Influenza vaccination among Malaysian healthcare workers: a survey of coverage and attitudes.

BACKGROUND: Healthcare workers (HCWs) are at increased risk of getting influenza than the general population, therefore putting patients at risk of nosocomial infection. Influenza vaccination coverage among HCWs is low despite the availability of a safe and effective vaccine. However, the reasons for such a poor uptake are not well reported in Malaysia. This study aimed at assessing the rate of influenza vaccination uptake, knowledge and attitude of healthcare workers regarding influenza, and employers' policy on influenza vaccination. METHODS: A cross-sectional questionnaire survey was conducted in three hospitals in the Klang Valley. Mann-Whitney test was used to assess possible differences in knowledge and attitude towards flu vaccination and the χ2 was used for categorical variables. Analyses were performed with SPSS 22.0. RESULTS: A total of 690 questionnaires were distributed; 527 were returned (giving a response rate of 76.4%. The vaccine uptake was 51.4% with the majority (83.5%) of those believing they were vaccinated to protect themselves. Higher proportion of vaccinated HCWs (p <0.05) agreeing to the fact that influenza is a serious threat to their health, however, 10% were not sure of its safety. Eighty-three (15.7%) claimed their employers did not have a vaccination policy, while 43.3% were not sure if their employers have vaccination policy. CONCLUSION: This study has demonstrated more than half of the healthcare workers were vaccinated, with a significant proportion of the healthcare workers believed they were vaccinated to protect themselves, while most of those that were not vaccinated claimed they are worried about the safety of the vaccine. Most employers did not have a flu vaccination policy in place. Hence, the need for government to enforce such policy and make annual flu vaccination free and compulsory for all healthcare workers.

Naturally occurring hepatitis B virus surface antigen mutant variants in Malaysian blood donors and vaccinees.

Hepatitis B virus surface mutants are of enormous importance because they are capable of escaping detection by serology and can infect both vaccinated and unvaccinated populations, thus putting the whole population at risk. This study aimed to detect and characterise hepatitis B-escaped mutants among blood donors and vaccinees. One thousand serum samples were collected for this study from blood donors and vaccinees. Hepatitis B surface antigen, antibodies and core antibodies were tested using a commercial enzyme-linked immunosorbent assay (ELISA) kit. DNA detection was performed via nested polymerase chain reaction (PCR), and the S gene was sequenced and analysed using bioinformatics. Of the 1,000 samples that were screened, 5.5% (55/1,000) were found to be HBsAg-negative and anti-HBc- and HBV DNA-positive. All 55 isolates were found to belong to genotype B. Several mutations were found across all the sequences from synonymous and non-synonymous mutations, with the most nucleotide mutations occurring at position 342, where adenine was replaced by guanine, and cytosine at position 46 was replaced by adenine in 96.4% and 98% of the isolates, respectively. Mutation at position 16 of the amino acid sequence was found to be common to all the Malaysian isolates, with 85.7% of the mutations occurring outside the major hydrophilic region. This study revealed a prevalence of 5.5% for hepatitis B-escaped mutations among blood donors and vaccinated undergraduates, with the most common mutation being found at position 16, where glutamine was substituted with lysine.