Factors affecting uptake of recommended immunizations among health care workers in South Australia

Figures & data

Table 1. Demographic details of participants

Variable	Levels	Number of respondents	Percent %
Age Group (years)	21–30	28	30.4%
	31–40	26	28.3%
	41–50	22	23.9%
	>50	16	17.4%
Sex	Male	5	5.4%
	Female	87	94.6%
Work Status	Full time	33	35.9%
	Part time	58	63.0%
	Casual	1	1.1%
Country of birth	Australia	74	80.4%
	United Kingdom	9	9.8%
	other EU countries	5	5.4%
	Asia	2	2.2%
	Refused	1	1.1%
	Africa	1	1.1%
First language is English	No	7	7.6%
	Yes	85	92.4%
Highest educational qualification obtained	Certificate/Diploma	12	13.2%
	High school certificate or less	3	3.3%
	Bachelor	54	59.3%
	Post Grad certificate/Diploma	18	19.8%
	PhD	1	1.1%
	Other*	3	3.3%
Category of Health Care Worker	Nurse	75	81.5%
	Admin Staff	3	3.3%
	Doctor	1	1.1%
	Allied Health	2	2.2%
	Other (not specified)	5	5.4%
	Midwife	6	6.5%
Time working in health sector	< 12 months	5	5.4%
	1–5 years	23	25.0%
	6–10 years	15	16.3%
	11–15 years	14	15.2%
	16+ years	35	38.0%
Time working in area / ward	< 12 months	13	14.3%
	1–5 years	30	33.0%
	6–10 years	19	20.9%
	11–15 years	8	8.8%
	16+ years	21	23.1%
Hours per week in area/ward	<15 hours	1	1.1%
	15–30 hours	33	35.9%
	30+hours	58	63.0%
High or Low uptake ward of seasonal influenza vaccine in 2012	High uptake ward	55	59.8%
	Low uptake ward	37	40.2%

*College membership =1, Hospital based nurse/midwife training = 1, Masters =1.

Table 2. Knowledge of recommended health care worker vaccines

Could you please list vaccines you think are recommended for health care workers?	Overall		High uptake wards		Low uptake wards
	Number	Percent %	Number	Percent %	Number	Percent%
Listed all recommended (MMR, Pertussis, Influenza, Hep B & Varicella)	9	9.8%	6	10.9	3	8.1
Diptheria	10	10.9%	8	14.5%	2	5.4%
Tetanus	22	23.9%	17	30.9%	5	13.5%
Pertussis	51	55.4%	34	61.8%	17	45.9%
measles-mumps-rubella	28	30.4%	20	36.4%	8	21.6%
Measles	1	1.1%	1	1.8%	0	0.0%
Mumps	1	1.1%	1	1.8%	0	0.0%
Rubella	2	2.2%	1	1.8%	1	2.7%
Influenza	79	85.9%	45	81.8%	34	91.9%
Polio	2	2.2%	2	3.6%	0	0.0%
Hepatitis B	60	65.2%	35	63.6%	25	67.6%
Hepatitis A	19	20.7%	15	27.3%	4	10.8%
Hepatitis (not specified)	5	5.4%	4	7.3%	1	2.7%
Tuberculosis	13	14.1%	9	16.4%	4	10.8%
Varicella	19	20.7%	13	23.6%	6	16.2%
Other^a	10	10.9%	8	14.5%	2	5.4%

^aOther included vaccines and comments: H1N1 n = 1, ‘All childhood vaccines/diseases’ n = 2, ‘Flu A’ n = 1, ‘Swine flu’ n = 1, ‘Hep C’ n = 2, ‘and they should include Hep A’ n = 1, ‘free immunology, TB test’ n = 1.

Table 3. Health care worker vaccination history

Which of the following vaccinations have you ever received (either at this workplace or elsewhere)?	Overall		High uptake wards		Low uptake wards
	Number^a	Percent %	Number	Percent %	Number^a	Percent %
Had received all recommended vaccines (MMR, Pertussis, Influenza, Hepatitis B &Varicella)	15	16.5%	11	20.0%	4	11.1%
HepB	60	65.9%	39	70.9%	21	58.3%
Pertussis	46	50.5%	31	56.4%	15	41.7%
Varicella	22	24.2%	16	29.1%	6	16.7%
BCG	15	16.5%	10	18.2%	5	13.9%
Influenza	87	95.6%	53	96.4%	34	94.4%
MMR	36	39.6%	24	43.6%	12	33.3%
HepA	27	29.7%	14	25.5%	13	36.1%
Tetanus	4	4.4%	4	7.3%	0	0.0%
Typhoid	5	5.5%	4	7.3%	1	2.7%
Other^b	4	4.4%	4	4.4%	0	0.0%

^aMissing data n = 1 (one respondent provided no response).

^bOther: Diphtheria n = 1, Small pox n = 2, Cholera n = 1, Yellow fever n = 1, whatever was required to commence working’ n = 1.

Figure 1. Reasons Health Care Workers receive vaccinations.

Table 4a. Logistic Generalized Estimating Equation for ever had pertussis vaccination versus multiple predictors/confounders, accounting for clustering on ward

		Univariate Model		Multivariate Model
Variable	Level	Odds Ratio (95% CI)	Stepdown Bonferroni P value	Adjusted Odds Ratio (95% CI)	Global P value
Age	31–40	0.60 (0.44, 0.82)	0.005
	41–50	0.54 (0.28, 1.04)
	>50	0.50 (0.25, 1.03)
	21–30	1.0
Highest Education Level	Bachelor vs Diploma or less	2.97 (1.87, 4.71)	<0.001
	Bachelor	1.65 (1.01, 2.69)
	Diploma or less	0.56 (0.26, 1.17)
	Postgraduate	1.0
Length of time in health sector	<12 months	2.25 (0.47, 10.67)	<0.001	2.75 (0.59, 12.80)	<0.001
	1–5 years	1.50 (0.51, 4.45)		3.35 (0.51, 21.99)
	6–10 years	2.25 (1.43, 3.54)		0.92 (0.41, 2.08)
	11–15 years	2.70 (1.11, 6.57)		1.37 (0.52, 3.62)
	16+ years	1.0		1.0
Length of time in area of work	<12 months	3.66 (1.28, 10.46)	<0.001
	1–5 years	1.32 (0.55, 3.19)
	6–10 years	1.81 (1.16, 2.81)
	11–15 years	2.71 (0.56, 13.02)
	16+ years	1.0
Received Hepatitis B vaccine	Yes	11.22 (5.23, 24.07)	<0.001	18.16 (3.38, 97.47)	<0.001
	No	1.0		1.0
Received MMR vaccine	Yes	12.19 (4.48, 33.18)	0.001	9.35 (4.14, 21.13)	<0.001
	No	1.0	-	1.0
Received Hepatitis A vaccine	Yes	5.46 (2.77, 10.77)	<0.001
	No	1.0	-
How severe do you think influenza infections in infants can be?	For every 1 point increase in severity	1.36 (1.18, 1.57)	0.002	1.63 (1.07, 2.49)	0.023

Table 4b. Logistic Generalized Estimating Equation for had influenza vaccination in past year vs. multiple predictors/confounders, accounting for clustering on ward

		Univariate Model		Multivariate Model
Variable	Level	Odds Ratio (95% CI)	Stepdown Bonferroni P value	Odds Ratio (95% CI)	Global P value
Age group	31–40	0.28 (0.14, 0.55)	<0.001	0.12 (0.04, 0.37)	<0.001
	41–50	0.43 (0.10, 1.87)		0.26 (0.04, 1.90)
	>50	0.81 (0.21, 3.20)		0.38 (0.07, 1.99)
	21–30	1.0		1.0
English as first language	English first language	6.57 (2.82, 15.33)	0.002	5.29 (1.90, 14.71)	0.002
	English not first language	1.0
Aware pertussis was a recommended vaccine for health care workers	Yes	1.75 (1.33, 2.31)	0.008
	No	1.0
How important do you think it is to receive the influenza vaccine annually to protect yourself?	Important	6.40 (3.79, 10.80)	<.001	3.36 (2.04, 5.54)	<0.001
	Not important	1.0		1.0
How severe do you think influenza infections in immunocompromised patients can be?	For every 1 point increase in severity	1.89 (1.45, 2.46)	0.003	1.62 (1.05, 2.51)	0.030
How important do you think it is to receive the influenza vaccine to protect patients?	For every 1 point increase in severity	1.48 (1.20, 1.82)	0.026	1.29 (1.06, 1.58)	0.012
Ever received the flu vaccine at this hospital	Yes	6.57 (2.80, 15.43)	0.007
	No	1.0

Table 4c. Logistic Generalized Estimating Equation for ever had pertussis and had influenza vaccination in past year versus multiple predictors/confounders, accounting for clustering on ward

		Univariate Model		Multivariate Model
Variable	Level	Odds Ratio (95% CI)	Stepdown Bonferroni P value	Odds Ratio (95% CI)	Global P value
Age group	31–40 years	0.38 (0.22, 0.64)	0.030	0.32 (0.18, 0.58)	<0.001
	41–50 years	0.46 (0.13, 1.61)		0.40 (0.03, 4.94)
	>50 years	0.48 (0.20, 1.15)		0.47 (0.06, 3.74)
	21–30 years	1.0		1.0
Length of time in area of work	<12 months	3.20 (0.90, 11.32)	<0.001	4.03 (0.37, 43.81)	0.020
	1–5 years	1.11 (0.34, 3.59)		2.15 (0.37, 12.40)
	6–10 years	1.45 (0.65, 3.27)		2.25 (0.21, 24.20)
	11–15 years	1.20 (0.28, 5.19)		1.81 (0.38, 8.52)
	16+ years	1.0		1.0
Received Hepatitis B vaccine	Yes	6.16 (2.65, 14.32)	0.003	9.70 (1.92, 48.91)	0.006
	No	1.0		1.0
How severe do you think influenza infections in infants can be?	For every 1 point increase in severity	1.83 (1.59, 2.10)	<0.001	2.23 (1.44, 3.46)	<0.001