Major Article
Influenza vaccination attitudes and practices among US registered nurses

https://doi.org/10.1016/j.ajic.2009.02.012Get rights and content

Background

The influenza vaccination rate among US health care personnel (HCP) remains low and may vary by occupational categories. The objective of this study was to explore knowledge, attitudes, and beliefs associated with influenza vaccination in a broad population of registered nurses.

Methods

The study used a cross-sectional mail survey, administered January-March 2006, of 2000 registered nurses in 4 US states.

Results

Of the 2000 surveys sent, 1310 (72%) were returned, and 1017 (67%) were eligible for analysis. The majority of respondents (59%) reported receiving influenza vaccine during the 2005-2006 influenza season. The most common reason for being vaccinated was protecting oneself from illness (95%), and the most common reason for not being vaccinated was concern about adverse reactions (39%). Respondents who reported their patient population as high risk related to influenza were more likely to be vaccinated and to agree with statements regarding influenza disease and influenza vaccination of HCP.

Conclusion

Concerns about adverse reactions and vaccine effectiveness continue to be barriers to influenza vaccination among registered nurses. Those most knowledgeable about influenza vaccination of HCP have higher vaccination rates. Future efforts to improve vaccination rates should include data on vaccine effectiveness and adverse effects, as well as descriptions of high-risk populations.

Section snippets

Study design

The study was a cross-sectional mailed survey of licensed RNs, fielded January-March 2006.

Sample

Because there is no national listing of registered nurses, we utilized a multi-state sampling strategy as a proxy. Of the 22 states for which mailing information for licensed RNs was available for research purposes at the time of the study, we chose 4 states (Colorado, Florida, Missouri, Pennsylvania) to reflect variation in geographic region and the ratio of employed RNs to state population (ranging from

Respondent data

Of the 2000 RNs in the mailing sample, 189 were excluded because mailing materials were returned as undeliverable. Surveys were returned by 1310 respondents for an overall response rate of 72%. Of the 1310 respondents, 293 were ineligible (eg, retired, no longer in clinical practice), leaving 1017 surveys available for analysis (67% eligible response rate). Table 1 presents characteristics of the 1017 eligible respondents.

Receipt of influenza vaccination

The majority of respondents (59%, n = 595) reported being vaccinated during

Discussion

This study of RNs in 4 diverse states confirms many aspects of, and adds additional context to, the findings from other, primarily small area studies that have looked specifically at the attitudes and practices of nurses in the United States related to influenza vaccination. The majority of responding RNs was vaccinated in the 2005-2006 influenza season, and vaccination rates were higher among respondents who are particularly targeted by the ACIP recommendation because of chronic conditions or

Conclusion

This study of RNs in 4 states confirms that concern about adverse reactions to influenza vaccine, coupled with questions about vaccine effectiveness, are strongly associated with nonvaccination. Serving a high-risk patient population and being “very aware” of the CDC's recommendation for influenza vaccination of HCP are associated both with increased likelihood of vaccination and with RNs' level of agreement on statements of KAB supportive of influenza vaccination. Future efforts to improve

References (17)

There are more references available in the full text version of this article.

Cited by (57)

  • Mapping vaccine hesitancy-Country-specific characteristics of a global phenomenon

    2014, Vaccine
    Citation Excerpt :

    Two IMs emphasized that health professionals may themselves be vaccine-hesitant. This is of particular concern as health professionals’ knowledge and attitudes about vaccines have been shown to be an important determinant of their own vaccine uptake, their intention to recommend vaccines to their patients, and the vaccine uptake of their patients [14–17]. The observation that vaccine hesitancy is not uniform throughout the country reveals another challenge.

View all citing articles on Scopus

Supported by the Centers for Disease Control and Prevention.

The findings and conclusions in this report are those of the authors and do not necessarily represent the view of the Centers for Disease Control and Prevention.

Conflicts of interest: None to report.

View full text