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Effect of influenza vaccination among healthcare workers on hospital-acquired influenza in short-stay hospitalized patients: A multicenter pilot study in France

Published online by Cambridge University Press:  06 April 2022

Sélilah Amour Open the ORCID record for Sélilah Amour [Opens in a new window] ,
Thomas Bénet ,
Corinne Regis ,
Olivier Robert ,
Luc Fontana Open the ORCID record for Luc Fontana [Opens in a new window] ,
Bruno Lina ,
Bruno Pozzetto ,
Philippe Berthelot  and
Philippe Vanhems
Sélilah Amour
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique Unité Mixte de Recherche, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
Thomas Bénet
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
Corinne Regis
Affiliation:
Université de Lyon, Université Claude Bernard Lyon, Lyon, France
Olivier Robert
Affiliation:
Service de Médecine du travail, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
Luc Fontana
Affiliation:
Service de Médecine du travail, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Bruno Lina
Affiliation:
Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France Centre National de Référence des Virus des Infections Respiratoires (dont la grippe), Hospices Civils de Lyon, Lyon, France Faculté de Médecine Lyon Est, CIRI, Inserm U1111 CNRS UMR5308, Université Lyon, Virpath, Lyon, France
Bruno Pozzetto
Affiliation:
Laboratoire Agents infectieux et Hygiène, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Philippe Berthelot
Affiliation:
Unité de Gestion du Risque Infectieux, Service d’Infectiologie et Service des Agents Infectieux et Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Philippe Vanhems*
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique Unité Mixte de Recherche, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
*
Author for correspondence: Prof. Philippe Vanhems, E-mail: [email protected]
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Abstract

Background:

Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs.

Methods:

A case–case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season.

Results:

The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21–1.29) to 0.14 (95% CI, 0.03–0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01–0.78).

Conclusions:

Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.

Trial Registration: clinicaltrials.gov identifier: NCT02198638.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 12 , December 2022 , pp. 1828 - 1832
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. This study was presented in part as abstract P092 at the Sixth International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on September 14–17, 2021.

References

Stott, DJ, Kerr, G, Carman, WF. Nosocomial transmission of influenza. Occup Med Oxf Engl 2002;52:249–253.CrossRefGoogle ScholarPubMed
Barlow, G, Nathwani, D. Nosocomial influenza infection. Lancet Lond Engl 2000;355:1187.CrossRefGoogle ScholarPubMed
Salgado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145–155.Google ScholarPubMed
Li, Y, Wang, L-L, Xie, L-L, Hou, W-L, Liu, X-Y, Yin, S. The epidemiological and clinical characteristics of the hospital-acquired influenza infections: a systematic review and meta-analysis. Medicine (Baltimore) 2021;100(11):e25142.Google ScholarPubMed
Vanhems, P, Voirin, N, Roche, S, et al. Risk of influenza-like illness in an acute health care setting during community influenza epidemics in 2004–2005, 2005–2006, and 2006–2007: a prospective study. Arch Intern Med 2011;171:151–157.Google Scholar
El Guerche-Séblain, C, Amour, S, Bénet, T, et al. Incidence of hospital-acquired influenza in adults: a prospective surveillance study from 2004 to 2017 in a French tertiary-care hospital. Am J Infect Control 2021;49:1066–1071.CrossRefGoogle Scholar
Fiore, AE, Uyeki, TM, Broder, K, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. Morb Mortal Wkly Rep Recomm Rep 2010;59(RR-8):1–62.Google ScholarPubMed
Bridges, CB, Kuehnert, MJ, Hall, CB. Transmission of influenza: implications for control in health care settings. Clin Infect Dis 2003;37:1094–1101.Google ScholarPubMed
Potter, J, Stott, DJ, Roberts, MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:1–6.CrossRefGoogle ScholarPubMed
Monto, AS, Hornbuckle, K, Ohmit, SE. Influenza vaccine effectiveness among elderly nursing home residents: a cohort study. Am J Epidemiol 2001;154:155–160.CrossRefGoogle ScholarPubMed
Armstrong, BG, Mangtani, P, Fletcher, A, et al. Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people. BMJ 2004;329:660.CrossRefGoogle ScholarPubMed
Carman, WF, Elder, AG, Wallace, LA, et al. Effects of influenza vaccination of healthcare workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet Lond Engl 2000;355:93–97.CrossRefGoogle ScholarPubMed
Guthmann, J, Fonteneau, L, Ciotti, C, et al. Couverture vaccinale des soignants travaillant dans les établissements de soins de France. Résultats de l’enquête nationale Vaxisoin, 2009. Bull Epidemiol Hebd 2011;371–376.Google Scholar
Verger, P, Collange, F, Fressard, L, et al. Prevalence and correlates of vaccine hesitancy among general practitioners: a cross-sectional telephone survey in France, April to July 2014. Eurosurveillance 2016;21:30406.CrossRefGoogle ScholarPubMed
Bénet, T, Régis, C, Voirin, N, et al. Influenza vaccination of healthcare workers in acute-care hospitals: a case–control study of its effect on hospital-acquired influenza among patients. BMC Infect Dis 2012;12:30.CrossRefGoogle ScholarPubMed
Benson, K, Hartz, AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med 2000;342:1878–1886.CrossRefGoogle ScholarPubMed
van den Dool, C, Bonten, MJM, Hak, E, Heijne, JCM, Wallinga, J. The effects of influenza vaccination of health care workers in nursing homes: insights from a mathematical model. PLoS Med 2008;5(10):e200.CrossRefGoogle ScholarPubMed
van den Dool, C, Bonten, MJM, Hak, E, Wallinga, J. Modeling the effects of influenza vaccination of healthcare workers in hospital departments. Vaccine 2009;27:6261–6267.CrossRefGoogle ScholarPubMed
Voirin, N, Payet, C, Barrat, A, et al. Combining high-resolution contact data with virological data to investigate influenza transmission in a tertiary care hospital. Infect Control Hosp Epidemiol 2015;36:254–260.CrossRefGoogle ScholarPubMed
Vaux, S, Fonteneau, L, Pefau, M, et al. Couvertures vaccinales des professionnels de santé en établissement de santé contre la grippe, la rougeole, la coqueluche et la varicelle et position vis-à-vis de l’obligation vaccinale, 2019. Médecine Mal Infect 2020;50(6):S17–S18.CrossRefGoogle Scholar
Vanhems, P, Baghdadi, Y, Roche, S, et al. Influenza vaccine effectiveness among healthcare workers in comparison to hospitalized patients: a 2004–2009 case-test, negative-control, prospective study. Hum Vaccines Immunother 2016;12:485–490.CrossRefGoogle ScholarPubMed
Perl, TM, Talbot, TR. Universal influenza vaccination among healthcare personnel: yes we should. Open Forum Infect Dis 2019;6(4):ofz096.CrossRefGoogle Scholar
Munier-Marion, E, Bénet, T, Vanhems, P. Definition of healthcare-associated influenza: a review and results from an international survey. Influenza Other Respir Viruses 2017;11:367–371.CrossRefGoogle ScholarPubMed
Amodio, E, Restivo, V, Firenze, A, Mammina, C, Tramuto, F, Vitale, F. Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients? J Hosp Infect 2014;86:182–187.CrossRefGoogle ScholarPubMed
Williams, VR, McGuire, M, Katz, K, Leis, JA. Minimum healthcare worker influenza immunization rates required to decrease influenza transmission in two acute-care hospitals. Infect Control Hosp Epidemiol 2021;42:109–110.CrossRefGoogle ScholarPubMed
Schumacher, S, Salmanton-García, J, Cornely, OA, Mellinghoff, SC. Increasing influenza vaccination coverage in healthcare workers: a review on campaign strategies and their effect. Infection 2021;49:387–399.CrossRefGoogle ScholarPubMed
Hickler, B, Guirguis, S, Obregon, R. Vaccine special issue on vaccine hesitancy. Vaccine 2015;33:4155–4156.CrossRefGoogle ScholarPubMed