Measurement of Influenza Vaccination Coverage among Healthcare Personnel in US Hospitals

Objective.To characterize practices related to measuring influenza vaccination rates among healthcare personnel in US hospitals.Design.Descriptive survey.Setting.Nonfederal, short-stay hospitals that provide general medical and surgical services, identified by use of the 2004 American Hospital Association Annual Survey Database.Participants.Healthcare personnel from 996 randomly sampled US hospitals stratified by region and bed size.Methods.A self-administered questionnaire was distributed in 2006 to infection control coordinators to gather data on policies and practices related to the provision of the influenza vaccine and on the measurement and reporting of influenza vaccination rates. Descriptive statistics and associations were calculated, and logistic regression was conducted.Results.The response rate was 56% (ie, 555 of 996 US hospitals responded to the questionnaire). Weighting accounted for sampling design and nonresponse. Most hospitals provided the influenza vaccine to employees (100%), credentialed medical staff (ie, independent practitioners; 94%), volunteers (86%), and contract staff (83%); provision for students and residents was less frequent (58%). Only 69% of hospitals measured vaccination rates (mean coverage rate, 55%). Most hospitals that measured coverage included employees (98%) in the vaccination rates, whereas contract staff (53%), credentialed medical staff (56%), volunteers (56%), and students and residents (30%) were less commonly included. Among hospitals measuring coverage, 44% included persons for which vaccine was contraindicated, and 51% included persons who refused vaccination. After adjustment for region and size, hospitals with vaccination plans written into policy (odds ratio, 2.0 [95% confidence interval, 1.22–7.67]) or that addressed internally reporting coverage (odds ratio, 4.8 [95% confidence interval, 2.97–7.66]) were more likely to measure coverage than were hospitals without such plans.Conclusions.Hospitals vary in terms of the groups of individuals included in influenza vaccination coverage measurements. Standardized measures may improve comparability of hospital-reported vaccination rates. Measuring coverage in a manner that facilitates identification of occupational groups with low vaccination rates may inform development of targeted interventions.

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Cluster Analysis: Vaccination Attitudes and Beliefs of Healthcare Personnel

American Journal of Health Behavior ◽

10.5993/ajhb.44.3.3 ◽

2020 ◽

Vol 44 (3) ◽

pp. 302-312

Author(s):

Barbara H. Bardenheier ◽

Megan C. Lindley ◽

Sarah W. Ball ◽

Marie A. de Perio ◽

Scott Laney ◽

...

Keyword(s):

Cluster Analysis ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Healthcare Personnel ◽

Attitudes And Beliefs ◽

Panel Survey ◽

Attitudes And Behaviors ◽

The Future ◽

And Behaviors

Objectives: We sought to identify patterns of knowledge, attitudes, and behaviors (KABs) about influenza and influenza vaccination among healthcare personnel (HCP) and define characteristics associated with these patterns. Methods: We used an Internet panel survey of HCP (N = 2265) during March 27-April 17, 2018; clustered HCP by their vaccination-related KABs. Results: Four clusters were identified: Immunization Champions (61.1% of the sample) received influenza vaccine to prevent disease; Unworried Vaccinators (15.4%) received the influenza vaccine but did not believe influenza is a serious threat to themselves; Fence Sitters (8.1%) believed the vaccine is safe and worth the time and expense but is not effective; Skeptics (15.4%) did not believe the vaccine is safe or effective. Influenza vaccination coverage was 78.4% overall and higher among Immunization Champions (90.2%) and Unworried Vaccinators (87.0%) than Fence Sitters (61.6%) or Skeptics (32.2%). Conclusions: Findings suggest that based on KABs, the 3 clusters comprising 85% of HCP might be vaccinated in the future. Using messages specific to each group may improve vaccination coverage among HCP.

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Influenza vaccination coverage in a population-based cohort of Australian-born Aboriginal and non-Indigenous older adults

Communicable Diseases Intelligence ◽

10.33321/cdi.2019.43.30 ◽

2019 ◽

Vol 43 ◽

Author(s):

Amalie Dyda ◽

Surendra Karki ◽

Marlene Kong ◽

Heather F Gidding ◽

John M Kaldor ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Torres Strait Islander ◽

Vaccine Coverage ◽

Vaccine Uptake ◽

P Value ◽

Healthy Weight ◽

Medical Risk ◽

Torres Strait

Background: There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults. Methods: Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults. Results: Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5–50.9%) and 38.5%, (37.9–39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9–74.7%) and 72.6% (72.2–73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44–3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37–3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26–5.20). Similar associations were found among non-Indigenous adults. Conclusions: In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.

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Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

Infection Control and Hospital Epidemiology ◽

10.1086/670992 ◽

2013 ◽

Vol 34 (7) ◽

pp. 723-729 ◽

Cited By ~ 6

Author(s):

Kayla L. Fricke ◽

Mariella M. Gastañaduy ◽

Renee Klos ◽

Rodolfo E. Bégué

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Influenza Vaccination ◽

Vaccination Campaign ◽

Vaccination Rate ◽

Healthcare Personnel ◽

Patient Contact ◽

Hospital Type ◽

Vaccination Rates ◽

Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

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Structural inequities in seasonal influenza vaccination rates

BMC Public Health ◽

10.1186/s12889-021-11179-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lara I. Brewer ◽

Mark J. Ommerborn ◽

Augustina Le Nguyen ◽

Cheryl R. Clark

Keyword(s):

Primary Care ◽

Health Insurance ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

American Indian ◽

Low Socioeconomic Status ◽

Behavioral Risk ◽

Vaccination Rates ◽

Access To Primary Care ◽

Structural Inequities

Abstract Background Influenza immunization is a highly effective method of reducing illness, hospitalization and mortality from this disease. However, influenza vaccination rates in the U.S. remain below public health targets and persistent structural inequities reduce the likelihood that Black, American Indian and Alaska Native, Latina/o, Asian groups, and populations of low socioeconomic status will receive the influenza vaccine. Methods We analyzed correlates of influenza vaccination rates using the 2019 Behavioral Risk Factor Surveillance System (BRFSS) in the year 2020. Our analysis compared influenza vaccination as the outcome of interest with the variables age, sex, race, education, income, geographic location, health insurance status, access to primary care, history of delaying care due to cost, and comorbidities such as: asthma, cardiovascular disease, hypertension, body mass index, cancer and diabetes. Results Non-Hispanic White (46.5%) and Asian (44.1%) participants are more likely to receive the influenza vaccine compared to Non-Hispanic Black (36.7%), Hispanic (33.9%), American Indian/Alaskan Native (36.6%), and Native Hawaiian/Other Pacific Islander (37.9%) participants. We found persistent structural inequities that predict influenza vaccination, within and across racial and ethnic groups, including not having health insurance [OR: 0.51 (0.47–0.55)], not having regular access to primary care [OR: 0.50 (0.48–0.52)], and the need to delay medical care due to cost [OR: 0.75 (0.71–0.79)]. Conclusion As COVID-19 vaccination efforts evolve, it is important for physicians and policymakers to identify the structural impediments to equitable U.S. influenza vaccination so that future vaccination campaigns are not impeded by these barriers to immunization.

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Influenza vaccination during the coronavirus pandemic: intention to vaccinate among the at-risk population in the Central Catalonia Health Region (VAGCOVID)

BMC Family Practice ◽

10.1186/s12875-021-01434-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Anna Bonet-Esteve ◽

Raquel Muñoz-Miralles ◽

Carla Gonzalez-Claramunt ◽

Ana M Rufas ◽

Xavier Pelegrin Cruz ◽

...

Keyword(s):

At Risk ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Perceived Risk ◽

Seasonal Influenza ◽

Public Health Issue ◽

Risk Population ◽

Previous Season ◽

The Individual

Abstract Background Influenza is a major public health issue, with the primary preventive measure being an annual influenza vaccination. Nevertheless, vaccination coverage among the at-risk population is low. Our understanding of the behaviour of the influenza virus during the SARS-CoV-2 coronavirus pandemic is limited, meaning influenza vaccination is still recommended for individuals at risk for severe complications due to influenza infection. The aim of the study is to determine the intention to vaccinate against seasonal influenza among the at-risk population in the 2020-21 campaign during the SARS-CoV-2 pandemic and to analyse the factors which influence such intention. Methods Cross-sectional telephone survey of adults (aged over 18) with risk factors in central Catalonia where the need for the Seasonal Influenza Vaccine (SIV) was recommended. Results A total of 434 participants responded to the survey, 43.3% of whom intended to be vaccinated against influenza for the 2020-2021 influenza season, 40.8% had no intention to be vaccinated and 15.9% were uncertain or did not express their opinion. The intention to get vaccinated against influenza is associated with having dependents, the individual’s perception of the risk of being infected with influenza and the perceived risk of transmission to dependents. It is also associated with age, whether the individual had received influenza vaccine the previous season or any other season before. The best predictors of the intention to vaccinate are the individual’s perception of the risk of catching influenza and whether the individual had been vaccinated in the previous season. Conclusions Intention to vaccinate can be a good predictor of individual behaviour in relation to vaccination. During the current SARS-CoV-2 pandemic many individuals are hesitant to influenza vaccination. In order to improve influenza vaccination coverage in people included in risk groups, it is necessary to promote educational actions, especially among those who express doubts.

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Influenza vaccine uptake among adults living with young children

Journal of Epidemiological Research ◽

10.5430/jer.v4n1p41 ◽

2018 ◽

Vol 4 (1) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Nirma Khatri Vadlamudi ◽

Fawziah Marra

Keyword(s):

Young Children ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Perceived Health ◽

Canadian Community Health Survey ◽

Demographic Characteristics ◽

Vaccine Uptake ◽

Vaccination Programs ◽

Vaccination Rates ◽

Vaccination Uptake

Background: Many studies report vaccine uptake among young adults aged 18 to 49 years is low. In Canada, the National Advisory Committee on Immunization (NACI) recommends influenza vaccination for adults in contact with young children, however vaccination rates for this specific population are missing. An estimate is required to identify appropriate public health interventions. The objective of this study was to describe recent trends in influenza vaccination uptake among Canadian adults aged 18 to 49 years old living with or without young children.Methods: The Canadian Community Health Survey (2013-2014) dataset, available for public use was used after grouping individuals by influenza vaccination uptake within the past year in adults aged 18 to 49 years. The relationship between living in a household with young children and influenza vaccination uptake was examined using a multivariable logistic regression model.Results: Among Canadian adults aged 18 to 49 years, the influenza vaccination uptake was 24.1% in adult household contacts with young children compared to 18.2% in those without young children (p<.0001). After adjusting for socio-demographic characteristics and self-perceived health, we determined that vaccine uptake was associated with living in a household with young children (adjusted OR: 1.30 [95%CI: 1.17-1.44]). While socio-demographic characteristics and self-perceived health greatly influenced influenza vaccination uptake, we also found marital status was a strong influencer of influenza vaccine uptake (adjusted OR: 1.31 [95%CI: 1.16-1.48]). Conclusion: Overall, influenza vaccination uptake among caregiving adults is low. Increased vaccine uptake was associated with living in a household with one or more young children. Targeted education and vaccination programs are required to improve uptake of the influenza vaccine in this age group.

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A Meta-Analysis of Influenza Vaccination Following Correspondence: Considerations for COVID-19

10.1101/2021.06.10.21258685 ◽

2021 ◽

Author(s):

Robert P Murphy ◽

Carol Taaffe ◽

Elayne Ahern ◽

Grace McMahon ◽

Orla Muldoon

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Publication Bias ◽

English Language ◽

Meta Analysis ◽

Group Analysis ◽

Vaccine Uptake ◽

Vaccination Rates ◽

Health Authorities ◽

Direct Correspondence

Background: High vaccination rates are needed to protect against influenza and to end the COVID-19 pandemic. Health authorities need to know if supplementing mass communications with direct correspondence to the community would increase uptake. Objectives: The primary objective is to determine if sending a single written message directly to individuals increases influenza vaccine uptake, and a secondary objective is to identify any identified content shown to increase influenza vaccine uptake. Methods: PubMed, PsycInfo and Web of Science were searched for English language RCTs testing a single correspondence for members of the community in OECD countries to obtain influenza vaccination. A meta-analysis with inverse-variance, random-effects modelling was used to estimate a mean, weighted risk ratio effect size measure of vaccine uptake. Studies were quality assessed and analysis was undertaken to account for potential publication bias. Results: Twenty-two randomized controlled trials were included covering 37 interventions. Of the 37 interventions, 32 (86%) report an increase in influenza vaccination rates. A formal meta-analysis shows that sending a single written message increases influenza vaccine uptake by 18% (RR = 1.18, 95%CI [1.13-1.22], Z = 8.56, p < .001) relative to the no contact comparator group. Analysis shows that the intervention is effective across correspondence type, age group, time, and location, and after allowing for risk of publication bias. Limitations: The review was restricted to English language publications, and the generalizability of results across the OECD may be questioned. Conclusions and implications: The implication for public health authorities organizing vaccination programs for influenza, and arguably also for COVID-19, is that sending written vaccination correspondence to members of the community is likely to increase uptake. Keywords: vaccine uptake, COVID-19, influenza, direct correspondence, meta-analysis.

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Racial/Ethnic Disparities in Influenza Vaccination Coverage Among US Adolescents, 2010-2016

Public Health Reports ◽

10.1177/0033354918805720 ◽

2018 ◽

Vol 133 (6) ◽

pp. 667-676 ◽

Cited By ~ 5

Author(s):

Noah S. Webb ◽

Benjamin Dowd-Arrow ◽

Miles G. Taylor ◽

Amy M. Burdette

Keyword(s):

Influenza Vaccination ◽

Vaccination Coverage ◽

Black Adolescents ◽

Ethnic Disparities ◽

White Adolescents ◽

Hispanic Adolescents ◽

Vaccination Rates ◽

Targeted Interventions ◽

Race Ethnicity ◽

Racial Ethnic

Objective: Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cross-sectional data to determine (1) trends in influenza vaccination rates among non-Hispanic white (hereinafter, white), non-Hispanic black (hereinafter, black), and Hispanic adolescents over time and (2) whether influenza vaccination rates among adolescents varied by race/ethnicity. Methods: We analyzed provider-reported vaccination histories for 2010-2016 from the National Immunization Survey–Teen. We used binary logistic regression models to determine trends in influenza vaccination rates by race/ethnicity for 117 273 adolescents, adjusted for sex, age, health insurance, physician visit in the previous 12 months, vaccination facility type, poverty status, maternal education level, children in the household, maternal marital status, maternal age, and census region of residence. We calculated adjusted probabilities for influenza vaccination for each racial/ethnic group, adjusted for the same demographic characteristics. Results: Compared with white adolescents, Hispanic adolescents had higher odds (adjusted odds ratio [aOR] = 1.11; 95% confidence interval [CI], 1.06-1.16) and black adolescents had lower odds (aOR = 0.95; 95% CI, 0.90-1.00) of vaccination. Compared with white adolescents, Hispanic adolescents had significantly higher adjusted probabilities of vaccination for 2011-2013 (2011: 0.22, P < .001; 2012: 0.23, P < .001; 2013: 0.26, P < .001). Compared with white adolescents, black adolescents had significantly lower probabilities of vaccination for 2016 (2016: 0.21, P < .001). Conclusions: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage.

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Influenza Vaccination in Massachusetts Jails: A Mixed-Methods Analysis

Public Health Reports ◽

10.1177/00333549211041659 ◽

2021 ◽

pp. 003335492110416

Author(s):

Sarah Khorasani ◽

Julia Zubiago ◽

Jac Carreiro ◽

Rubeen Guardado ◽

Alysse G. Wurcel

Keyword(s):

Public Health ◽

Health Care ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Summary Statistics ◽

Vaccination Rates ◽

Delivery Practices ◽

County Jails ◽

Influenza Vaccinations ◽

Health Administrators

Objectives Influenza infects millions of people each year and contributes to tens of thousands of deaths annually despite the availability of vaccines. People most at risk of influenza complications are disproportionately represented in people incarcerated in US prisons and jails. The objectives of this study were to survey health administrators in Massachusetts county jails about institutional influenza vaccine policies and practices and estimate influenza vaccination rates in Massachusetts jails from 2013 to 2020. Methods In April 2020, we administered surveys to the health services administrators in Massachusetts’ 14 county jails to gather information about influenza vaccination policies and delivery practices. To calculate influenza vaccination rates for each facility, we obtained data on influenza vaccine orders from the Massachusetts Department of Public Health for each county in Massachusetts for influenza seasons 2013-2020. We calculated summary statistics for each reporting facility and each year, conducted a Kruskal–Wallis analysis to compare vaccination rates between years, and used a linear regression model to identify predictors of vaccination rates. Results Influenza vaccination rates in Massachusetts jails ranged from 1.9% to 11.8%. We found no significant differences in vaccination rates between years. Influenza vaccine ordering and delivery practices varied by jail, and respondents had high levels of confidence in influenza policies and vaccine delivery practices. Conclusions Influenza vaccination rates in Massachusetts jails are low, and delivery practices in jails vary. Lack of influenza vaccinations in jails is a gap in health care that needs to be prioritized, especially considering the current COVID-19 pandemic. Further investigations for effective and equitable vaccination in this population should involve people who are incarcerated and people who make influenza vaccine policies in jails.

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The influence of a community intervention on influenza vaccination knowledge and behavior among diabetic patients

BMC Public Health ◽

10.1186/s12889-019-8101-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Lili Tao ◽

Ming Lu ◽

Xiaoning Wang ◽

Xiaoyan Han ◽

Shuming Li ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Community Intervention ◽

Vaccination Rate ◽

Control Group ◽

Diabetic Patients ◽

Vaccination Rates ◽

Significant Difference ◽

The Impact ◽

Experimental Group

Abstract Background This study was conducted to evaluate the impact of a comprehensive community intervention on cognition and inoculation behaviors of diabetic patients immunized with influenza vaccine. Methods A total of 1538 diabetic patients aged 35 years and above for outpatient visits and follow-up treatments were selected from six community health service centers (three for the experimental group, and the other three for the control group) in Chaoyang District, Beijing. Comprehensive interventions applied to the experimental group include patient intervention and community climate interventions. We compared the total awareness of influenza vaccine knowledge and influenza vaccination rates between the two groups before and after the intervention. Results Before the intervention, the total awareness rate of influenza vaccine in the experimental group and the control group was similar (50.6 and 50.2%, respectively. P = 0.171). After the intervention, the awareness rate of influenza vaccine in the experimental group and the control group increased. The amplitude of the increase was similar (70.3 and 70.1%, respectively. P = 0.822,). Before the intervention, there was no significant difference in the influenza vaccination rate between the experimental group and the control group (29.0 and 26.8%, respectively. P = 0.334). After the intervention, the vaccination rate of the experimental group was higher than that of the control group. The difference was statistically significant (The vaccination rate 45.8 and 27.4% for the experimental group and the control group, respectively. P < 0.001). Conclusion Comprehensive community interventions had a positive effect on vaccination in diabetic patients. Trial registration ChiCTR1900025194, registered in Aug,16th, 2019. Retrospectively registered.

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