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Am J Infect Control. 2014 Apr;42(4):371-5. doi: 10.1016/j.ajic.2013.11.003.

Barriers and facilitators to influenza vaccination and vaccine coverage in a cohort of health care personnel.

Author information

  • 1Center for Health Research, Kaiser Permanente Northwest, Portland, OR. Electronic address:
  • 2Center for Health Research, Kaiser Permanente Northwest, Portland, OR.
  • 3Abt Associates, Inc, Cambridge, MA.
  • 4Scott and White Healthcare, Temple, TX.
  • 5Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA.
  • 6Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.



Annual influenza vaccination is recommended for health care personnel (HCP). We describe influenza vaccination coverage among HCP during the 2010-2011 season and present reported facilitators of and barriers to vaccination.


We enrolled HCP 18 to 65 years of age, working full time, with direct patient contact. Participants completed an Internet-based survey at enrollment and the end of influenza season. In addition to self-reported data, we collected information about the 2010-2011 influenza vaccine from electronic employee health and medical records.


Vaccination coverage was 77% (1,307/1,701). Factors associated with higher vaccination coverage include older age, being married or partnered, working as a physician or dentist, prior history of influenza vaccination, more years in patient care, and higher job satisfaction. Personal protection was reported as the most important reason for vaccination followed closely by convenience, protection of patients, and protection of family and friends. Concerns about perceived vaccine safety and effectiveness and low perceived susceptibility to influenza were the most commonly reported barriers to vaccination. About half of the unvaccinated HCP said they would have been vaccinated if required by their employer.


Influenza vaccination in this cohort was relatively high but still fell short of the recommended target of 90% coverage for HCP. Addressing concerns about vaccine safety and effectiveness are possible areas for future education or intervention to improve coverage among HCP.

Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.


Employee health; Vaccination coverage; Vaccination mandate

[PubMed - indexed for MEDLINE]
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