Focus on the Myths: An Approach To Improving Healthcare Worker Influenza Immunization Rates

ISSUE: Every year approximately 200,000 Americans are hospitalized and more than 36,000 die from influenza and influenza-related complications, and influenza is the sixth leading cause of death in the United States; despite longstanding recommendations for healthcare worker immunization from the Centers for Disease Prevention and Control, immunization rates for health care workers average only about 36%. For this pediatric care organization which includes inpatient and outpatient rehabilitative and habilitative services, the employee immunization rate was 41% for the 2003-2004 influenza season. PROJECT: In the summer of 2004, the infection control and employee health coordinators conducted a survey to determine employeesʹ knowledge and beliefs regarding influenza vaccine, and to identify barriers to immunization. A 32% response rate was received. Only 78% of respondents who were immunized and 63% of respondents who were not immunized believed that influenza immunization was a patient safety issue. Of the 140 respondents who were not immunized, 46% stated they had a fear of side effects, 33% feared getting influenza from the vaccine and 18% did not believe they were at risk of contracting influenza. Due to the vaccine shortage for the 2004 season, the project was put on hold. With the support of administration, increasing the employee influenza immunization rate to 50% became an organizational goal in 2005. An educational program and publicity campaign were designed to address the issues identified in the 2004 survey, employee incentives were offered, and a system was developed to track education and immunization rates. RESULTS: For the 2005- 2006 influenza season, 74% of employees had documentation of education regarding influenza and influenza immunization, and 57% of total staff received influenza vaccine. Review of discipline specific data indicated that staff in some clinical areas, therapeutic services and support services did not reach the 50% goal. LESSONS LEARNED: The survey process proved beneficial in identifying employee misconceptions and targeting these issues through education. Tracking also identified areas where different strategies may be needed to increase immunization rates. The organizational goal for 2006 includes increasing the total percentage of employees immunized to 60%, with focus on the clinical areas.