1868. Addressing Hospital Health Care Workers Who Refuse Influenza Vaccination: Rationale and Beliefs
Session: Poster Abstract Session: Vaccines: Improving Immunization Uptake
Saturday, October 10, 2015
Room: Poster Hall

Influenza immunization among health care workers (HCW) is a concern. Nosocomial influenza is a safety issue; HCW with influenza can transmit the infection to patients and staff. A performance improvement (PI) project was conducted by a multidisciplinary team in our hospital during the influenza season 2014 - 2015 to understand the barriers and better facilitate vaccination among HCW.


During Dec 2014-Jan 2015, a multidisciplinary team (residents, infection control staff, medical attendings) was formed per hospital administration request to increase the >80% hospital vaccination rate.  Educational sessions were provided to hospital staff; attendance included several hundred personnel. Thereafter, 106 HCWs who have declined vaccination were individually interviewed using a standard questionnaire. 


Demographics: 76 (71%) female. 69 (65%) African American, 14 (13%) Hispanic, 18 (17%) White, and 3 (2%) Asian. 38 (36%) high school educated, 68 (64%) attended college. 28 (26%) lived alone and 74 (69%) lived with family. Average interview time: 5±2 minutes.


Reasons For Declining Vaccine

Number (%)

True egg allergy

4 (3%)

Vaccine Reactions

21 (19%)

Doubt vaccine efficacy

43 (40%)

Influenza-like illness despite vaccine

8 (7%)

Illness from vaccine

11 (10%)

Never gets sick

18 (17%)

Dislike needles

3 (2%)

Insufficient vaccine information

6 (5%)

Religious/Cultural beliefs

2 (1%)


14 (13%)

Multiple reasons

28 (26%)

Reasons not revealed

4 (3%)

Of 106 interviewed, 22 (20%) subsequently took the vaccine; 1 person did not answer.

All subjects believe in other ways to prevent influenza: 60 (57%) mask wear; 38(36%) a healthy life style; 27(25%) hand washing alone. 19(18%) believe education is crucial and a better vaccine is needed. Only 8 (7.5%) believe in mandating vaccination.  


  1. Although influenza vaccination improves patient and staff safety, reduces morbidity and mortality, substantial ill-founded beliefs nevertheless play a role in HCWs refusing to accept influenza vaccination.
  2. Despite gargantuan efforts by hospitals, many HCWs still resist vaccination. In this difficult group, 20% agreed to take the vaccine, a significant increase, achieved through group education and individual counseling.
Geny George, MD1, Sowmya Reddy, MD2, Milica Jovanovic, MD2, Gurpreet Singh, MD2, Annu Gupta, MD2, Nishith Patel, MD2, Manisha Ghimire, MD2, Swapna Mapakshi, MD2, Carmel Boland-Reardon, RN2, Brenda Denneny, RN2, Marilou Corpuz, MD3 and TS Dharmarajan, MD/ FACP/AGSF3, (1)Internal Medicine, Montefiore Medical Center, Wakefield, Bronx, NY, (2)Montefiore Medical Center, Wakefield, Bronx, NY, (3)Internal Medicine, Montefiore Medical Center, Wakefield campus, Bronx, NY


G. George, None

S. Reddy, None

M. Jovanovic, None

G. Singh, None

A. Gupta, None

N. Patel, None

M. Ghimire, None

S. Mapakshi, None

C. Boland-Reardon, None

B. Denneny, None

M. Corpuz, None

T. Dharmarajan, None

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.