Attitudes and Beliefs Associated with Influenza Vaccination and Support for Mandatory Healthcare Worker Vaccination among Allied Health Providers, Technical Staff, and Medical Students

Background: Healthcare workers (HCW) are at risk for occupational influenza infection and can serve as vectors for healthcare-associated influenza transmission. Although influenza vaccination is recommended for all HCW, little is known about the determinants of vaccine uptake among allied health providers (AHP), technical staff (TS), and medical students (MS) and whether these groups support mandatory HCW influenza vaccination. Objective: To identify attitudes and beliefs associated with influenza vaccine uptake and support of mandatory vaccination among different groups of HCW in order to inform future influenza vaccination efforts. Methods: Self-administered, printed surveys assessed vaccination status, attitudes and beliefs about vaccination, and support for mandatory influenza vaccination among AHP (physical and occupational therapists and social workers), TS (radiology technologists, respiratory therapists, emergency department and patient care technicians) and third year MS. Univariable analysis was used to identify associations between attitudes and beliefs and self-reported vaccine uptake and support for mandatory vaccination. Results: Surveys were completed by 416 individuals (116 AHP, 122 TS, and 178 MS). In all groups, a high perceived risk of occupational influenza infection was associated with vaccine uptake while vaccination was less frequent among those concerned about long term vaccine effects (p<0.05 for all). Perceived benefit of vaccination for the HCW and the HCW’s family was associated with vaccine uptake among AHP and TS. Perceived benefit to patients and vaccination recommendations from family, coworkers, and personal physicians were associated with vaccine uptake among AHP. Trust in the hospital administration’s influenza-related communication was associated with vaccine uptake among TS. Mandatory vaccination was supported by 46% of AHP, 53% of TS and 78% of MS. In all groups, perceptions of coworker support, a high risk of HCW influenza infection, vaccine efficacy, and patient benefit from HCW vaccination were associated with support for mandatory vaccination. In addition, TS and MS who reported convenient vaccine access and AHP and TS who received an influenza vaccine supported mandatory vaccination. Conclusions: Most health care facilities have been unable to increase HCW influenza vaccination rates to desired levels in the absence of a vaccine mandate. This study found that beliefs and concerns associated with vaccination and support for mandatory vaccination differ among HCW groups. Thus, efforts to increase vaccine uptake and gain support for mandatory vaccination that address specific concerns and beliefs of each group may be more effective than “one size fits all” campaigns. The impact of job-specific educational messages on vaccine uptake should be studied.