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 (); 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];), 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.