Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-29T16:54:39.819Z Has data issue: false hasContentIssue false

Influenza Immunization: Improving Compliance of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Stephan Harbarth
Affiliation:
Infection Control Program, University Hospitals of Geneva, Geneva, Switzerland
Claire-Anne Siegrist
Affiliation:
Center for Neonatal Vaccination, University Hospitals of Geneva, Geneva, Switzerland
Jean-Claude Schira
Affiliation:
Department of Employee Health, University Hospitals of Geneva, Geneva, Switzerland
Werner Wunderli
Affiliation:
Laboratory of Virology, University Hospitals of Geneva, Geneva, Switzerland
Didier Pittet
Affiliation:
Infection Control Program, University Hospitals of Geneva, Geneva, Switzerland

Abstract

OBJECTIVE: In spite of yearly recalls, influenza immunization rates of healthcare workers (HCWs) remained low (10%) at the University Hospitals of Geneva. This study was conducted to identify HCWs' reasons for rejection of immunization, to design specific intervention methods based on these reasons, and to evaluate the impact of such interventions.

METHODS:Three departments with high-risk patients (geriatrics, obstetrics, and pediatrics) were selected as main targets. Questionnaires were distributed in these units. Based on HCWs' perceptions, different intervention methods were designed and used either in these departments only (educational conferences, on-site availability of a vaccination nurse) or in the whole institution (posters, personal letters). Immunization rates were collected throughout the institution.

RESULTS: 797 completed questionnaires from 1,092 HCWs (73%) were returned. Major reasons for immunization rejection were confidence that their bodies' self-defense mechanisms would ward off infection (32%), perception of low exposure risk (23%), and doubts concerning vaccine efficacy (19%). The use of intervention methods designed to address these factors increased influenza immunization rates in the three targeted departments from 13% (95% confidence interval [CI95], 11.4-15.6) in 1995 and 1996 to 37% (CI95, 34.5-40.3) in the following season (P<.001). In all other departments, immunization rates rose from 9% (CI95, 8.5-10.3) to 23%% (CI95, 21.6-24.1; P<.001). Nurses were, and remained, more reluctant to be immunized compared to other HCWs.

CONCLUSIONS:Influenza immunization rates can be increased significantly by specific interventions based on local concerns of HCWs, among which educational conferences and the on-site availability of a vaccination nurse appeared important

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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

REFERENCES

1. Hoffman, PC, Dixon, RE. Control of influenza in the hospital. Ann Intern Med 1977;87:725728.CrossRefGoogle ScholarPubMed
2. Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations from the immunization practices advisory committee (ACIP). MMWR 1992;41:117.Google Scholar
3. Potter, J, Stott, DJ, Roberts, MA, Elder, AG, O'Donell, B, Knight, PV, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:16.Google Scholar
4. Weingarten, S, Riedinger, M, Bolton, LB, Miles, P, Ault, M. Barriers to influenza vaccine acceptance. A survey of physicians and nurses. Am J Infect Control 1989;17:202207.Google Scholar
5. Watanakunakorn, C, Ellis, G, Gemmel, D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol 1993;14:1720.Google Scholar
6. Heimberger, T, Chang, HG, 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;16:412415.Google Scholar
7. Fleiss, JL. An introduction to applied probability. In: Fleiss, JL, ed. Statistical Methods for Rates and Proportions. 2nd ed. New York, NY: John Wiley & Sons; 1981:119.Google Scholar
8. 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
9. Yassi, A, Murdzak, C, Cheang, M, Tran, N, Aoki, FY. Influenza immunization: knowledge, attitude and behaviour of health care workers. Canadian Journal of Infection Control 1994;9:103108.Google Scholar
10. Christian, MA. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991;19:177184.CrossRefGoogle ScholarPubMed
11. 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
12. Nafziger, DA, Herwaldt, LA. Attitudes of internal medicine residents regarding influenza vaccination. Infect Control Hosp Epidemiol 1994;15:3235.Google Scholar
13. Adal, KA, Flowers, RH, Anglim, AM, Hayden, FG, Titus, MG, Coyner, BJ, et al. Prevention of nosocomial influenza. Infect Control Hosp Epidemiol 1996;17:641648.CrossRefGoogle ScholarPubMed
14. Weingarten, S, Staniloff, H, Ault, M, Miles, P, Bamberger, M, Meyer, RD. Do hospital employees benefit from the influenza vaccine? A placebo-controlled clinical trial. J Gen Intern Med 1988;3:3237.Google Scholar