| Abstract |
Introduction: Vaccination of health care workers (HCWs) reduces
the risk of occupational vaccine-preventable diseases (VPDs),
prevents nosocomial transmission and preserves health care delivery
during outbreaks. Especially pediatricians who take care of
vulnerable patient groups, including newborns and infants, who
have not been vaccinated yet, should have a positive immunization
status in order to protect their patients. The investigation of
vaccination coverage of pediatricians working in national health
system (NHS) and private sector is of special interest.
Methods: A cross-sectional, questionnaire-based study was
conducted between September and December 2020. The
questionnaire was sent by email to all 302 active pediatricians in
Crete, Greece. They were asked to specify their sex, age, years in
present job, sector (NHS vs private) and geographic area of work.
Vaccination coverage was investigated for the following vaccines:
seasonal influenza, for the present and the three previous seasons,
measles, rubella, mumps, varicella, hepatitis A, hepatitis B, tetanusdiphtheria-
pertussis with Tdap, herpes zoster, pneumococcus,
meningococcus and TB. Self-reported immunity was defined as
either previous natural infection or complete vaccination and was
investigated for measles, rubella, mumps, varicella, hepatitis A and
hepatitis B. The association between vaccination coverage and the
following factors was examined: gender, age, sector (NHS vs
private), and geographic area. Data were analyzed using Microsoft
Excel and SPSS software. Results: A total of 282 of the 302 active pediatricians of Crete
participated in the study (response rate 93.37%). High vaccination
rate, 94.7%, was found against seasonal influenza during the current
period 2020-2021. Influenza vaccination rate was significantly
increasing each year from the 2017-2018 to the 2020-2021 influenza
season, p<0.001. Influenza vaccination during the current period
was significantly higher in the NHS (p=0.01). Complete vaccination
coverage against measles (42.3%), rubella (40.8%), mumps
(41.1%), and varicella (7.8%) were below target. Self-reported
immunity for measles, rubella, mumps, and varicella were 85.8%,
79.8%, 74.1% and 93.3%, respectively.
Complete vaccination coverage against hepatitis B was 84.8%,
while vaccination against hepatitis A was less accepted among
pediatricians, 20.21%. High vaccination rate was observed for
tetanus-diphtheria-pertussis (Tdap), 64.5%. Vaccination rate for
herpes zoster vaccine in the targeted age group, ≥ 60 years, was
29.3%. Vaccination rates for pneumococcus, meningitococcus and
TB were 43.4%, 25.4% and 77.3% respectively. Vaccination
coverage for the study vaccines was significantly higher in younger
age groups (p<0.05). Female gender was associated with higher
rates of complete vaccination and immunity for rubella (p=0.015
and p=0.003, respectively). Vaccination rates against rubella,
mumps, varicella, hepatitis A, hepatitis B and Tdap were
significantly higher among pediatricians vaccinated for measles.
The most common reasons for non-vaccination for influenza were:
lack of necessity (low risk 25%), doubtful vaccine efficacy (17.85
%) and fear of side effects (10.71%).
Conclusions: Vaccination coverage of pediatricians in Crete was
rather high for some but not all of the recommended vaccines.
Especially influenza immunization in the era of COVID-19
pandemic was highly accepted among pediatricians. High
vaccination coverage with Tdap was observed. Nevertheless, there
are still immunization gaps and a proportion of pediatricians were
not aware of their immunity status against a number of vaccine preventable diseases. Documentation of vaccination and immunity
status and initiatives to improve vaccination in HCWs are urgently
needed.
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