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.

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.