Impact of severe acute respiratory syndrome and the perceived avian influenza epidemic on the increased rate of influenza vaccination among nurses in Hong Kong.

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.