A study to assess the knowledge , attitude and practices on optional

vaccines among health care personnel in Pondicherry institute of

medical sciences

Introduction

World health organization (WHO) states Health is a state of complete physical, mental and
social well-being and not merely the absence of disease or infirmity.

Health is more than just the absence of disease. It is affected by a wide range of spectrum of
physical, mental, social and political factors. The promotion of health is social as well as
individual responsibility. It has been that 5 million children were dying each year and another
5 million were disabled by infectious diseases. The growth and development of children is a
long term contribution of country as a whole. The key to attain the goal of health for all
primary health care emphasizes on the preventive principles one of the most cost effective
health intervention is vaccine for all infectious disease. Immunization is a high priority area
in care of infants and children. High immunization rates have almost eliminated many
infectious diseases which used to decimate sizable of the population for countries. A number
of deadly and disabling infectious diseases can be prevented by timely administration of
vaccines when child is effectively immunized at the right age, most of these diseases are
either entirely prevented or at least modified so that child suffer from a mild disease without
any disability. The IAP committee on immunization has classified some vaccines as optional
vaccines, e.g., hepatitis ‘a’ vaccine, HIB vaccine and varicella vaccine. The word optional
means ‘not compulsory’, ‘which may be chosen or not as one wishes’ ‘discretionary’ or
‘elective’. Optional means that one may elect to have it or not without any risk or
disadvantage optional vaccines are those which are not included in the routine immunisation
programme and given on an optional basis.

Optional vaccines are

 Pneumococcal
 Rota Virus
 Typhoid
 varicella (chicken pox)
 Hepatitis A
 Hemophilus influenza b hib Vaccines
 Human Papilloma Virus
NEED OF THE STUDY

Access to immunization services and up to date immunization coverage are essential for
disease protecting every age group from deliberating and potentially life threatening effects
of infectious. The risk of mortality and morbidity is statistically high during childhood
period. Prevention is ultimately the most effective defence system in controlling infectious
disease. So the knowledge regarding optional vaccine can be preventing infectious disease
among health care professionals. This point of view only this study was conducted to assess
the knowledge and attitude regarding optional vaccines among health care professionals

Hip was estimated to have caused two to three million cases of serious disease, notably
pneumonia and meningitis, and 3,86,000 deaths .

The HBV infection is a global problem. More than 2 billion people. worldwide have evidence
of past or current HBV infection and 350 million are chronic carriers of the virus, and causes
an estimated 620,000 deaths.ng children

According to WHO about 10-50 persons per 100.000 are affected annually for hepatitis A. In
2004, WHO estimated the global typhoid fever disease burden at 21 million cases annually,
Meningococcal disease is endemic in India. During 2005, about 8367 cases of meningococcal
meningitis were reported in India with about 485 deaths. More than 2 million children die
from pneumonia each year, accounting for almost one in 5 under-five deaths .worldwide.
According to WHO APCRI National multicentre rabies Survey, there are an estimated
17.4million animal bite cases and 20,000 deaths due to human rabies annually in India
corresponding to 36% of total global deaths due to human rabies.

Research question

Does a health care personnel have adequate knowledge, attitude practices towards optional
vaccines?

Objectives

1. To assess the level of knowledge , attitude and practices among health care
personnel in Pondicherry institute of medical sciences.
2. To correlate the knowledge , attitude and practices among health care
personnel in Pondicherry institute of medical sciences
 3. To associate the level of knowledge, attitude and practices among health care
personnel with selected demographical variables.

Hypothesis

H1-There is significant difference between knowledge , attitude and practices on optional

vaccines among health workers in Pondicherry institute of medical sciences.

Operational definition

Knowledge

In this study it refers to the correct written responses given by the health care personnel on
optional vaccines which is assessed using a self administered questionnaire.

Attitude

In this study it refers to the beliefs and feelings regarding optional vaccines among health
care personnel which is assessed using a Likert scale.

Practice

In this study it refers to the activity of immunization their children according to the schedule
for optional vaccines

Optional vaccines

It refers to vaccines which are not present in the universal immunization schedule, which is
used in pims. There are,

 Pneumococcal
 Rota Virus
 Typhoid
 varicella (chicken pox)
 Hepatitis A
 Hemophilus influenza b hib vaccine
 Human Papilloma Virus
Health care personnel

In this study it refers to doctors , staff nurses , technicians, auxillary nurses

Research methodology

Research approach: Quantitative approach

Research design: Descriptive research design

Variables

Independent variables:

In this study the independent variables are knowledge , attitude and practices of
health care personnel on optional vaccines

Setting

The setting of this study was Pondicherry institute of medical sciences . The Pondicherry
institute of medical sciences is a 640 bedded multi speciality hospital and teaching institute
at kalapet, . This setting was selected because of the availability of samples, feasibility of
conducting the study and for ethical clearance
 RESEARCH APPROACH
Exploratory approach

RESEARCH DESIGN

Non experimental descripitive research design

SETTING OF THE STUDY

Pondicherry Institute Of Medical Science

POPULATION
Health care personnel

SAMPLE
Health care personnel working at P.I.M.S.

SAMPLING
TECHNIQUE SAMPLE SIZE
Convenience N=236
sampling

DATA COLLECTION

Self adminstered questionaire-knowledge,attitude scale,practice scale

DATA ANALYSIS

INTERPRETATION OF FINDINGS

Fig.1: Schematic representation of methodology

Population

health care personnel

sample

Health care personnel working at P.I.M.S

Sample size

236

Sampling Criteria

Inclusion criteria

It includes:

Health care personnel who a

 Available during the period of collecting data.

 Willing to participate in the study.

Exclusion criteria:

 Who are all not on duty during data collection.

 Employees who are outsourced by P.I.M.S.

Sampling technique

convenient sampling technique

Description of tool

Section I:

Interview questionnaire-demographical variable of health care personnel such as age ,gender,

religion, education, area of residence, Sources of information regarding optional vaccines
Section II

Self administered questionnaire to measure knowledge of health care personnel on optional

vaccines. 20 multiple choice questions with 4 option abd one correct answer

Score

Correct answer-1

Wrong answer-0

Grading of knowledge

80%-100% -adequate

50%-79% -moderatly adequate

Knowledge regarding optional vaccines

Attitude towards optional vaccines

Data analysis plan

Chi-squire test

Scope of the study

There are many grey areas and lacunae in our understanding of infections and vaccines. It is
prudent that we build our own epidemiological data to evolve a sound strategy in this area,
though we may be forced to take some decisions temporarily in the absence of reliable data.
It is also true that the epidemiology of infections keeps changing over time, requiring
appropriate modifications in our immunization strategies.

India may be considered a conglomeration of many countries within a country. A national

policy must be evolved after considering many variables. One may justify selective
protection of individuals with certain vaccines on a scientific basis (such as pneumococcal
vaccine in splenectomised patients), but one must be cautious about the routine use of
‘optional’ vaccines. It is important to think beyond mere availability and affordability
An estimated 527,000 children aged <5 years die from rotavirus diarrhea each year, with
>85% of these deaths occurring in low-income countries of Africa and Asia. Most (approx.
70%) cases of meningitis occur in children under the age of 5 or in people over the age of
60.7 Out of that an annual incidence of 86 per 100,000 (95%CI 69 to 109) in 0-4 yr old
children, and 357 per 100,000 in 0-11 month infants in India.

In India rotavirus causes 5 lacks of hospitalization annually. Usually the hospitalization

occurs within 6 months of age. The W H O estimates that the two bacteria alone Hib and
pneumococcal causes 50% of pneumonia deaths in children under five years of age in India.
In 2006, 206 polio cases were reported in India. In 2007 a total of 864 polio cases were
reported. In 1988 polio was endemic in 125 countries. By mid 2009 poliovirus remained
endemic in only four countries India, Pakistan, Afghanistan, and Nigeria. The mothers play a
vital role in the care of children are unaware of many dreadful diseases its complications and
its prevention.

Chicken-pox is one more newer vaccine in our armamentarium against infectious diseases.
Due to its extremely contagious nature, varicella is experienced by almost every child or
young adult in the world. Each year from 1990 to 1994, prior to availability of varicella
vaccine, about 4 million cases of varicella occurred in the United States. Of these cases
approximately 10,000 required hospitalization and 100 died. Although varicella is not
commonly perceived as an important public health problem, the socioeconomic consequences
in industrialized countries of a disease that affects practically every child and causes the
carrier absence from work should not be underestimated.

Hepatitis A in most developing countries is a sporadic childhood disease, but lately focal
outbreaks have been observed among children in India. A study conducted during 2004,
investigated a large-scale outbreak of hepatitis among children living in a residential colony
in Daund Taluk of District Pune in the western region of India. In total, 123 overt and 56 sub-
clinical cases were detected. This report of a large-scale, explosive outbreak of hepatitis A in
Indian children once again emphasizes the need to evolve proper public health strategies,
especially for vaccination, in countries in the transitional phase from hyperendemicity to
intermediate endemicity.11

Data from national cancer registries in India indicate that cervical cancer is the most common
cancer/ cause of cancer related death in Indian women. Approximately 1,32,000 cases occur
annually with 74,000 deaths. Indian women face a 2.5% cumulative lifetime risk of cervical
cancer and 1.4% cumulative risk of death from cervical cancer. HPV types 16 and 18 account
for 76.7% of cervical cancer in India. There is no data on burden of anogenital warts in the
general community; warts have been reported in 2-25.2% of STI clinic attendees in India.

Although one-third of the world cervical cancer burden is endured in India, Bangladesh,
Nepal and Sri Lanka, there are important gaps in our knowledge of the distribution and
determinants of the disease in addition to inadequate investments in screening, diagnosis and
treatment in these countries. Prevalence of human papillomavirus (HPV) infection among the
general populations varies from 7–14% and the age-specific prevalence across age groups is
constant with no clear peak in young women. High-risk HPV types were found in 97% of
cervical cancers, and HPV-16 and 18 were found in 80% of cancers in India. Cervical cancer
is a relatively neglected disease in terms of advocacy, screening and prevention from
professional or public health organizations

While HPV vaccination provides hope for the future, several barriers prohibit the
introduction of prophylactic vaccines in these countries such as high costs and low public
awareness of cervical cancer. Efforts to implement screening based on the research
experiences in the region offer the only currently viable means of rapidly reducing the heavy
burden of disease

Ethical consideration

Ethical clearance should be optained

1 Name of the investigator Poonthalir.J
1st year M.SC nursing

2 Name of the research guide Dr. Rebecca Samson

Dean College Of Nursing
PIMS

3 Name of the guide Dr, Rose Rajesh

Nursing Superintendent
PIMS

4 Name of the co guide Mrs .Usha

Lecturer
College of nursing
PIMS

5 Name of the study A Study To Assess The Knowledge On Optional

Vaccines Among Health Care Professional