Copyright
©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Mandatory meningococcal vaccine, and other recommended immunisations: Uptake, barriers, and facilitators among health care workers and trainees at Hajj
Al-Mamoon Badahdah, Mohammad Alfelali, Amani S Alqahtani, Saeed Alsharif, Osamah Barasheed, Harunor Rashid, the Hajj Research Team
Al-Mamoon Badahdah, Mohammad Alfelali, Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 22252, Saudi Arabia
Al-Mamoon Badahdah, Mohammad Alfelali, Osamah Barasheed, Harunor Rashid, National Centre for Immunisation Research and Surveillance, the Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
Al-Mamoon Badahdah, Mohammad Alfelali, Osamah Barasheed, Harunor Rashid, the Discipline of Child and Adolescent Health, the Faculty of Medicine and Health, the University of Sydney, Westmead, NSW 2145, Australia
Amani S Alqahtani, Saudi Food and Drug Authority, Riyadh 13312, Saudi Arabia
Saeed Alsharif, Command and Control Centre of Infectious Diseases of Public Health Department of Ministry of Health, Taif 26521, Saudi Arabia
Osamah Barasheed, the Executive Administration of Research and Innovation at King Abdullah Medical City in Holy Capital, Makkah 24246, Saudi Arabia
Author contributions: Rashid H, Alqahtani AS and Barasheed O contributed to study conception and design; Badahdah AM and Alfelali M contributed to data acquisition; Badahdah AM and Alsharif S contributed to data analysis and interpretation and writing of article; Badahdah AM, Alfelali M, Alqahtani AS, Alsharif S, Barasheed O and Rashid H contributed to editing, reviewing and final approval of article.
Institutional review board statement: This study was reviewed and approved by Institutional Review Board of King Abdullah Medical City, Saudi Arabia (Ref: 15-202).
Informed consent statement: Respondents’ completion of the survey was considered as their implied consent, so signed informed consent was not obtained, and no identifiable personal data were collected.
Conflict-of-interest statement: Dr Rashid has received fees from Sanofi, Pfizer and Novartis for consulting or serving on an advisory board. The other authors have no conflict of interest in relation to this manuscript.
STROBE statement: The guidelines of the STROBE Statement have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Harunor Rashid, MBBS, MD, National Centre for Immunisation Research and Surveillance, the Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. harunor.rashid@health.nsw.gov.au
Telephone: +61-2-98451489 Fax: +61-2-98451418
Received: October 2, 2018
Peer-review started: October 2, 2018
First decision: October 11, 2018
Revised: October 19, 2018
Accepted: November 23, 2018
Article in press: November 24, 2018
Published online: December 26, 2018
ARTICLE HIGHLIGHTS
Research background
In the last few decades, meningococcal outbreaks from Hajj gathering have been a major global public health concern. It is now compulsory for anyone who is going to attend Hajj congregation or serve the pilgrims to be vaccinated with a quadrivalent meningococcal vaccine (against serogroups A, C, W and Y). Seasonal influenza vaccine is also highly advised for all Hajj attendees, and pneumococcal vaccine is recommended for pilgrims with co-morbidities.
Research motivation
The uptake of these vaccines among health care workers (HCWs) at Hajj has been suboptimal and there is no data on pneumococcal vaccine uptake. In previous reports non-availability of vaccine and lack of time were key barriers to vaccination among HCWs at Hajj, however there is no data on facilitators of vaccination.
Research objectives
The objectives are to evaluate the uptake of meningococcal, influenza, pneumococcal vaccines among HCWs who serve at Hajj, and to explore the key factors, including facilitators, affecting their vaccination rate.
Research methods
An anonymous cross-sectional online survey was conducted among HCWs and trainees who worked or volunteered at the Hajj 2015-2017 in Makkah and Mina. Pearson’s chi-squared test was used to compare categorical variables; and odds ratio (OR) was calculated by “risk estimate” statistics along with 95% confidence interval (95%CI).
Research results
A total of 138 respondents aged 20 to 59 (median 25.6) years with a male to female ratio of 2.5 participated in the survey. Only 11.6% (16/138) participants reported receiving all three vaccines, 15.2% (21/138) did not receive any vaccine; 76.1% (105/138) received meningococcal, 68.1% (94/138) influenza and 13.8% (19/138) pneumococcal vaccine. Females were more likely to receive a vaccine than males (OR 3.6, 95%CI: 1.0-12.7, P < 0.05). Willingness to follow health authority’s recommendation was the main reason for receipt of vaccine (78.8%) while believing that they were up-to-date with vaccination (39.8%) was the prime reason for non-receipt.
Research conclusions
This survey shows that many HCWs at Hajj miss out the compulsory and highly recommended vaccines; lack of awareness is a key barrier and authority’s advice is an important motivator.
Research perspectives
Achieving satisfactory vaccination coverage among local HCWs at Hajj remains a challenge. Health education followed by stringent measures may be required to improve their vaccination rate. Evaluation of the role of workplace vaccination campaigns and the “Basic Infection Control Skills License” should be considered to better understand the uptake of vaccination among HCWs at Hajj.
