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Clusters of Nosocomial Meningitis Associated With a Single Anesthesiologist

hour theoretical and practical training course that addressed the composition of the vaccine, adverse events, contraindications, postvaccination advice, conservation of vaccine, the transportation and storage of vaccine at the required cold temperature, and administration of vaccine. The organization and training of the vaccination teams, as well as the campaign itself, were conducted by the hospital's employees. A supervisor and 3 mobile teams, each composed of 4 nurses, conducted the entire campaign in the main building. The vaccine remained available to the HCWs at the Immunization Center of the hospital until the end of the season. In the entire hospital complex, 9,024 HCWs (45% of the target population) were vaccinated against influenza in 2006. The strategy was repeated in 2007, when the vaccine was administered to 9,713 HCWs (48.5%) during the 2-week campaign. The intervention in 2006 increased the HCW influenza vaccination rate from 6% to 45%. Both the institutional commitment to improve the rates and the involvement of employees were essential. Offering the vaccine to the HCWs in their work sites during their work hours by mobile teams, which made vaccination more convenient to the target population, was crucial to the success of the effort. The results are consistent with those of other studies showing that increasing access to vaccination is the most effective strategy to overcome barriers and to increase HCW vaccination rates. However, no single strategy is sufficient to vaccinate a high percentage of HCWs. Ensuring the program's longevity and guaranteeing that a high percentage of HCWs get the vaccination every year is a challenge. A survey conducted at the Hospital das Clinicas in 2004 showed that 50%-70% of employees who had been vaccinated also received vaccination the following year, whereas more than 80% of those who had not been vaccinated remained unvaccinated. To work in the long term, the educational campaign and vaccination program must be conducted annually to reach new employees and those who chose not to be vaccinated in the previous year. Although the intervention increased the rate of vaccination among HCWs, we do not feel the achieved rate is good enough.