Influenza Vaccination of Health Care Workers: Evaluation of Factors That Are Important in Acceptance

doi:10.1006/pmed.1996.9991

Preventive Medicine

Volume 26, Issue 1, January 1997, Pages 68-77

https://doi.org/10.1006/pmed.1996.9991 Get rights and content

Abstract

Background.We evaluated the associations between putative occupational and epidemiologic determinants and influenza vaccine acceptance among health care workers during two consecutive seasons.

Methods.Multiple logistic regression models were developed to identify predictors of vaccine acceptance during 1991–1992, then validated in the subsequent year. A combined repeated-measures regression model using generalized estimating equations was fit to examine workers' vaccine acceptance over the 2-year period.

Results.Nearly one-third of hospital employees received influenza vaccine each year [2,364 of 7,320 (32%) in 1991–1992 vs 2,679 of 8,632 (31%) in 1992–1993]. Independent predictors among nurse clinicians included older age, higher salary, longer employment, and minimal absenteeism. Female sex, marriage, higher salary, and employment duration were independent predictors for professional support staff. Older age was the only independent predictor among nonprofessional staff.

Conclusions.We conclude that older individuals, those with higher socioeconomic status, and those employed longer are more likely to accept the influenza vaccine. Sex, marital status, and prior work absenteeism are also important predictors in specific groups of health care workers.

References (46)

SC Schoenbaum
Economic impact of influenza: the individual's perspective
Am J Med
(1987)
S Weingarten et al.
Barriers to influenza vaccine acceptance: a survey of physicians and nurses
AM J Infect Control
(1989)
R Ganguly et al.
Influenza vaccination status among health care professionals for prevention of nosocomial infection to hospitalized elderly patients
Serodiag Immunother Infect Dis
(1990)
MA Christian
Influenza and hepatitis B vaccine acceptance: a survey of health care workers
Am J Infect Control
(1991)
CS Davis
A computer program for regression analysis of repeated measures using generalized estimating equations
Comp Methods Progr Biomed
(1993)
NH Fiebach et al.
Patient acceptance of influenza vaccination
Am J Med
(1991)
FL Ruben
Prevention and control of influenza: role of vaccine
Am J Med
(1987)
KM Sullivan et al.
Estimates of the U.S. health impact of influenza
Am J Public Health
(1993)
AM McBean et al.
The impact and cost of influenza in the elderly
Arch Intern Med
(1993)
S Weingarten et al.
Influenza surveillance in an acute-care hospital
Arch Intern Med
(1988)

CT Pachucki et al.

Influenza A among hospital personnel and patients: implications for recognition, prevention, and control

Arch Intern Med

(1989)

MMWR

(1993)

MMWR

(1995)

C Watanakunakorn et al.

Attitude of healthcare personnel regarding influenza immunization

Infect Control Hosp Epidemiol

(1993)

CT Pachucki et al.

Attitudes and behavior of health care personnel regarding the use and efficacy of influenza vaccine

J Infect Dis

(1985)

CK Ohrt et al.

Achieving compliance with influenza immunization of medical house staff and students: a randomized controlled trial

JAMA

(1992)

T Heimberger et al.

Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated

Infect Control Hosp Epidemiol

(1995)

KL Nichol et al.

The effectiveness of vaccination against influenza in healthy, working adults

N Engl J Med

(1995)

S Weingarten et al.

Do hospital employees benefit from the influenza vaccine? A placebo-controlled clinical trial

J Gen Intern Med

(1988)

SR Mostow et al.

Studies of inactivated influenza virus vaccines in hospital employees: reactogenicity and absenteeism

J Infect Dis

(1977)

Guide for adult immunization

(1994)

DA Nafziger et al.

Attitudes of internal medicine residents regarding influenza vaccination

Infect Control Hosp Epidemiol

(1994)

Cited by (86)

Factors associated with repeated influenza vaccine uptake among aged care staff in an Australian sample from 2017 to 2019
2022, Vaccine
Influenza vaccination is strongly recommended every year for aged care staff to protect themselves and minimise risk of transmission to residents. This study aimed to determine the factors associated with repeated annual influenza vaccine uptake among Australian aged care staff from 2017 to 2019.
Demographic, medical and vaccination data collected from the staff, who participated in an observational study from nine aged care facilities under a single provider in Sydney Australia, were analysed retrospectively. Based on the pattern of repeated influenza vaccination from 2017 to 2019, three groups were identified: (1) unvaccinated all three years; (2) vaccinated occasionally(once or twice) over three years; and (3)vaccinated all three years. Multinomial logistic regression analysis was performed to better understand the factors associated with the pattern of repeated influenza vaccination.
From a total of 138 staff, between 2017 and 2019, 28.9 % (n = 40) never had a vaccination, while 44.2 % (n = 61) had vaccination occasionally and 26.8 % (n = 37) had vaccination all three years. In the multinomial logistic regression model, those who were<40 years old (OR = 0.57, 95 % CI: 0.19–0.90, p < 0.05) and those who were current smokers (OR = 0.20; 95 % CI: 0.03–0.76, p < 0.05) were less likely to have repeated vaccination for all three years compared to the unvaccinated group. Those who were<40 years old (OR = 0.61; 95 % CI: 0.22–0.68, p < 0.05) and those who were born overseas (OR = 0.50; 95 % CI:0.27–0.69, p < 0.05) were more likely to be vaccinated occasionally compared to the unvaccinated group.
The significant predictors of repeated vaccine uptake across the three-year study period among aged care staff were age, smoking status and country of birth (Other vs Australia). Targeted interventions towards the younger age group (<40 years old), smokers and those who were born overseas could improve repeated influenza vaccination uptake in the aged care workforce.
Knowledge, attitude and awareness among healthcare professionals about influenza vaccination in Peshawar, Pakistan
2016, Vaccine
A cross-sectional study was carried out among HCPs in Northwest General Hospital & Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N = 170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n = 165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24–30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF) = 0.71), due to needle fear I do not like to get vaccinated (RIWF = 0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF = 0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (−0.215 [−0.389 to 0.040]; p = 0.016) and job experience (0.823 [0.521–1.125]; p < 0.001) HCPs age (−0.409 [−0.755 to −0.064]; p = 0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5 ± 0.8, p < 0.001*), followed by pharmacists (6.3 ± 1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.
Employee influenza vaccination in residential care facilities
2014, American Journal of Infection Control
The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities.
The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study’s objectives.
Facility size, director’s educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates.
Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies.
Predictors of acceptance of H1N1 influenza vaccination by FDNY firefighters and EMS workers
2011, Vaccine
Citation Excerpt :
Acceptance rates vary widely based, in part, on the population studied, and their perception of the vaccine's safety, efficacy, and benefit [9,11,16]. Among health care workers (HCWs), predictors of seasonal influenza vaccination acceptance include prior vaccination, older age, longer tenure as a HCW, and a vaccine awareness campaign with vaccine-related education and easy access to no-cost, on-site vaccination during work hours [9–11]. Influenza vaccination is offered to HCWs in the belief that it will reduce influenza-like illness (ILI)-related absenteeism and nosocomial infection [11].
There is a widely recognized need for vaccination of health care workers (HCWs). We undertook this study to assess the 2009–2010 H1N1 vaccination rates in ∼14,000 firefighters and emergency medical service (EMS) workers at the Fire Department of New York (FDNY) and to determine predictors of H1N1 vaccine acceptance.
After 9/11/01, FDNY developed a bio-preparedness drill where units are dispatched to FDNY-BIOPOD (biologic points of distributions) for rapid distribution of medications/vaccines in the event of a biological disaster. Since 2005, FDNY offers free, voluntary seasonal influenza vaccination during routine medical monitoring/treatment examinations and at FDNY-BIOPOD. In 2009, FDNY-BIOPOD instead offered the H1N1 vaccine. We report on FDNY H1N1 vaccination rates and on predictors of acceptance using bivariate and multivariable techniques.
Overall, 10,612 (77%) FDNY workers were offered H1N1 vaccination, of whom 5831 (55%) accepted. Acceptance was 57.2% during FDNY-BIOPOD compared with 34.4% during medical monitoring/treatment exams (p = 0.0001). Workers who accepted prior seasonal influenza vaccinations were 4 times more likely to accept H1N1 vaccination (AOR = 4.4, CI₉₅ = 4.0–4.8).
FDNY offered H1N1 vaccination to 77% of its workforce during the 2009–2010 season. Prior seasonal vaccine acceptance and vaccination in a group setting such as FDNY-BIOPOD dramatically increased acceptance of the H1N1 vaccine. However, within a voluntary program, additional strategies are needed to further increase vaccine acceptance in first responders and other HCWs.
Influenza vaccination for healthcare workers who work with the elderly: Systematic review
2010, Vaccine
To identify studies of influenza vaccination of HCWs and influenza in elderly residents in long-term care facilities.
We searched seven electronic databases for randomised controlled trials (RCTs) and non-RCTs. Two reviewers independently extracted data and assessed trial quality.
The key outcomes are serologically proven influenza, pneumonia, and deaths from pneumonia, and pooled data from three C-RCTs showed no effect. Pooled data from three C-RCTs showed lower resident all-cause mortality, but as influenza constituted less than 10% of all deaths even in epidemic years we question the appropriateness of this outcome measure. Pooled data from three C-RCTs showed vaccination of HCWs reduced ILI and data from one C-RCT that HCW vaccination reduced GP consultations for ILI, but as influenza constitutes less than 25% of ILI and we did not show that HCW influenza vaccination reduced serologically proven influenza we question whether this effect is due to confounding.
Promotion of seasonal influenza vaccination among staff in residential care homes for elderly in Hong Kong
2010, Healthcare Infection
Annual influenza epidemics continue to cause worldwide morbidity, mortality and societal disruption, especially among the aged residents of residential care homes for the elderly (RCHEs). Vaccination remains the most effective measure to prevent influenza and its associated complications. The seasonal influenza vaccine uptake rates among RCHE staff were much lower than that among residents. In order to increase uptake of influenza vaccination among RCHE staff in Hong Kong, this study developed and evaluated amultimodal vaccine promotion program (VPP) based on identified factors affecting vaccination acceptance or refusal within the Hong Kong Chinese context. Vaccine acceptance was found to be significantly associated with belief in vaccine efficacy, duration of service, staff group and providing direct care to residents. The focus group study revealed that RCHE staff's belief in the efficacy and safety of the vaccine played a major role in vaccine acceptance. VPP effectiveness was evaluated with a cluster randomised controlled trial among RCHEs with staff vaccination rates below 50%. Compared with 2008/09, the 2009/10 mean staff vaccination rates increased significantly in both the intervention (39.4% to 59.6% (P < 0.001)) and control groups (36.3% to 47.6% (P = 0.008)). RCHE staff in the intervention group had a higher vaccination rate than in the control group (59.6% versus 47.6%, P = 0.072). This program reinforces the importance of a comprehensive and culturally sensitive approach to promote influenza vaccination for RCHE staff.

View all citing articles on Scopus

^☆: P, GardnerT, EickhoffM, Griffin, et al. editors

¹: B.N.D. is the recipient of a Special Emphasis Research Career Award, 1 K01 OH00131-03, from the National Institute for Occupational Safety and Health.

²: To whom correspondence should be addressed at C31 GH, Department of Internal Medicine, The University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242. Fax: (319) 356-7893; E-mail: [email protected].

³: Current address: Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298.

View full text

Regular ArticleInfluenza Vaccination of Health Care Workers: Evaluation of Factors That Are Important in Acceptance☆

Abstract

Am J Med

AM J Infect Control

Serodiag Immunother Infect Dis

Am J Infect Control

Comp Methods Progr Biomed

Am J Med

Am J Med

Estimates of the U.S. health impact of influenza

Am J Public Health

The impact and cost of influenza in the elderly

Arch Intern Med

Influenza surveillance in an acute-care hospital

Arch Intern Med

Influenza A among hospital personnel and patients: implications for recognition, prevention, and control

Arch Intern Med

MMWR

MMWR

Attitude of healthcare personnel regarding influenza immunization

Infect Control Hosp Epidemiol

Attitudes and behavior of health care personnel regarding the use and efficacy of influenza vaccine

J Infect Dis

Achieving compliance with influenza immunization of medical house staff and students: a randomized controlled trial

JAMA

Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated

Infect Control Hosp Epidemiol

The effectiveness of vaccination against influenza in healthy, working adults

N Engl J Med

Do hospital employees benefit from the influenza vaccine? A placebo-controlled clinical trial

J Gen Intern Med

Studies of inactivated influenza virus vaccines in hospital employees: reactogenicity and absenteeism

J Infect Dis

Guide for adult immunization

Attitudes of internal medicine residents regarding influenza vaccination

Infect Control Hosp Epidemiol

Regular Article
Influenza Vaccination of Health Care Workers: Evaluation of Factors That Are Important in Acceptance☆