Impact of a customized educational program on knowledge and beliefs about influenza and vaccination among working adults

Influenza vaccination rates remain low despite aggressive educational campaigns about universal vaccination in response to the novel 2009 H1N1 pandemic. A 63-item survey assessed industrial employees' perceptions and knowledge about influenza and vaccination in May-June 2010. Results were used to enhance educational interventions and increase vaccine uptake. Respondents (N=1,000) reflected the demographics of the population (60% male; mean age 44 years). Only 43% of vaccinated employees reported physician recommendation was a reason for receiving vaccine. Unvaccinated employees believed vaccine could make them ill (61%), is unnecessary for healthy adults (49%), is ineffective (36%), or is not advised by their physician (22%). Most survey respondents understood influenza is more serious than a “bad cold” (87%) and can be transmitted by coughing or sneezing (85%). However, misconceptions were common. Many respondents believed influenza is “stomach flu” (38%), vaccination can cause long-term health problems (39%), or vaccine can transmit influenza (49%). Only 50% knew about recommendations for universal vaccination. Customized educational interventions, designed in collaboration with factory workers, addressed employees' concerns and misconceptions. Information, including colorful images and cartoons, was distributed via flyers, newsletters, posters, a health fair, and factory health coaches. A follow-up survey (N=767) revealed no significant changes in knowledge or beliefs. Even a highly-customized educational campaign was not effective at shifting perceptions about vaccination among workers, given strongly-held beliefs and a lack of physician recommendation for universal vaccination. New strategies, such as repositioning immunization as a community initiative rather than a medical treatment, are needed to increase vaccination rates.