Annotate in Word<\/p>\n
Student and faculty perceptions about\u00a0mandatory\u00a0influenza\u00a0vaccinations\u00a0on a health sciences campus.<\/p>\n
Every year, 5\u201320% of Americans are diagnosed with influenza. Mortality rates vary from 3,000 to 49,000 per year in the\u00a0United\u00a0States\u00a0with the large majority of deaths occurring in adults of 65\u00a0years and older. The Centers for Disease Control and Prevention recommends influenza\u00a0vaccination\u00a0in everyone 6\u00a0months or older without contraindications. Health care personnel are designated as one of the groups at higher risk for influenza-related complications.[\u00a01]\u00a0Mandatory\u00a0influenza\u00a0vaccination\u00a0policies for hospitals and health systems have emerged as a way to increase\u00a0immunization\u00a0rates among this population. Overall, influenza\u00a0vaccination\u00a0rates among health care personnel have been less than optimal with an estimated\u00a0vaccination\u00a0rate of 77.2% for the 2015\u20132016 season with the highest\u00a0vaccination\u00a0rate observed in those with a\u00a0mandatory\u00a0requirement (vaccination\u00a0rate of 96.5%).[\u00a02] Health care personnel may unintentionally expose patients to influenza because the virus can spread for 1\u00a0day prior to symptom onset and up to 5\u20137\u00a0days after symptom onset. Improving health care personnel\u00a0vaccination\u00a0rates may decrease the spread of the influenza virus to patients and other health care personnel as well as avoid work absenteeism.[\u00a01]<\/p>\n
Every year at the University of Oklahoma Health Sciences Center (OUHSC), campus-wide, pharmacy-delivered influenza\u00a0vaccination\u00a0clinics are offered at multiple locations throughout the month of October to provide no-cost, convenient\u00a0vaccinations\u00a0to the faculty, staff, and students. The OUHSC is a comprehensive health sciences center encompassing seven colleges (pharmacy, medicine, dentistry, nursing, allied health, public health, and graduate), two hospitals, numerous adult and pediatric specialty clinics, and various research centers. Our campus-based influenza\u00a0vaccination\u00a0clinics have been described in detail previously in the literature.[\u00a03] Physician faculty as well as all employees and students working within the campus hospitals have a\u00a0mandatory\u00a0requirement to receive the influenza\u00a0vaccination\u00a0or submit documentation for a contraindication. A tamper-resistant sticker affixed to the name badge is used throughout influenza season to show proof of current\u00a0immunization\u00a0status. Those not in compliance with the\u00a0vaccination\u00a0mandate are required to wear a mask in patient care areas for the duration of the influenza season. Perceptions of both current and future health care personnel regarding\u00a0mandatory\u00a0vaccination\u00a0policies are relatively unknown. The goal of this investigation was to examine perceptions among health care faculty and health professional students regarding\u00a0mandatory\u00a0vaccination\u00a0policies on the OUHSC campus.<\/p>\n
Methods<\/p>\n
In October 2015, coordinators of the influenza\u00a0vaccination\u00a0clinics emailed an electronic survey to the entire OUHSC campus, including 1,431 faculty and 3,379 students. The initial email invitation to participate in the survey explained the purpose of the study and included a link to the survey hosting website, Qualtrics, where individuals needed to consent to participate. During the clinic times, candy incentives and paper invitations to complete the survey were handed out to all who were vaccinated. A modified electronic Dillman method was used for distribution of the survey with campus-wide reminder emails sent at day 17 and day 30 following the conclusion of the\u00a0vaccination\u00a0clinics.<\/p>\n
Previous studies have been completed assessing medical students’ and health care professionals’ attitudes or beliefs about recommended and\u00a0mandatory\u00a0vaccination\u00a0using similar methods.[[\u00a04]] This study’s survey items were based on review of prior literature of\u00a0mandatory\u00a0vaccination\u00a0requirements in health care settings and student and health care personnel beliefs.[[\u00a04]] Survey revisions were made through an iterative, item-review process for face and content validity by the pharmacy faculty who coordinated the\u00a0vaccination\u00a0clinics and graduate students involved in the research project.<\/p>\n
The survey included 20 response items associated with times, places, and preferences associated with receiving an influenza\u00a0vaccination\u00a0at a campus clinic as well as perceptions of a\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0policy. No demographic data beyond the individual’s role as a student, faculty member, or staff were included. Individuals who did not receive an influenza\u00a0vaccination\u00a0at a campus clinic were not able to take the survey. Specifically, the survey included five items that assessed perceptions of employer-mandated\u00a0vaccination\u00a0policies. Where applicable, a 4-point Likert-type scale of agreement was used (e.g., strongly agree\/somewhat agree\/somewhat disagree\/strongly disagree). Participants were asked to select their level of agreement with five statements regarding\u00a0mandatory\u00a0influenza\u00a0vaccinations: (a) I believe\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0is appropriate for a heath care work environment; (b) I would still get the influenza\u00a0vaccination\u00a0if there was NOT a\u00a0mandatory\u00a0vaccination\u00a0requirement; (c) I believe health care employees obtaining the influenza\u00a0vaccination\u00a0have a positive impact on their patients’ health; (d) I believe a health care employee NOT obtaining the influenza\u00a0vaccination\u00a0has a negative impact on patients’ health; and (e) A\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0requirement would make me consider other employment. Faculty also identified whether\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0requirements for their respective place of employment exist. Additionally, all participants identified whether they had direct patient care associated with their employment or academic responsibilities. Electronic survey data were incorporated into and analyzed utilizing SAS v.9.4 (Cary, NC). An\u00a0a priori\u00a0level of \u03b1 = 0.05 was set for determining statistical significance. Univariate analysis and differences between group responses to Likert-type items were determined by chi-square analysis.<\/p>\n
Participants who provided their contact information after submission of their survey were entered into drawings for one of five fitness trackers. The OUHSC Institutional Review Board granted approval for the conduct of this study.<\/p>\n
Results<\/p>\n
Of the 2,533 individuals who received an influenza\u00a0vaccination\u00a0at an on campus clinic, a total of 1,672 participants completed surveys, giving a response rate of 66%. A total of 948 students and a combined 1585 faculty and staff received an influenza\u00a0vaccination\u00a0from a campus clinic. A subset of the 296 faculty and 244 student surveys were included for the analysis. Surveys from staff or others were excluded from the analysis so that faculty and health professional student perceptions could specifically be evaluated.<\/p>\n
Direct patient care within either employment or academic responsibilities was reported in more students (77.37%) than faculty (68.14%) (p\u00a0= 0.0173). Additionally, a\u00a0mandatory\u00a0requirement to receive an influenza\u00a0vaccination\u00a0from either their employer or academic assignment was reported more commonly in students (74.49%) compared to faculty (67.69%) (p\u00a0= 0.0086).<\/p>\n
Four survey items specifically related to perceptions regarding\u00a0mandatory\u00a0vaccinations\u00a0are summarized in Table\u00a01. Both students and faculty either somewhat or strongly agreed that\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0is appropriate for the health care work environment (p\u00a0> 0.05). When comparing students (79.67%) to faculty (94.94%), more faculty either somewhat or strongly agreed that they would still get the influenza\u00a0vaccination\u00a0if there was no\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0requirement (p\u00a0 0.05) and that health care employees who did not obtain the influenza\u00a0vaccination\u00a0had a negative impact on their patients’ health outcomes (p\u00a0> 0.05). An additional chi-square analysis that separated out faculty and students who had direct patient care showed similar results. The final question specifically addressed faculty agreement to a\u00a0mandatory\u00a0vaccination\u00a0policy since no student responses were allowed. A majority of faculty (97.27%) would not consider other employment options due to the implementation of a\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0policy, while a minority (2.73%) would consider other employment options.<\/p>\n
Table 1. Perceptions of\u00a0mandatory\u00a0influenza\u00a0vaccination.<\/p>\n
Overall<\/p>\n
Only those with direct patient care<\/p>\n
Students n (%)<\/p>\n
Faculty n (%)<\/p>\n
p-value<\/p>\n
Students n (%)<\/p>\n
Faculty n (%)<\/p>\n
p-value<\/p>\n
Mandatory flu vaccination is appropriate for a health care work environment<\/p>\n
Strongly or somewhat agree<\/p>\n
229 (95.0)<\/p>\n
274 (92.9)<\/p>\n
0.6676<\/p>\n
177 (95.2)<\/p>\n
188 (94.0)<\/p>\n
0.9576<\/p>\n
Strongly or somewhat disagree<\/p>\n
12 (5.0)<\/p>\n
21 (7.1)<\/p>\n
9 (4.8)<\/p>\n
12 (6.0)<\/p>\n
I would still get the flu vaccination if there was NOT a mandatory vaccination requirement<\/p>\n
Strongly or somewhat agree<\/p>\n
192 (79.7)<\/p>\n
281 (94.9)<\/p>\n
<0.0001<\/p>\n
144 (77.4)<\/p>\n
190 (94.5)<\/p>\n
<0.0001<\/p>\n
Strongly or somewhat disagree<\/p>\n
49 (20.3)<\/p>\n
15 (5.1)<\/p>\n
42 (22.6)<\/p>\n
11 (5.5)<\/p>\n
Health care employees obtaining the flu vaccination has a positive impact on their patients’ health<\/p>\n
Strongly or somewhat agree<\/p>\n
235 (96.7)<\/p>\n
285 (96.9)<\/p>\n
0.2281<\/p>\n
180 (95.7)<\/p>\n
193 (96.5)<\/p>\n
0.4115<\/p>\n
Strongly or somewhat disagree<\/p>\n
8 (3.3)<\/p>\n
9(3.1)<\/p>\n
8 (4.3)<\/p>\n
7 (3.5)<\/p>\n
Health care employees NOT obtaining the flu vaccination has a negative impact on patients’ health<\/p>\n
Strongly or somewhat agree<\/p>\n
195 (79.9)<\/p>\n
239 (80.7)<\/p>\n
0.5184<\/p>\n
147 (78.2)<\/p>\n
163 (81.1)<\/p>\n
0.6427<\/p>\n
Strongly or somewhat disagree<\/p>\n
49(20.1)<\/p>\n
57(19.3)<\/p>\n
41 (21.8)<\/p>\n
38 (18.9)<\/p>\n
Comment<\/p>\n
The findings of this investigation give insight into the perceptions of health care faculty and health professional students about\u00a0mandatory\u00a0vaccination\u00a0policies. Specifically, no difference between these two groups was found in their agreement that\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0policies are appropriate. These findings support the appropriateness of\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0policies, which has been supported in previous studies as being effective at increasing\u00a0vaccination\u00a0rates.[[\u00a07]] Similarly, Durando and colleagues surveyed 830 health care workers’ attitudes and beliefs of seasonal influenza vaccine uptake and found that those who agreed with the statement “I believe that\u00a0mandatory\u00a0flu\u00a0vaccination\u00a0should be implemented in health care settings” were significantly associated with increased influenza\u00a0vaccination\u00a0rates.[10]<\/p>\n
Additionally, no difference between the two groups was found concerning agreement that the influenza\u00a0vaccination\u00a0positively impacts patients if received by health care workers and the lack of influenza\u00a0vaccination\u00a0of health care workers negatively impacts patients. The perception of both students and faculty about the positive impact of receiving the influenza vaccine supports previous research by Godoy and colleagues where the\u00a0vaccination\u00a0of physicians was found to be a possible predictor of\u00a0vaccination\u00a0uptake by their patients.[11] Results from Godoy’s survey analyzed responses from 815 physicians and showed that influenza coverage was higher in those patients whose primary physicians had also received the influenza vaccine (57.3% versus 55.2%,\u00a0p\u00a0= 0.008).[11]<\/p>\n
Although a majority of both faculty and students agreed they would still receive the influenza\u00a0vaccination\u00a0without a mandate, fewer students would get the vaccine compared to faculty. A number of factors could be playing a role in this difference as noted in previous research. Kelly, Macy, and Mak investigated factors associated with receiving annual influenza\u00a0vaccination\u00a0using an online survey of 438 students from multiple health-related fields (e.g., medicine, nursing, physiotherapy). They reported that convenience and awareness of influenza\u00a0vaccination\u00a0policies was a key enabler to increase student influenza\u00a0vaccination\u00a0rates.[12] Additionally, Bednarczyk and colleagues surveyed 600 students and found that healthy students tend to not perceive a need for influenza vaccine.[13]<\/p>\n
The final result obtained through this investigation pertained to faculty employment decisions based on\u00a0mandatory\u00a0vaccination\u00a0policy. About 97% of faculty would not consider leaving their current place of employment, while only 3% would consider other employment options. Literature on the dilemmas presented by\u00a0mandatory\u00a0vaccination\u00a0policies has been previously published by Tilburt and colleagues. Their discussion of the ethical principles of beneficence, nonmaleficence, autonomy, and justice ended with the conclusion that\u00a0mandatory\u00a0vaccination\u00a0policies were supported and outweighed the health care worker’s autonomy in light of public safety.[14] In a discussion of the ethical implications of\u00a0mandatory\u00a0vaccinations, Van Delden and colleagues similarly concluded that\u00a0vaccination\u00a0is important for safety and improved health.[15]<\/p>\n
Limitations<\/p>\n
Despite finding significant differences among the preferences for\u00a0mandatory\u00a0influenza\u00a0vaccination\u00a0between students and faculty, our chi-square analyses limit the robustness of the findings since the substantive significance of the differences cannot be clearly established. Only individuals receiving the influenza\u00a0vaccination\u00a0were analyzed, so an inherent bias toward getting the vaccine may influence these results. The low percent of student responses and inability to differentiate staff and faculty from each other limit the generalizability of the results and may be associated with nonresponse bias. Gathering more information about the participants would have allowed for more rigorous analysis. Additionally, students and faculty from several different colleges (e.g., medicine, dentistry, pharmacy, etc.) participated in the study with differences between those individuals and colleges not taken into account. Without college- and individual-specific information, demographic- and curriculum-based differences could not be assessed. Finally, the study results may be limited in generalizability to similar health sciences center campus settings and structure.<\/p>\n
Conclusions<\/p>\n
Overall, health care faculty and health professional students had favorable perceptions about\u00a0mandatory\u00a0influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, improvements should be made in the education of health professional students about influenza\u00a0vaccination\u00a0benefits, misconceptions, and how their receipt of the influenza vaccine helps prevent illness their colleagues and patients. Improving the understanding of how current and future health care professionals view\u00a0mandatory\u00a0influenza\u00a0vaccinations\u00a0can help inform development and refinement of future influenza\u00a0vaccination\u00a0policies. Additionally, gaining a better understanding of why the small portion of employees who would consider other employment due to\u00a0mandatory\u00a0vaccination\u00a0policies could assist in finding reasonable alternatives to ameliorate those issues.<\/p>\n
Conflict of interest disclosure<\/p>\n
The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the\u00a0United\u00a0States\u00a0and received approval from the Institutional Review Board of The University of Oklahoma.<\/p>\n
Funding<\/p>\n
No funding was used to support this research and\/or the preparation of the manuscript.<\/p>\n
By Philip Looper; David George; Eric J. Johnson and Susan E. Conway<\/p>\n","protected":false},"excerpt":{"rendered":"
Annotate in Word Student and faculty perceptions about\u00a0mandatory\u00a0influenza\u00a0vaccinations\u00a0on a health sciences campus. Every year, 5\u201320% of Americans are diagnosed with influenza. Mortality rates vary from 3,000 to 49,000 per year in the\u00a0United\u00a0States\u00a0with the large majority of deaths occurring in adults of 65\u00a0years and older. The Centers for Disease Control and Prevention recommends influenza\u00a0vaccination\u00a0in everyone 6\u00a0months […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[10],"class_list":["post-78196","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing","tag-writing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/78196","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=78196"}],"version-history":[{"count":0,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/78196\/revisions"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=78196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=78196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=78196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}