Nurse Focus Groups on Influenza Vaccination Pascale Wortley, MD, MPH National Immunization Program CDC

Objectives Collect information that will help develop strategies to increase currently low influenza vaccination rates among nurses

Methods 8 focus groups: 4 in Birmingham, 4 in Detroit In each city: 2 groups of vaccinated and 2 groups of unvaccinated nurses Black-White mix

Demographics 54/71 RNs were hospital-based Range of hospital settings Most were female, had >5 years experience, were >35

Attitudes and beliefs about influenza and influenza vaccine Lack of information, not very different from general public. Vaccinated nurses more knowledgeable than unvaccinated Misconceptions (not sure vaccine works, concerned it will make them ill)

Attitudes, cont’d Never get sick, not in a high risk group Firm believers in handwashing Distrust (only mentioned in Birmingham) Avoid sick leave

Information needs Many felt they did not have adequate information, lack of detailed information targeted specifically to nurses Wanted more “evidence-based statistics” Presented in brief format

Knowledge around ACIP recommendations Mixed knowledge of ACIP recommendation Generally not aware that reason for recommendation is to protect patients (reducing sick days frequently mentioned) Most nurses agreed that wider knowledge of this might influence nurses to get vaccinated

Their work place vaccination programs Inconvenient Generally must get vaccination on their own time Many who were vaccinated were simply because it had been made easy for them (brought to them) Lack of strong or effective promotion Passive approach: posters, flyers Missed opportunities, e.g. tie in with annual PPD Vaccine available free at work

Attitudes towards mandatory offering of vaccine Mix of positive and negative Might be effective, as long as opt out form available “We have so many tests and other things that are mandatory…” Could incite more negative feelings towards vaccination Disciplinary/liability concerns Hidden agenda? (employers monitoring sick time)

What would get them to be vaccinated? Easier of access More active promotion More information

Role of nurses in promoting vaccination Unvaccinated nurses less comfortable with promoting vaccination Among those who were comfortable, great enthusiasm for playing a role

Conclusions Need to reach out more to nurses through appropriate channels Need more proactive vaccination programs in hospitals putting the onus on the hospital rather than on the nurses Need to be more clear about why nurses should be vaccinated Need to expand educational efforts through appropriate channels

Next steps Field survey in a few states to obtain quantitative information Use information obtained here to inform hospital immunization programs