EDCP Mission/Vision

Influence of Occupation and Education Level on Influenza Vaccination Rates Among Employees at Maryland State Treatment and Residential Facilities

Leslie Edwards ¹, MHS, Elizabeth Boyer¹, Laura Novelli²,
Nora Chen², Brenda Roup¹, PhD, RN, CIC, Elizabeth Beiger, MD, MPH², David Blythe¹, MD, MPH,
¹Maryland Department of Health and Mental Hygiene,
²Johns Hopkins University Bloomberg School of Public Health

Introduction: Influenza causes substantial morbidity and mortality, particularly among the elderly and immunocompromised. Health Care Workers (HCWs), including those who work at treatment and residential facilities, are encouraged to receive an annual influenza vaccination to decrease their risk of transmitting influenza to patients. We surveyed employees at Maryland Department of Health and Mental Hygiene residential and treatment facilities to assess the vaccination rate and determine factors that influenced HCWs’ vaccination.

Methods: The Infection Control Practitioners at 9 of 17 State facilities distributed surveys to their employees. Participants were asked questions about influenza vaccination, job type, and education level.

Results: During the 2000-2001 influenza season, 756 (40%) questionnaires were completed and returned. Only 59% of respondents reported being vaccinated against influenza (81% at work.) The likelihood of being vaccinated varied by occupation: 69% of administrative employees surveyed were vaccinated (RR=1.26, p<0.01) while only 55% of employees involved in direct patient care (RR=0.89, p=0.05) received the immunization. Of those employees who work in patient care, physicians had the highest rate of vaccination (81%), followed by nurses (57%), and nurses’ aides (54%). Vaccination rates varied with highest level of education completed as follows: high school (60%), associates (52%), bachelors (58%), masters (74%), and doctoral degree (76%).

Conclusions: Vaccination rates for HCWs in Maryland DHMH facilities remain low; this may contribute to the transmission of influenza to patients. All efforts should be made to encourage HCWs, particularly nurses and nurse’s aides, to receive a yearly influenza vaccination.

Statement of Purpose

Topic: The practice of epidemiology in public health settings

Theme: Putting the public back in public health

A successful public health campaign to influence the public to receive annual influenza vaccinations must begin with employees in the health care field. It is crucial that health care workers, particularly those who work with populations at high risk for influenza (including the elderly and immunocompromised), are vaccinated against influenza to prevent transmission to susceptible patients. Our study assessed the rate of vaccination of employees at Maryland state health care facilities and examined factors that influenced employees’ decisions whether or not to receive the vaccination. By determining the factors that influence this decision, future efforts can be made to target employees who are less likely to receive a vaccination. A high rate of vaccination of health care workers will contribute to a decrease in the transmission of influenza to patients, thereby decreasing the risk for morbidity and mortality from influenza in high-risk populations.

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