Introduction

The National Immunisation Advisory Committee (NIAC) of the RCPI and the HSE recommends annual seasonal influenza vaccination to individuals at risk of severe influenza disease (those who are aged 65 and older, pregnant, morbidly obese and those with specified chronic medical conditions requiring regular follow up), to certain occupational groups (those working with poultry, wild fowl and pigs), health care workers (HCWs) and to those likely to transmit influenza to those at high risk of influenza complications.

Due to the nature of their work and regular and close contact with patients, the risk of infection to HCWs is high, who in turn can easily transmit influenza to other non-infected patients. For this reason, seasonal influenza vaccination for HCWs is an important infection control measure in the health care setting.

HSE provides the seasonal influenza vaccine free of charge to all health care facilities or to the occupational health departments of these facilities. Implementation of the vaccination programme is, for the most part, organised by the health care facility management or the relevant occupational health provider.

To estimate uptake among healthcare workers employed in these units for the 2015-2016 influenza season, HPSC undertook a survey of all HSE-funded hospitals and long term care facilities (LTCFs). In addition, a small number of private hospitals and private LTCFs participated in the survey. This is the fifth seasonal influenza vaccination uptake survey in hospitals and LTCFs in Ireland.

This report presents a summary of key data relating to the influenza vaccination uptake programme for 2015-2016, which is now available on the HPSC website. For this report, average uptake results (rather than overall figures as in previous annual reports) were calculated as this allows inclusion of all reporting institutions each season and allows comparison of average uptake estimates since the 2011-2012 season. Table 1 details the average influenza vaccine uptake in hospital HCWs by hospital group, staff category grade, staff size and season.

Summary and key points

Influenza vaccine uptake in hospitals, 2015-2016 (n=50 hospitals)

• 89.7% (52/58) of known hospitals (including three private ones) participated in the 2015-2016 survey
• Based on 50 complete returns: Average uptake generally increased as the category size of eligible staff within hospitals also increased
  • Average uptake among all categories of hospital HCWs was 22.5%
  • Average uptake varied by HSE staff category (16.7-38.2%), the highest value was reported among 'medical and dental' professionals and lowest among 'nursing' staff
  • 7 (14.0%) hospitals exceeded the 40% national uptake target
  • Average uptake varied by Hospital Group (range 14.7-37.6%)
  • Highest average uptake was reported in Acute Paediatric Services Hospital group
• Average uptake generally increased as the category size of eligible staff within hospitals also increased.

Influenza vaccine uptake in LTCFs, 2015-2016 (n=98 LTCFs)

• 44.1% (101/229) of known LTCFs participated in the 2015-2016 survey
• Based on 98 complete returns: No association was observed between average uptake and the category size of eligible staff within LTCFs
  • Average uptake among all categories of LTCF HCWs was 26.6%
  • At national level, the average uptake varied by HSE staff category (25.7-43.4%), the highest value was reported among 'medical and dental' professionals and lowest among 'nursing' staff
  • 18 (18.4%) LTCFs exceeded the 40% national uptake target
  • Average uptake varied by Community Health Organisation (CHO) (range 15.2-48.1%)
  • Highest average uptake was reported in CHO 9 (Dublin North, Dublin North Central, Dublin North West)
  • No association was observed between average uptake and the category size of eligible staff within LTCFs
• Uptake among long stay residents since the beginning of the season was 87.5% among LTCFs
• Uptake among respite residents vaccinated within 101 LTCFs was 11.2%
• Uptake among respite residents vaccinated before admission to 101 LTCFs was 26.8%

Table 1. Average influenza vaccine uptake in hospital HCWs by Hospital Group, Staff Category Grade, Staff Size and Season (based on complete returns only)

na = not available/data not reported

*Other = non-acute publicly funded hospitals

**See http://www.nehb.ie/eng/about/Who/acute/hospitalgroups.html for details of hospital groups and their location

Comment

Influenza vaccination of healthcare workers is an important infection control, patient care and occupational health intervention. However, the latest seasonal survey report indicates that the national average influenza vaccine uptake for HCWs remains low, with an average uptake of 22.5% in reporting hospitals, and 26.6% in reporting LTCFs. These uptake figures are considerably less than the 40% national uptake target set by the HSE for the 2015-2016 season.

For the 2016-2017 influenza season all HCWs, including those working in the community, as well as hospital and long term care facilities, should obtain influenza vaccination (unless contraindicated) to protect themselves, their patients, work colleagues and vulnerable family members from influenza. Influenza vaccination is the most effective way to prevent influenza. There is a professional responsibility among health care workers to receive influenza vaccination as a patient safety. Medical professional bodies in Ireland and the World Health Organization have issued guidance in relation to vaccination of healthcare workers for many years – all HCWs are urged to avail of the influenza vaccine in the coming months.

Suzanne Cotter, Piaras O’Lorcain, HPSC

Acknowledgements

Sincere thanks to all participating hospitals and LTCFs for providing this data.

Further data is provided in the report which is available on line at http://www.hpsc.ie/A-Z/Respiratory/Influenza/SeasonalInfluenza/Vaccination/

National Immunisation Advisory Committee, RCPI, Influenza Recommendations available at http://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter11.pdf