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Auteur     Tamara M Schult
Auteur     Ebi R Awosika
Auteur     Michael J Hodgson
Auteur     Pamela R Hirsch
Auteur     Kristin L Nichol
Auteur     Sue R Dyrenforth
Auteur     Scott C Moore
Résumé     OBJECTIVE The main objectives of our study were to explore reasons for seasonal influenza vaccine acceptance and declination in employees of a large integrated healthcare system and to identify underlying constructs that influence acceptance versus declination. Secondary objectives were to determine whether vaccine acceptance varied by hospital location and to identify facility-level measures that explained variability. DESIGN A national health promotion survey of employees was conducted that included items on vaccination in the 2009-2010 influenza season. The survey was administered with two other institutional surveys in a stratified fashion: approximately 40% of participating employees were randomly assigned to complete the health promotion survey. SETTING National single-payer healthcare system with 152 hospitals. PARTICIPANTS Employees of the healthcare system in 2010 who responded to the survey. METHODS Factor analysis was used to identify underlying constructs that influenced vaccine acceptance versus declination. Mean factor scores were examined in relation to demographic characteristics and occupation. Multilevel logistic regression models were used to determine whether vaccine acceptance varied by location and to identify facility-level measures that explained variability. RESULTS Four factors were identified related to vaccine declination and were labeled as (1) « don’t care, » (2) « don’t want, » (3) « don’t believe, » and (4) « don’t know. » Significant differences in mean factor scores existed by demographic characteristics and occupation. Vaccine acceptance varied by location, and vaccination rates in the previous year were an important facility-level predictor. CONCLUSIONS Results should guide interventions that tailor messages on the basis of particular reasons for declination. Occupation-specific and culturally appropriate messaging should be considered. Continued efforts will be taken to better understand how workplace context influences vaccine acceptance.
Publication     Infection control and hospital epidemiology: the official journal of the Society of Hospital Epidemiologists of America
Volume     33
Numéro     9
Pages     924-931
Date     Sep 2012