January 29, 2015
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Influenza vaccination rates low among nursing home HCWs

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Researchers from the Rollins School of Public Health at Emory University have found low rates of influenza vaccination among health care workers at nursing homes.

“Vaccination rates would be higher if staff held accurate beliefs about vaccination and influenza,” the researchers wrote in American Journal of Infection Control. “Low vaccination rates among employees place vulnerable populations (eg, older adults), in whom the vaccine is not as effective, at risk of contracting the virus. Our findings support the need for additional research on the use of incentives and educational strategies targeted at staff.”

Employees at 37 nursing facilities in Florida, Georgia and Wisconsin participated in surveys about their influenza vaccination status for the most recent influenza season, their beliefs about influenza and the vaccine, and their demographic information, job title and tenure. The researchers conducted site visits in 2011 and 2012 to collect the surveys and interview the nursing home’s leadership team about policies for staff and resident vaccination.

The study included 1,965 completed surveys. The cumulative staff vaccination rate was 53.9%. By individual nursing home, the staff vaccination rate varied from 15% to 97%. By state, Florida has the lowest rate of 36.4%, while the rates in Georgia and Wisconsin were 58.5% and 73.4%, respectively. Older employees were more likely to receive the vaccine. Black employees and employees in Florida had lower vaccination rates. Offering incentives increased the probability of receiving the vaccine by 12.3 percentage points.

In a second model, the researchers evaluated staff beliefs and their association with receiving the vaccine. They found that a belief that the vaccine was effective increased the probability of vaccination by 30.3 percentage points. Other beliefs associated with receiving the vaccine included feelings that the staff and the residents are at risk for influenza, a belief that staff spread influenza, and the belief that influenza is contagious.

“As evidence accumulates questioning the effectiveness of the influenza vaccine in older adults, it is increasingly important to consider staff as a source of influenza transmission,” the researchers wrote. “Our research indicates that educational strategies that counter inaccurate beliefs and tout the effectiveness of the vaccine may be crucial in helping to overcome staff resistance to vaccination.”

Disclosure: The researchers report no relevant financial disclosures.