Influenza vaccination coverage determinants among employees of the nazareth hospital in Israel

Background: Health care workers bear the risk of both contracting influenza from patients and transmitting it to them. Although influenza vaccine is the most effective and safest public health measure against influenza and its complications, and despite recommendations that HCWs be vaccinated, influenza vaccination coverage among them remains low. Objectives: To characterize influenza vaccination coverage and its determinants among employees in an Arab hospital in Israel. Methods: An anonymous self-administered questionnaire was distributed among employees involved in patient care in the winter of 2004-2005 at Nazareth Hospital in Israel. The questionnaire included items related to health demographic characteristics, health behaviors and attitudes, knowledge and attitude concerning influenza vaccination, and whether the respondent had received the flu shot during the previous winter or any other winter. Results: The overall rate of questionnaire return was 66%; 256 employees participated in the study. The immunization coverage rate was 16.4%, similar to that reported for other hospitals in Israel. Logistic regression analysis demonstrated that influenza vaccination coverage was significantly and solely associated with the presence of chronic illness and influenza vaccination. Conclusions: Influenza vaccination coverage among Nazareth Hospital health care workers was low. They did not view themselves as different from the general population with regard to vaccination. Three years after the study, an intervention program was launched with the aim of increasing knowledge on the efficacy and safety of the vaccine; it stressed the importance of vaccinating HCWs and administering the vaccine at the workplace. The program led to a 50% increase in vaccination coverage.