National Institute for Health and Care Excellence Final Flu vaccination: increasing uptake Evidence reviews for increasing uptake in health and social care staff NICE guideline NG103 Evidence reviews August, 2018 Final These evidence reviews were developed by Public Health – Internal Guideline Development team Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn. Copyright © NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-2864-4 Contents Contents Increasing flu vaccination uptake in health and social care staff .................................... 7 Review question(s) ......................................................................................................... 7 Introduction ........................................................................................................... 7 PICO table ............................................................................................................. 8 Public Health evidence .......................................................................................... 9 Evidence Review ................................................................................................. 10 Summary of included effectiveness studies ......................................................... 10 Synthesis and quality assessment of effectiveness evidence .............................. 16 Evidence statements ........................................................................................... 18 Qualitative evidence review ................................................................................. 26 Qualitative evidence statements .......................................................................... 28 Economic evidence ............................................................................................. 32 Economic model .................................................................................................. 33 Appendix A: Review protocols ................................................................................... 34 Appendix B: Health economic analysis ...................................................................... 45 Appendix C: Research recommendations .................................................................. 46 Appendix D: Included evidence study selection ......................................................... 47 Appendix E: Economic evidence study selection ....................................................... 51 Appendix F: Literature search strategies ................................................................... 52 Appendix G: Evidence tables ..................................................................................... 57 G.1 Effectiveness – primary studies .................................................................... 57 G.1.1 Afonso 2014 .................................................................................... 57 G.1.2 Bruce 2007 ..................................................................................... 60 G.1.3 Cadena 2011 .................................................................................. 62 G.1.4 Chambers 2015 .............................................................................. 64 G.1.5 Conner 2011 ................................................................................... 68 G.1.6 Drees 2015 ..................................................................................... 70 G.1.7 Friedl 2012 ...................................................................................... 75 G.1.8 Kim 2015 ........................................................................................ 77 G.1.9 Koharchik 2012 ............................................................................... 80 G.1.10 Lehman 2016 .............................................................................. 82 G.1.11 Leibu 2015 .................................................................................. 84 G.1.12 Llupia 2013 ................................................................................. 86 G.1.13 Maltezou 2007............................................................................. 89 G.1.14 Marwaha 2015 ............................................................................ 91 G.1.15 Mouzoon ..................................................................................... 94 G.1.16 Munford 2008 .............................................................................. 98 G.1.17 Nace 2007 ................................................................................. 100 4 Contents G.1.18 Nace 2012 ................................................................................. 105 G.1.19 Palmore 2009 ............................................................................ 109 G.1.20 Parry 2004 ................................................................................ 111 G.1.21 Patterson 2011 .......................................................................... 113 G.1.22 Quan 2014 ................................................................................ 116 G.1.23 Perlin 2013 ................................................................................ 119 G.1.24 Polgreen 2008 ........................................................................... 122 G.1.25 Rothan-Tondeur 2010 ............................................................... 124 G.1.26 Sanchez 2003 ........................................................................... 127 G.1.27 Salgado 2004 ............................................................................ 129 G.1.28 Sand 2007 ................................................................................. 130 G.2 Effectiveness – systematic reviews............................................................. 132 G.2.1 Hollmeyer 2012 ............................................................................. 133 G.2.2 Lam 2010 ...................................................................................... 136 G.2.3 Lytras 2016 ................................................................................... 139 G.2.4 Pitts 2014 ...................................................................................... 141 G.3 Qualitative studies ...................................................................................... 145 G.3.1 Chalmers 2006 ............................................................................. 145 G.3.2 Hill 2015 ........................................................................................ 147 G.3.3 Hollmeyer 2009 ............................................................................. 150 G.3.4 Leask 2010 ................................................................................... 152 G.3.5 Lim 2014 ....................................................................................... 156 G.3.6 Real 2013 ..................................................................................... 158 G.3.7 Rhudy 2010 .................................................................................. 160 G.3.8 Willis 2007 .................................................................................... 164 Appendix H: Economic evidence tables ................................................................... 167 Appendix I: GRADE tables ..................................................................................... 168 I.1 GRADE profile 1 ......................................................................................... 168 I.2 GRADE profile 2 ......................................................................................... 170 I.3 GRADE profile 3 ......................................................................................... 172 I.4 GRADE profile 4 ......................................................................................... 176 I.5 GRADE profile 5 ......................................................................................... 180 I.6 GRADE profile 6 ......................................................................................... 183 I.7 GRADE profile 7 ........................................................................................