Health care workers' influenza vaccination: motivations and mandatory mask policy.
BACKGROUND
Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced.


OBJECTIVE
To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy.


METHODS
A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed.


RESULTS
There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%).


CONCLUSIONS
The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW.
Service of Occupational Medicine, Institute for Work and Health, CH-1066 Epalinges - Lausanne, Switzerland, victor.dorribo@chuv.ch.
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Dorribo
Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland.
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Lazor-Blanchet
Emergency Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland.
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O
Hugli
Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland, Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland.
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Zanetti
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006291:Health Policy; D006761:Hospitals; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D008397:Masks / Q000706:statistics & numerical data*; D009042:Motivation; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data; D058873:Pandemics / Q000517:prevention & control*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D014611:Vaccination
D007252:Influenza Vaccines
Health care workers; microbiological hazards; occupational health policy; risk management; vaccination; workplace health promotion.