The expected emotional benefits of influenza vaccination strongly affect pre-season intentions and subsequent vaccination among healthcare personnel
ABSTRACT The relative importance of different attitudes in predicting vaccination among healthcare personnel (HCP) is unclear. We hypothesized that HCP who feel at risk without vaccination or say they would regret not getting vaccinated would be more likely to get vaccinated than HCP who do not expect these emotional benefits.
A prospective cohort of 1544 HCP with direct patient care was enrolled from September 18 to December 18, 2010 at Scott & White Healthcare in Texas and Kaiser Permanente Northwest in Oregon and Washington. An Internet-based questionnaire assessed pre-season intention to be vaccinated and included 12 questions on attitudes about vaccination: single-item measures of perceived susceptibility and vaccine effectiveness, 5 items that were summed to form a concerns about vaccine scale, and 5 items summed to form an emotional benefits of vaccination scale. Influenza vaccination status for the 2010-2011 season and for 5 prior seasons was confirmed by medical record extraction.
There were significant differences between vaccinated and unvaccinated HCP on all attitude items; 72% of vaccinated HCP agreed that they "worry less about getting the flu" if vaccinated, compared to only 26% of the unvaccinated (odds ratio=7.4, 95% confidence interval=5.8-9.5). In a multivariate model, the emotional benefits scale was the strongest predictor of 2010-2011 seasonal influenza vaccination, after adjusting for other attitude measures, prior vaccination history, and pre-season intention to be vaccinated. The predictive value of the emotional benefits scale was strongest for HCP with low pre-season intention to be vaccinated, where HCP vaccine receipt was 15% versus 83% for those with low versus high scores on the emotional benefits scale.
The expected emotional benefits of vaccination strongly affect seasonal influenza vaccination among HCP, even after taking into account other attitudes, pre-season intentions, and prior vaccination history. These attitudes are promising targets for future vaccination campaigns.
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ABSTRACT: Background Annual influenza vaccination is recommended for health care personnel (HCP). We describe influenza vaccination coverage among HCP during the 2010-2011 season and present reported facilitators of and barriers to vaccination. Methods We enrolled HCP 18 to 65 years of age, working full time, with direct patient contact. Participants completed an Internet-based survey at enrollment and the end of influenza season. In addition to self-reported data, we collected information about the 2010-2011 influenza vaccine from electronic employee health and medical records. Results Vaccination coverage was 77% (1,307/1,701). Factors associated with higher vaccination coverage include older age, being married or partnered, working as a physician or dentist, prior history of influenza vaccination, more years in patient care, and higher job satisfaction. Personal protection was reported as the most important reason for vaccination followed closely by convenience, protection of patients, and protection of family and friends. Concerns about perceived vaccine safety and effectiveness and low perceived susceptibility to influenza were the most commonly reported barriers to vaccination. About half of the unvaccinated HCP said they would have been vaccinated if required by their employer. Conclusion Influenza vaccination in this cohort was relatively high but still fell short of the recommended target of 90% coverage for HCP. Addressing concerns about vaccine safety and effectiveness are possible areas for future education or intervention to improve coverage among HCP.American journal of infection control 04/2014; 42(4):371–375. DOI:10.1016/j.ajic.2013.11.003 · 2.33 Impact Factor
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ABSTRACT: Background Factors associated with influenza vaccine receipt are well studied in healthcare personnel, pregnant women, and the elderly. There has been substantially less research in community dwelling adults and children, and none among entire households. Many studies determine vaccination status by self-report or behavioral intention, outcomes susceptible to misclassification. Given that vaccine is recommended for everyone over six months, re-evaluating these factors is warranted. Methods The Household Influenza Vaccine Effectiveness (HIVE) study is a prospective cohort of households with children. In 2010–2011, 549 adults representing 312 households completed surveys evaluating knowledge, attitudes, and practices regarding influenza vaccination for themselves and their children. Using the health belief model (HBM) as a framework, we examined factors associated with documented seasonal influenza vaccine receipt using log-binomial regression models. Results In multivariate models, cues to action such as doctor recommendation, (RR 1.62, 95% CI: 1.25–2.10), perceived benefits (RR 1.25, 95% CI: 1.04–1.50), and perceived susceptibility (RR 1.21, 95% CI: 1.03–1.42) were significantly associated with increased likelihood of vaccine receipt among adults while high perceived barriers were associated with decreased likelihood (RR 0.38, 95% CI: 0.25–0.59). Similarly, parents reporting higher barriers were less likely (RR 0.58, 95% CI: 0.42–0.79) and those perceiving greater benefits (RR 4.16, 95% CI: 2.28–7.59) and severity (RR 1.13, 95% CI: 1.00–1.27 were more likely to vaccinate their children. The observed effects of perceptions of susceptibility, severity, and benefits were more pronounced at low cues to action for children, as were the effects of perceptions of barriers and severity among adults. Conclusion Perceived benefits and barriers are most strongly associated with vaccine receipt. However, the effects of various factors were most pronounced in the absence of cues to action, which may be an important component of targeted interventions.Vaccine 04/2014; 32(16). DOI:10.1016/j.vaccine.2014.01.075 · 3.49 Impact Factor
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ABSTRACT: Objective. Compare the severity of illnesses associated with influenza and noninfluenza acute respiratory illness (ARI) in healthcare personnel (HCP). Design. Prospective observational cohort. Participants. HCP at 2 healthcare organizations with direct patient contact were enrolled prior to the 2010-2011 influenza season. Methods. HCP who were fewer than 8 days from the start of fever/feverishness/chills and cough were eligible for real-time reverse-transcription polymerase chain reaction influenza virus testing of respiratory specimen. Illness severity was assessed by the sum of self-rated severity (0, absent; 3, severe) of 12 illness symptoms, subjective health (0, best health; 9, worst health), activities of daily living impairment (0, able to perform; 9, unable to perform), missed work, and duration of illness. Results. Of 1,701 HCP enrolled, 267 were tested for influenza, and 58 (22%) of these tested positive. Influenza compared with noninfluenza illnesses was associated with higher summed 12-symptom severity score (mean [standard deviation], 17.9 [5.4] vs 14.6 [4.8]; P < .001), worse subjective health (4.5 [1.8] vs 4.0 [1.8]; P <.05), greater impairment of activities of daily living (4.9 [2.5] vs 3.8 [2.5]; P < .01), and more missed work (12.1 [10.5] vs 7.8 [10.5] hours; P < .01). Differences in symptom severity, activities of daily living, and missed work remained significant after adjusting for illness and participant characteristics. Conclusions. Influenza had a greater negative impact on HCP than noninfluenza ARIs, indicated by higher symptom severity scores, less ability to perform activities of daily living, and more missed work. These results highlight the importance of efforts to prevent influenza infection in HCP.Infection Control and Hospital Epidemiology 05/2014; 35(5):538-46. DOI:10.1086/675832 · 3.94 Impact Factor