Intention of nurses to receiving influenza vaccination before the 2013–14 season

Abstract

A study was conducted to determine the influenza vaccination uptake rate of nurses in Hong Kong after the pH1N1 epidemic, and examine their intention for vaccination before the next influenza season. Questionnaires in Chinese with multiple choice responses were delivered by post through 4 nurses organizations. The following were explored: intentions and reasons for vaccination in the forthcoming season; perceptions of influenza outbreak risk; attitudes toward professional obligation and vaccination policies. Cramer's V and Eta values were calculated to analyze association and effect size. Between March and May 2013, analysis was made on 1,934 (6.8%) valid questionnaires, with 620 (30.7%) having received influenza vaccination before the season of 2012-13. Some 30.7% and 42% intended to accept and decline vaccination respectively in the forthcoming season (2013-14) while 27.3% remained indecisive. Over 80% of indecisive nurses had refused vaccination in the last season. More nurses refusing (18.1%) or indecisive (9.8%) of vaccination perceived being "significantly unwell" after past vaccinations, compared to only 1% in those who intended to accept. Expert opinions and guidelines were important for making decision on vaccination in 40% of nurses. The ranking of professional responsibilities of vaccination in indecisive nurses was between those declining and accepting future vaccination. Overall, past vaccination experience, professional responsibilities and reference to guidelines were major factors affecting nurses' decision on future vaccination against influenza in Hong Kong. The results might however not be generalizable to all nurses as the analyses were restricted to those responding to the appeal from selected professional organisations.

Can the Health Belief Model and moral responsibility explain influenza vaccination uptake among nurses?

“…First of all, results from the multiple stepwise logistic regressions showed that perceived susceptibility of influenza was the most significant factor of having received influenza vaccination in the last influenza season and intention to receive influenza vaccination in the coming influenza season. Findings are consistent with the previous studies, which indicated that those who did not receive the vaccination might not realize their own risk in getting influenza (Ajenjo et al., ; Clark et al., ; Hollmeyer et al., ; Maltezou et al., ; Wang et al., ). Findings support the notion that interventions to promote influenza vaccinations should highlight the risk of the nurses in contracting influenza as well as their potential sources of infection for their patients.…”

“…In fact, misconceptions about the vaccine and side effects have been widely reported among nurses despite their relatively high level of education and knowledge in the health‐related field. One study showed that 58% or more healthcare workers experienced side effects after vaccination and those “significant” side effects were associated with refusal of vaccination (Wang et al., ). Findings suggest that in addition to highlighting the importance and necessity of influenza vaccination, intervention efforts should be sought to clarify the myths or misconceptions of vaccination and to highlight the minimal time required for receiving influenza vaccination.…”

“…Several reasons for receiving and not receiving vaccination have been identified in the literatures. For example, studies have shown that the common reasons for not receiving vaccination among nurses included low levels of risk perception, concerns about side effects, questions about vaccine's effectiveness/safety, inconvenience in accessing vaccination, fear of pain, or negative reports from media (Ajenjo et al, 2010;Clark, Cowan, & Wortley, 2009;Corace et al, 2013;Giannattasio et al, 2015;Hollmeyer, Hayden, Poland, & Buchholz, 2009;Maltezou et al, 2008;Schmid, Rauber, Betsch, Lidolt, & Denker, 2017;Wang, Lee, & Lee, 2015;Weingarten, Riedinger, Bolton, Miles, & Ault, 1989;Zhang, While, & Norman, 2011). On the other hand, the reasons for receiving vaccination among nurses included protecting oneself, patient, family members, friends and children, to avoid sick leave, recommendation/mandate by employer, perception of vaccine's effectiveness/ safety and accessibility of vaccination (Haviari et al, 2015;Hollmeyer et al, 2009;Maltezou et al, 2008;Tosh, Jacobson, & Poland, 2010;Zhang et al, 2011).…”

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

“…In this multiseason study of adults working in acute care hospitals in Canada, the odds ratio for influenza vaccine uptake increased exponentially with every additional year of influenza vaccine uptake over the previous three seasons. Similar findings have been illustrated in studies from the USA, Europe and China, suggesting that the individual perceptions associated with vaccine acceptance and refusal remain stable over several years. It is likely necessary to tailor immunization programs differently to reach HCW at all levels of uptake, from refusers to those accepting influenza vaccine intermittently to those vaccinated annually.…”

A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers

“…International guidelines stress the significance of this approach with recommendations of organizational strategies to immunize HCW annually [ 7 , 8 ]. However, the challenge in maintaining high vaccination coverage of HCW has been marked by unfavorably low compliance rates [ 9 , 10 ], and limited improvement by voluntary motivations through incentives and provision of free vaccine [ 11 , 12 ]. The use of mandatory or regulatory policy has consequently gained popularity and has been implemented in organizations based on the premise of indirect patient benefits [ 13 , 14 ], while the evidence for this as a primary driver for HCW programs remains contentious [ 15 ].…”