title: Differences in efficiency, satisfaction and adverse events between self-administered intradermal and nurse-administered intramuscular influenza vaccines in hospital workers.
abstract: Vaccinating healthcare workers against influenza takes tens of thousands of hours of work annually. This study was undertaken to determine the acceptability, success rate, and time to vaccinate healthcare workers in nurse-led groups that self-vaccinated with intradermal influenza vaccine compared with nurse-administered intramuscular vaccine.
  
  
  METHODS
  Volunteer hospital workers were randomly assigned to groups that either self-administered intradermal influenza vaccine (Intanza(®)) in a nurse-led group or received nurse-administered intramuscular vaccine (Vaxigrip(®)). Research assistants timed vaccination procedures; pre- and post-injection questionnaires assessed acceptability and reactogenicity.
  
  
  RESULTS
  810 adults, 21-69 years of age, from two study sites were vaccinated: 401 self-administered the intradermal vaccine while 409 received their intramuscular vaccine from a nurse. Of those who self-administered for the first time, 98.5% were successful on their first attempt with an additional 1.5% on their second attempt. Acceptability was high: 96% were very or somewhat certain that they administered the vaccine correctly, 83% would choose intradermal influenza vaccine again and of those, 75% would choose self-administration again, if given the choice. It took 51.3-72.6s per person for the nurses to guide the groups through the self-administration process, which was significantly less time than it took to individually administer the intramuscular vaccines (93.6s).
  
  
  CONCLUSIONS
  Self-administration of intradermal influenza vaccine by people working in healthcare settings is a possible alternative to nurse administered vaccinations, with nurse-led group sessions a good way of teaching the technique while being available to respond to unanticipated problems (NCT01665807).
authors.affiliation: Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada; University of Toronto, 155 College Street, Toronto, ON, Canada. Electronic address: bcoleman@mtsinai.on.ca.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Coleman
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; QE II Health Sciences Centre, Nova Scotia Health Authority, 1276 South Park Street, Halifax, NS, Canada. Electronic address: shelly.mcneil@cdha.nshealth.ca.
authors.forename: Shelly A
authors.initials: SA
authors.lastname: McNeil
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; IWK Health Centre, Nova Scotia Health Authority, 5980 University Avenue, Halifax, NS, Canada. Electronic address: jmlangle@dal.ca.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Langley
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; QE II Health Sciences Centre, Nova Scotia Health Authority, 1276 South Park Street, Halifax, NS, Canada. Electronic address: scott.halperin@dal.ca.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Halperin
authors.affiliation: Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada; University of Toronto, 155 College Street, Toronto, ON, Canada. Electronic address: amcgeer@mtsinai.on.ca.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: McGeer
mesh_terms: D000328:Adult; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000517:prevention & control*; D007271:Injections, Intradermal / Q000009:adverse effects / Q000523:psychology; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010549:Personal Satisfaction; D010564:Personnel, Hospital / Q000523:psychology; D012646:Self Administration / Q000009:adverse effects / Q000523:psychology; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000379:methods*; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D015164:Vaccines, Inactivated; C478242:vaxigrip
keywords: Campaign; Influenza vaccines; Intradermal; Intramuscular; Vaccination