Compliance with immunization and a biological risk assessment of heathcare workers as part of an occupational health surveillance program: the experience of a university hospital in southern Italy

Background: The active immunization of health care workers (HCWs) is a primary measure to prevent nosocomial infection; despite this, vaccine coverage among HCWs in most countries is low. To increase vaccine coverage in the health care setting, the hygiene and occupational medicine departments of Bari Policlinico General University-Hospital implemented a vaccination procedure. This operative procedure requires that during the occupational medical examination, all employees are evaluated for immunity/susceptibility to vaccine-preventable diseases, with vaccination offered to those determined to be susceptible. Methods: The study sample comprised HCWs who attended the biological risk assessment program from December 2017 to January 2019 (n = 449). Results: Susceptibility was higher for hepatitis B virus (23%), followed by rubella (11%), varicella (9%), mumps (8%), and measles (7%). The seroconversion rate after the administration of booster dose(s) was >80% for all vaccines. Overall, 15% of the HCWs refused the offered vaccine(s), and the main determinants of vaccination compliance were younger age (P < .0001) and being a physician (P < .05). Discussion: Despite the several recommendations and campaigns to promote vaccinations, achieving high immunization rates among HCWs is still a challenge. Conclusions: In this scenario, public health institutions have to choose between the enforcement of the promotion or the adoption of a mandatory policy.