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Determinants of Influenza Vaccination among Healthcare Workers

Objective. To identify the determinants of influenza vaccination and the moderators of the intention-behavior relationship among healthcare workers (HCWs). Design. Prospective survey with 2-month follow-up. Setting. Three university-affiliated public hospitals. Participants. Random sample of 424 HCWs. Methods. The intention of an HCW to get vaccinated against influenza was measured by means of a self-administered questionnaire based on an extended version of the theory of planned behavior. An objective measure of behavior was extracted 2 months later from the vaccination database of the hospitals. Results. Controlling for past behavior, we found that the determinants of influenza vaccination were intention (odds ratio [OR], 8.32 [95% confidence interval {CI}, 2.82–24.50]), moral norm (OR, 3.01 [95% CI, 1.17–7.76]), anticipated regret (OR, 2.33 [95% CI, 1.23–4.41]), and work status (ie, full time vs part time; OR, 1.99 [95% CI, 1.92–3.29]). Moral norm also interacted with intention as a significant moderator of the intention-behavior relationship (OR, 0.09 [95% CI, 0.03–0.30]). Again, apart from the influence of past behavior, intention to get vaccinated was predicted by use of the following variables: attitude (ß = .32; P < .001), professional norm (β = .18; P < .001), moral norm (β = .18; P < .001), subjective norm (ß = .09; P < .001), and self-efficacy (ß = .08; P < .001). This latter model explained 89% of the variance in HCWs' intentions to get vaccinated against influenza during the next vaccination campaign. Conclusions. Our study suggests that influenza vaccination among HCWs is mainly a motivational issue. In this regard, it can be suggested to reinforce the idea that getting vaccinated can reduce worry and protect family members.