Factors Influencing the Decision to Receive an Influenza Vaccination Among Manufacturing Plant and Day Care Center Employees

Abstract

To improve influenza immunization rates, it is essential to understand why adults are not immunized and the factors that influence their decisions. This information can be used to tailor educational materials and outreach.

Annual influenza vaccination is recommended by the Advisory Committee on Immunization Practices for all individuals above 6 months of age to reduce influenza-related morbidity and mortality (Centers for Disease Control and Prevention [CDC], 2013b). Despite this recommendation, only 43.6% of adults in the United States received an influenza immunization during the 2014-2015 season (CDC, 2015). Influenza can be devastating, affecting the health and productivity of working adults. “Direct medical costs for influenza in adults totaled [US]$8.7 billion including [US]$4.5 billion for adult hospitalizations resulting from influenza-attributable illness” (CDC, 2013a, para 6). In addition, adults aged 18 to 64 years lose 17 million workdays to influenza-related illness (CDC, 2013a).

Multiple factors influence the decision to be vaccinated, including social, disease-related, and vaccine-related factors; habits; general attitudes toward health and vaccines; awareness and knowledge of influenza and vaccines; practical barriers and motivators; and altruism (Wheelock, Thomson, & Sevdalis, 2013). Common reasons for adults not to seek immunizations are mistaken assumptions (e.g., healthy people do not need immunizations) and lack of physician recommendations (Johnson, Nichol, & Lipczynski, 2008).

To improve influenza immunization rates, it is essential to understand why adults do not seek immunizations and what factors influenced their decisions. For this reason, employees of a manufacturing plant and day care center were offered free influenza immunizations and asked to complete a survey regarding factors influencing their decisions to be vaccinated. The Washington State University Institutional Review Board granted this survey exempted status.

A total of 17 manufacturing plant employees and 14 day care center employees were vaccinated and completed the survey. Of the 31 participants, 15 (48.4%) were male and 16 (51.6%) female, ranging in age from 24 years to 64 years. When asked which of these reasons influenced their decision to be vaccinated, the responses were as follows: “I want to protect myself from the flu”—61.2% (19); “I want to protect my friends and family from the flu”—48.3% (15); “It is easy and convenient to get”—48.3% (15); “I want to protect the community from the flu”—29.0% (9); “It was effective at preventing the flu in the past”—19.4% (6); and “My health care provider suggested it”—9.6% (3).

Because two of the highest rated reasons for being vaccinated were “I want to protect myself from the flu” and “I want to protect my friends and family from the flu,” future educational efforts should emphasize how vaccinations prevent illness. Providing immunizations at work is also beneficial because almost half of those surveyed (48%) responded it was convenient to receive the vaccine at work. Surprisingly, the lowest rated reason was “My health care provider suggested it.” Further research is needed to determine whether that response was due to lack of recommendation by health care providers, lack of value placed on health care providers’ recommendations, or other unknown reasons.

Occupational and environmental health nurses can use this information in planning annual influenza immunization programs. Educational sessions should emphasize the benefits of influenza vaccination. Further studies are needed to investigate motivational factors and barriers to being vaccinated against influenza and how this information can be used to improve immunization rates and health outcomes.