Emergency Medical Services Personnel's Pandemic Influenza Training Received and Willingness to Work during a Future Pandemic.

Objective: Identify determinants of emergency medical service (EMS) personnel's willingness to work during an influenza pandemic. Background: Little is known about the willingness of EMS personnel to work during a future influenza pandemic or the extent to which they are receiving pandemic training. Methods: EMS personnel were surveyed in July 2018 - Feb 2019 using a cross-sectional approach; the survey was available both electronically and on paper. Participants were provided a pandemic scenario and asked about their willingness to respond if requested or required; additional questions assessed their attitudes and beliefs and training received. Chi-square tests assessed differences in attitude/belief questions by willingness to work. Logistic regressions were used to identify significant predictors of response willingness when requested or required, controlling for gender and race. Results: 433 individuals completed the survey (response rate = 82.9%). A quarter (26.8%, n = 116) received no pandemic training; 14.3% (n = 62) participated in a pandemic exercise. Significantly more EMS personnel were willing to work when required versus when only requested (88.2% vs 76.9%, X2 = 164.1, p < .001). Predictors of willingness to work when requested included believing it is their responsibility to work, believing their coworkers were likely to work, receiving prophylaxis for themselves and their family members, and feeling safe working during a pandemic. Discussion: Many emergency medical services personnel report lacking training or disaster exercises related to influenza pandemics, and a fair percentage are unwilling to work during a future event. This may limit healthcare surge capacity and could contribute to increased morbidity and mortality. Findings from this study indicate that prehospital staff's attitudes and beliefs about pandemics influence their willingness to work. Pre-event training and planning should address these concerns.

Racial disparities in vaccination for seasonal influenza in early childhood.

OBJECTIVES: Influenza vaccination is the best protection against infection and severe complications of disease, such as hospitalization and death. Therefore, it is important to accurately estimate vaccination coverage and to evaluate the role of race/ethnicity. This study examines racial disparities in influenza vaccination among children using a nationally representative sample. STUDY DESIGN: This study used cross-sectional data from the 2009-2014 National Immunization Survey for children aged 19-35 months (n = 98,186) in the United States. METHODS: The outcome variable was receipt of influenza vaccination (yes/no) and exposure variable was race/ethnicity. Weighted multivariate logistic regression was used to estimate the odds ratio and 95% confidence intervals (CIs) for the effect of race/ethnicity on receipt of the influenza vaccine. RESULTS: The overall vaccination rates were 81.6% for non-Hispanic whites, 79.2% for Hispanics, 80.5% for non-Hispanic blacks, and 80.7% for non-Hispanic mixed/other. In the adjusted model, compared with non-Hispanic white children, Hispanic children were 13% less likely to receive influenza vaccination within the last 12 months (adjusted odds ratio [aOR] = 0.87; 95% CI: 0.80-0.94). In addition, children aged 24-29 months (aOR = 0.48; 95% CI: 0.44-0.52) and 30-35 months (aOR = 0.33; 95% CI: 0.30-0.36) were significantly less likely to receive influenza vaccination within the last 12 months compared with those who were 19-23 months old. CONCLUSIONS: There were differences in influenza vaccination rates among different racial groups. Hispanic children had the lowest vaccination rates. Findings from our study have significant implications for targeted interventions to increase the overall vaccination rate for children in the United States.

Uptake and attitudes regarding hepatitis A vaccine among childcare centre staff, administrators, and parents.

OBJECTIVES: Study objectives were to assess parents' and childcare agency staff's uptake of and attitudes/beliefs related to hepatitis A vaccine. STUDY DESIGN: Cross-sectional survey. METHODS: Questionnaires were administered to parents and staff in 23 St. Louis childcare agencies between September and December 2014. Categorical data were compared using Chi-squared test. Multivariate logistic regression, stratified by staff vs parents, was used to find predictors of hepatitis A vaccine uptake. RESULTS: In total, 351 staff and parents participated (response rate = 32%). More staff than parents had been offered or recommended to receive hepatitis A vaccine by a healthcare provider (55.4% vs 36.6% and 53.3% vs 28.7%, respectively; P = .001 for both). More staff than parents received hepatitis A vaccine (85.3% vs 67.5%, Chi-squared test = 11.0, P < .001). Predictors of staff vaccine uptake included being aware of CDC vaccination recommendations (OR = 11.2, CI = [1.4-91], P < .05), employer recommendation to get vaccinated (OR = 8.1, CI = [1.8-36.8], P < .01), and having a mandatory staff vaccination policy (OR = 4.8, CI = [1.2-19.7], P < .05). Predictors of parent vaccine uptake included being offered the vaccine by a healthcare provider (OR = 4.3, CI = [1.3-4.9], P < .001), being aware of the CDC vaccination recommendations (OR = 4.0, CI = [2.0-8.0], P < .001), and having received influenza vaccine previously (OR = 2.5, CI = [1.3-4.9], P < .01). CONCLUSION: In this study population, many childcare agency staff and parents have received hepatitis A vaccine, though staff immunization rates are at the minimum needed to reach herd immunity levels. Having employers encourage vaccination, offer free vaccine, or make vaccine available onsite could increase staff vaccination rates. Public health should partner with childcare agencies to increase staff vaccine uptake, which could result in community herd immunity.

What we need to know about bioterrorism preparedness: results from focus groups conducted at APIC 2000.

Infection control practitioners (ICPs) are important partners in enhancing the US public health infrastructure, both as essential recipients of continuing education and as instructors responsible for providing this education. Focus groups were conducted at APIC 2000, the annual meeting for the Association for Professionals in Infection Control and Epidemiology, Inc, to determine the ICPs' priorities for educational opportunities in bioterrorism preparedness and the preferred methods of education delivery. Focus group participants affirmed the need to provide education in sessions of less than 60 minutes, with use of a variety of technologies and methods of presentation such as video, Internet, and paper-based self-learning texts. The participants' comments suggested a lack of awareness by employees in health care institutions about the potential threat of bioterrorism in the United States and a deficiency in knowledge about the potential consequences of an attack. The focus group participants believed this lack of awareness also leads to unwillingness by their administrators to allocate funds for planning and education. Since it appears that ICPs will be looking for direction and expertise from the local health departments in their communities, the first subset of professionals to target for bioterrorism education and preparedness should probably be the public health professionals.