Objectives. The national influenza vaccination rate among healthcare workers (HCWs) remains low despite clear benefits to patients, coworkers, and families. We sought to evaluate formally the effect of a one-hour time off incentive on attitudes towards influenza vaccination during the 2011-2012 influenza season. Methods. All HCWs at the Philadelphia Veterans Affairs (VA) Medical Center were invited to complete an anonymous web-based survey. We described respondents’ characteristics and attitudes toward influenza vaccination and determined the relationship of specific attitudes with respondents’ acceptance of influenza vaccination, using a 5-point Likert scale. Results. We analyzed survey responses from 154 HCWs employed at the Philadelphia VA Medical Center, with a response rate of 8%. Among 121 respondents who reported receiving influenza vaccination, 34 (28%, 95% CI 20–37%) reported agreement with the statement that the time off incentive made a difference in their decision to accept influenza vaccination. Conclusions. Our study provides evidence that modest incentives such as one-hour paid time off will be unlikely to promote influenza vaccination rates within medical facilities. More potent interventions that include mandatory vaccination combined with penalties for noncompliance will likely provide the only means to achieve near-universal influenza vaccination among HCWs. 1. Background The Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee recommend that all HCWs be vaccinated annually against influenza [1]. Vaccination of HCWs against influenza has been shown to prevent transmission of influenza to patients [2, 3], coworkers [4], and families [5]. Despite these benefits, the national influenza vaccination rate among HCWs remains low [6]. Vaccination uptake is limited by concerns regarding vaccine safety and efficacy and misconceptions regarding the perceived risk of nosocomial transmission of influenza [7]. Late in the 2010-2011 influenza season, we instituted a novel incentive to promote influenza vaccination, providing one-hour paid time off immediately following receipt of vaccination, and we achieved our target vaccination rate soon after this incentive program was begun. Based on this experience at our medical facility, we sought to evaluate formally the effect of this time off incentive on attitudes towards influenza vaccination during the 2011-2012 influenza season. We hypothesized that HCWs who had received the influenza vaccine would report a more favorable attitude
References
[1]
M. L. Pearson, C. B. Bridges, and S. A. Harper, “Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP),” Morbidity and Mortality Weekly Report, vol. 55, no. RR-2, pp. 1–16, 2006, Erratum in: Morbidity and Mortality Weekly Report, vol. 55, no. 9, article 252, 2006.
[2]
G. P. Dolan, R. C. Harris, M. Clarkson, et al., “Vaccination of health care workers to protect patients at increased risk for acute respiratory disease,” Emerging Infectious Diseases, vol. 18, no. 8, pp. 1225–1234, 2012.
[3]
T. Bénet, C. Régis, N. Voirin et al., “Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients,” BMC Infectious Diseases, vol. 12, article 30, 2012.
[4]
A. Apisarnthanarak, T. M. Uyeki, P. Puthavathana, R. Kitphati, and L. M. Mundy, “Reduction of seasonal influenza transmission among healthcare workers in an intensive care unit: a 4-year intervention study in Thailand,” Infection Control and Hospital Epidemiology, vol. 31, no. 10, pp. 996–1003, 2010.
[5]
P. Cooley, B. Y. Lee, S. Brown et al., “Protecting health care workers: a pandemic simulation based on Allegheny County,” Influenza and other Respiratory Viruses, vol. 4, no. 2, pp. 61–72, 2010.
[6]
F. J. Walker, J. A. Singleton, P. Lu, K. G. Wooten, and R. A. Strikas, “Influenza vaccination of healthcare workers in the United States, 1989–2002,” Infection Control and Hospital Epidemiology, vol. 27, no. 3, pp. 257–265, 2006.
[7]
M. P. Nowalk, C. J. Lin, R. K. Zimmerman et al., “Self-reported influenza vaccination rates among health care workers in a large health system,” American Journal of Infection Control, vol. 36, no. 8, pp. 574–581, 2008.
[8]
“Influenza vaccination coverage among health-care personnel—United States, 2010-11 Influenza season,” Morbidity and Mortality Weekly Report, vol. 60, no. 32, pp. 1073–1077, 2011.
[9]
M. J. Butteri, C. Radu, F. Huq, A. Wiglesworth, S. C. Durso, and M. Bellantoni, “Flu in 15: a novel 15-minute education program to promote acceptance of the influenza vaccine among health care workers,” Journal of the American Medical Directors Association, vol. 11, no. 7, pp. 523–527, 2010.
[10]
Z. H. Abramson, O. Avni, O. Levi, and I. N. Miskin, “Randomized trial of a program to increase staff infl uenza vaccination in primary care clinics,” Annals of Family Medicine, vol. 8, no. 4, pp. 293–298, 2010.
[11]
A. C. Kimura, C. N. Nguyen, J. I. Higa, E. L. Hurwitz, and D. J. Vugia, “The effectiveness of vaccine day and educational interventions on influenza vaccine coverage among health care workers at long-term care facilities,” American Journal of Public Health, vol. 97, no. 4, pp. 684–690, 2007.
[12]
S. J. D'Heilly and K. L. Nichol, “Work-site-based influenza vaccination in healthcare and non-healthcare settings,” Infection Control and Hospital Epidemiology, vol. 25, no. 11, pp. 941–945, 2004.
[13]
H. Hollmeyer, F. Hayden, and A. Mounts, “Review: interventions to increase influenza vaccination among healthcare workers in hospitals,” Influenza and other Respiratory Viruses, vol. 7, no. 4, pp. 604–621, 2012.
[14]
G. Godin, L. Vézina-Im, and H. Naccache, “Determinants of influenza vaccination among healthcare workers,” Infection Control and Hospital Epidemiology, vol. 31, no. 7, pp. 689–693, 2010.
[15]
K. Quan, D. M. Tehrani, L. Dickey et al., “Voluntary to mandatory: evolution of strategies and attitudes toward influenza vaccination of healthcare personnel,” Infection Control and Hospital Epidemiology, vol. 33, no. 1, pp. 63–70, 2012.
[16]
K. Harris, J. Maurer, C. Black, G. Euler, and S. Kadiyala, “Workplace efforts to promote influenza vaccination among healthcare personnel and their association with uptake during the 2009 pandemic influenza A (H1N1),” Vaccine, vol. 29, no. 16, pp. 2978–2985, 2011.
