- Email: [email protected]
Immunization against influenza among working adults: the Philippines experience
Vaccine 17 (1999) S59±S62
ww.elsevier.com/locate/vaccine
Immunization against in¯uenza among working adults: the Philippines experience Franc° ois Ausseil* Asian Development Bank, 6 ADB Avenue, Mandaluyong, PO Box 789, 0980, Manila, Philippines
1. Introduction In the Philippines, in¯uenza usually strikes biannually, in June±July and December±January, corresponding roughly to the beginning and the end of the rainy season. Although in¯uenza has always been present in the Philippines, as in other countries, vaccination was introduced only last year. A pilot in¯uenza vaccination campaign, sponsored by the local branch of Pasteur MeÂrieux-Connaught, was conducted in our company, an international banking institution consisting of 1825 sta divided into 665 (36.5%) professional sta, mostly foreigners, and 1160 (63.5%) supporting sta, mostly Filipinos (Fig. 1). In June 1997, a sample of 292 sta received one injection of Vaxigrip. Of the vaccinated sta, 33 (11%) were professionals and 259 (89%) were supporting sta. The number of vaccinated women (219 or 75% of vaccinated sta) far exceeded the number of vaccinated men (73 or 25% of vaccinated sta) (Fig. 2).
parison between vaccinated and non-vaccinated sta, we also compared the percentage increase in sick leave between these two categories (Table 1 and Fig. 5).
3. Analysis and comments Although the total number of female sta in the company is not much higher than the number of males (977 versus 848), 75% of the sta who requested vaccination were women. This is consistent with the results of other studies within our company and con®rms that women are usually more concerned than men about prevention. The foreign sta showed less concern than local sta (5 versus 22%), although vaccination against in¯uenza is known in western countries but has never been oered in the Philippines. This may re¯ect a growing interest in prevention by local sta and
2. Results The number of days of sick leave claimed by sta in 1997 was compared with that taken in 1996 (Fig. 3), and the average number of days of sick leave taken by the vaccinated sta was compared with that taken by the non-vaccinated sta, in both 1997 and 1996 (Fig. 4). The sta thus claimed more sick leave in 1997 than in 1996. The increase was seen in all sta categories but was more substantial for supporting than for professional sta. In order to make a more reliable com* Tel.: +632-632-4020; fax: +632-632-5715.
Table 1 Percentage increase in days of sick leave claimed between 1996 and 1997 Year
Average days of sick leave All sta All
Vaccinated sta
PSa SSb All
PSa
SSb
Non-vaccinated sta All
PSa SSb
1996 6.07 3.03 7.70 7.18 3.23 7.69 5.86 3.02 7.71 1997 6.80 3.20 8.87 7.96 4.11 8.46 6.61 3.15 8.98 % increase 12.02 5.61 5.19 10.86 27.24 10.01 12.79 4.30 16.47 a
PS, professional sta. SS, supporting sta.
0264-410X/99/$ - see front matter # 1999 Published by Elsevier Science Ltd. All rights reserved. PII: S 0 2 6 4 - 4 1 0 X ( 9 9 ) 0 0 1 0 8 - 5
S60
F. Ausseil / Vaccine 17 (1999) S59±S62 871
900 800 700 600
559
500 400 289
300 200 106 100 Male
Female
Male
Female
0 Professional
Supporting
Fig. 1. Distribution of sta.
lack of concern with regard to in¯uenza by foreign sta. Unexpectedly, the attendance of vaccinated sta was not improved in 1997 in comparison with 1996; however, the attendance of non-vaccinated sta was also worse in 1997. This may be due to a severe epidemic of in¯uenza at the beginning of 1997, before the June vaccination campaign, and several small epidemics of upper respiratory tract and dengue fever infections in
1997. Statistics that include the ®rst trimester of 1998, once completed, will probably show more accurate ®gures. Although the global number of days of sick leave taken by all sta was larger in 1997, the percent increase was smaller for vaccinated than for non-vaccinated sta (10.9 versus 12.8%). The dierence was even larger for supporting sta (10 versus 16.5%). The surprising 27% increase in days of sick leave
250 214 200
150
100
45
50 28 Male
Female 5
Male
Female
0 Professional
Supporting
Fig. 2. Numbers of sta vaccinated in 1997.
F. Ausseil / Vaccine 17 (1999) S59±S62
S61
8.87
9
7.7 6.8 6.07
3.2
3.03
All
Professional
All
Supporting
Professional
Supporting
0 1996
1997
Fig. 3. Average numbers of days of sick leave taken by all sta in 1996 and 1997.
A
B 10
10
8.98 8.46 7.69
7.96
7.71
7.18 6.61 5.86
4.11
All
All
PS
PS
SS
SS
3.23
3.02
3.15
1996
1997
0
0 1996
1997
Fig. 4. Average numbers of days of sick leave taken by (A) vaccinated sta and (B) non-vaccinated sta in 1996 and 1997; PS, professional sta; SS, supporting sta.
S62
F. Ausseil / Vaccine 17 (1999) S59±S62 30 27.24 25
% Increase
20 16.47 15.19 15
12.79
12.02 10.86
10.01
10 5.61 4.3
5
0 All staff
All All vaccinated nonstaff vaccinated staff
All PS
Vaccinated NonPS vaccinated PS
All SS
Vaccinated NonSS vaccinated SS
Fig. 5. Percentage increase in days of sick leave claimed between 1996 and 1997; PS, professional sta; SS, supporting sta.
taken by professional sta in 1997 is not signi®cant because of the very small sample (only 33 vaccinated sta, or 5% of the total professional sta) and because one sta member who had particularly severe (but not in¯uenza-related) pneumonia accounted for almost 20% of the total number of days of sick leave in this group. 4. Conclusions and recommendations Although the result of the vaccination campaign was
not as positive as expected with regard to sta attendance, the trend shows that better gains in terms of illness and sick leave could be expected from mass vaccination. Flu awareness campaigns should be organized among working adults and doctors in order to eliminate the old, common confusion between in¯uenza and the common cold. In the Philippines, vaccination against in¯uenza should be proposed yearly to working adults from April or May, as soon as the new vaccine becomes available.
ww.elsevier.com/locate/vaccine
Immunization against in¯uenza among working adults: the Philippines experience Franc° ois Ausseil* Asian Development Bank, 6 ADB Avenue, Mandaluyong, PO Box 789, 0980, Manila, Philippines
1. Introduction In the Philippines, in¯uenza usually strikes biannually, in June±July and December±January, corresponding roughly to the beginning and the end of the rainy season. Although in¯uenza has always been present in the Philippines, as in other countries, vaccination was introduced only last year. A pilot in¯uenza vaccination campaign, sponsored by the local branch of Pasteur MeÂrieux-Connaught, was conducted in our company, an international banking institution consisting of 1825 sta divided into 665 (36.5%) professional sta, mostly foreigners, and 1160 (63.5%) supporting sta, mostly Filipinos (Fig. 1). In June 1997, a sample of 292 sta received one injection of Vaxigrip. Of the vaccinated sta, 33 (11%) were professionals and 259 (89%) were supporting sta. The number of vaccinated women (219 or 75% of vaccinated sta) far exceeded the number of vaccinated men (73 or 25% of vaccinated sta) (Fig. 2).
parison between vaccinated and non-vaccinated sta, we also compared the percentage increase in sick leave between these two categories (Table 1 and Fig. 5).
3. Analysis and comments Although the total number of female sta in the company is not much higher than the number of males (977 versus 848), 75% of the sta who requested vaccination were women. This is consistent with the results of other studies within our company and con®rms that women are usually more concerned than men about prevention. The foreign sta showed less concern than local sta (5 versus 22%), although vaccination against in¯uenza is known in western countries but has never been oered in the Philippines. This may re¯ect a growing interest in prevention by local sta and
2. Results The number of days of sick leave claimed by sta in 1997 was compared with that taken in 1996 (Fig. 3), and the average number of days of sick leave taken by the vaccinated sta was compared with that taken by the non-vaccinated sta, in both 1997 and 1996 (Fig. 4). The sta thus claimed more sick leave in 1997 than in 1996. The increase was seen in all sta categories but was more substantial for supporting than for professional sta. In order to make a more reliable com* Tel.: +632-632-4020; fax: +632-632-5715.
Table 1 Percentage increase in days of sick leave claimed between 1996 and 1997 Year
Average days of sick leave All sta All
Vaccinated sta
PSa SSb All
PSa
SSb
Non-vaccinated sta All
PSa SSb
1996 6.07 3.03 7.70 7.18 3.23 7.69 5.86 3.02 7.71 1997 6.80 3.20 8.87 7.96 4.11 8.46 6.61 3.15 8.98 % increase 12.02 5.61 5.19 10.86 27.24 10.01 12.79 4.30 16.47 a
PS, professional sta. SS, supporting sta.
0264-410X/99/$ - see front matter # 1999 Published by Elsevier Science Ltd. All rights reserved. PII: S 0 2 6 4 - 4 1 0 X ( 9 9 ) 0 0 1 0 8 - 5
S60
F. Ausseil / Vaccine 17 (1999) S59±S62 871
900 800 700 600
559
500 400 289
300 200 106 100 Male
Female
Male
Female
0 Professional
Supporting
Fig. 1. Distribution of sta.
lack of concern with regard to in¯uenza by foreign sta. Unexpectedly, the attendance of vaccinated sta was not improved in 1997 in comparison with 1996; however, the attendance of non-vaccinated sta was also worse in 1997. This may be due to a severe epidemic of in¯uenza at the beginning of 1997, before the June vaccination campaign, and several small epidemics of upper respiratory tract and dengue fever infections in
1997. Statistics that include the ®rst trimester of 1998, once completed, will probably show more accurate ®gures. Although the global number of days of sick leave taken by all sta was larger in 1997, the percent increase was smaller for vaccinated than for non-vaccinated sta (10.9 versus 12.8%). The dierence was even larger for supporting sta (10 versus 16.5%). The surprising 27% increase in days of sick leave
250 214 200
150
100
45
50 28 Male
Female 5
Male
Female
0 Professional
Supporting
Fig. 2. Numbers of sta vaccinated in 1997.
F. Ausseil / Vaccine 17 (1999) S59±S62
S61
8.87
9
7.7 6.8 6.07
3.2
3.03
All
Professional
All
Supporting
Professional
Supporting
0 1996
1997
Fig. 3. Average numbers of days of sick leave taken by all sta in 1996 and 1997.
A
B 10
10
8.98 8.46 7.69
7.96
7.71
7.18 6.61 5.86
4.11
All
All
PS
PS
SS
SS
3.23
3.02
3.15
1996
1997
0
0 1996
1997
Fig. 4. Average numbers of days of sick leave taken by (A) vaccinated sta and (B) non-vaccinated sta in 1996 and 1997; PS, professional sta; SS, supporting sta.
S62
F. Ausseil / Vaccine 17 (1999) S59±S62 30 27.24 25
% Increase
20 16.47 15.19 15
12.79
12.02 10.86
10.01
10 5.61 4.3
5
0 All staff
All All vaccinated nonstaff vaccinated staff
All PS
Vaccinated NonPS vaccinated PS
All SS
Vaccinated NonSS vaccinated SS
Fig. 5. Percentage increase in days of sick leave claimed between 1996 and 1997; PS, professional sta; SS, supporting sta.
taken by professional sta in 1997 is not signi®cant because of the very small sample (only 33 vaccinated sta, or 5% of the total professional sta) and because one sta member who had particularly severe (but not in¯uenza-related) pneumonia accounted for almost 20% of the total number of days of sick leave in this group. 4. Conclusions and recommendations Although the result of the vaccination campaign was
not as positive as expected with regard to sta attendance, the trend shows that better gains in terms of illness and sick leave could be expected from mass vaccination. Flu awareness campaigns should be organized among working adults and doctors in order to eliminate the old, common confusion between in¯uenza and the common cold. In the Philippines, vaccination against in¯uenza should be proposed yearly to working adults from April or May, as soon as the new vaccine becomes available.