title: Attitudes of health care workers to influenza vaccination: why are they not vaccinated?
abstract: BACKGROUND
  Compliance rates with influenza vaccination among health care workers (HCW) are historically low. Although a safe and effective vaccine is available, the reasons for such poor compliance are not well understood.
  
  
  METHODS
  After a campaign encouraging HWC to vaccinate against influenza, we conducted an epidemiologic survey to evaluate the reasons for compliance and accompanied the impact of these measures (campaign and questionnaire) during the subsequent 2 years.
  
  
  RESULTS
  Compliance rate was 34.4%. Multivariate analysis showed that "older age" (P = .008), "believing that most departmental colleagues had been vaccinated" (P < .0001), and "having cared for patients suffering from severe influenza" (P = .031) were significantly associated with compliance with influenza vaccination. The main reason given for being vaccinated was "individual protection" and, to a lesser extent, "protection for the patient." In subsequent years, compliance rates among those participating in the survey fell to 20.2% in 2004, when the only measure taken was the questionnaire, and to 12.75% in 2005, when no educational intervention was scheduled.
  
  
  CONCLUSIONS
  We conclude that a better understanding of HCW's negative attitude regarding influenza vaccination is needed as are more appealing and convincing continuous education programs, to ensure motivation for influenza vaccination over a longer period.
authors.affiliation: Virology Laboratory, Institute of Tropical Medicine of University of São Paulo, São Paulo, Brazil.
authors.forename: Irvin Jo
authors.initials: IJ
authors.lastname: Takayanagi
authors.forename: Maria Regina Alves
authors.initials: MR
authors.lastname: Cardoso
authors.forename: Silvia F
authors.initials: SF
authors.lastname: Costa
authors.forename: Marion Elke S
authors.initials: ME
authors.lastname: Araya
authors.forename: Clarisse M
authors.initials: CM
authors.lastname: Machado
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001938:Brazil; D003428:Cross Infection / Q000517:prevention & control; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017053:Infection Control / Q000379:methods; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D007318:Inservice Training / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D013337:Students, Medical
chemical_list: D007252:Influenza Vaccines