Tuesday, March 18, 2008

Preliminary Analysis of Factors Associated with Low Influenza Coverage Among Health Care Workers in Los Angeles County

Wendy L. Berger1, Carla Higbee2, Carol Salminen3, Dulmini Kodagoda1, and Nidhi M. Nakra4. (1) Los Angeles County Immunization Program, 3530 Wilshire Blvd., Suite 700, Los Angeles, CA, USA, (2) California Hospital Medical Center, 1401 S. Grand Avenue, Los Angeles, CA, USA, (3) Epidemiology, LAC + USC Health Care Network, 1240 N. Mission Road, Los Angeles, USA, (4) Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention, 3530 Wilshire Blvd., Suite 700, Los Angeles, CA, USA

Learning Objectives for this Presentation:
By the end of the presentation, participants will identify why healthcare workers (HCWs) decline influenza vaccinations and factors influencing vaccine acceptance by occupational type.

Voluntary influenza immunizations among HCWs have not improved above the national average of 40% (MMWR, 2/06). Low coverage is thought to be a source of hospital-acquired infections causing high patient morbidity/mortality and cost. In 2005 and 2006, the Immunization Coalition of Los Angeles County collaborated with two hospitals on employee influenza vaccination campaigns during National Adult Immunization Awareness Week.

1) Describe self-reported attitudes/beliefs about influenza vaccine by occupational type and 2) Identify self-reported vaccine acceptance/barriers.

A self-administered convenience sample among HCWs at two hospitals.

Of 1,600 eligible respondents at Hospital A, 500 (31%) participated. Of 6,800 eligible respondents at Hospital B, 1500 (22%) participated (298 surveys analyzed thus far). Barriers included: misperceptions about influenza risk, concerns about side-effects/efficacy, and inconvenient vaccination hours. Of Hospital A respondents, 33% of nurses, 19% of physicians, and 27% of ancillary staff believed the vaccine made them sick, compared to nurses, physicians, and ancillary staff at Hospital B (21%, 18%, and 14%, respectively). Among respondents at Hospital A, 22% of nurses, 19% of physicians, and 21% of ancillary staff perceived the influenza vaccine ineffective in preventing illness, compared to nurses, physicians, ancillary staff at Hospital B (19%, 12%, and 22%, respectively). Across hospitals, nurses, physicians, and ancillary staff believed they did not need influenza vaccinations (A: 17%, 15%, 20%; B: 20%, 20%, 19%). Physicians at both hospitals (A: 30%; B: 27%) believed vaccination hours were inconvenient, compared to nurses and ancillary staff (A: 12%, 16%; B: 17%, 14%).

Misperceptions about disease risk and vaccine side-effects/efficacy applied across institutions and occupations. Physicians, more so than others, believed vaccination hours were inconvenient. Hospital-based influenza programs should address both systemic barriers and vaccine concerns.