• M Rothan-Tondeur, Y Filali-Zegzouti, J-L Golmard, B De Wazieres, F Piette, F Carrat, B Lejeune, and G Gavazzi.
• ORIG (French Geriatric Infection Risk Institute), Charles Foix Hospital, AP-HP (Publicly-owned hospitals of Paris), Ivry-sur-Seine, France. monique.r-tondeur@cfx.ap-hop-paris.fr
• J Nutr Health Aging. 2011 Feb 1; 15 (2): 126-32.

BackgroundBecause of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination.ObjectivesTo implement multicenter programs to enhance HCW influenza vaccination.DesignIt was a cluster randomised interventional studies.Setting43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France.Participants1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group.InterventionAfter the failure of a first educational program giving scientific information and. tested during the 2005-06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of "safety zones", and to give personal satisfaction. Program 2 was tested during the 2006-07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs).MeasurementsThe efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters.ResultsProgram 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p > 0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p < 0.001) regardless their occupational group but only in the non previous vaccinated subgroup.ConclusionsIn geriatric health care centres in France, an active multicenter program giving personal satisfaction and taking into account the profile of non-vaccinated HCWs was more effective in promoting flu vaccination than a scientifically factual information program. HCW involvement is required in program implementation in order to avoid rejection of top-down information.

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