Belief in Flu Shot's Value Boosts Health Workers' Uptake

Troy Brown

March 08, 2012

March 8, 2012 — Healthcare workers (HCWs) who believe that it is important to prevent influenza are almost 4 times as likely to accept vaccination as those who do not, according to a newly published meta-analysis.

Josien Riphagen-Dalhuisen, from the University of Groningen, the Netherlands, and colleagues describe the findings of their meta-analysis in an article published online December 15, 2011, and in the April issue of Occupational and Environmental Medicine.

They looked at the factors that predict whether or not HCWs in hospitals get vaccinated against seasonal influenza. HCWs are currently encouraged to get vaccinated to reduce their likelihood of becoming ill and, more important, to avoid infecting patients under their care.

After conducting a literature search of PubMed and Embase in December 2009, the authors included nonpandemic, nonintervention studies whose participants were hospital-based HCWs. Studies also had to have reported current influenza vaccination status and provided crude data on at least 1 predictor of interest addressed in this study. The sample included 13 studies with a total of 84,880 participants.

The investigators were particularly interested in data that could be used to develop more successful HCW influenza vaccination campaigns. "Seasonal influenza vaccination reduces influenza-confirmed episodes among healthy adults by approximately 75% when matched with circulating strains and there is evidence that vaccinating HCWs against influenza reduces the number of respiratory tract infections among these workers," they write.


The researchers calculated risk ratios (RRs) when information about a predictor was only included in 1 study, and Mantel-Haenszel risk ratios (mhRRs) and 95% confidence intervals (CIs) for pooled analyses.

HCWs who believed that influenza prevention is important were the most likely to accept vaccination (mhRR, 3.63; 95% CI, 2.87 - 4.59).

Several other predictors more than doubled the vaccination uptake rate in hospital-based HCWs:

  • HCWs whose families were usually vaccinated (RR, 2.32; 95% CI, 1.64 - 3.28);

  • HCWs who were willing to prevent influenza transmission (mhRR, 2.31; 95% CI, 1.97 - 2.70);

  • HCWs who believed influenza is highly contagious (RR, 2.25; 95% CI, 1.66 - 3.05);

  • Convenient vaccination clinics (RR, 2.25; 95% CI, 0.95 - 5.34);

  • HCWs who believed the vaccine is effective (mhRR, 2.22; 95% CI, 1.93 - 2.54).

A number of other predictors were associated with influenza vaccine uptake in hospital-based HCWs, but their risk ratios were closer to 1.

According to the investigators, information on the factors that influence vaccine uptake will help vaccination campaigns focus on interventions most likely to make a significant effect, such as education about the importance of influenza prevention and the effectiveness of vaccines.

"Influenza vaccination will only be successful in HCWs if they are properly educated and if the vaccine is easily accessible. Therefore, we recommend targeting these predictors when developing new influenza vaccination implementation strategies for hospital HCWs," write the authors.

"Future studies could use this information for their interventions and target the predictors that seem to have the most influence on vaccine uptake, and also focus on educating HCWs in order to prevent misinformation," the authors write.

The study was supported by the Netherlands Organization for Health Care. The authors have disclosed no relevant financial relationships.

Occup Environ Med. 2012;69:230-235. Abstract


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