title: Vaccination of health care workers for influenza: promote safety culture, not coercion.
abstract: OBJECTIVE
  In British Columbia (BC), Canada, all health care facilities must have a written staff policy on influenza immunization that includes notice that non-immunized staff can be excluded from work without pay during an influenza outbreak in the facility. In light of this policy, our objectives were to explore the views of BC health care workers (HCWs) regarding how best to promote vaccine uptake.
  
  
  METHODS
  Long-term care, and acute and community health sites in three of six health regions were divided into thirds, according to their previous season's vaccine uptake rates, and the upper and lower thirds targeted. Ten focus groups were held. NVivo software (QSR International) and a separate editing style were used for analysis.
  
  
  RESULTS
  Four dominant themes emerged: knowledge, communication, perceived punitive nature of workplace policy, and safety climate. HCWs across all focus groups noted that influenza campaign communications should include reinforcement of basic infection control, workplace health and healthy lifestyle choices that affect overall health. HCWs indicated that they wanted a workplace policy that is easy to understand, respectful of individual choice and not punitive.
  
  
  CONCLUSIONS
  Our findings highlight the importance of comprehensive approaches, a message that has not appeared as strongly in previous literature. Focus group participants pointed out the importance of health and safety at work generally and felt that creating a healthy workplace culture is necessary to promoting vaccine uptake. Future vaccine promotion initiatives should be integrated into facility-wide workplace health campaigns and care taken to ensure that vaccination campaigns do not appear coercive to HCWs.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC. annalee.yassi@ubc.ca
authors.forename: Annalee
authors.initials: A
authors.lastname: Yassi
authors.forename: Karen
authors.initials: K
authors.lastname: Lockhart
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
authors.forename: Isobel
authors.initials: I
authors.lastname: McDonald
mesh_terms: D001291:Attitude of Health Personnel; D001955:British Columbia; D003068:Coercion; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control* / Q000821:virology; D015279:Organizational Culture; D016134:Organizational Policy
chemical_list: D007252:Influenza Vaccines