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Work-Site-Based Influenza Vaccination in Healthcare and Non-Healthcare Settings

  • Sarah J. D'Heilly (a1) and Kristin L. Nichol (a1)



To better understand work-site–based programs for influenza vaccination.


Self-administered, mailed questionnaire.


Healthcare and non-healthcare companies.


Random sample of 2,000 members of the American Association of Occupational Health Nurses.


The response rate was 55%, and 88% of the respondents were employed by companies sponsoring work-site influenza vaccination. Thirty-two percent of respondents worked for healthcare and healthcare-related services companies. Healthcare companies were more likely to sponsor worksite-based vaccination (94% vs 85%; P < .0001) compared with non-healthcare companies. Healthcare companies were also more likely to encourage vaccination of high-risk employees (70% vs 55%; P < .0001) and cover its cost (86% vs 61%; P < .0001). Multivariate logistic regression was used to determine factors associated with highly successful vaccination. Being a healthcare-related company (OR, 2.1; CI95 1.4–3.2; P < .0001), employers covering the vaccination cost (OR, 3.1; CI95, 1.4–6.6; P = .004), having more experience with work-site vaccination (OR, 1.6; CI95, 1.0–2.4; P = .036), and management encouraging vaccination (OR, 2.6; CI95, 1.4–4.9; P = .002) were associated with highly successful programs.


Most of the occupational health nurses surveyed work for employers sponsoring work-site vaccination, and 32% were employed by healthcare and related services companies. Healthcare companies were more likely to sponsor worksite–based vaccination and to vaccinate most of their employees; however, only 18% had vaccination rates higher than 50%. Strategies need to be developed to increase vaccination rates so that benefits of vaccination can be realized by employers and employees.


Corresponding author

VA Medical Center (111), One Veterans Drive, Minneapolis, MN 55417


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1. Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices. MMWR 2003;52(RR-8):136.
2. Thompson, WW, Shay, DK, Weintraub, E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289:179186.
3. Monto, AS, Sullivan, KM. Acute respiratory illness in the community: frequency of illness and the agents involved. Epidemiol Infect 1993;110:145160.
4. Kavet, J. A perspective on the significance of pandemic influenza. Am J Public Health 1977;67:10631070.
5. Meltzer, MI, Cox, NJ, Fukuda, K. The economic impact of pandemic influenza in the United States: priorities for intervention. Emerg Infect Dis 1999:5:659671.
6. Adams, PF, Hendershot, GE, Marano, MA. Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 1999:10:1258.
7. Smith, A. Effects of cold and influenza on human performance. J Soc Occ Med 1989;39:6568.
8. Nichol, KL, Lind, A, Margolis, KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995;333:889893.
9. Keech, M, Scott, AJ, Ryan, PJ. The impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population. Occup Med 1998;48:8590.
10. Bridges, CB, Thompson, WW, Meltzer, MI, et al. Effectiveness and cost-benefit of influenza vaccination of health working adults: a randomized controlled trial. JAMA 2000;248:16551663.
11. Leighton, L, Williams, M, Aubery, D, Parker, SH. Sickness absence following a campaign of vaccination against influenza in the workplace. Occup Med 1996;46:146150.
12. Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riodan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281:908913.
13. Nichol, KL. Cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza. Arch Intern Med 2001;161:749759.
14. Nichol, KL. The efficacy, effectiveness and cost-effectiveness of inactivated influenza virus vaccines. Vaccine 2003;21:17691775.
15. Nichol, KL, Mallon, KP, Mendelman, PM. Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine. Vaccine 2003;21:22072217.
16. Ni, H, Schiller, J, Hao, C, RA, Cohen, Barnes, P. Early Release of Selected Estimates Based on Data From the 2002 National Health Interview Survey. Hyattsville, MD: National Center for Health Statistics; 2003. Available at Accessed June 16, 2004.
17. Spradey, E, Johnson, A, Sochalski, J, Fritz, M, Spencer, W. March 2000: Findings From the National Sample Survey of Registered Nurses. Rockville, MD: U.S. Department of Health and Human Services, Health Resources and Service Administration; 2002. Available at Accessed April 21, 2004.
18. Centers for Disease Control and Prevention. Vaccine-preventable diseases: improving vaccination coverage in children, adolescents, and adults. MMWR 1999;48(RR-8):115.
19. Chapman, GB, Coups, EJ. Predictors of influenza vaccine acceptance among healthy adults. Prev Med 1999;29:249262.
20. Blue, CL, Valley, JM. Predictors of influenza vaccine: acceptance among healthy adult workers. AAOHN J 2002;50:227233.
21. Centers for Disease Control and Prevention. Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS): Supplement B. Sars Surveillance. Atlanta, GA: Centers for Disease Control and Prevention; 2003. Available at Accessed November 24, 2003.
22. Asch, DA, Jedrziewski, MK, Christakis, NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997:50:11291136.


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