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Factors Associated with Increased Healthcare Worker Influenza Vaccination Rates: Results from a National Survey of University Hospitals and Medical Centers

Published online by Cambridge University Press:  02 January 2015

Thomas R. Talbot*
Departments of Medicine and Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Timothy H. Dellit
Department of Medicine, Harborview Medical Center, Seattle, Washington
Joan Hebden
Department of Infection Control, University of Maryland Medical Center, Baltimore, Maryland
Danny Sama
University HealthSystem Consortium, Oak Brook, Illinois
Joanne Cuny
University HealthSystem Consortium, Oak Brook, Illinois
A-2200 Medical Center North, 1161 21st Ave South, Vanderbilt University Medical Center, Nashville, TN 37232, (



To ascertain which components of healthcare worker (HCW) influenza vaccination programs are associated with higher vaccination rates.




University-affiliated hospitals.


Participating hospitals were surveyed with regard to their institutional HCW influenza vaccination program for the 2007-2008 influenza season. Topics assessed included vaccination adherence and availability, use of declination statements, education methods, accountability, and data reporting. Factors associated with higher vaccination rates were ascertained.


Fifty hospitals representing 368,696 HCWs participated in the project. The median vaccination rate was 55.0% (range, 25.6%-80.6%); however, the types of HCWs targeted by vaccination programs varied. Programs with the following components had significantly higher vaccination rates: weekend provision of vaccine (58.8% in those with this feature vs 43.9% in those without; P = .01), train-the-trainer programs (59.5% vs 46.5%; P = .005), report of vaccination rates to administrators (57.2% vs 48.1%; P = .04) or to the board of trustees (63.9% vs 53.4%; P = .01), a letter sent to employees emphasizing the importance of vaccination (59.3% vs 47%; P = .01), and any form of visible leadership support (57.9% vs 36.9%; P = .01). Vaccination rates were not significantly different between facilities that did and those that did not require a signed declination form for HCWs who refused vaccination (56.9% vs 55.1%; P = .68), although the precise content of such statements varied.


Vaccination programs that emphasized accountability to the highest levels of the organization, provided weekend access to vaccination, and used train-the-trainer programs had higher vaccination coverage. Of concern, the types of HCWs targeted by vaccination programs differed, and uniform definitions will be essential in the event of public reporting of vaccination rates.

Original Articles
Copyright © The Society for Healthcare Epidemiology of America 2010

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