Health care workers in the United States harbor significant fears and misconceptions about influenza vaccination, according to the results of a survey conducted at a large tertiary children’s hospital in the country’s Midwestern region.
Researchers in Kansas City, Missouri, administered a 44-question survey to 63 physicians, 135 nurses, and 376 allied health care workers at a 317-bed, freestanding children’s hospital where rates of seasonal influenza immunization are high, Dr. Mary Anne Jackson said Oct. 29 at a press conference during the annual meeting of the Infectious Diseases Society of America (IDSA).
Results of the study were “somewhat surprising” for a highly-educated, highly immunized group of health care workers who are known to be at high risk of acquiring seasonal influenza and passing it on to vulnerable patients, said Dr. Jackson, chief of infectious diseases at Children’s Mercy Hospital in Kansas City.
She pointed to “significant gaps in knowledge” about influenza transmission, nosocomial spread, and vaccine efficacy and safety among all levels of health care professionals.
“[Accurate knowledge] wasn’t 100% even for physicians,” she said.
Still, physicians were significantly more likely than nurses or other health care workers (p value less than 0.0001) to know that they are at high risk of influenza; that the vaccine prevents spread of the disease; and that it is a safe vaccine for adults and children.
Compared to physicians, other health care workers were significantly more likely to believe erroneously that the vaccine can cause influenza.
Further, many allied health care workers and nurses also believed, incorrectly, that an individual must be symptomatic to transmit the influenza virus.
About 75% of physicians advocated policies mandating influenza immunization among health care workers, compared with fewer than half of nurses or allied healthcare professionals surveyed.
Mandating influenza immunization for health care workers, a highly controversial proposition briefly enacted in New York State in response to the H1N1 influenza pandemic this year, was rescinded by New York Gov. David A. Paterson on Oct. 22. The governor’s office stated that the mandatory vaccination policy for health care workers was dropped due to shortages of vaccine for high-risk populations. Widespread protests, however, were speculated to have played a role in the decision as well.
Based on her study findings and recent public responses to H1N1 vaccine mandates for healthcare workers, Dr. Jackson concluded that “mandates are going to be difficult.”
On the other hand, educational efforts and campaigns aimed at getting health care workers immunized “have failed dismally in most institutions.”
At Children’s Mercy Hospital, a vigorous campaign conducted over several years finally achieved an 85% influenza vaccine rate among employees, compared with an average 40% rate among health care workers across the country.
In her institution, the rising immunization rate proved to have a ripple effect, despite the persistence of myths and misconceptions, she said. When health care workers were vaccinated against the seasonal influenza virus, their children also were more likely to receive the vaccine (p value, less than 0.001).
Dr. Jackson reported no relevant financial disclosures.
