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Factors Affecting Influenza Vaccination Among Employees at Maryland State Health Care Facilities, 1999

Leslie D. Edwards, MHS, Carmela Groves, RN, MS, and Jeffrey C. Roche, MD, MPH.
Office of Epidemiology and Disease Control Programs, Maryland Department of Health and Mental Hygiene

Introduction: Both medical and non-medical employees of health-care facilities can introduce influenza into institutions, yet only 10-60% of employees are vaccinated each year. To assess the influenza vaccination rate and identify barriers limiting employee vaccination, personnel at eight Maryland health-care facilities were surveyed.

Methods: The infection control practitioner at each facility distributed a brief self-administered questionnaire to all employees. Questions were included about influenza vaccination status, job category, and reasons for not getting vaccinated.

Results: Overall, 57% of employees surveyed returned completed questionnaires. Influenza vaccine coverage among respondents was 70% for the 1999/2000 influenza season. Personnel involved in patient care were no more likely to have been vaccinated than other facility employees (RR=0.94, 95%CI=0.85-1.04, p>0.2). Of those employees who were not vaccinated, 33% indicated that they were afraid that vaccine would cause influenza and 27% thought themselves unlikely to acquire influenza. Although only 3% of respondents indicated that an out-of-pocket charge for the vaccine contributed to their decision against influenza vaccination, employees of facilities that charged for the vaccine were significantly less likely to have been vaccinated (OR=2.09, 95%CI=1.29 – 3.4, p<0.001).

Conclusions: In this particular cohort, influenza vaccination coverage was high and employees involved in patient care were no more likely to receive the influenza vaccine than non-patient care employees. In order to improve influenza vaccine coverage among personnel, facilities should educate staff about vaccine safety and the importance of vaccination. Even the nominal cost of the vaccine may be a barrier against influenza vaccination for some employees.

Maryland Department of Health & Mental Hygiene — Epidemiology & Disease Control Program