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

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.

Background:
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.

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

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

Results:
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%).

Conclusions:
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.