American Journal of Infection Control
Volume 42, Issue 8, p819-940 August 2014
http://www.ajicjournal.org/current

Health care workers—part of the system or part of the public? Ambivalent risk perception in health care workers
Anat Gesser-Edelsburg, PhD, Nathan Walter, MA, Manfred S. Green, MSc, MBChB, MPH, PhD
Published Online: June 14, 2014
DOI: http://dx.doi.org/10.1016/j.ajic.2014.04.012
Abstract
Background
The emergence of the avian influenza A (H7N9) in China during 2013 illustrates the importance of health care professionals as a mediating channel between health agencies and the public. Our study examined health care professionals’ risk perceptions considering their unique position as representing the health care system and yet also being part of the public, hence a risk group. Recent studies have examined the role of health professionals’ personal risk perceptions and attitudes regarding compliance of the general public with vaccination. Our study examined how risk perception affects their risk analysis.
Methods
We employed an online survey of Israeli health care professionals and the general public in Israel (N = 240).
Results
When risk perception is relatively low, health care professionals tend to base their attitudes toward vaccines on analytical knowledge (Rc = 0.315; P < .05), whereas in situations with high risk perception, the results did not indicate any significant difference between Israeli health professionals and the Israeli general public, hence both groups base their attitudes more on emotions and personal experience than on analytical knowledge. Conclusions Public health organizations must consider the fact that health professionals are a group that cannot be automatically treated as an extension of the organization. When the risk is tangible and relevant, health care workers behave and act like everybody else. Our study contributes to understanding health care professionals’ perceptions about vaccines and the thinking processes underlying such perceptions.

Varicella seroprevalence among health care workers in Korea: Validity of self-reported history and cost-effectiveness of prevaccination screening
Ji-Hea Kang, RN1, Yoon Soo Park, MD1, Shin Young Park, RN, Sae Bom Kim, RN, Kwang-Pil Ko, MD, Yiel-Hea Seo, MD 1These authors contributed equally to this work. DOI: http://dx.doi.org/10.1016/j.ajic.2014.05.013
Abstract
Background The validity of self-reported varicella history and cost-effectiveness of a prevaccination screening strategy have not been examined among health care workers (HCWs) living in Korea.
Methods We investigated varicella-zoster virus immunity of all HCWs in high-risk departments. To determine the history of varicella, all applicants completed a standardized questionnaire at the time of blood sampling for serologic testing.
Results Of the 550 HCWs, 526 (96%) were varicella seropositive. Although self-reported history was highly predictive of seropositivity (≥96%) among all age groups, the negative predictive value was extremely low (4%-5%) among all age groups. The prevaccination screening strategy was cheaper than vaccination without antibody screening if the varicella seroprevalence was >28%.
Conclusion
Seroprevalence was high (≥95%) among HCWs born in Korea before 1988. The self-reported varicella history did not accurately predict immunity, especially for individuals who have negative or uncertain varicella history. Given the high seroprevalence of varicella in Korean HCWs, serologic screening before vaccination was more cost-effective than universal vaccination.