Comparison of influenza vaccination among clinical and nonclinical health care personnel (HCP), United States, early 2012-13 influenza season

Background: HCP vaccination can reduce influenza complications among themselves, family members, co-workers, and patients. Despite recommendations for annual HCP influenza vaccination, coverage remains below 70%, with clinical HCP coverage higher than nonclinical HCP coverage although both are at risk. We examined HCP employment characteristics to understand factors associated with vaccination. Methods: Data from a November 2012 national internet-panel survey of HCP were used to assess self-reported vaccination status and employment characteristics. Nonclinical HCP reported working as administrative staff, managers, or support staff (e.g., housekeeping). The sample was weighted to reflect the U.S. HCP population. Of HCP starting the survey, 1,976 were eligible for analysis (95%). We compared clinical (n=1,534) and nonclinical (n=442) HCP using weighted analyses. Results: Coverage was higher among clinical vs. nonclinical HCP (65.7% vs. 54.7%). Compared to clinical HCP, nonclinical HCP were less likely to work in hospitals (39.3% vs. 33.9%) and report employer vaccination requirements (23.6% vs. 18.7%). The majority of HCP with employer requirements worked in hospitals. In hospital settings with employer requirements, vaccination coverage among clinical HCP was 92.4% vs. 76.9% among nonclinical HCP peers. In non-hospital settings without employer requirements, vaccination coverage among clinical HCP was 47.7% vs. 42.6% among nonclinical HCP peers. Conclusions: While employer requirements were associated with higher vaccination among clinical and nonclinical HCP, requirements alone did not ensure all HCP were vaccinated. Barriers to vaccination should be assessed and addressed as part of a comprehensive HCP immunization strategy, particularly among nonclinical HCP and in non-hospital settings without employer requirements.