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Innovative Approaches for Understanding Seasonal Influenza Vaccine Declination in Healthcare Personnel Support Development of New Campaign Strategies

Published online by Cambridge University Press:  02 January 2015

Tamara M. Schult ,
Ebi R. Awosika ,
Michael J. Hodgson ,
Pamela R. Hirsch ,
Kristin L. Nichol ,
Sue R. Dyrenforth  and
Scott C. Moore
Tamara M. Schult*
Affiliation:
Office of Public Health, Veterans Health Administration, Washington, DC
Ebi R. Awosika
Affiliation:
Office of Public Health, Veterans Health Administration, Washington, DC University of Minnesota Medical School, Minneapolis, Minnesota
Michael J. Hodgson
Affiliation:
Office of Public Health, Veterans Health Administration, Washington, DC
Pamela R. Hirsch
Affiliation:
Office of Public Health, Veterans Health Administration, Washington, DC
Kristin L. Nichol
Affiliation:
University of Minnesota Medical School, Minneapolis, Minnesota Minneapolis VA Health Care System, Minneapolis, Minnesota
Sue R. Dyrenforth
Affiliation:
National Center for Organizational Development, Veterans Health Administration, Cincinnati, Ohio
Scott C. Moore
Affiliation:
National Center for Organizational Development, Veterans Health Administration, Cincinnati, Ohio
*
One Veterans Drive (V68), Minneapolis, MN 55417 ([email protected])
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Abstract

Objective.

The main objectives of our study were to explore reasons for seasonal influenza vaccine acceptance and declination in employees of a large integrated healthcare system and to identify underlying constructs that influence acceptance versus declination. Secondary objectives were to determine whether vaccine acceptance varied by hospital location and to identify facility-level measures that explained variability.

Design.

A national health promotion survey of employees was conducted that included items on vaccination in the 2009-2010 influenza season. The survey was administered with two other institutional surveys in a stratified fashion: approximately 40% of participating employees were randomly assigned to complete the health promotion survey.

Setting.

National single-payer healthcare system with 152 hospitals.

Participants.

Employees of the healthcare system in 2010 who responded to the survey.

Methods.

Factor analysis was used to identify underlying constructs that influenced vaccine acceptance versus declination. Mean factor scores were examined in relation to demographic characteristics and occupation. Multilevel logistic regression models were used to determine whether vaccine acceptance varied by location and to identify facility-level measures that explained variability.

Results.

Four factors were identified related to vaccine declination and were labeled as (1) “don't care,” (2) “don't want,” (3) “don't believe,” and (4) “don't know.” Significant differences in mean factor scores existed by demographic characteristics and occupation. Vaccine acceptance varied by location, and vaccination rates in the previous year were an important facility-level predictor.

Conclusions.

Results should guide interventions that tailor messages on the basis of particular reasons for declination. Occupation-specific and culturally appropriate messaging should be considered. Continued efforts will be taken to better understand how workplace context influences vaccine acceptance.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 9 , September 2012 , pp. 924 - 931
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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