Perceptions and Influence of a Hospital Influenza Vaccination Policy

Objective. Seasonal influenza is a significant cause of morbidity and mortality in the United States each year. Healthcare worker (HCW) influenza vaccination is associated with both decreased absenteeism among employees and improved outcomes among patients. However, HCW influenza vaccine uptake remains suboptimal. The objective of this study was to characterize HCWs' understanding of and response to a stringent vaccination policy. Design, Setting, and Participants. A survey of 928 hospital staff at a tertiary academic medical center in Baltimore during the 2008-2009 influenza season. Results. Of those surveyed, 75% (n = 695) completed the survey; 623 respondents reported regular patient contact, and 91% of those reported vaccination in the current influenza season. However, only 60% reported consistently receiving the vaccine every year. Of those who were vaccinated, 8% (n = 48) reported being vaccinated for the first time during that influenza season. A significant proportion (42%) of respondents were unaware of the major change in hospital policy regarding vaccination. Influences on the decision to be vaccinated varied significantly between those who are regularly vaccinated and those with inconsistent vaccination habits. Attitudes toward hospital policy varied significantly by race and clinical role. Conclusions. Although 91% of respondents with regular patient contact reported being vaccinated for influenza in the 2008–2009 season, only 60% reported consistent annual vaccination. Misinformation regarding hospital policies is widespread. Improvements in vaccination rates will likely require multifaceted, targeted efforts focused on specific influences on less adherent groups. The identified variability in influences on the decision to be vaccinated suggests possible targets for future interventions.

[1]  R. Rakita,et al.  Mandatory Influenza Vaccination of Healthcare Workers: A 5-Year Study , 2010, Infection Control & Hospital Epidemiology.

[2]  W. C. Dunagan,et al.  Mandatory influenza vaccination of health care workers: translating policy to practice. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  J. Kaldor,et al.  Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. , 2010, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[4]  C. Rand,et al.  Survey Study of the Knowledge, Attitudes, and Expected Behaviors of Critical Care Clinicians Regarding an Influenza Pandemic , 2009, Infection Control & Hospital Epidemiology.

[5]  N. Cox,et al.  Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. , 2009 .

[6]  D. Needham,et al.  The use of personal protective equipment for control of influenza among critical care clinicians: A survey study , 2009, Critical care medicine.

[7]  M. Nowalk,et al.  Self-reported influenza vaccination rates among health care workers in a large health system. , 2008, American journal of infection control.

[8]  P. Monahan,et al.  Understanding ethnic disparities in the use of total joint arthroplasty: application of the health belief model. , 2008, Arthritis and rheumatism.

[9]  N. Lugo.  Will carrots or sticks raise influenza immunization rates of health care personnel? , 2007, American journal of infection control.

[10]  C. Mangione,et al.  Effect of health beliefs on delays in care for abnormal cervical cytology in a multiethnic population , 2002, Journal of General Internal Medicine.

[11]  Giselle Corbie-Smith,et al.  Attitudes and beliefs of african americans toward participation in medical research , 1999, Journal of General Internal Medicine.

[12]  Anne M Johnson,et al.  Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial , 2006, BMJ : British Medical Journal.

[13]  R. Strikas,et al.  Influenza Vaccination of Healthcare Workers in the United States, 1989-2002 , 2006, Infection Control & Hospital Epidemiology.

[14]  Arleen F. Brown,et al.  Brief report: Influenza vaccination and health care workers in the United States. , 2006 .

[15]  Brady T. West,et al.  Health beliefs and practices related to breast cancer screening in Filipino, Chinese and Asian-Indian women. , 2006, Cancer detection and prevention.

[16]  S. Cosgrove,et al.  Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages , 2005, Infection Control & Hospital Epidemiology.

[17]  J. Siegel,et al.  Infection Control and Hospital Epidemiology Improving Influenza Immunization Rates among Healthcare Workers Caring for High-risk Pediatric Patients , 2022 .

[18]  A. Detsky,et al.  Use of, Effectiveness of, and Attitudes Regarding Influenza Vaccine Among House Staff , 2003, Infection Control & Hospital Epidemiology.

[19]  R. Martinello,et al.  Correlation Between Healthcare Workers' Knowledge of Influenza Vaccine and Vaccine Receipt , 2003, Infection Control & Hospital Epidemiology.

[20]  N. Powe,et al.  Race and Trust in the Health Care System , 2003, Public health reports.

[21]  T. Pumarola,et al.  A nosocomial outbreak of influenza during a period without influenza epidemic activity , 2003, European Respiratory Journal.

[22]  J. Mullahy,et al.  Factors Influencing Decisions Regarding Influenza Vaccination and Treatment: A Survey of Healthcare Workers , 2002, Infection Control & Hospital Epidemiology.

[23]  D. Stott,et al.  Nosocomial transmission of influenza. , 2002, Occupational medicine.

[24]  Keiji Fukuda,et al.  Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2002, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[25]  Karen McAulay,et al.  Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial , 2000, The Lancet.

[26]  M. Steinhoff,et al.  Effectiveness of influenza vaccine in health care professionals: a randomized trial. , 1999, JAMA.

[27]  Influenza immunization: improving compliance of healthcare workers. , 1998, Infection control and hospital epidemiology.

[28]  K. Nichol,et al.  Influenza Vaccination of Healthcare Workers , 1997, Infection Control & Hospital Epidemiology.

[29]  R. Bennett.  Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients , 1997 .

[30]  B. O'Donnell,et al.  Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993–4 epidemic: results of serum testing and questionnaire , 1996, BMJ.

[31]  G. Birkhead,et al.  Knowledge and Attitudes of Healthcare Workers About Influenza: Why Are They Not Getting Vaccinated? , 1995, Infection Control & Hospital Epidemiology.

[32]  S. Weingarten,et al.  Barriers to influenza vaccine acceptance. A survey of physicians and nurses. , 1989, American journal of infection control.