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Barriers and facilitators to influenza vaccination and vaccine coverage in a cohort of health care personnel

      Background

      Annual influenza vaccination is recommended for health care personnel (HCP). We describe influenza vaccination coverage among HCP during the 2010-2011 season and present reported facilitators of and barriers to vaccination.

      Methods

      We enrolled HCP 18 to 65 years of age, working full time, with direct patient contact. Participants completed an Internet-based survey at enrollment and the end of influenza season. In addition to self-reported data, we collected information about the 2010-2011 influenza vaccine from electronic employee health and medical records.

      Results

      Vaccination coverage was 77% (1,307/1,701). Factors associated with higher vaccination coverage include older age, being married or partnered, working as a physician or dentist, prior history of influenza vaccination, more years in patient care, and higher job satisfaction. Personal protection was reported as the most important reason for vaccination followed closely by convenience, protection of patients, and protection of family and friends. Concerns about perceived vaccine safety and effectiveness and low perceived susceptibility to influenza were the most commonly reported barriers to vaccination. About half of the unvaccinated HCP said they would have been vaccinated if required by their employer.

      Conclusion

      Influenza vaccination in this cohort was relatively high but still fell short of the recommended target of 90% coverage for HCP. Addressing concerns about vaccine safety and effectiveness are possible areas for future education or intervention to improve coverage among HCP.

      Key Words

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      References

        • Centers for Disease Control and Prevention
        Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP).
        MMWR Morb Mortal Wkly Rep. 2006; 55: 1-20
        • Centers for Disease Control and Prevention
        Prevention and control of influenza.
        MMWR Morb Mortal Wkly Rep. 1984; 33 (265-6): 253-260
        • Walker F.J.
        • Singleton J.A.
        • Lu P.
        • Wooten K.G.
        • Strikas R.A.
        Influenza vaccination of healthcare workers in the United States, 1989-2002.
        Infect Control Hosp Epidemiol. 2006; 27: 257-265
        • Caban-Martinez A.J.
        • Lee D.J.
        • Davila E.P.
        • LeBlanc W.G.
        • Arheart K.L.
        • McCollister K.E.
        • et al.
        Sustained low influenza vaccination rates in US healthcare workers.
        Prev Med. 2010; 50: 210-212
        • Lu P.
        • Ding H.
        • Black C.L.
        H1N1 and seasonal influenza vaccination of US healthcare personnel, 2010.
        Am J Prev Med. 2012; 43: 282-292
        • Hollmeyer H.G.
        • Hayden F.
        • Poland G.
        • Buchholz U.
        Influenza vaccination of healthcare workers in hospitals: a review of studies on attitudes and predictors.
        Vaccine. 2009; 27: 3935-3944
        • Rakita R.M.
        • Hagar B.A.
        • Crome P.
        • Lammert J.K.
        Mandatory influenza vaccination of healthcare workers: a 5-year study.
        Infect Control Hosp Epidemiol. 2010; 31: 881-888
        • Centers for Disease Control and Prevention
        Influenza vaccination coverage among health-care personnel, 2010-2011 influenza season, United States.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 1073-1077
        • Centers for Disease Control and Prevention
        Influenza vaccination coverage among health-care personnel, 2011-2012 influenza season, United States.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 753-757
        • US Department of Health and Human Services
        Healthy People 2020. Objective IID-12.9.
        US Department of Health and Human Services, Washington [DC]2012 (Available from:) (Accessed May 8, 2013)
        • Stewart A.M.
        • Cox M.A.
        State law and influenza vaccination of health care personnel.
        Vaccine. 2013; 31: 827-832
        • Hollmeyer H.
        • Hayden F.
        • Mounts A.
        • Buchholz U.
        Review: interventions to increase influenza vaccination among healthcare workers in hospitals.
        Influenza Other Respi Viruses. 2013; 7: 604-621
        • Feemster K.A.
        • Prasad P.
        • Smith M.J.
        • Feudtner C.
        • Caplan A.
        • Offit P.
        • et al.
        Employee designation and health care worker support of an influenza vaccine mandate at a large pediatric tertiary care hospital.
        Vaccine. 2011; 29: 1762-1769
        • Hakim H.
        • Gaur A.H.
        • McCullers J.A.
        Motivating factors for high rates of influenza vaccination among healthcare workers.
        Vaccine. 2011; 29: 5963-5969
        • deSante J.
        • Caplan A.
        • Shofer F.
        • Behrman A.J.
        Physician attitudes toward influenza immunization and vaccine mandates.
        Vaccine. 2010; 28: 2517-2525
        • Poland G.A.
        Mandating influenza vaccination for health care workers: putting patients and professional ethics over personal preference.
        Vaccine. 2010; 28: 5757-5759
        • Caplan A.L.
        Morality of influenza vaccine mandates.
        Clin Ther. 2013; 35: 106-108
        • Thompson M.G.
        • Gaglani M.J.
        • Naleway A.
        • Ball S.
        • Henkle E.M.
        • Sokolow L.Z.
        • et al.
        The expected emotional benefits of influenza vaccination strongly affect pre-season intentions and subsequent vaccination among healthcare personnel.
        Vaccine. 2012; 30: 3557-3565
        • Melia M.
        • O’Neill S.
        • Calderon S.
        • Hewitt S.
        • Orlando K.
        • Bithell-Taylor K.
        • et al.
        Development of a flexible, computerized database to prioritize, record, and report influenza vaccination rates for healthcare personnel.
        Infect Control Hosp Epidemiol. 2009; 30: 361-369
        • Wanous J.P.
        • Reichers A.E.
        • Hudy M.J.
        Overall job satisfaction: how good are single-item measures?.
        J Appl Psychol. 1997; 82: 247-252
        • Frank E.
        • Rothenberg R.
        • Lewis C.
        • Belodoff B.F.
        Correlates of physicians’ prevention-related practices: findings from the Women Physicians’ Health Study.
        Arch Fam Med. 2000; 9: 359-367
        • Nichol K.L.
        • Zimmerman R.
        Generalist and subspecialist physicians’ knowledge, attitudes, and practices regarding influenza and pneumococcal vaccinations for elderly and other high-risk patients: a nationwide survey.
        Arch Intern Med. 2001; 161: 2702-2708
        • Schwarzinger M.
        • Verger P.
        • Guerville M.A.
        • Aubry C.
        • Rolland S.
        • Obadia Y.
        • et al.
        Positive attitudes of French general practitioners towards A/H1N1 influenza-pandemic vaccination: a missed opportunity to increase vaccination uptakes in the general public?.
        Vaccine. 2010; 28: 2743-2748