title: Immunizing health care workers against influenza: a glimpse into the challenges with voluntary programs and considerations for mandatory policies.
abstract: BACKGROUND
  Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of mandatory influenza immunization policies were discussed in key informant interviews with influenza immunization program planners.
  
  
  METHODS
  We conducted telephone interviews with 23 influenza immunization program planners from 21 organizations (7 acute care hospitals, 6 continuing care facilities, and 8 public health organizations) across Canada. We used content analysis to identify themes from the interviews.
  
  
  RESULTS
  Participants used a variety of promotional and educational activities, and many vaccine delivery approaches, to support HCW immunization programs. Barriers to achieving high coverage in HCWs included misconceptions about the safety and effectiveness of the influenza vaccine, negative personal experiences associated with the vaccine, and antivaccine sentiments. Participants mentioned mandatory influenza immunizations as a solution to low coverage. However, they identified challenges with this approach such as obtaining support from stakeholders, enforcement, and limiting personal autonomy.
  
  
  CONCLUSIONS
  Participants believed immunization coverage in health care organizations will continue to be suboptimal using existing program strategies. Although participants discussed mandatory immunization as a way to improve uptake, potential obstacles will need to be addressed for this to be implemented successfully.
authors: Surveillance and Epidemiology, Public Health Ontario, Toronto, Canada.
authors: Susan
authors: S
authors: Quach
authors: Jennifer A
authors: JA
authors: Pereira
authors: Jeffrey C
authors: JC
authors: Kwong
authors: Sherman
authors: S
authors: Quan
authors: Lois
authors: L
authors: Crowe
authors: Maryse
authors: M
authors: Guay
authors: Julie A
authors: JA
authors: Bettinger
mesh_terms: D002170:Canada; D003428:Cross Infection / Q000517:prevention & control; D006282:Health Personnel; D006291:Health Policy; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D007407:Interviews as Topic; D037141:Mandatory Programs; D014611:Vaccination / Q000706:statistics & numerical data*; D035141:Voluntary Programs
chemical_list: D007252:Influenza Vaccines
keywords: Health care personnel; Influenza vaccination; Vaccine coverage