LACK OF COMPLIANCE WITH INFLUENZA IMMUNIZATION FOR CARETAKERS OF NEONATAL INTENSIVE-CARE UNIT PATIENTS

Background: Both the Centers for Disease Control and Prevention and th e American Academy of Pediatrics have recommended influenza immunizati ons for neonatal intensive care unit staff. Compliance rates for influ enza immunization among neonatal intensive care unit staff have not ye t been reported. Methods: To determine both the rates and the associat ed factors for compliance between 1990 and 1993 among neonatal intensi ve care unit nursing staff, interviews were conducted at three Hartfor d area hospitals by means of a structured questionnaire. Results: Comp liance rates at the three hospitals were 15% in 1990 to 1991, 20% in 1 991 to 1992, and 17% in 1992 to 1993 (89% sampling of all nurses with direct patient care). Sixty-three percent were not immunized between 1 991 and 1993, 26% were vaccinated once, 9% were vaccinated twice, and 2% were vaccinated three times within the 3-year period. Convictions r egarding vaccine safety and effectiveness, concern about getting influ enza, and awareness of national recommendations for annual influenza i mmunization were shown to be associated with vaccination compliance. C oncern over exposing neonates, peer influence, pain from injection, an d previous adverse reaction were not statistically significant factors differentiating compliers from noncompliers. Conclusions: There is a poor acceptance of the influenza vaccine among our neonatal intensive care unit nursing staff. Educational and research efforts directed tow ard influenza risks among neonates and vaccine safety and effectivenes s, along with incentives to comply, may improve compliance rates.