Disparities in influenza vaccination rates among healthcare personnel, United States, 2007-2008

Background:

In 2006 the Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee have strongly recommended influenza vaccination of healthcare personnel (HCP) to protect HCP from influenza illness and prevent nosocomial influenza transmission..  The Healthy People (HP) 2010 objective for HCP influenza vaccination rate is 60 percent.  Despite these recommendations, the overall influenza vaccination rate of healthcare personnel has remained below 50 per cent.  This overall rate hides disparities within specific HCP groups and settings.

Objective: We describe self-reported influenza vaccination rates of different categories of HCP, and in different medical settings, to identify those most in need of improvement.

Methods: The National Center for Health Statistics conducts the National Health Interview Survey (NHIS) annually.  The NHIS monitors the health of the United States population through the collection and analysis of data on a broad range of health topics.  It is a cross-sectional household interview survey. Sampling and interviewing are continuous throughout each year.  In 2008, 74,236 persons were interviewed, of whom 1,037 were HCP. Among other questions, they were asked if they had received influenza vaccine in the previous 12 months.

Results:

Forty-nine percent (95 % confidence intervals (CI): 45-53) of all HCP reported having received influenza vaccine.  Vaccination rates by HCP type and setting are described in the Table.

HCP Influenza vaccination coverage--NHIS† 2008
Crude Sample Size (n)     Weighted Prevalence     [95% CI]
NHIS Year				2008
Influenza Season				2007/08
Selected HCP groups
Physicians				(  46) 77.9% [62-89]
Nurses				(276) 61.0% [54-68]
Other HCP				(715) 41.3 [36-46]
All HCP groups§				(1037) 49.0% [45-53]
HCP Settings
Ambulatory Health Care				(446) 40.4% [35-46]
Hospital				(415) 63.4% [57-69]
Nursing Home				(176) 36.2% [28-56]
All HCP settings				(1,037) 49.0% [45-53]
____________________
†National Health Interview Survey conducted by the National Center for Health Statistics at CDC,
with U.S. Census Bureau interviewers collecting data primarily using in-person interviews
§Includes all HCP occupations delineated by NHIS -- physicians, nurses, respiratory therapists,
treating HCP's, laboratory technicians, physical therapists, home health aides, and healthcare support.
Source:  CDC, unpublished  www.cdc.gov/nchs

Conclusions: Self-reported influenza vaccination rates of HCP varied widely among different categories of personnel and settings.  The rates for physicians and nurses exceed the HP 2010 objective, and are significantly higher than rates of other HCP.  Hospital HCP vaccination rates are significantly higher than those in ambulatory care or nursing homes.  Additional or alternative approaches to raise vaccination rates for other HCP and for those in ambulatory care and nursing homes are necessary.