Advertisement

Influenza vaccination rates and beliefs about vaccination among nursing home employees

      Highlights

      • We surveyed nearly 2,000 nursing home staff members from 37 agencies regarding their influenza vaccination policies and procedures.
      • During the most recent influenza season, approximately 54% of nursing home staff members had received the influenza vaccine.
      • Black and younger nursing home employees were less likely to obtain the vaccine than white or older employees.
      • Certain beliefs and/or attitudes toward the influenza vaccine had a statistically significant impact on the likelihood that respondents had received the vaccine.

      Background

      Recent studies have suggested that vaccination of nursing home staff members may reduce the incidence of influenza among nursing home residents. Current national estimates of employee vaccination rates (around 50%) indicate that residents may be at an unnecessarily high risk of contracting influenza. This article reports on the influenza vaccination rates and attitudes toward the vaccine among employees in 37 nursing homes in 3 states.

      Methods

      Nursing home employees were surveyed at nursing homes in Florida, Georgia, and Wisconsin in 2011-2012. Completed surveys were received from a total of 1,965 employees.

      Results

      Approximately 54% of the employees surveyed received the vaccination during the 2010-2011 and 2011-2012 influenza seasons. Nursing home–level staff vaccination rates varied widely, from 15%-97%. Black and younger employees were less likely to receive the vaccine. Employee vaccination rates in nursing homes that used incentives were 12 percentage points higher than those that did not use incentives (P = .08).

      Conclusion

      Low vaccination rates among nursing home workers may put residents at increased risk for influenza-related morbidity and mortality. The Centers for Medicare and Medicaid Services may consider employee vaccination rates as a quality indicator in addition to resident vaccination rates. Our findings support the use of a trial to test the use of incentives to increase employee vaccination rates.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Centers for Medicare & Medicaid Services (CMS), HHS
        Medicare and Medicaid programs; condition of participation: immunization standard for long term care facilities. Final rule.
        Fed Reg. 2005; 70: 58834-58852
        • Bardenheier B.H.
        • Wortley P.
        • Ahmed F.
        • Hales C.
        • Shefer A.
        Influenza immunization coverage among residents of long-term care facilities certified by CMS, 2005–2006: the newest MDS quality indicator.
        J Am Med Dir Assoc. 2010; 11: 59-69
        • Harper S.A.
        • Fukuda K.
        • Uyeki T.M.
        • Cox N.J.
        • Bridges C.B.
        • Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices Advisory Committee on Immunization Practices (ACIP)
        Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP).
        MMWR Recomm Rep. 2004; 53: 1-40
        • Mehta M.
        • Pastor C.A.
        • Shah B.
        Achieving optimal influenza vaccination rates: a survey-based study of healthcare workers in an urban hospital.
        J Hosp Infect. 2008; 70: 76-79
        • Carnicer-Pont D.
        • White D.
        • Pike C.
        • Lyons M.
        Influenza A outbreak in a community hospital in south east Wales, February 2005.
        Euro Surveill. 2005; 10: E050217
        • Poland G.A.
        • Tosh P.
        • Jacobson R.M.
        Requiring influenza vaccination for health care workers: seven truths we must accept.
        Vaccine. 2005; 23: 2251-2255
        • Wendelboe A.M.
        • Avery C.
        • Andrade B.
        • Baumbach J.
        • Landen M.G.
        Importance of employee vaccination against influenza in preventing cases in long-term care facilities.
        Infect Control Hosp Epidemiol. 2011; 32: 990-997
        • Shugarman L.R.
        • Hales C.
        • Setodji C.M.
        • Bardenheier B.
        • Lynn J.
        The influence of staff and resident immunization rates on influenza-like illness outbreaks in nursing homes.
        J Am Med Dir Assoc. 2006; 7: 562-567
        • National Vaccine Advisory Committee
        Strategies to achieve the healthy people 2020 annual influenza vaccine Coverage goal for health-care personnel: recommendations from the national vaccine advisory committee.
        Public Health Rep. 2013; 28: 7-25
        • Advisory Committee on Immunization Practices; Centers for Disease Control and Prevention (CDC)
        Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP).
        MMWR Recomm Rep. 2011; 60: 1-45
        • Centers for Disease Control and Prevention (CDC)
        Influenza vaccination coverage among health-care personnel–United States, 2012-13 influenza season.
        MMWR Morb Mortal Wkly Rep. 2013; 62: 781-786
        • Burls A.
        • Jordan R.
        • Barton P.
        • Olowokure B.
        • Wake B.
        • Albon E.
        • et al.
        Vaccinating healthcare workers against influenza to protect the vulnerable–is it a good use of healthcare resources? A systematic review of the evidence and an economic evaluation.
        Vaccine. 2006; 24: 4212-4221
        • Mills C.E.
        • Robins J.M.
        • Lipsitch M.
        Transmissibility of 1918 pandemic influenza.
        Nature. 2004; 432: 904-906
        • Molinari N.A.
        • Ortega-Sanchez I.R.
        • Messonnier M.L.
        • Thompson W.W.
        • Wortley P.M.
        • Weintraub E.
        • et al.
        The annual impact of seasonal influenza in the US: measuring disease burden and costs.
        Vaccine. 2007; 25: 5086-5096
        • Nichol K.L.
        • Lind A.
        • Margolis K.L.
        • Murdoch M.
        • McFadden R.
        • Hauge M.
        • et al.
        The effectiveness of vaccination against influenza in healthy, working adults.
        N Engl J Med. 1995; 333: 889-893
        • Centers for Disease Control and Prevention (CDC)
        Influenza vaccination Coverage among health-care personnel — 2011–12 influenza season, United States.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 753-757
        • Canning H.S.
        • Phillips J.
        • Allsup S.
        Health care worker beliefs about influenza vaccine and reasons for non-vaccination–a cross-sectional survey.
        J Clin Nurs. 2005; 14: 922-925
        • Manuel D.G.
        • Henry B.
        • Hockin J.
        • Naus M.
        Health behavior associated with influenza vaccination among healthcare workers in long-term–care facilities.
        Infect Control Hosp Epidemiol. 2002; 23: 609-614
        • Hollmeyer H.G.
        • Hayden F.
        • Poland G.
        • Buchholz U.
        Influenza vaccination of health care workers in hospitals–a review of studies on attitudes and predictors.
        Vaccine. 2009; 27: 3935-3944
        • Centers for Disease Control and Prevention (CDC)
        Interim adjusted estimates of seasonal influenza vaccine effectiveness - United States, February 2013.
        MMWR Morb Mortal Wkly Rep. 2013; 62: 119-123
        • Heimberger T.
        • Chang H.G.
        • Shaikh M.
        • Crotty L.
        • Morse D.
        • Birkhead G.
        Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated?.
        Infect Control Hosp Epidemiol. 1995; 16: 412-415
        • Lam P.P.
        • Chambers L.W.
        • MacDougall D.M.
        • McCarthy A.E.
        Seasonal influenza vaccination campaigns for health care personnel: systematic review.
        CMAJ. 2010; 182: E542-E548
        • Karanfil L.V.
        • Bahner J.
        • Hovatter J.
        • Thomas W.L.
        Championing patient safety through mandatory influenza vaccination for all healthcare personnel and affiliated physicians.
        Infect Control Hosp Epidemiol. 2011; 32: 375-379
        • 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
        • Septimus E.J.
        • Perlin J.B.
        • Cormier S.B.
        • Moody J.A.
        • Hickok J.D.
        A multifaceted mandatory patient safety program and seasonal influenza vaccination of health care workers in community hospitals.
        JAMA. 2011; 305: 999-1000
      1. Community Preventive Services Task Force. Increasing appropriate vaccination: client or family incentive awards. The community guide: what works to promote health 2011. Available at: http://www.thecommunityguide.org/vaccines/RRIncentiveRewards.html. Accessed October 10, 2014.