Pandemic influenza A (H1N1) 2009 in a critical care and theatre setting: beliefs and attitudes towards staff vaccination

J Hosp Infect. 2011 Aug;78(4):302-7. doi: 10.1016/j.jhin.2011.02.009. Epub 2011 Apr 9.


West Midlands was particularly affected by the 2009 H1N1 influenza A (pH1N1) pandemic. Vaccination of frontline healthcare professionals (HCPs) aimed to prevent spread to vulnerable patients, minimise service disruption and protect staff. HCPs involved in upper airway management are particularly at risk of aerosol exposure. We assessed the attitudes of these HCPs towards pandemic influenza A (H1N1) 2009 vaccination uptake: primary reasons for acceptance, barriers to vaccination, and knowledge surrounding pH1N1 influenza. We performed a voluntary, anonymous questionnaire survey based in two West Midlands National Health Service Trusts, one month after introduction of the vaccine. In all, 187 useable responses were received (60.5% response rate); 43.8% (N=82) had/intended to receive vaccination. Concern over long term side-effects was the main deterrent (37.4%, N=70). Primary reasons for potentially accepting vaccination were: to protect themselves (36.9%, N=69), to protect family (35.3%, N=66), and to protect patients (10.2%, N=19). Of responders, 76.5% were unsure that the vaccines had undergone suitably rigorous clinical trials to ensure safety; 20.9% correctly identified reported vaccine efficacy. We conclude that pH1N1 vaccination uptake among high risk HCPs remained low, although twice that of peak seasonal influenza vaccination rates. HCPs' knowledge of vaccine efficacy is poor. Barriers to vaccination include concerns over safety profile given the short chronological time-span between the pandemic being declared and vaccine introduction. Side-effects, both acute and chronic, are a significant barrier to vaccination. Further reassurance/education surrounding vaccine safety/efficacy at the time of any future pandemic may improve uptake rates.

MeSH terms

  • Attitude of Health Personnel*
  • Critical Care
  • Cross Infection / prevention & control*
  • Cross Infection / transmission
  • Cross Infection / virology
  • Disease Transmission, Infectious / prevention & control
  • Health Knowledge, Attitudes, Practice*
  • Hospitals
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology*
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / prevention & control*
  • Influenza, Human / transmission
  • Influenza, Human / virology
  • Surveys and Questionnaires
  • Vaccination / statistics & numerical data*


  • Influenza Vaccines