Seasonal and 2009 H1N1 influenza vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination among secondary school teachers and staff.
OBJECTIVE
Teachers, like healthcare workers, may be a strategic target for influenza immunization programs. Influenza vaccination is critical to protect both teachers and the students they come into contact with. This study assessed factors associated with seasonal and H1N1 influenza vaccine uptake among middle- and high-school teachers.


METHODS
Participants were recruited from two counties in rural Georgia. Data were collected from surveys in September 2009 and May 2010. Multivariate logistic regression was used to assess the association between teachers' attitudes toward seasonal and H1N1 influenza vaccination and vaccine uptake.


RESULTS
Seventy-eight percent of teachers who planned to receive seasonal influenza vaccine and 36% of those who planned to receive H1N1 influenza vaccine at baseline reported that they did so. Seasonal vaccine uptake was significantly associated with perceived severity (odds ratio [OR] 1.57, P = 0.05) and self-efficacy (OR 4.46, P = 0.006). H1N1 vaccine uptake was associated with perceived barriers (OR 0.7, P = 0.014) and social norms (OR 1.39, P = 0.05). The number one reason for both seasonal and H1N1 influenza vaccine uptake was to avoid getting seasonal/H1N1 influenza disease. The number one reason for seasonal influenza vaccine refusal was a concern it would make them sick and for H1N1 influenza vaccine refusal was concern about vaccine side effects.


CONCLUSIONS
There is a strong association between the intention to be vaccinated against influenza (seasonal or 2009 H1N1) and actual vaccination uptake. Understanding and addressing factors associated with teachers' influenza vaccine uptake may enhance future influenza immunization efforts.
Emory University, School of Medicine, Atlanta, GA, USA. lgargan@emory.edu
Lisa M
LM
Gargano
Julia E
JE
Painter
Jessica M
JM
Sales
Christopher
C
Morfaw
Ladawna M
LM
Jones
Dennis
D
Murray
Gina M
GM
Wingood
Ralph J
RJ
DiClemente
James M
JM
Hughes
D000328:Adult; D000368:Aged; D005178:Faculty; D005260:Female; D005845:Georgia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012574:Schools; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
D007252:Influenza Vaccines
Public Health Nurs. 2006 Nov-Dec;23(6):506-15
17096775
MMWR Morb Mortal Wkly Rep. 2010 Apr 2;59(12):357-62
20360669
Health Educ Monogr. 1978 Winter;6(4):394-405
299611
Vaccine. 2009 Jun 19;27(30):3935-44
19467744
Science. 2006 Feb 3;311(5761):615-6
16456066
Euro Surveill. 2010 Feb 11;15(6):
20158980
Eur J Public Health. 2010 Oct;20(5):490-4
20444821
Vaccine. 2009 Sep 25;27(42):5732-4
19679219
Pediatrics. 2004 Oct;114(4):948-52
15466089
MMWR Morb Mortal Wkly Rep. 2010 Apr 30;59(16):477-84
20431523
J Dev Behav Pediatr. 2005 Dec;26(6):441-52
16344662
MMWR Morb Mortal Wkly Rep. 2010 Apr 2;59(12):363-8
20360670
Ann Acad Med Singap. 2010 Apr;39(4):307-6
20473457
Clin Pediatr (Phila). 2007 Jun;46(5):408-17
17556737
Vaccine. 2010 Jun 17;28(28):4499-505
20451639
MMWR Morb Mortal Wkly Rep. 2009 Dec 25;58(50):1401-5
20032923
Vaccine. 2008 Mar 10;26(11):1408-10
18313179
N Engl J Med. 2010 Jun 3;362(22):e65
20484390
BMC Infect Dis. 2010 Apr 19;10:99
20403201
Lancet. 2010 Mar 27;375(9720):1100-8
20096450
Vaccine. 2008 Jun 2;26(23):2942-8
18448210
J Womens Health (Larchmt). 2009 Oct;18(10):1679-86
19785564
Pediatrics. 2006 Feb;117(2):e268-77
16452334
BMC Public Health. 2010 Mar 14;10:130
20226093
Pediatrics. 2001 Dec;108(6):E99
11731626
Arch Med Res. 2009 Nov;40(8):705-11
20304260
Pediatrics. 2006 Feb;117(2):e157-63
16452325
J Gen Intern Med. 2009 Dec;24(12):1311-3
19838758