Availability of trivalent inactivated influenza vaccine to parents of neonatal intensive care unit patients and its effect on the healthcare worker vaccination rate

Abstract

Background: Trivalent inactivated influenza vaccine (TIV) is indicated for healthcare workers (HCWs); however, the vaccination rate in this population is estimated at 35%. We implemented a program for the administration of TIV, targeted at parents of neonatal intensive care unit (NICU) patients.

Objective: To determine the effect of availability of TIV to parents in the NICU on HCW vaccination rates.

Design: Questionnaire survey after an intervention-based study.

Setting: Tertiary-care neonatal intensive care unit.

Participants: Physicians, nurses, and other NICU-based staff.

Methods: For the 2005-2006 influenza season, parents of NICU patients were screened and administered TIV, if informed consent was obtained. As a consequence, TIV was available 20 hours/day to all staff. Previous vaccination history and comorbidities in HCWs were also assessed.

Results: Of 120 neonatal HCWs, 112 (93%) were screened during the 2005-2006 season; 80 (67%) were vaccinated, compared with 49 (41%) prior to the implementation of this program (P < .03, by Student's t test); 54 (45% of the study population, which includes senior neonatologists, fellow and resident physicians, nurses, respiratory therapists, X-ray technicians and clerical staff) received TIV in the NICU, compared with the 17 (14%) of 120 HCWs the previous year; and 20 (46%) of 43 HCWs of the nursing staff were vaccinated in the NICU, whereas only 3 (7%) of 43 HWCs were vaccinated outside the unit. Attending physicians had the lowest vaccination rate, and most cited efficacy and/or side effects in their deferral. Nurses most often refused influenza vaccination because they had a fear of injection.

Conclusions: Administration of TIV in the NICU is an effective means of increasing the vaccination rate among neonatal HCWs. To increase compliance with vaccination, educational efforts for nurses should emphasize the possibility of viral transmission to neonates as motivation for vaccination. Physician-directed efforts should include tolerability of vaccine side effects. Live attenuated influenza vaccine, administered intranasally, should be considered to increase vaccination rates among NICU nurses.