Attitudes and practices regarding influenza vaccination among healthcare workers providing services to individuals with spinal cord injuries and disorders

Infect Control Hosp Epidemiol. 2004 Nov;25(11):933-40. doi: 10.1086/502323.


Objective: To examine influenza vaccination status and predictors for vaccine receipt among healthcare workers (HCWs) caring for patients with spinal cord injuries and disorders.

Design: Cross-sectional, nationwide anonymous survey.

Setting: Twenty-three Veterans Affairs spinal cord injury centers.

Participants: One thousand five hundred fifty-six HCWs.

Methods: The primary outcome was staff vaccination status. Independent variables included staff demographic and employment characteristics, health status, attitudes and beliefs about the vaccine, and implications for its use.

Results: The staff vaccination rate was 51%. Leading motivators of vaccine receipt were self-protection (77%) and patient protection (49%). The most common reasons for nonreceipt were concerns about side effects (49%), preventive quality (20%), and inconvenience (14%). Logistic regression results suggested that age of 50 years or older (OR, 1.47; P = .021), male gender (OR, 2.50; P < .001), strong belief in vaccine effectiveness (OR, 19.03; P = .008), and importance of HCW vaccination (OR, 20.50; P = .005) significantly increased the probability of vaccination. Recommending the vaccine to coworkers, patients, or patients' families was also associated with HCW vaccination (OR, 3.20; P < .001). Providers who did not believe the vaccine was protective (P < .001) or effective (P < .001) were less likely to recommend it to patients.

Conclusions: Strategies to increase vaccination rates among HCWs should address concerns about side effects, effectiveness, and protective value of the vaccine and access to it. The impact of provider recommendations should be stressed. Vaccination and subsequent prevention of illness may limit morbidity and mortality, thus benefiting HCWs, healthcare facilities, and patients.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Hospitals, Veterans / statistics & numerical data
  • Humans
  • Influenza Vaccines / therapeutic use*
  • Influenza, Human / prevention & control*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Personnel, Hospital / statistics & numerical data*
  • Sex Distribution
  • Spinal Cord Diseases / therapy*
  • United States


  • Influenza Vaccines