Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-12-03T00:35:34.522Z Has data issue: false hasContentIssue false

Influenza Vaccination of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Kristin L. Nichol*
Affiliation:
Preventive Medicine Program, Medicine Service, Veterans' Affairs Medical Center, Minneapolis, Minnesota
Meri Hauge
Affiliation:
Preventive Medicine Program, Medicine Service, Veterans' Affairs Medical Center, Minneapolis, Minnesota
*
Medicine Service (111), VA Medical Center, One Veterans Dr, Minneapolis, MN 55417

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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;77:712716.Google Scholar
2. McBean, AM, Babish, JD, Warren, JC. The impact and cost of influenza in the elderly. Arch Intern Med 1993;153:21052111.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;136:550555.CrossRefGoogle 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; 1985:342364.Google Scholar
5. Sullivan, KM, Monto, AS, Longini, IM. Estimates of the US health impact of influenza. Am J Public Health 1993;83:17121716.Google Scholar
6. Monto, AS. Influenza: quantifying morbidity and mortality. Am J Med 1987;82(suppl 6A):2025.CrossRefGoogle ScholarPubMed
7. Cate, TR. Clinical manifestations and consequences of influenza. Am J Med 1987;82(suppl 6A):1519.CrossRefGoogle ScholarPubMed
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, 2426.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):122.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; 1994:3437.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;7:595600.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;149:7780.Google Scholar
13. Weingarten, S, Friedlander, M, Rascon, D, et al. Influenza surveillance in an acute care hospital. Arch Intern Med 1988;148:113116.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;17:202207.CrossRefGoogle ScholarPubMed
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;151:11701171.CrossRefGoogle ScholarPubMed
16. Christian, MA. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991;19:177184.Google Scholar
17. Russell, DW, Cameron, DJ, Lockey, RF, et al. Influenza vaccination acceptance among health care professionals. Vaccine 1991;9:691692.CrossRefGoogle ScholarPubMed
18. Watanakunakorn, C, Ellis, G, Gemmel, D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol 1993;14:1720.CrossRefGoogle ScholarPubMed
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;264:11391141.CrossRefGoogle ScholarPubMed
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;307:988990.CrossRefGoogle ScholarPubMed
21. Nichol, KL, Margolis, KL, Lind, A, et al. Side effects associated with influenza vaccination in healthy working adults. Arch Intern Med 1996;156:15461550.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;133:940951.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;272:16611665.CrossRefGoogle ScholarPubMed
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;136:296307.Google Scholar
25. Fedson, DS, Wajda, A, Nicol, JP, et al. Clinical effectiveness of influenza vaccination in Manitoba. JAMA 1993;270:19561961.CrossRefGoogle ScholarPubMed
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;331:778784.CrossRefGoogle ScholarPubMed
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;121:947952.CrossRefGoogle 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;333:889893.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;93:480486.CrossRefGoogle ScholarPubMed
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;2:101108.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;29:433436.Google ScholarPubMed
33. Nichol, KL. Preventing influenza: the physician's role. Semin Respir Infect 1992;7:7177.Google ScholarPubMed
34. Fedson, DS. Influenza and pneumococcal immunization strategies for physicians. Chest 1987;91:436443.CrossRefGoogle ScholarPubMed
35. Girasek, DC. Increasing hospital staff compliance with influenza immunization recommendations. Am J Public Health 1990;80:12721273.Google ScholarPubMed
36. Ohrt, CK, McKinney, WP. Achieving compliance with influenza immunization of medical house staff and students. A randomized controlled trial. JAMA 1992;267:13771380.Google Scholar
37. Shannon, SC. Community hospitals can increase staff influenza vaccination rates. Am J Public Health 1993;83:11741175.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;41:928930.Google Scholar
39. Nelson, DE, Giovino, GA, Emont, SL, et al. Trends in cigarette smoking among US physicians and nurses. JAMA 1994;271:12731275.Google Scholar