INFLUENZA IMMUNIZATION - IMPROVING COMPLIANCE OF HEALTH-CARE WORKERS

OBJECTIVE: In spite of yearly recalls, influenza immunization rates of healthcare workers (HCWs) remained low (10%) at the University Hospit als of Geneva. This study was conducted to identify HCWs' reasons for rejection of immunization, to design specific intervention methods bas ed on these reasons, and to evaluate the impact of such interventions. METHODS: Three departments with high-risk patients (geriatrics, obste trics, and pediatrics) were selected as main targets. Questionnaires w ere distributed in these units. Based on HCWs' perceptions, different intervention methods were designed and used either in these department s only (educational conferences, on-site availability of a vaccination nurse) or in the whole institution (posters, personal letters). Immun ization rates were collected throughout the institution. RESULTS: 797 completed questionnaires from 1,092 HCWs (73%) were returned. Major re asons for immunization rejection were confidence that their bodies' se lf-defense mechanisms would ward off infection (32%), perception of lo w exposure risk (23%), and doubts concerning vaccine efficacy (19%). T he use of intervention methods designed to address these factors incre ased influenza immunization rates in the three targeted departments fr om 13% (95% confidence interval [CI95], 11.4-15.6) in 1995 and 1996 to 37% (CI95, 34.5-40.3) In the following season (P<.001), In all other departments, immunization rates rose from 9% (CI95, 8.5-10.3) to 23% ( CI95, 21.6-24.1; P<.001). Nurses were, and remained, more reluctant to be immunized compared to other HCWs. CONCLUSIONS: Influenza immunizat ion rates can be increased significantly by specific interventions bas ed on local concerns of HCWs, among which educational conferences and the on-site availability of a vaccination nurse appeared important (In fect Control Hosp Epidemiol 1998;19:337-342).