Impact of Severe Acute Respiratory Syndrome and the Perceived Avian Influenza Epidemic on the Increased Rate of Influenza Vaccination Among Nurses in Hong Kong

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Abstract
Objective.: To determine the rate of influenza vaccination and the factors associated with the vaccination's acceptance among nurses in Hong Kong.Design.: Cross-sectional survey.Participants.: Nurses practicing between 2003 and 2007.Methods.: A questionnaire was sent to all nurses registered with any of the 3 nursing associations that participated in this study.Results.: A total of 941 completed questionnaires were available for analysis, though not all nurses responded to every question (response rate, 33.5%-36.3%). Vaccination rates in 2006 and 2007 were 57.2% and 46.2%, respectively. Nurses who were vaccinated in 2006 were more likely to get vaccinated in 2007 (P<.01); 56% of the nurses perceived influenza vaccine as being effective against influenza. The perceived effectiveness of influenza vaccine was a consistent predictor of rates of vaccination in 2006 (odds ratio [OR], 8.47 [95% confidence interval {CI}, 6.13-11.70];P<.01) and 2007 (OR, 6.05 [95% CI, 3.79-9.67];P<.01). Concern about contracting avian influenza was a predictor of the vaccination rate in 2006 but not in 2007 (OR, 1.47 [95% CI, 1.03-2.09];P<.05), as was the perceived lack of control over avian influenza infection (OR, 1.52 [95% CI, 1.06-2.18];P<.05).Conclusions.: The overall influenza vaccination rate for nurses in Hong Kong was about 50%. It was affected by the perceived threat of an impending outbreak. The attitudes of nurses toward the effectiveness of and rationale for vaccination were a major barrier to increasing the rate of vaccination.