the end, there was no significant increase in the number of workers willing to receive SIV compared with the numbers who had received it in previous years.
T82 15494-15594 Sentence denotes Uptake of seasonal vaccine among HCWs in China was also found to be little affected by the pandemic.
T83 15595-15821 Sentence denotes 15 In this study, however, PIV coverage reached 25%, which is comparable with or exceeds the overall coverage rates for seasonal vaccination in this group, as well as coverage with the pandemic vaccine seen in other countries.
T84 15822-16150 Sentence denotes 10, 11, 42, 51 Other studies have also showed different coverage rates for seasonal and pandemic vaccination in the 2009/2010 season: in Istanbul half of the respondents in the study sample who had received SIV in 2009 also received the pandemic vaccine 10 and in Greece, approximately 40% of HCWs who received SIV accepted PIV.
T85 16151-16404 Sentence denotes 9 The reasons why PIV remained below the levels achieved for SIV could be related to the novelty of the influenza strain causing the pandemic and heightened concerns over the safety of a vaccine that had undergone an accelerated authorisation procedure.
T86 16405-16578 Sentence denotes 15, 44 Fear over the safety of the vaccine, as well as mention of concerns over Guillain-Barr e Syndrome surfaced as important barriers to PIV among HCWs in several studies.
T87 16579-16631 Sentence denotes 9, 12, 15, 44, 54, 63 In their article, Seale et al.
T88 16632-16763 Sentence denotes 15 discussed the potential reasons for uptake rates for PIV remaining low with the introduction of influenza A (H1N1) into society.
T89 16764-17057 Sentence denotes They argued that while intentions to be vaccinated may have been high at the start of the pandemic due to fear and perceptions of personal risk, the establishment of the virus in society resulted in a certain degree of emotional tolerance that dampened the initial motivation to be vaccinated.
T90 17058-17304 Sentence denotes Similarly, a study conducted in China found that while perceived risk of contracting avian influenza was a predictor of SIV uptake among nurses in 2006, the threat from avian influenza was no longer an influence on vaccination behaviours in 2007.
T91 17305-17496 Sentence denotes These authors pointed out that time elapsed because the appearance of the threat, its failure to progress, and notions of its controllability may have changed intended vaccination behaviours.
T92 17497-17499 Sentence denotes 55
T93 17501-17726 Sentence denotes Despite the interesting findings that can be extracted from the volume of literature available on influenza vaccination among HCWs, it is important to highlight some challenges that we encountered when interpreting this data.
T94 17727-18003 Sentence denotes The focus is on two main issues; the lack of longitudinal studies that help identify the factors that govern the translation of stated intentions into actual vaccination behaviours and the challenges of drawing conclusions from studies that use various definitions of the HCW.
T95 18004-18204 Sentence denotes Much of the social sciences literature exploring the factors associated with vaccine compliance in HCWs are crosssectional studies that assess intention or receipt of seasonal or pandemic vaccination.
T96 18205-18377 Sentence denotes 9, 15, 21, 51 In a systematic review published in 2011, Bish et al. included a total of 37 articles examining factors associated with Influenza A (H1N1) vaccine compliance.
T97 18378-18489 Sentence denotes Nineteen of these focused specifically on HCWs, and all reported the results of a cross-sectional study design.
T98 18490-18813 Sentence denotes 64 Studies that looked at the intentions or willingness of HCWs to receive pandemic vaccine were an important contribution to the research on vaccination compliance during the initial stages of the 2009 pandemic and identified groups of HCWs that could have been targeted to ensure the effectiveness of vaccination efforts.
T99 18814-19006 Sentence denotes 9, 19, 21, 29, 54 However, there was little effort to follow whether these stated intentions were translated into vaccination behaviours through longitudinal or serial cross-sectional methods.
T100 19007-19172 Sentence denotes Using our search criteria, we were only able to uncover one study that followed up stated intentions with data on actual receipt of influenza vaccination among HCWs.
T101 19173-19401 Sentence denotes 65 Godin et al. used an extended version of the theory of planned behaviour (TPB) to find determinants of SIV intentions and vaccine receipt in HCWs and also explored potential moderators of the intention-behaviour relationship.
T102 19402-19549 Sentence denotes These authors found that moral norm, or one's feelings of obligation to adopt a certain behaviour, is a significant moderator of this relationship.
T103 19550-19694 Sentence denotes Interestingly, however, they also found that HCWs who had low levels of moral norm were the ones who acted according to their stated intentions.
T104 19695-19814 Sentence denotes This means that those who felt less of an obligation to do good for others often did not receive influenza vaccination.
T105 19815-19985 Sentence denotes One of the main conclusions drawn from this study was that interventions need to focus on emphasising to HCWs the benefits of vaccination for patients and family members.
T106 19986-20225 Sentence denotes Indeed, many studies have shown that HCWs generally fail to understand the importance of influenza vaccination as a means to protect their patients and families, with selfprotection often quoted as the primary reason to accept vaccination.
T107 20226-20244 Sentence denotes 11, 22, 34, 38, 59
T108 20246-20486 Sentence denotes Understanding attitudes among HCWs towards influenza vaccination may have been further complicated by the changing definition of the HCW used by most authors and the issues associated with the generalisability of many of the study findings.
T109 20487-20679 Sentence denotes 16, 19, 62 In many publications, the term 'healthcare worker' insinuates a group of workers employed in a healthcare institution that may or may not be responsible for patient care activities.
T110 20680-20704 Sentence denotes 21, 29, 40 Wicker et al.
T111 20705-20771 Sentence denotes 66 included physicians, nurses and laboratory technicians as HCWs.
T112 20772-20786 Sentence denotes Canning et al.
T113 20787-20876 Sentence denotes 34 restricted their definition of the healthcare worker to nurses and nursing assistants.
T114 20877-20888 Sentence denotes Chor et al.
T115 20889-20977 Sentence denotes 31 included allied healthcare professionals and administrators under this umbrella term.
T116 20978-21451 Sentence denotes Besides a difference in the categorisation of HCWs, studies also differ according to the setting in which they are based, for example hospital vs. community settings (with fewer studies on community-based HCWs) and the country context. [9] [10] [11] 31, 67 While the main conclusions are consistent, an emphasis on the barriers specific to a particular group of HCWs allows for a better understanding of their concerns and the formulation of targeted vaccination campaigns.
T117 21452-21658 Sentence denotes The use of findings on attitudes and perceptions towards vaccination in the formulation of tailored outreach programmes directed at a specific study population has only been undertaken by a few researchers.
T118 21659-21661 Sentence denotes 68
T119 21663-21771 Sentence denotes Many vaccination programmes have used educational information as a means to improve HCW compliance with SIV.
T120 21772-21987 Sentence denotes 16, 69, 70 Education is a necessary component of such strategies because health professionals often harbour misconceptions about the influenza vaccine that can be addressed with provision of appropriate information.
T121 21988-22099 Sentence denotes Furthermore, improved knowledge about influenza and influenza vaccination can positively impact vaccine uptake.
T122 22100-22354 Sentence denotes 52, 71, 72 These educational campaigns need to emphasise the rationale behind vaccination, that is, the protection of patients and preservation of the healthcare infrastructure, and simultaneously allay personal concerns over vaccine safety and efficacy.
T123 22355-22552 Sentence denotes 12, 52, 61, 70, 71 Although education is important, the literature has now shown that relying on a single component strategy may not be sufficient to enhance compliance with vaccination among HCWs.
T124 22553-22683 Sentence denotes 73, 74 Many have highlighted the importance of combining educational programmes with the provision of free and accessible vaccine.
T125 22684-22958 Sentence denotes 67, 75 A focus group study revealed that the creation of a 'safety culture' at work that emphasised the importance of influenza vaccination as part of a broader set of measures to ensure HCW and patient protection could be a better approach to ensure vaccine uptake by HCWs.
T126 22959-23230 Sentence denotes 48 Others have argued for the use of an 'ecological model' when addressing HCW compliance to vaccination; a holistic approach that incorporates the community, organisations and policy-makers in making changes that can help influence vaccine uptake among the target group.
T127 23231-23407 Sentence denotes 16 Such models are an important step forward in the formulation of multi-pronged strategies that will be better suited to address the target behaviours that need to be changed.
T128 23408-23535 Sentence denotes Interventions must take into consideration the differences of those within the HCW group as well as context-specific variables.
T129 23536-24012 Sentence denotes For example, many studies identify nurses as a group that is particularly resistant to influenza immunisation, 34, 55, 62 and others have targeted HCWs working in specific settings, such as nursing homes, oncology centres or paediatric units. [76] [77] [78] The focus on specific subgroups of HCWs, especially those in closest contact with high-risk populations, has been noted in the literature as an important step to a better understanding of the concerns among HCW groups.
T130 24013-24230 Sentence denotes The combination of strategies that encompass all HCWs with those that target HCWs showing the least susceptibility to vaccination campaigns can be instrumental in ensuring broad vaccine coverage in different settings.
T131 24231-24376 Sentence denotes 33, 49, 52, 79 Conclusion HCW compliance with influenza vaccine depends on a number of factors that come into play in the decisionmaking process.
T132 24377-24488 Sentence denotes Utilitarian arguments have been used as a foundation for promoting vaccination policies in healthcare settings.
T133 24489-24732 Sentence denotes However, these efforts have not improved coverage rates among HCWs, and the challenges of ensuring adherence to vaccine policies for novel influenza viruses have recently been highlighted with the emergence of the H1N1 pandemic strain in 2009.
T134 24733-24963 Sentence denotes In the future, researchers should engage hospital and public authorities when planning and conducting studies to ensure that findings are translated to evidence-based policies that are in-line with the general thinking among HCWs.
T135 24964-25151 Sentence denotes Perceptions of vulnerability and severity, as well as concerns over one's health or the health of others, have been consistently proven to be associated with compliance with this measure.
T136 25152-25390 Sentence denotes However, research has also shown that determinants of compliance extend to situational and organisational factors that need to be considered in the formulation and implementation of strategies to encourage uptake of influenza vaccination.
T137 25391-25583 Sentence denotes One of the important situational criteria that need to be considered is the potential influence of an outbreak/pandemic with an emerging influenza virus in swaying vaccination-related choices.
T138 25584-25842 Sentence denotes Studies have shown that the influenza A (H1N1) pandemic has had variable impact in shifting acceptance towards SIV among HCWs, and despite improvements seen in some settings, uptake of pandemic vaccine has generally failed to match seasonal vaccine coverage.
T139 25843-26001 Sentence denotes There may be a number of reasons for this, including the perception of novel influenza as a mild disease, and fears over rapidly authorised pandemic vaccines.
T140 26002-26182 Sentence denotes Further research such as longer-term follow-up of study populations is needed to better understand the translation of HCWs' willingness and intentions to be vaccinated into action.
T141 26183-26380 Sentence denotes Such assessments could be a step towards a better understanding of the real-world barriers to vaccination compliance among HCWs and highlight the modulators of the intention-behaviour relationship.
T142 26381-26577 Sentence denotes There appears to be a need to tailor informational and educational campaigns so as to appeal to the main concerns and perceptions among HCWs, and allay fears these may have related to vaccination.
T143 26578-26796 Sentence denotes Furthermore, an exploration of the barriers to this measure among some of the most resistant HCW groups and a targeted campaign to address their concerns could be an important step in ensuring broader vaccine coverage.
T144 26797-27121 Sentence denotes Communication efforts need to be sensitive to the fact that HCWs respond to the implementation of influenza vaccination policies differently to the rest of the general population, and that even within this group, some healthcare professionals appear less susceptible to strategies to enhance compliance compared with others.
T145 27122-27357 Sentence denotes Studies that specifically analyse the role of risk communication in changing vaccination behaviours among HCWs, and the role of social or peer influence should be an integral component of future initiatives to improve compliance rates.
T146 27358-27580 Sentence denotes Despite the need for the provision of information to HCWs as a means to enhance compliance, there is increasing recognition of the limited capacity for information alone to stimulate great improvements in vaccine coverage.
T147 27581-27728 Sentence denotes Many researchers now advocate the use of multi-pronged strategies that combine personal-and organisational-level changes to promote vaccine uptake.
T148 27729-27846 Sentence denotes This is part of a movement towards the use of more holistic and all-encompassing interventions to enhance compliance.
T149 27847-28063 Sentence denotes The promotion of influenza vaccination among HCWs could be 'sold' to this audience more effectively if it is packaged as part of broader initiatives to ensure safe and conducive environments to influenza vaccination.
T150 28064-28270 Sentence denotes This would require integrating vaccination campaigns within wider initiatives promoting health and safety at the workplace and a non-punitive and non-coercive approach to vaccination enforcement among HCWs.
T151 28271-28427 Sentence denotes Evaluations of the comparative effectiveness of such initiatives should be conducted and tailored recommendations made to overcome any remaining challenges.