Personal decision-making criteria related to seasonal and pandemic A(H1N1) influenza-vaccination acceptance among French healthcare workers.

BackgroundInfluenza-vaccination rates among healthcare workers (HCW) remain low worldwide, even during the 2009 A(H1N1) pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination.MethodsIn June-July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV) and pandemic (PIV) influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression-tree method.ResultsOf the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (pConclusionsBoth vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model

Study flow chart.

<p>HCW  =  healthcare workers.</p

Factors associated with healthcare workers' vaccinations against seasonal and pandemic A(H1N1) influenza: results of multivariate analysis.

*<p>For SIV the adjusting factors were pandemic vaccination, age, working hours, professional category, ward and center. For PIV the adjusting factors were seasonal vaccination, gender, age, working hours, professional category, ward, living alone, pregnancy and center. **Including obstetrics and pediatrics.</p

Sociodemographic and professional characteristics of the 1,881 study respondents.

<p>HCW = healthcare workers. ICU/ED = intensive care unit/emergency department. SIV = seasonal influenza vaccination. *Including obstetrics and pediatrics.</p

Perception of the benefit/risk ratio of vaccination, according to current vaccination status for paramedical and medical healthcare workers.

<p>NV = nonvaccinated. V = vaccinated. HCW = healthcare workers. A positive perception was defined as agreement (agree, or strongly agree) with the statement “I thought that the benefit of flu vaccination was greater than its related risks”.</p

Classification-and-regression trees (CART) according to seasonal and pandemic A(H1N1) influenza vaccination status for paramedical and medical healthcare workers (HCW).

<p>The overall areas of the rectangles indicate the proportional sizes of the subgroup relative to the root population of HCW. Shaded areas represent the percentages of HCW in each subgroup that were actually vaccinated. The entire population was divided into subgroups based on the statements (reported in italics) that best discriminated between vaccinated and nonvaccinated HCW. At the termination and for each analysis, HCW were subdivided into profiles with high, intermediate and low prevalences of vaccination. Panel A: Seasonal influenza vaccination of paramedical HCW (N = 1,423). Panel B: Pandemic influenza vaccination of paramedical healthcare workers (N = 1,392). Panel C: Seasonal influenza vaccination of medical healthcare workers (N = 390). Panel D: Pandemic influenza vaccination of medical healthcare workers (N = 389).</p