Influenza Vaccination of Healthcare Workers | Infection Control & Hospital Epidemiology | Cambridge Core (original) (raw)

Article contents

Abstract

Objective:

To assess factors associated with influenza vaccination of healthcare workers.

Design:

Cross-sectional survey.

Setting:

University-affiliated Veterans' Affairs medical center.

Participants:

Staff physicians and nurses employed by the medical center.

Methods:

A mailed, self-administered questionnaire.

Results:

The response rate was 38.0%. The mean age of the respondents was 43.6 years, 71.5% were females, and 26.2% were physicians. Nearly all of the practitioners had daily or weekly contact with elderly or high-risk patients. The influenza vaccination rate of the respondents was 61.2%. More than 50% of vaccine recipients indicated that avoiding illness, protecting patients, and being able to receive the vaccine conveniently and free of charge all were very important factors influencing their decisions to receive the vaccine. Avoiding illness was rated the most important factor by 58.8% of vaccine recipients. Among vaccine nonrecipients, concern about side effects was identified as a very important factor by 36.2% and as the most important factor by 30.9%.

Vaccine recipients were significantly more likely than were vaccine nonrecipients to indicate that influenza and its complications are very serious for high-risk patients. They also were more likely to report that the vaccine is very effective, that influenza vaccination is uncommonly associated with side effects, that healthcare workers' risk for contracting influenza is higher than the general public's risk, and that it is very important for healthcare workers to receive the vaccine to decrease risk for transmission to high-risk patients. After stepwise logistic regression, variables independently associated with receipt of vaccine were age, prior receipt of vaccine, being a physician, considering the vaccine to be very effective, believing that systemic side effects are uncommon, and indicating that it is very important for healthcare workers to receive vaccine for the protection of their patients.

Conclusion:

Many healthcare workers fail to receive influenza vaccine each year. Strategies to improve immunization levels should address concerns about vaccine safety and efficacy, barriers to vaccination including inconvenience and cost, and the reasons for targeting healthcare workers.

Information

Type

Original Articles

Copyright

Copyright © The Society for Healthcare Epidemiology of America 1997

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References

  1. Lui, K, Kendal, AP. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health 1987;77:712–716.Google Scholar

  2. McBean, AM, Babish, JD, Warren, JC. The impact and cost of influenza in the elderly. Arch Intern Med 1993;153:2105–2111.Google Scholar

  3. Glezen, WP, Decker, M, Perrotta, DM. Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978-81. Am Rev Respir Dis 1987;136:550–555.Google Scholar

  4. Committee on Issues and Priorities for New Vaccine Development, Institute of Medicine. New Vaccine Development: Establishing Priorities, I: Diseases of Importance in the United States. Washington, DC: National Academy Press; 1985:342–364.Google Scholar

  5. Sullivan, KM, Monto, AS, Longini, IM. Estimates of the US health impact of influenza. Am J Public Health 1993;83:1712–1716.Google Scholar

  6. Monto, AS. Influenza: quantifying morbidity and mortality. Am J Med 1987;82(suppl 6A):20–25.Google Scholar

  7. Cate, TR. Clinical manifestations and consequences of influenza. Am J Med 1987;82(suppl 6A):15–19.Google Scholar

  8. Office of Technology Assessment, Congress of the United States. Cost Effectiveness of Influenza Vaccination. Washington, DC: Congress of the United States; 1981:16-20, 24–26.Google Scholar

  9. Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1995;44(RR-3):1–22.Google Scholar

  10. ACP Task Force on Adult Immunization and Infectious Diseases Society of America. Guide for Adult Immunization. 3rd ed. Philadelphia, PA: American College of Physicians; 1994:34–37.Google Scholar

  11. Nichol, KL. Long-term success with the national health objective for influenza vaccination: an institution-wide model. J Gen Intern Med 1992;7:595–600.Google Scholar

  12. Pachucki, CT, Walsh Pappas, SA, Fuller, GF, et al. Influenza A among hospital personnel and patients. Implications for recognition, prevention, and control. Arch Intern Med 1989;149:77–80.Google Scholar

  13. Weingarten, S, Friedlander, M, Rascon, D, et al. Influenza surveillance in an acute care hospital. Arch Intern Med 1988;148:113–116.Google Scholar

  14. Weingarten, S, Riedinger, M, Bolton, LB, et al. Barriers to influenza vaccine acceptance. A survey of physicians and nurses. Am J Infect Control 1989;17:202–207.Google Scholar

  15. Pachucki, CT, Lentino, JR, Jackson, GG. Attitudes and behavior of health care personnel regarding the use and efficacy of influenza vaccine. J Infect Dis 1985;151:1170–1171.Google Scholar

  16. Christian, MA. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991;19:177–184.Google Scholar

  17. Russell, DW, Cameron, DJ, Lockey, RF, et al. Influenza vaccination acceptance among health care professionals. Vaccine 1991;9:691–692.Google Scholar

  18. Watanakunakorn, C, Ellis, G, Gemmel, D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol 1993;14:17–20.Google Scholar

  19. Margolis, KL, Nichol, KL, Poland, GA, et al. Frequency of adverse reactions to influenza vaccine in the elderly: a randomized, placebo-controlled trial. JAMA 1990;264:1139–1141.Google Scholar

  20. Govaert, TME, Aretz, K, Masurel, N, et al. Adverse reactions to influenza vaccine in elderly people: a randomised double blind placebo-controlled trial. BMJ 1993;307:988–990.Google Scholar

  21. Nichol, KL, Margolis, KL, Lind, A, et al. Side effects associated with influenza vaccination in healthy working adults. Arch Intern Med 1996;156:1546–1550.Google Scholar

  22. Safranek, TJ, Lawrence, DN, Kurland, LT, et al. Reassessment of the association between Guillain-Barre syndrome and receipt of swine influenza vaccine in 1976-1977: results of a two-state study. Am J Epidemiol 1991;133:940–951.Google Scholar

  23. Govaert, TME, Thijs, CTM, Masurel, N, et al. The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial. JAMA 1994;272:1661–1665.Google Scholar

  24. Foster, DA, Talsma, A, Furumoto-Dawson, A, et al. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol 1992;136:296–307.Google Scholar

  25. Fedson, DS, Wajda, A, Nicol, JP, et al. Clinical effectiveness of influenza vaccination in Manitoba. JAMA 1993;270:1956–1961.Google Scholar

  26. Nichol, KL, Margolis, KL, Wuorenma, J, VonSternberg, T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med 1994;331:778–784.Google Scholar

  27. Mullooly, JP, Bennett, MD, Hornbrook, MC, et al. Influenza vaccination programs for elderly persons: cost-effectiveness in a health maintenance organization. Ann Intern Med 1994;121:947–952.Google Scholar

  28. Nichol, KL, Lind, A, Margolis, KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995;333:889–893.Google Scholar

  29. Edmondson, WP, Rothenberg, R, White, PW, Gwaltney, JM. A comparison of subcutaneous, nasal, and combined influenza vaccination, II: protection against natural challenge. Am J Epidemiol 1971;93:480–486.Google Scholar

  30. Yassi, A, Kettner, J, Hammond, G, et al. Effectiveness and costbenefit of an influenza vaccination program for health care workers. Can J Infect Dis 1991;2:101–108.Google Scholar

  31. Brechtelsbauer, DA. Influenza vaccine—resident and faculty use. Fam Med 1986;18:189.Google Scholar

  32. Lewy, R. Immunizations among hospital personnel. J Occup Med 1987;29:433–436.Google Scholar

  33. Nichol, KL. Preventing influenza: the physician's role. Semin Respir Infect 1992;7:71–77.Google Scholar

  34. Fedson, DS. Influenza and pneumococcal immunization strategies for physicians. Chest 1987;91:436–443.Google Scholar

  35. Girasek, DC. Increasing hospital staff compliance with influenza immunization recommendations. Am J Public Health 1990;80:1272–1273.Google Scholar

  36. Ohrt, CK, McKinney, WP. Achieving compliance with influenza immunization of medical house staff and students. A randomized controlled trial. JAMA 1992;267:1377–1380.Google Scholar

  37. Shannon, SC. Community hospitals can increase staff influenza vaccination rates. Am J Public Health 1993;83:1174–1175.Google Scholar

  38. Thomas, DR, Winsted, B, Koontz, C. Improving neglected influenza vaccination among healthcare workers in long-term care. J Am Geriatr Soc 1993;41:928–930.Google Scholar

  39. Nelson, DE, Giovino, GA, Emont, SL, et al. Trends in cigarette smoking among US physicians and nurses. JAMA 1994;271:1273–1275.Google Scholar