Improving influenza vaccination rates in a large health service

Abstract

Influenza vaccination of healthcare workers (HCWs) is an important consideration for all health services. In 2007, Southern Health set a target vaccination rate of 75% for all staff within the health service. To achieve this, an extended vaccination service was implemented that included the use of additional mobile rounds and extra staffing for night and weekend duty. The target of 75% was not achieved, however the overall uptake increased by 14%. To prepare for the 2008 program, a quality activity was undertaken to gain an understanding of why more than 40% of HCWs were still not vaccinated. An in-depth interview was conducted of 20 HCWs to identify common themes of vaccine refusal. Twenty HCWs who were known to have openly refused influenza vaccination, were approached by an experienced infection control nurse consultant and an interview time was arranged. An in-depth interview comprising of six open-ended questions was used in a standardised interview model. Common themes emerged from the in-depth interview, including limited understanding of the importance of influenza vaccination, disbelief of herd immunity, doubt about the protection of influenza vaccine, fear of needles and concern about becoming unwell from the vaccine. The results of the interviews were used to develop strategies for the 2008 program. Education about the importance of influenza vaccination for HCWs was commenced well in advance of the arrival of vaccines for the 2008 program. Information disseminated to HCWs focussed on vaccine effectiveness, risk of illness in HCWs and patients, and the duty of care HCWs provide to patients through vaccination. A declination form was introduced to improve vaccine knowledge and reinforce the importance of duty of care.