Introduction: Immunization guidelines from many countries recommend influenza vaccination of health
care workers (HCW). However, influenza vaccination rates among HCW are universally low. To aid in
designing effective immunization programs we reviewed the literature for studies reporting on (1) selfreported
reasons of HCW regarding vaccination against influenza and (2) predictive factors for influenza
vaccination in HCW.
Methods:We searched PUBMED for relevant publications from 1980 to 2008 with predetermined search
strategies and applied pre-defined criteria for inclusion or exclusion. To be included in the review as a
predictor study, a multivariate analysis must have been conducted.
Results: We included 25 studies relevant to self-reported reasons for rejecting or accepting vaccination.
These studies identified two major reasons for lack of vaccine uptake by HCW: firstly, a wide range of
misconceptions or lack of knowledge about influenza infection; and secondly, a lack of convenient access
to vaccine. In contrast, among studies reporting on reasons for vaccination acceptance, all but two found
that HCW stated self-protection was the most important reason. In the area of “predictive factors for
influenza vaccination”,we included 13 studies. At least five of them identified the following three factors:
previous receipt of influenza vaccine, belief in the vaccine’s effectiveness, and older age.
Conclusion: Our findings indicate that if HCW get immunized against influenza, they do so primarily for
their own benefit and not for the benefit to their patients. Misconceptions about influenza and influenza
vaccine could be improved by education, and organizational barriers could be bridged with sustainable,
structural changes to allow flexible and workplace vaccine delivery.
Introduction: Immunization guidelines from many countries recommend influenza vaccination of health
care workers (HCW). However, influenza vaccination rates among HCW are universally low. To aid in
designing effective immunization programs we reviewed the literature for studies reporting on (1) selfreported
reasons of HCW regarding vaccination against influenza and (2) predictive factors for influenza
vaccination in HCW.
Methods:We searched PUBMED for relevant publications from 1980 to 2008 with predetermined search
strategies and applied pre-defined criteria for inclusion or exclusion. To be included in the review as a
predictor study, a multivariate analysis must have been conducted.
Results: We included 25 studies relevant to self-reported reasons for rejecting or accepting vaccination.
These studies identified two major reasons for lack of vaccine uptake by HCW: firstly, a wide range of
misconceptions or lack of knowledge about influenza infection; and secondly, a lack of convenient access
to vaccine. In contrast, among studies reporting on reasons for vaccination acceptance, all but two found
that HCW stated self-protection was the most important reason. In the area of “predictive factors for
influenza vaccination”,we included 13 studies. At least five of them identified the following three factors:
previous receipt of influenza vaccine, belief in the vaccine’s effectiveness, and older age.
Conclusion: Our findings indicate that if HCW get immunized against influenza, they do so primarily for
their own benefit and not for the benefit to their patients. Misconceptions about influenza and influenza
vaccine could be improved by education, and organizational barriers could be bridged with sustainable,
structural changes to allow flexible and workplace vaccine delivery.
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