title: Qualitative motivators and barriers to pandemic vs. seasonal influenza vaccination among healthcare workers: a content analysis.
abstract: BACKGROUND
  Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCW) remains a key mode of influenza prevention in healthcare settings. Yet influenza vaccine coverage among HCWs continues to be below recommended targets, in pandemic and non-pandemic settings. Thus, the primary objective of this analysis is to identify motivators and barriers to pandemic (panINFLU) and seasonal influenza vaccination (sINFLU) through the qualitative analysis of HCW provided reasons driving HCW's personal vaccination decisions.
  
  
  METHODS
  Data were collected from a multi-professional sample of HCWs via a cross-sectional survey study, conducted at a tertiary-care hospital in Ontario, Canada. HCW provided and ranked qualitative reasons for personal (1) panINFLU (pH1N1) and (2) sINFLU (2008/2009 season) vaccine uptake and avoidance were used to identify key vaccination motivators and barriers through content analysis methodology.
  
  
  RESULTS
  Most HCW vaccination motivators and barriers were found to be similar for panINFLU and sINFLU vaccines. Personal motivators had the greatest impact on vaccination (panINFLU 29.9% and sINFLU 33.9%). Other motivators included preventing influenza in loved ones, patients, and community, and awareness of HCW role in influenza transmission. In contrast, concerns of vaccine safety and limited HCW knowledge of influenza vaccines (panINFLU 46.2% and sINFLU 37.3%). HCW vaccination during the pandemic was motivated by panINFLU related fear, epidemiology, and workplace pro-vaccination policies. HCW perceptions of accelerated panINFLU vaccine development and vaccine safety compromises, negative views of external sources (i.e. media, pharmaceutical companies, and regulatory agencies) and pandemic management strategies were barriers specific to panINFLU vaccine.
  
  
  CONCLUSIONS
  HCW panINFLU and sINFLU vaccine coverage can increase if future vaccination programs (1) highlight personal vaccination benefits (2) emphasize the impact HCW non-vaccination on family members, patients and community, (3) address HCW vaccine related knowledge gaps, and (4) implement pro-vaccination workplace policies consistent with those in place at the study site during pH1N1.
authors.affiliation: Ontario Agency for Health Promotion and Protection, Infection Prevention and Control, Toronto, ON, Canada; University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada. Electronic address: chatura.prematunge@oahpp.ca.
authors.forename: Chatura
authors.initials: C
authors.lastname: Prematunge
authors.affiliation: University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Canada.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Corace
authors.affiliation: University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: McCarthy
authors.affiliation: University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.
authors.forename: Rama C
authors.initials: RC
authors.lastname: Nair
authors.affiliation: University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: Virginia
authors.initials: V
authors.lastname: Roth
authors.affiliation: University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: Suh
authors.affiliation: Ontario Agency for Health Promotion and Protection, Infection Prevention and Control, Toronto, ON, Canada; University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Garber
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001521:Behavior Therapy; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006282:Health Personnel; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D009864:Ontario; D062606:Tertiary Care Centers; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Content analysis; Healthcare workers; Pandemic influenza vaccine; Qualitative analysis; Seasonal influenza vaccine; pH1N1