Review: interventions to increase influenza vaccination among healthcare workers in hospitals

Abstract

Please cite this paper as: Hollmeyer et al. (2012) Review: interventions to increase influenza vaccination among healthcare workers in hospitals. Influenza and Other Respiratory Viruses 7(4), 604–621.Annual influenza vaccination rates among hospital healthcare workers (HCW) are almost universally low despite recommendations from WHO and public health authorities in many countries. To assist in the development of successful vaccination programmes, we reviewed studies where interventions aimed to increase the uptake of influenza vaccination among hospital HCW. We searched PUBMED from 1990 up to December 2011 for publications with predetermined search strategies and of pre‐defined criteria for inclusion or exclusion. We evaluated a large number of ‘intervention programmes’ each employing one or more ‘intervention components’ or strategies, such as easy access to vaccine or educational activities, with the goal to raise influenza vaccine uptake rates in hospital HCW during one influenza season. Included studies reported results of intervention programmes and compared the uptake with the season prior to the intervention (historical control) or to another intervention programme within the same season that started from the same set of baseline activities. Twenty‐five studies performed in eight countries met our selection criteria and described 45 distinct intervention programmes. Most studies used their own facility as historical control and evaluated only one season. The following elements were used in intervention programmes that increased vaccine uptake: provision of free vaccine, easy access to the vaccine (e.g. through mobile carts or on‐site vaccination), knowledge and behaviour modification through educational activities and/or reminders and/or incentives, management or organizational changes, such as the assignment of personnel dedicated to the intervention programme, long‐term implementation of the strategy, requiring active declination and mandatory immunization policies. The number of these components applied appeared to be proportional to the increase in uptake. If influenza uptake in hospital HCW is to be increased on sustained basis, hospital managers need to be committed to conduct a well‐designed long‐term intervention programme that includes a variety of co‐ordinated managerial and organizational elements.

Understanding motivators and barriers of hospital-based obstetric and pediatric health care worker influenza vaccination programs in Australia

“…That many participants could identify ways to improve the rotating trolleys is important. While the use of rotating trolleys or mobile carts have previously been seen as a positive in other studies, 21 identifying ways in which to build on this are important if access to greater numbers of HCWs is to be achieved.…”

“…Previous studies have identified that free cost, as well as other incentives such as lollipops or chocolate may act as a sufficient motivator for staff. 21 Thirdly, senior support for the program correlated to a positive ward/department culture toward the program. Wards where a dialog about the program existed between HCWs or where there was strong senior/management support fostered a positive culture toward the program.…”

“…While the reasons for and against influenza vaccinations have been well studied in other developed countries, [21][22][23][24][25][26][27][28] it is unclear as to whether these reasons are similar or different in Australian HCWs. Additionally, it is possible that the reasons for and against influenza vaccinations might differ for Australian HCWs serving pediatric 12 or obstetric populations compared with other patient groups.…”

Factors affecting uptake of recommended immunizations among health care workers in South Australia

“…[1][2][3][4][5][6][7] Despite this, HCW uptake of recommended vaccines is low 2,[8][9][10][11][12][13][14][15][16] , particularly for seasonal influenza and pertussis. 13,[16][17][18][19] In Australia, both pertussis and seasonal influenza vaccines are recommended for all HCWs 17 however providing free influenza vaccine is a policy decision for each hospital or state and is not uniform across Australia.…”

Influenza immunization among Canadian health care personnel: a cross-sectional study

“…32,[46][47][48][49][50] Some research highlighted the beneficial impacts of enhanced education and the use of "champions" to increase coverage, 49,50 whereas others suggested the need for a larger paradigm shift to a culture of vaccine promotion. 32,48,51 Despite this research at the organizational level, further studies focused on individual health care occupations, such as those identified here, and their specific concerns are needed; targeted strategies can then help bolster immunization coverage within the respective group.…”