Susceptibility to vaccine-preventable diseases and vaccination adherence among healthcare workers in Italy: A cross-sectional survey at a regional acute-care university hospital and a systematic review

Figures & data

Table 1. Characteristics of the study population (n = 171).

Professional categories	Subjects n (%)	Female n (%)	Age (years) mean ± SD
Obstetricians and gynaecologists	19 (11.1)	5 (16.3)	59.3 ± 5.8
Residents in Obstetrics and Gynecology	23 (13.5)	22 (95.7)	28.7 ± 1.3
Anaesthesiologists	10 (5.8)	6 (60.0)	50.5 ± 4.5
Neonatologists	11 (6.4)	6 (54.5)	53.0 ± 10.9
General nurses	38 (22.2)	37 (97.4)	48.7 ± 6.3
Midwives	28 (16.4)	28 (100)	48.3 ± 7.8
Health care assistants	10 (5.8)	7 (70.0)	52.3 ± 7.8
Neonatal nurses	32 (18.7)	30 (37.5)	49.0 ± 6.7

SD: Standard Deviation

Table 2. Previous history of Vaccine Preventable Diseases and immunization status among Healthcare Workers of the Obstetric Unit of the referral adult acute-care University hospital of Genoa, Liguria Region, Italy, according to professional category.

	Obstetricians and gynaecologistsn (%)	Residents in Obstetrics and Gynecologyn (%)	Anesthesiologistsn (%)	Neonatologistsn (%)	General nursesn (%)	Midwivesn (%)	Health care assistantsn (%)	Neonatal nursesn (%)	Total(%)
Subjects included	19	23	10	11	38	28	10	32	171
Rubella
Positive history	14 (73.7)	16 (69.6)	7 (70.0)	6 (54.5)	29 (76.3)	17 (60.7)	6 (60.0)	17 (53.1)	112(65.5)
Previous vaccination	0 (0)	4 (17.4)	1 (10.0)	1 (9.1)	7 (18.4)	5 (17.9)	3 (30.0)	6 (18.7)	27(15.8)
Not known	5 (26.3)	3 (13.1)	2 (20.0)	4 (36.4)	2 (5.3)	6 (7.1)	1 (10.0)	9 (21.9)	32(18.7)
HBV
Positive history	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0
Previous vaccination	16 (84.2)	18 (78.3)	7 (70.0)	8 (72.7)	34 (89.5)	25 (89.3)	5 (50.0)	23 (71.9)	136(79.5)
Not known	3 (15.8)	5 (21.7)	3 (30.0)	3 (27.3)	4 (10.5)	3 (10.7)	5 (50.0)	9 (28.1)	35(20.5)
Varicella
Positive history	17 (89.4)	18 (78.3)	4 (40.0)	11 (100)	30 (78.9)	24 (85.7)	8 (80.0)	27 (84.4)	139(81.3)
Previous vaccination	1 (5.3)	2 (8.7)	0 (0)	0 (0)	1 (2.7)	1 (3.6)	0 (0)	3 (9.4)	8(4.7)
Not known	1 (5.3)	3 (13.0)	6 (60.0)	0 (0)	7 (18.4)	3 (10.7)	2 (20.0)	2 (6.2)	24(14)
Measles
Positive history	10 (52.6)	9 (39.2)	5 (50.0)	7 (63.6)	25 (65.8)	15 (53.6)	7 (70.0)	16 (50.0)	94(54.9)
Previous vaccination	3 (15.8)	3 (13.0)	0 (0)	0 (0)	3 (7.9)	4 (14.3)	0 (0)	2 (6.3)	15(8.8)
Not known	6 (31.5)	11 (47.8)	5 (50.0)	4 (36.4)	10 (26.3)	9 (32.1)	3 (30.0)	14 (43.7)	62(36.3)
Influenza*
Performed	6 (31.6)	7 (30.4)	3 (30.0)	6 (54.5)	8 (21.1)	5 (17.9)	2 (20.0)	7 (21.9)	44(25.7)
Not performed	13 (60.4)	16 (69.6)	7 (70.0)	5 (45.5)	30 (78.9)	23 (82.1)	8 (80.0)	25 (78.1)	127(74.3)

HBV: Hepatitis B virus;

* During the previous year.

Figure 1. Flow diagram of the search strategy, screening, eligibility and inclusion criteria.

Table 3. Summary of the main characteristics of the studies included in the systematic review.

Author	Study design	Year	N°	Aim of the study
Fortunato et al.^13	Retrospective	2009–2011	2198	To assess levels of immunization and factors influencing adherence to vaccinations needed for HCWs in Puglia region.
Stroffolini et al.^14	Retrospective	2006	1632	To assess the vaccination coverage against HBV in HCWs.
Copello et al.^15	Prospective	2014	2661	To assess the risk of healthcare associated infections in HCWs of a Sardinian Local Health Authority
Campagna et al.^16	Prospective	2013	32*	To investigate whether, how, and which vaccination underwent Sardinia Health Care Workers (HCWs) and the variability of policies in different Hospital Health Managements of the whole region
Campagna et al.^17	Retrospective	2009–2010	32196	To evaluate the risk assessment, health surveillance and fitness for work of HCWs exposed to rubella, measles, varicella and mumps.
Cologni et al.^18	Retrospective	2007–2012	4000	To determine the percentage of susceptible HCWs to rubella, measles, varicella and mumps infection.
Fedeli et al.^19	Retrospective	1998–2001	333	To determine the proportion of workers employed in high-risk healthcare areas who are susceptible to measles, mumps, rubella or varicella.
Porru et al.^20	Retrospective	2004–2007	4000	To evaluate the prevalence of HCWs susceptible to measles, mumps, rubella and varicella infection.
Esposito et al.^21	Retrospective	2006	2240	A cross-sectional study of influenza vaccination coverage among HCWs as well as their knowledge of and attitudes toward influenza vaccination.
Alicino et al.^22	Prospective	2005–2014	929	A comprehensive, multifaceted intervention project based on education, promotion, and easy access to influenza vaccination.

HCWs: Health Care Workers; HBV: hepatitis B virus;

* Hospitals

Table 4. Characteristics of the studies included in the systematic review based on the STROBE statement.

Table

Author	Study design	Clear definition of the study population	Clear description of assessment of the main outcome	Clear description of assessment of all outcomes	Description of missing data
Fedeli U et al.^19	Retrospective	Yes	Yes	Yes	NA
Campagna M et al.^17	Retrospective	Yes	Yes	Yes	NA
Cologni L et al.^18	Retrospective	Yes	Yes	Yes	NA
Fortunato F et al.^13	Retrospective	Yes	Yes	Yes	NA
Porru S et al.^20	Retrospective	Yes	Yes	Yes	NA
Stroffolini T et al.^14	Retrospective	Yes	Yes	Yes	No
Esposito S et al.^21	Retrospective	Yes	Yes	Yes	NA
Alicino C et al.^22	Prospective	Yes	Yes	Yes	Yes
Copello F et al.^15	Prospective	Yes	Yes	Yes	No
Campagna M et al.^16	Prospective	Yes	Yes	Yes	Yes

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