Tailor your message to boost flu vaccine
November 1, 2003 3 minutes read
Tailor your message to boost flu vaccine
Reasons for rejecting vaccine vary by unit
If you’re struggling to improve your influenza vaccination rates, consider this: You may need to tailor your message to particular hospital units.
A survey of 1,000 health care workers at 15 children’s hospitals found an overall median rate of vaccination of 53%. But the vaccination patterns varied by unit, as did attitudes about the vaccine, says lead author Kris Bryant, MD, assistant professor of pediatrics at the University of Louisville and hospital epidemiologist at Kosair Children’s Hospital in Louisville.
"In general, health care workers who worked in high-risk areas — the neonatal intensive care unit [NICU], pediatric intensive care unit [PICU], and oncology — had rates that were higher than the hospital rates at large," she says. "Potentially, those people are getting the message. They know the children they work with are at risk for severe complications from influenza, and they are getting immunized in greater numbers than health care workers at large."
In fact, the No. 1 factor that health care workers said "strongly influences" their decision to get the vaccine was "the desire to protect one’s patients," Bryant says. At eight hospitals, the influenza vaccination rate was greater than 50% in all high-risk units. At one hospital, the PICU and oncology units had a 100% vaccination rate. Still, many health care workers even in high-risk units are not getting the vaccine. "I think there is a disconnect," she adds. "Many health care workers don’t perceive that they can become vectors of influenza and that there can be real consequences for real children [at pediatric hospitals]."
The study was a project of the Pediatric Prevention Network, a collaboration between the National Association for Children’s Hospitals and Related Institutions and the Centers for Disease Control and Prevention.
To boost vaccination, the network sent out educational materials and promotional posters. They also sent letters to hospital administrators stressing the importance of influenza vaccination. They asked hospitals about how they conducted their influenza campaigns. "We found almost universally [that] hospitals provided free vaccine to employees," Bryant says. "That doesn’t seem to matter. Employees don’t take advantage of it even though it’s free."
Why don’t health care workers get the vaccine? The reasons differed by unit. Employees in the NICU were most likely to say they were worried that the vaccine actually would cause influenza. (The vaccine uses an inactivated virus and cannot cause disease.) They also were more likely to claim they had an allergy to the vaccine. In the PICU, workers reported a fear of injection and of side effects. Oncology employees who were not vaccinated claimed that they never get the flu, anyway.
"What that suggested to us is that you may need to have focused campaigns within a hospital," Bryant says. "You need to know the concerns of the group. The approach that gets your NICU immunized may not work two floors up when you talk to the PICU health care workers."
Just correcting misperceptions and providing more education won’t be enough, she cautions. Even at Kosair, there is a disparity in vaccination rates, which are about 90% in the PICU and 80% in oncology, but only about 50% in the NICU.
"I am not sure that education will ever be enough," she adds. "Our own experience is a good example of that. In the units where we have had great success in getting people immunized, the support has been top down. [The message is,] You work in this unit with high-risk kids, we think it’s important that you get the vaccine.’"
If youre struggling to improve your influenza vaccination rates, consider this: You may need to tailor your message to particular hospital units.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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