Letter to the Editor
Influenza vaccination and critical patient protection: Responsibility of healthcare workers
Vacunación antigripal y protección del paciente crítico: responsabilidad de los profesionales sanitarios
a Servicio de Estudios, Documentación y Estadística, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, Spain
b Servicio de Seguridad y Salud en el Trabajo, Gerencia Regional de Salud de la Junta de Castilla y León, Valladolid, Spain
c Dirección Médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
d Departamento de Microbiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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"apellidos" => "López-Gobernado" "email" => array:1 [ 0 => "mlopezgob@saludcastillayleon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "Villalba Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Pérez-Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "J.M." "apellidos" => "Eiros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Estudios, Documentación y Estadística, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Seguridad y Salud en el Trabajo, Gerencia Regional de Salud de la Junta de Castilla y León, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Dirección Médica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Microbiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Vacunación antigripal y protección del paciente crítico: responsabilidad de los profesionales sanitarios" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the study conducted by Marin-Corral et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and based on the recommendation of reinforcing the annual vaccination campaigns in populations at risk, we wish to make our contribution and emphasize the importance of influenza vaccination in healthcare providers to avoid spreading the infection.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Each year health organizations face seasonal outbreaks of influenza and the corresponding morbimortality associated with these outbreaks. It is estimated that the worldwide incidence of influenza infections is 5.3 cases for every 1000 people and 58,193 people die every year due to this infectious disease.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In Spain, the seasonal flu epidemic of 2017–2018<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> generated 5977 confirmed hospitalizations for severe complications of influenza virus infection (HSCIVI) out of which 1281 patients (21.8%) were admitted to intensive care units (ICU); a percentage similar to the one from last season and significantly lower than the one from previous seasons when the influenza A (H1N1) pdm09 virus and influenza A (H3N2) variants were prevalent.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Influenza epidemics are usually managed with vaccination campaigns to prevent cases and complications from happening. Vaccines are officially recommended in our country for certain groups at risk such as the elderly, patients with chronic conditions and institutionalized populations.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The vaccination of healthcare providers is an effective strategy to reduce influenza-related mortality in hospitalized patients. And yet despite all this, the rates of immunization among healthcare providers are modest. During the influenza vaccination campaign of 2017–2018 in Castile and León the prevalence of immunization among healthcare providers was 30.1% and lower compared to the country's prevalence (31.3%). The highest rate of immunization reported was seen among primary care physicians compared to special care providers and also higher in healthcare providers compared to non-healthcare professionals. The reasons given by several studies<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> to explain these rates of immunization are diverse and have to do with organizational barriers associated with the lack of time and accessibility to vaccines, doubts on their effectiveness, fears about side effects, and other personal reasons.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The strategies implemented to increase influenza immunization among healthcare providers are based on informing and training these professionals, although several studies<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> claim that establishing mandatory vaccination campaigns is the most effective individual intervention of all followed by a declaration of refusal of vaccines in a vaccine information statement. Other interventions such as greater availability, better awareness of what vaccines represent, and even the implementation of programs with incentives are less effective strategies.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The negative impact due to the low rate of immunization among healthcare providers in the public system and, in particular, in patients hospitalized at ICUs should be approached by legislators, and specialists in occupational safety and health, especially after the confirmation that adequate vaccination strategies have a positive impact on everyone's health.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Gobernado M, Villalba Gil D, Pérez-Rubio A, Eiros JM. Vacunación antigripal y protección del paciente crítico: responsabilidad de los profesionales sanitarios. Med Intensiva. 2019;43:584–585.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patients with influenza A (H1N1)pdm09 admitted to the ICU. Impact of the recommendations of the SEMICYUC [Article in English, Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Marin-Corral" 1 => "C. Climent" 2 => "R. Muñoz" 3 => "M. Samper" 4 => "I. Dot" 5 => "C. 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Eiros Bouza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Quimioter" "fecha" => "2018" "volumen" => "31" "paginaInicial" => "43" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30209923" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers-across-sectional survey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Boey" 1 => "C. Bral" 2 => "M. Roelants" 3 => "A. de Schryver" 4 => "L. Godderis" 5 => "K. 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Bonovas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hum Vaccin Immunother" "fecha" => "2016" "volumen" => "3" "paginaInicial" => "671" "paginaFinal" => "681" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004300000009/v1_201911280636/S2173572719301365/v1_201911280636/en/main.assets" "Apartado" => array:4 [ "identificador" => "64604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000009/v1_201911280636/S2173572719301365/v1_201911280636/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301365?idApp=WMIE" ]
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