Nursesʹ attitudes and beliefs about influenza and the influenza vaccine: A summary of focus groups in Alabama and Michigan

Background The U.S. Advisory Committee on Immunization Practices (ACIP) recommends influenza immunization among United States health care workers (HCWs) to reduce the spread of influenza to and from workers and patients. Despite these recommendations, influenza immunization coverage of health care workers is less than 50%. Participants and Methods Eight focus groups of registered nurses (RNs) were conducted in Birmingham, Alabama (n = 34) and Detroit, Michigan (n = 37). In each city, the focus groups consisted of 2 groups each of vaccinated and unvaccinated RNs. Results These focus groups revealed that many nurses were concerned about influenza vaccine effectiveness and safety; their lack of information about the vaccine plays a part in their willingness to promote it to patients. Unvaccinated nurses tended to be less aware of the ACIP recommendations for HCW vaccination, and overall, nurses were not aware of the rationale for HCW vaccination. Attitudes were mixed regarding mandatory influenza vaccination programs, including the hope that such programs would result in higher vaccination rates and concern about potential disciplinary action if vaccine was declined. Participants believed that increasing convenience was the key to increasing HCW vaccination. Conclusions Our findings confirm the importance of comprehensive approaches that combine education and convenience, and suggest that emphasizing the rationale for HCW vaccination may contribute to increasing vaccination rates.