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Infect Control Hosp Epidemiol. 2002 Oct;23(10):609-14.

Health behavior associated with influenza vaccination among healthcare workers in long-term-care facilities.

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Field Epidemiology Training Program, Population and Public Health Branch, Health Canada, Ottawa, Ontario.



To investigate the health behavior associated with influenza vaccination among healthcare workers (HCWs) in long-term-care facilities.


A cross-sectional, self-administered survey of HCWs, augmented with focus groups to further examine attitudes toward influenza vaccination.


Two long-term-care facilities participated in the survey. The focus groups were held at one of the two facilities.


All HCWs were invited to participate in the survey and all nonmanagerial staff members were invited to participate in the focus groups. The response rate for the survey was 58% (231 of 401).


Vaccinated HCWs had a more positive attitude toward influenza vaccination and a greater belief that the vaccine is effective. This was not accompanied by differences in vaccine knowledge or values of potential preventive outcomes. Nonvaccinated respondents were more likely to believe that other preventive measures, such as washing hands, taking vitamins and supplements, eating a nutritious diet, exercising, and taking homeopathic or naturopathic medications, were more effective than vaccination. Additional findings from the focus groups suggest that HCWs believe that the main purpose of influenza vaccination programs is to protect residents' health at the expense, potential harm, and burden of responsibility of the staff.


This study identifies challenges to and opportunities for improving vaccination rates among HCWs. A message that emphasizes the health benefits of vaccination to staff members, such as including vaccination as part of a staff "wellness" program, may improve the credibility of influenza immunization programs and coverage rates.

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